Spectrum of Thyroid lesions in a tertiary care hospital using Bethesda System for Reporting Thyroid Cytopathology.

Authors

  • Mallikarjun A Pattanashetti Department of Pathology, S.Nijalingappa Medical College, Bagalkot
  • Ranjit P Kangle Department of Pathology, Jawaharlal Nehru Medical College, Belagavi
  • Hema B Bannur Department of of Pathology, Jawaharlal Nehru Medical College, Belagavi

Keywords:

Thyroid FNAC, Bethesda System

Abstract

Background : Thyroid Fine Needle Aspiration (FNA) has been widely used as a firstline investigation to assess thyroid nodules, as it is rapid, cost effective, safe and reliable. To bring uniformity and standardization in thyroid cytology reporting, “The Bethesda System for Reporting Thyroid Cytopathology†(TBSRTC) was introduced and it is gaining acceptance. This study has been undertaken to evaluate the reproducibility using TBSRTC system while reporting thyroid FNACs and to find out the utility of Bethesda system after correlating with the histopathology.

Methods: A retrospective study was conducted in which 173 cases of thyroid aspirates were reclassified according to TBSRTC in to six categories by cytologist.

 Results: A total of 173 thyroid lesions were analysed. Category wise distribution of aspirates was Non diagnostic (ND) 9 (5.20%), Benign (BN) 145 (83.81 %), Follicular neoplasm (FN) 9 (5.20%), Follicular lesion of uncertain significance (FLUS) Nil, suspicious of malignancy(SM) 1(0.57 %) and malignant category 9 (5.20 %). Age and sex wise distribution was interpreted.Thyroid diseases were more prevalent in women and most common age group affected was 3rd to 4th decade. Out of 164 lesions which were satisfactory for evaluation,120 (73.17 %) were simple goitre , 15(9.14 %) were of thyroiditis, 6 (3.65%) were toxic goitre, 4 (2.43%) were thyroid cysts & 19 (11.57 %) were neoplasms of which benign included 1 (0.6%) Hurthle cell neoplasm and 8 (4.87 %) follicular neoplasm. Malignant lesions were 8 (4.87%) papillary carcinoma, 1 (0.6%) anaplastic carcinoma and 1(0.6%) medullary carcinoma.

Conclusions: It was observed that standardized nomenclature of the Bethesda system has brought much needed clarity in thyroid FNAC reporting.. Along with malignant category, the FLUS, FN and SM categories carry higher malignancy risk.

 

DOI: 10.21276/APALM.1340

References

1. Sakorafas GH. Thyroid nodules; interpretation and importance of fine needle aspiration (FNA) for the clinician – Practical considerations. Surg Oncol 2010;19:130-9.
2. Redman R, Yoder BJ, Massoll NA. Perceptions of diagnostic terminology and cytopathologic reporting of fineneedle aspiration biopsies of thyroid nodules: a survey of clinicians and pathologists. Thyroid.2006;16:1003-8.
3. Baqqa PK, Mahajan NC. Fine needle aspiration cytology of thyroid swelling: how useful and accurate is it? Indian Journal of Cancer.2010;47:437-42.
4. Cibas ES. Fine needle aspiration in the workup of thyroid nodules. Otolaryngol Clin North Am 2010;43:257-71.
5. Park JH, Kim HK, Kang SW, Jeong JJ, Nam KH, Chung WY, et al. Second opinion in thyroid fine needle aspiration biopsy by the Bethesda System. Endocr J.2012;59:205-12.
6. Baloch ZW, Li Volsi VA, Asa SL, Rosai J, Merino MJ, Randolph G, et al. Diagnostic terminology and morphologic criteria for cytologic diagnosis of thyroid lesions: A synopsis of the national cancer institute thyroid fine needle aspiration state of the science conference. Diagn Cytopathol 2008;36:425-37.
7. Cibas ES, Ali SZ. The Bethesda system for reporting thyroid cytopathology. Am J Clin Pathol 2009;132:658-65.
8. Richmond BK, O’Brien BA, Mangano W, Thompson S, Kemper S. The impact of implementation of the bethesda system for reporting thyroid cytopathology on the surgical treatment of thyroid nodules. Am Surg 2012;78:706-10.
9. Layfield LJ, Morton MJ, Cramer HM, Hirschowitz S.Implications of the proposed thyroid fine needle aspiration category of “follicular lesion of undetermined significance”: A five year multi institutional analysis.Diagn Cytopathol 2009;37:710-4.
10. Parikh UR, Goswami H.M., Shah AM., Mehta N.P, Gonsai R.N. Fine Needle Aspiration Cytology (FNAC) Study of Thyroid Lesions (Study of 240 Cases) Gujarat medical Journal; 2012;67(2):25–30.
11. Bhatta S, Makaju R, Mohammad . Role of fine needle aspiration cytology in the diagnosis of thyroid lesions; Journal of Pathology of Nepal.2012;2:186-8.
12. Handa U, Garg S, Mohan H, Nagarkar N .Role of fine needle aspiration cytology in diagnosis and management of thyroid lesions: A study on 434 patients. J Cytol. 2008;25(1):13-8.

Downloads

Published

13-06-2017

How to Cite

1.
Pattanashetti MA, Kangle RP, Bannur HB. Spectrum of Thyroid lesions in a tertiary care hospital using Bethesda System for Reporting Thyroid Cytopathology. Ann of Pathol and Lab Med [Internet]. 2017 Jun. 13 [cited 2024 Dec. 26];4(3):A279-283. Available from: https://pacificejournals.com/journal/index.php/apalm/article/view/apalm1340

Issue

Vol. 4 No. 3 (2017)

Section

Original Article

License

Copyright (c) 2017 Mallikarjun A Pattanashetti, Ranjit P Kangle, Hema B Bannur

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

  1. 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.
  2. 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.
  3. 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).