The Japanese reporting system for thyroid aspiration cytology 2019 (JRSTAC2019)

Abstract

We introduce the Japanese reporting system for thyroid aspiration cytology 2019 (JRSTAC2019) proposed by the Japan Association of Endocrine Surgery and the Japanese Society of Thyroid Pathology.Pathological classification and recommended clinical management for thyroid nodules in Japan are different from those described in the World Health Organization classification or the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). Therefore, it was necessary to develop a reporting system adapted for Japan. JRSTAC2019 is a modified version of TBSRTC. Currently, JRSTAC2019 is widely used in Japan, although the details of the system have not been introduced in English. JRSTAC2019 comprises seven categories: (I) unsatisfactory, (II) cyst fluid, (III) benign, (IV) undetermined significance, (V) follicular neoplasm (FN), (VI) suspicious for malignancy (SFM), and (VII) malignant. "Cyst fluid" nodules are classified as an independent category, and "recommended management" is in the same category as "benign" nodules. Surgical resection for FN nodules is decided upon by considering several parameters, and the decision is made without performing gene analysis. Non-invasive follicular thyroid neoplasm with papillarylike nuclear features tends to be more often diagnosed as papillary carcinoma. The risk of malignancy of SFM in Japan is higher than that in Western countries, and resection rates of SFM and malignant tumors are lower owing to active surveillance for low-risk papillary microcarcinoma. We recommend that each country should develop its reporting system, suitable for its medical and social needs. However, it should be easily compatible with TBSRTC for the ease of academic data sharing.

Introduction of histological classification and cytology reporting format of the Japanese General Rules for the Description of Thyroid Cancer with a special focus on the differences of the WHO Histological Classification and The Bethesda System of Thyroid Cytology

“…Concerning thyroid cytopathology, Hirokawa, one of the authors, reported as The Japanese reporting system for thyroid Amyloid deposition is present in the stroma. aspiration cytology 2019 (JRSTAC2019) [16] as the modified version of the Bethesda System. JRSTAC2019 explained the contents of the cytological aspects of the Japanese General Rules, which is widely used in Japan.…”

Reporting Thyroid Cytology in a Globalized World

“…In addition to the Italian classification and the Bethesda system, other thyroid cytology reporting systems frequently used by pathologists are The Guidance On The Reporting Of Thyroid Cytology Specimens from The UK Royal College Of Pathologists proposed in 2009 and revised in 2016 [7] and The Japanese reporting system for thyroid aspiration cytology proposed by the Japanese Thyroid Association in 2019 [8].…”

“…In order to distinguish nodules to be sent for surgical treatment from those to be observed over time with clinical and ultrasonographic examinations, classifications (or reporting systems) based on cytological criteria have been drawn up. Among the reporting systems, the Italian SIAPeC-AIT classification, in its latest version updated in 2014/(CI14) and The Bethesda System for Reporting Thyroid Cytopathology, proposed in 2007 and updated in 2017 (TBSRTC) are among the most widely used in the world [5,6] together with the Guidance On The Reporting Of Thyroid Cytology Specimens from The UK Royal College Of Pathologists [7] and The Japanese reporting system for thyroid aspiration cytology [8].…”

Molecular Tests for Risk-Stratifying Cytologically Indeterminate Thyroid Nodules: An Overview of Commercially Available Testing Platforms in the United States

“…Thyroid nodules are a common clinical finding, with palpable thyroid nodules detected in 1% of men and 5% of women in iodine-sufficient regions of the world [1][2][3][4][5]. However, with the increasing use of radiologic screening, one or more thyroid nodules are found in 60-70% of the population [1,6].…”

“…FNA has proven to be an important tool in the management of thyroid nodules. Currently, thyroid FNA cytology is reported in a standardized fashion by employing one of the known tiered classification systems [3,[11][12][13][14]. While FNA cytology can effectively differentiate between benign and malignant thyroid lesions in up to 75% of cases, 20-30% of aspirated nodules are reported as indeterminate for malignancy [14,15].…”