Title: Evaluation of Bethesda System for Reporting Thyroid Cytology with Histopathological Correlation
Authors: P N Kadam, Nafela A Siddiqui, Deepak S Sadhu
DOI: https://dx.doi.org/10.18535/jmscr/v8i1.91
Abstract
Background: The Bethesda system of reporting thyroid cytopathology is a standardised system, improving communication between cytopathologists and clinicians, leading to more consistent management approaches. The aim of the research work was to study the utility of Bethesda system in reporting thyroid cytology with histopathological correlation of all the cases undergoing surgical resection.
Methods: We studied all the thyroid cytology cases received between January 2017 to June 2018, and classified them according to the Bethesda system. Histopathological correlation was done for all the cases which underwent surgical resection with evaluation of cyto-histological discrepancies.
Results: Out of 423 cases studied on FNAC, 152 cases available for histopathological follow-up, cyto-histological discrepancies were noted in 11 cases. 132 (86.84%) were benign lesions, 13 (8.55%) were Follicular neoplasm/Suspicious for neoplasm, 3 (1.97%) were suspicious for malignancy, and 04 (2.63%) were malignant, 0 case in Unsatisfactory/ Non diagnostic & Atypia of undetermined significance. Statistical analysis of the present study showed that cytological analysis of thyroid lesions by Bethesda system has got high sensitivity (73.68%), high specificity (95.48%) with a positive predictive value of 70% and negative predictive value of 96.24% and a high efficacy (97.55%).
Conclusions: Reviewing the thyroid FNAs (fine needle aspirates) using Bethesda system allowed a more specific cytological diagnosis with better inter laboratory agreement. As evidenced by its high sensitivity and specificity, Bethesda system has proven to be a very effective guide for the clinical management of thyroid nodules.
Keywords: Bethesda, Cytology, Thyroid.
References
- Jo VY, Stele EB, Dustin SM, Hanley KZ. Malignancy risk for Fine needle aspiration of thyroid lesions according to Bethesda System for reporting thyroid cytopathology. Am J Clin Pathol. 2010; 134:450-56.
- Fine-needle aspiration biopsy of thyroid nodules: impact on thyroid practice and cost of care. Am J Med. 1982;73:381-84.
- Rosen Y, Rosenblatt P, Saltzman E. Intraoperative pathologic diagnosis of thyroid neoplasm’s. Cancer. 1990;66:2001-6.
- Mondal SK, Sinha S, Basak B, Roy DN, Sinha SK. The Bethesda system for reporting thyroid fine needle aspiration : A cytologic study with histologic follow-up. J Cytol. 2013;30:94-99.
- Ji Hye Park, Sun Och Yoon, Eun Ju Son, Hye Min Kim, Ji Hae Nahm, SoonWon Hong. Incidence and Malignancy Rates of Diagnoses in the Bethesda System for Reporting Thyroid Aspiration Cytology: An Institutional Experience. Korean J Pathol. 2014 Apr; 48(2): 133–139.
- Jo VY, Stelow EB, Dustin SM, Hanley KZ. Malignancy risk for fine-needle aspiration of thyroid lesions according to the Bethesda System for Reporting Thyroid Cytopathology. American journal of clinical pathology. 2010 Sep 1;134(3):450-6.
- Afroze N, Kayani N, Hasan S. Role of fine needle aspiration cytology in the diagnosis of palpable thyroid lesions. Indian J. pathol. Microbial. 2002; 45(3): 241-246.
- Tabaqchali M, Hanson JM, Jhonson S J, Wadehra V, Lenard T, proud G. Thyroid aspiration cytology in Newcastle: a six year cytology/histology correlation study. Ann R Coll Surg Engl 2000; 82:149-155.