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ORIGINAL ARTICLE
Year : 2016  |  Volume : 13  |  Issue : 1  |  Page : 9-14

Impact of the Bethesda System in Reporting Thyroid Cytopathology


1 Department of Pathology, Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bengaluru, India
2 Department of Pathology and Surgery, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka, India

Correspondence Address:
S Prathima
Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bengaluru, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-0354.168900

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Context: Fine needle aspiration cytology (FNAC) has emerged as one of the well-established first-line diagnostic techniques in the evaluation of thyroid lesions as well as solitary thyroid nodule. But in the cytological diagnosis of borderline lesions, various diagnostic criteria have led to confusion and differences in reporting between cytopathologists and clinicians. To overcome this situation, the Bethescda System of Reporting Thyroid Cytopathology (TBSRTC) 2007 recommended by the National Cancer Institute put down six general diagnostic categories. Aims: The current study evaluates diagnostic utility, reproducibility, and prognostic significance of TBSRTC and report the malignancy risk for FNA of thyroid lesions. Settings and Design: Retrospective study. Materials and Methods: It is a retrospective study of FNAC in 178 patients presenting with thyroid swelling from January 2013 to December 2013 to cytopathology section at our rural based tertiary care center. Distribution of cases in different age groups, sex, size, and type was analyzed. FNAC slides were reviewed and reported by both conventional and TBSRTC method. Diagnostic efficacy was assessed by comparing subsequent histopathological examination wherever possible. Statistical Analysis Used: SPSS version 14. Results: Among the 178 thyroid FNA's, 60 were followed by surgical resection. The overall surgical yield of malignancy was 23.3%. The malignancy rate for the six diagnostic categories was as follows: Nondiagnostic: 33.3%, benign: 2.1%, atypia of undetermined significance: 50%, suspicious for follicular neoplasm: 1%, suspicious for malignancy: 67% and malignant: 100%. Conclusion: TBSTRC has been proven to be an efficient and robust thyroid classification scheme to guide the clinical treatment of patients with thyroid nodules.


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