REPRODUCIBILITY OF “THE BETHESDA SYSTEM FOR REPORTING THYROID CYTOPATHOLOGY” WITH IMPLICATION FOR RISK OF MALIGNANCY: AN EXPERIENCE AT A TERTIARY CARE CENTRE.
*Dr. Deepika Gupta, Dr. Namita Bhutani and Dr. Saumya Bhagat
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: The objective of this study was to analyze the thyroid cytology smears by TBSRTC, to determine the distribution of diagnostic categories and subcategories, to analyze cytological features and to correlate the cytopathology with histopathology, wherever surgery was done. Materials and Methods: This was a prospective study of 212 fine needle aspirations (FNA) of thyroid nodules. All fine needle aspiration cytology (FNAC) diagnoses were classified according to the features given in the monograph of TBSRTC into nondiagnostic/unsatisfactory (ND/UNS), benign, atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FUS), follicular neoplasm/suspicious of a follicular neoplasm (FN/SFN), suspicious for malignancy (SFM) and malignant. Cytohistological correlation was done, when surgical material was available. Results: The distribution of various categories from 225 evaluated thyroid nodules was as follows: 3.7% ND/UNS, 87.2% benign, 1.4% AUS/FLUS, 1.4% FN, 1.4% SFM and 5.1% malignant. Conclusion: TBSRTC is an excellent reporting system for thyroid FNA. It also provides clear management guidelines to clinicians to go for follow-up FNA or surgery and also the extent of surgery.
Keywords: follicular neoplasm/suspicious of a follicular neoplasm (FN/SFN).
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