Title: To Study the Clinical Profile among Different Bethesda Categories of Thyroid Lesions: A Study of 917 Cases

Authors: Usha Joshi, Harsh Khetan, Binay Kumar

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i4.58

Abstract

Background: Fine needle aspiration (FNA) is the primary diagnostic tool in initial evaluation of the thyroid lesions. The New Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is considered a standard reporting system for categorization of the thyroid lesions in cytology.

Aims/Objectives: To correlate the clinical profile of patients of thyroid lesions with different Bethesda categories.

Materials and Methods: The study was conducted at department of pathology Government Medical College, Haldwani. It comprised of 917 cases of thyroid lesions, spanning over a period of five years. The clinical findings, history and lab investigations were correlated with the Bethesda categories of thyroid lesions.

Results: The age of the patients ranged from 5 to 90 years. Female to male ratio was 6.51:1. Bethesda category II lesions had less specificity with duration of thyroid swelling and presented with any duration, while malignant lesions presented mostly with short duration of swelling (1-6 month). Eye signs were mostly seen in patients with hyperplastic thyroid (Bethesda category II) lesions. Thyroid nodules were mostly seen to involve right lobe (15.59%) of thyroid, while isthmic (3.48%) involvement was least common. Tenderness (4.15%) was mostly associated with thyroiditis (Bethesda category II) cases and was rarely associated with malignant cases. While Bethesda category II, showed all 3 patterns of thyroid profile, Bethesda category III, IV, V & VI were either euthyroid or hyperthyroid and none hypothyroid.

Conclusion: Our study concluded that FNAC, if interpreted in conjunction with clinical profile of the patients, could prove useful for the diagnosis and categorization of thyroid lesions.

Keywords: Fine needle aspiration (FNA), Thyroid lesions, The New Bethesda System for Reporting Thyroid Cytopathology (TBSRTC).

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Corresponding Author

Usha Joshi

Associate Professor, Department of Pathology, Government Medical College & Hospital

Haldwani, Distt: Nainital (Uttarakhand) India