Evaluation of FNAC Thyroid Smears Using Bethesda System For Reporting Thyroid Cytopathology Nomenclature With Clinicopathological Correlation
DOI:
https://doi.org/10.21276/apalm.3186Keywords:
FNAC, Bethesda, thyroid nodules, neoplastic, benignAbstract
Background: The study aimed to interpret thyroid cytology by the Bethesda System for reporting thyroid cytology (TBSRTC) and to analyze the distribution of lesions under various diagnostic categories and subcategories.
Methodology: This study was conducted as an observational study at tertiary care centre on patients with thyroid lesions. After history taking and detailed local, general and systemic examination, thyroid function tests were conducted. Apart from this, ultrasonography of lesion was done. Patients were subjected to FNAC and after fixation smears were stained with Papanicolaou stain.
Results: About 53% thyroid lesions were hemorrhagic, followed by 17% blood mixed colloid and 4% colorless serous fluid. Sample adequacy was noted in 93.5% cases in our study. According to Bethesda system of classification, majority of lesions were benign (81.5%) whereas 6.5% lesions were unsatisfactory. Only 6% lesions were categorsied as malignant.
Conclusion: FNAC is widely accepted as the most accurate, sensitive, specific, and cost- effective diagnostic procedure in the preoperative assessment of thyroid nodules. It is the first line of investigation and can differentiate benign nodules from malignant nodules of the thyroid in 95% cases. Applying a standard reporting system for thyroid cytology may enhance the communication between pathologists and clinicians, assists them to find out the rate of malignancy in each cytological group, and facilitating a more reliable approach for patient management.
References
King TW. Observations in the Thyroid gland. Guys Hosp Rep. 1836;1:429.
Tan GH, Gharib H. Thyroid incidentalomas: management approaches to nonpalpable nodules discovered incidentally on thyroid imaging. Ann Intern Med. 1997;126:226-31.
Mandel SJA. 64-year-old woman with a thyroid nodule. JAMA. 2004;292:2632-42.
Kishore N, Shrivastava A, Sharma LK, Chumber S, Kochupillai N, Griwan MS. Thyroid neoplasm. A profile. Indian J Surg. 1996;58:143-8.
Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedüs L, Vitti P. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: executive summary of recommendations. J Endocrinol Invest. 2010 May;33(5):287-91.
Cibas ES, Ali SZ. Conference NTFSotS. The Bethesda System For Reporting Thyroid Cytopathology. Am J Clin Pathol. 2009;132:658-65.
Orell SR, Sterrett GF, Whitaker D, Vielh P. Techniques of FNA cytology. Fine Needle Aspiration Cytology. 5th ed. New Delhi: Elsevier India Pvt. Ltd.; 2011. p. 8-27.
Sanchez MA, Stahl RE. The thyroid, parathyroid, and neck masses other than lymph nodes. Williams & Wilkins; 2006. p. 1148-85.
Koss LG, Durfee GR, Decker JP. Diagnostic cytology and its histopathologic bases. Obstet Gynecol. 1962 Jan 1;19(1):130.
Liechty RD, Graham M, Freemeyer P. Benign Solitary Thyroid Nodule. Surg Gynecol Obstet. 1965;121:571-3.
Sengupta A, Pal R, Kar S, Zaman FA, Sengupta S, Pal S. Fine needl aspiration cytology as the primary diagnostic tool in thyroidenlargement. J Nat Sci Biol Med. 2011;2(1):113-8.
Kamran SC, Marqusee E, Kim MI, Frates MC, Ritner J, Peters H, Benson CB, Doubilet PM, Cibas ES, Barletta J, Cho N. Thyroid nodule size and prediction of cancer. J Clin Endocrinol Metab. 2013 Feb 1;98(2):564-70.
Smith-Bindman R, Lebda P, Feldstein VA, Sellami D, Goldstein RB, Brasic N, Jin C, Kornak J. Risk of thyroid cancer based on thyroid ultrasound imaging characteristics: results of a population-based study. JAMA Intern Med. 2013 Oct 28;173(19):1788-95.
Kirdak VR, Chintale SG, Jatale SP, Shaikh KA. Our experience of clinico-pathological study of thyroid swelling. Int J Otorhinolaryngol Head Neck Surg. 2018 Sep;4:1156.
Cady B, Sedgwick CE, Meissner WA, Wool MS, Salzman FA, Werber J. Risk factor analysis in differentiated thyroid cancer. Cancer. 1979 Mar;43(3):810-20.
Charles ND. Scintigraphic evaluation of nodular goitre. Semin Nucl Med. 1971;1:316.
Hathiram BT, Khattar VS. Atlas of Operative Otorhinolaryngology and Head & Neck Surgery: Facial Plastics, Cosmetics and Reconstructive Surgery. JP Medical Ltd; 2013 Mar 31.
Jayaram G, Orell SR. Thyroid. In: Orell SR, Sterrett GF, editors. Fine Needle Aspiration Cytology. 5th ed. Gurgaon: Reed Elsevier India Private Limited; 2012. p. 118-55.
Yassa L, Cibas ES, Benson CB, Frates MC, Doubilet PM, Gawande AA, Moore Jr FD, et al. Long-term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluation. Cancer Cytopathol. 2007 Dec 25;111(6):508-16.
Nayar R, Ivanovic M. The Bethesda system for reporting thyroid fine needle aspirates: A cytologic study with histologic follow-up. J Cytol. 2013 Apr;30(2):94.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Shamim Ahmad Ansari, Reeni Malik, Pramila Jain
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
