The Bethesda system for reporting thyroid fine needle aspirates: A cytologic study with histologic follow-up

Abstract

Background:The Bethesda system for reporting thyroid cytopathology represents a major step towards standardization, reproducibility, improved clinical significance, and greater predictive value of thyroid fine needle aspirates (FNAs).Aims:To elucidate the utility of the Bethesda system in reporting thyroid FNAs.Materials and Methods:We retrospectively reviewed thyroid FNAs between April 2009 and March 2012, classified them using the Bethesda system, found out the distribution of cases in each Bethesda category, and calculated the malignancy risk for each category by follow-up histopathology.Results:Of the 1020 FNAs, 1.2% were non-diagnostic, 87.5% were benign, 1% were atypical follicular lesion of undetermined significance (AFLUS), 4.2% were suspicious for follicular neoplasm (SFN), 1.4% were suspicious for malignancy (SM), and 4.7% malignant. Of 69 cases originally interpreted as non-diagnostic, 12 remained non-diagnostic after re-aspiration. In 323 cases, data of follow-up histopathologic examination (HPE) were available. Rates of malignancy reported on follow-up HPE were non-diagnostic 0%, benign 4.5%, AFLUS 20%, SFN 30.6%, SM 75%, and malignant 97.8%.Conclusions:Reviewing the thyroid FNAs with the Bethesda system allowed a more specific cytological diagnosis. In this study, the distribution of cases in the Bethesda categories differed from some studies, with the number of benign cases being higher and the number of non-diagnostic and AFLUS cases being lower. The malignancy risk for each category correlated well with other studies. The Bethesda system thus allows standardization in reporting, improves perceptions of diagnostic terminology between cytopathologists and clinicians, and leads to more consistent management approaches.

Cytological Evaluation of Thyroid Lesion on The Basis Of Bethesda System

“…The findings similar to the observations carried out by Constantine et al (2009) [9] and Mondal et al (2013) [11]. However, observations of several other studies conducted by Yang et al (2007) [7], Yassa et al (2007) [6], Nayar and Ivanovic (2009) [8] and Jo et al (2010) [10] were differed.…”

“…6 percent cases were reported malignant in our study which is similar from the earlier studies conducted by Yang et al (2007) [7], Yassa et al (2007) [6], Constantine et al (2009) [9], Nayar and Ivanovic (2009) [8] and Jo et al (2010) [10]whereas dissimilar with Mondal et al (2013 [11]). …”

“…The present study revealed suspicion of malignancy in two percent of the cases, which was similar to the observations made by Nayar and Ivanovic (2009) [8], Constantine et al (2009) [9], Jo et al (2010) [10] and Mondal et al (2013) [11]but inconsistent with the studies conducted by Yang et al (2007) [7] and Yassa et al (2007) [6] which revealed 2.6 and 9 percent cases respectively. 6 percent cases were reported malignant in our study which is similar from the earlier studies conducted by Yang et al (2007) [7], Yassa et al (2007) [6], Constantine et al (2009) [9], Nayar and Ivanovic (2009) [8] and Jo et al (2010) [10]whereas dissimilar with Mondal et al (2013 [11]).…”

Podejrzenie nowotworu pęcherzykowego czy nowotwór pęcherzykowy? Dylemat patologa i chirurga

“…First of all, the elaborations that we encountered concern smaller study groups. Mondal et al achieved 43 DC IV in 1020 FNAs, which comprise 4.2% [9]. Nayar et al in their study based on 5194 cases assessed the quantity of DC IV at 4.7% [6].…”

“…[16]. Mondal reported a malignancy rate of 30.6% in the analysis of 1020 FNA [9]. A lower rate was achieved by Srbova et al, who obtained a risk of malignancy of 23.6%, and a risk of neoplasia of 55% [11].…”