Malignancy Risk for Fine-Needle Aspiration of Thyroid Nodules according to the Bethesda System for Reporting Thyroid Cytopathology, at King Abdul-Aziz, National Guard Hospital

Abstract

Introduction: The Bethesda System was introduced to help us in risk of malignancy in reporting thyroid cytopathology. The Bethesda system is high predictive value of thyroid fine needle aspirates. FNA of the thyroid gland is an accurate method in our approach to manage our patient. Aim: The aim of this study was to determine the rates of malignancy of thyroid nodules in each standard cytologic diagnostic category of Bethesda system in our hospital. Materials and methods: A retrospective cross-sectional study in which all cases of thyroid nodules, presented to the OPC between September 2009 and August 2015 at King Abdulaziz NGHA. All preoperative cytologic examination by FNA and concurrent postoperative histopathologic examination were included. All FNA diagnoses were reclassified using the thyroid FNA Bethesda reporting system, including nondiagnostic, benign, atypical follicular lesion of undetermined significance, follicular/ hurthle cell neoplasm, suspicious for malignancy and malignant categories, the rate of malignancy based on final histopathologic evaluation was analyzed for each of these cytologic groups. Results: We reviewed 237 thyroid FNA samples and recorded interpretations according to the proposed standardized 6 categories and pursued follow-up cytology and histology. Of the 237 FNAs, 4.2% were nondiagnostic, 39.2% were benign, 15.6 % were AFLUS, 8.9 % were SFN, 16.9% were SM, and 15.2% were malignant. The rates of malignancy in histology were as follows: nondiagnostic, 0.0% benign, 4.3%; AFLUS, 18.9%; SFN 34 %: SM 95.0% and malignant, 94.4% Conclusion: The Bethesda system is a standardized system of reporting thyroid cytopathology, improving communication between cytopathologists and clinicians leading to ideal management approaches.