A Comparative Study of Thyroid Cytology Reporting by Bethesda System and Routine Cytology in a Teaching Institute of Sub Himalayan Region

Authors

  • Nirmalesh Mahata Medical Officer (Pathology), Mal Superspeciality Hospital, Jalpaiguri
  • Indranil Chakrabarti Associate Professor Department of Pathology, North Bengal Medical College, Darjeeling,West Bengal

DOI:

https://doi.org/10.21276/apalm.1898

Keywords:

Thyroid Swelling, FNAC, Conventional Reporting System, BSRTC

Abstract

Introduction: Fine needle aspiration cytology (FNAC) is an important preoperative diagnostic tool for thyroid lesions which are endemic in the Sub-Himalayan belt. But sometimes, the FNAC procedures are unable to guide clinicians for definite management. Bethesda System for Reporting Thyroid Cytology (BSRTC) has been formulated to be more sensitive and specific than routine cytological examination in diagnosis of thyroid swellings and act a better tool than the latter due to its objectivity. It may, thus, improve the clinical management of thyroid diseases and even may prevent unnecessary thyroidectomy.

Aims and Objective: The study is aimed to compare the interpretation of thyroid FNAC smears by conventional reporting and by BSRTC in patients of thyroid swellings in the Sub-Himalayan regions.

Material and Methods: This observational study was done at the Department of Pathology from July 2015 to June 2016. Total 145 cases of thyroid swellings were included for study and reported by both BSRTC and conventional (routine) reporting system. Each of the reporting system was correlated with the available histopathological findings and statistical assessments were performed.

Results: Among the total 145 cases, colloid nodules followed by thyroiditis were most common benign conditions in both the reporting systems and among the malignancies; papillary carcinoma was the most predominant. Statistical assessment showed that sensitivity, specificity as well as positive and negative predictive values was higher in BSRTC compared to the conventional reporting system.

Conclusion: BSRTC is more accurate than conventional reporting system for thyroid cytology and its management strategy can help to prevent unnecessary thyroidectomy.

References

Naz S, Hashmi AA, Khurshid A, Faridi N, Edhi MM, Kamal A, Khan M. Diagnostic accuracy of Bethesda system for reporting thyroid cytopathology: an institutional perspective. Int Arch Med 2014;7:46-50

Sarda AK, Bal S, Kapoor MM. Near-total thyroidectomy for carcinoma of the thyroid. Br J Surg 1989;76:90-2.

Yassa L, Cibas ES, Benson CB, Frates MC, Doubilet PM, Gawande AA et al. Long term assessment of a multi disciplinary approach to thyroid nodule diagnostic evaluation. Cancer 2007;111:508–11.

Cibas ES, Ali SZ. The Bethesda system for reporting thyroid cytopathology. Thyroid 2009;19:1159–65.

Kiernan CM, Broome JT, Solórzano CC. The Bethesda system for reporting thyroid cytopathology. A single-center experience over 5 years. Ann Surg Oncol 2014;21:3522–7.

Gharib H, Goellner JR, Johnson DA. Fine-needle aspiration cytology of the thyroid: a 12-year experience with 11,000 biopsies. Clin Lab Med. 1993;13:699-709.

Crothers BA, Henry MR, Firat P, Hamper UM. Nondiagnostic/Unsatisfactory. In, Ali SZ, Cibas ES(Eds). The Bethesda System for Reporting Thyroid Cytopathology, New York, Springer 2010:6.

Goellner JR, Gharib H, Grant CS, Johnson DA. Fine-needle aspiration cytology of the thyroid, 1980 to 1986. Acta Cytol 1987;31:587-90.

Grant CS, Hay ID, Gough IR, McCarthy PM, Goellner JR. Long-term follow-up of patients with benign thyroid fine-needle aspiration cytologic diagnoses. Surgery 1989;106:980-5.

Dean DS, Gharib H. Fine-Needle Aspiration Biopsy of the Thyroid Gland.. In: De Groot LJ, Chrousos G, Dungan K, et al, editors. Endotext [Internet]. South Dartmouth (MA): MD Text.com,Inc.;2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK285544. [Accessed September 27, 2017].

Renshaw AA, Pinnar N. Comparison of Thyroid Fine-Needle Aspiration and Core Needle Biopsy. Am J Clin Pathol 2007;128:370-4.

Mamatha M, Chandra Sekhar S, Sandhya Rani H, Sandhya Anil S, Vandana G. A comparative study between conventional system and the Bethesda system applied for reporting thyroid cytopathology. IAIM 2015;2:87-95.

Baloch ZW, Alexander EK, Gharib H, Raab SS. Overview of Diagnostic Terminology and Reporting. In, Ali SZ, Cibas ES(Eds). The Bethesda System for Reporting Thyroid Cytopathology, New York, Springer 2010:2.

Raab SS, Vrbin CM, Grzybick DM, Sudilovsky D, Balassanian R, Zarbo RJ et al. Errors in Thyroid Gland Fine-Needle Aspiration. Am J Clin Pathol 2006;125:873-82.

Papanicolaou Society of Cytopathology Recommendations for Thyroid Fine Needle Aspiration. Available at from https://www.papsociety.org/guidelines.html. [Accessed July 27, 2017].

AACE/AME Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists and Associazione of Medici Endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules– 2016 Update. Endocr Pract. 2006;12:63–102.

Mamoon N, Jamy R, Khan AH. Evaluation of fine needle aspiration cytology as a screening tool in thyroid lesions. J Pak Med Assoc 2013;63:1120-3.

Bukhari MH, Khan AA, Niazi S, Arshad M, Akhtar ZM, Al-Sindi KA.(2012) Better Thyroid Cytopathology Reporting System May Increase the Clinical Management and Patients Outcome. J Cytol Histol 2012;3:158-63.

Kasliwal N, Tanwar S, Pachori G, Gupta N, Maheshwari N, Jain D. Usefulness of Preoperative FNAC of Thyroid Swelling Along with Application of Bethesda System of Reporting. Int J Med Res Prof. 2016;2:204-9.

Cibas ES, Ali SZ. The Bethesda system for reporting thyroid cytopathology. Am J Clin Pathol 2009;132:658-65.

Downloads

Published

20-06-2018

How to Cite

1.
Mahata N, Chakrabarti I. A Comparative Study of Thyroid Cytology Reporting by Bethesda System and Routine Cytology in a Teaching Institute of Sub Himalayan Region. Ann of Pathol and Lab Med [Internet]. 2018 Jun. 20 [cited 2024 Oct. 30];5(6):A504-510. Available from: https://pacificejournals.com/journal/index.php/apalm/article/view/1898

Issue

Section

Original Article