DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20184412

Reporting of thyroid fine needle aspiration cytology with the use of the Bethesda System (TBS) of 150 cases

Mandakini M. Patel, Mubim I. Patel, Bhavna G. Gamit, Sharmistha M. Patel

Abstract


Background: Fine needle aspiration cytology (FNAC) is very simple, rapid, cost effective diagnostic test to evaluate thyroid swelling. The Bethesda system for reporting thyroid cytopathology gives guidelines which remains the same while reporting the thyroid FNAC. There are six diagnostic categories of lesions: (I) Non-diagnostic/Unsatisfactory, (II) Benign, (III) Atypical follicular lesion of undetermined significance (AFLUS), (IV) Suspicious for follicular neoplasm (SFN), (V) Suspicious for malignancy (SM), (VI) Malignant.

Methods: The study was carried out in Department of Pathology, Government Medical College affiliated with a Government hospital, Gujarat. It includes 150 patients, coming to the outpatient departments with a complaint of thyroid swelling from January 2017 to December 2017. The patients age ranges from 7 years to 75 years (Male-20, Female-130). The procedure was done with the patient in a supine position without a pillow. Patients were instructed not to speak or swallow during the procedure to avoid movement of the gland. The reporting was done with the current Bethesda nomenclature.

Results: There were 150 cases of thyroid FNAC, 3 cases (2 %) were non-diagnostic (TBS-I), 133 cases (88.7 %) were benign (TBS-II), 6 cases (4 %) were atypical follicular lesion of undetermined significance (AFLUS) (TBS-III), 5 cases (3.4 %) were suspicious for follicular neoplasm (TBS-IV), 2 cases (1.3 %) were suspicious for malignancy (TBS-V), and 1 case (0.6 %) was malignancy (TBS-VI).

Conclusions: The Bethesda system is very useful standardized system for reporting thyroid cytopathology, improving communication between cyto-pathologists and clinicians, inter-laboratory agreement, leading to more consistent management approaches.

 


Keywords


Bethesda, FNAC, Hashimoto, Thyroid, TBS

Full Text:

PDF

References


Rojeski MT, Gharib H. Nodular thyroid disease: evaluation and management. N Eng J Med. 1985 Aug 15;313(7):428-36.

Ali SZ, Cibas ES. The Bethesda system for reporting thyroid cytopathology. Definitions, criteria and explanatory notes. New York, NY:Springer; 2010.

Redman R, Yoder BJ, Massoll NA. Perceptions of diagnostic terminology and cytopathologic reporting of fine-needle aspiration biopsies of thyroid nodules: a survey of clinicians and pathologists. Thyroid. 2006 Oct 1;16(10):1003-8.

Lewis CM, Chang KP, Pitman M, Faquin WC, Randolph GW. Thyroid fine-needle aspiration biopsy: variability in reporting. Thyroid. 2009 Jul 1;19(7):717-23.

Diagnostic cytology and its histological basis. Koss, Leopold G, Melamed, Myron R. The Thyroid, Parathyroid, and Neck Masses Other Than Lymph Nodes. Sanchez MA, Stahl RE, 5th ed. 2006:1149-1185.

Tunbridge WM, Evered DC, Hall R, Appleton D, Brewis M, Clark F, et al. The spectrum of thyroid disease in a community: the Whickham survey. Clinical Endocrinol. 1977 Dec;7(6):481-93.

Griffin JE. Southwestern internal medicine conference: management of thyroid nodules. Am J Med Sci. 1988;296:336-47.

Baloch ZW, LiVolsi 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. Diagnostic Cytopathol. 2008 Jun;36(6):425-37.

Hamburger JI, Husain M. Semiquantitative criteria for fine‐needle biopsy diagnosis: Reduced false‐negative diagnoses. Diagnostic Cytopathol. 1988 Jan;4(1):14-7.

Nguyen GK, Ginsberg J, Crockford PM. Fine-needle aspiration biopsy cytology of the thyroid. Its value and limitations in the diagnosis and management of solitary thyroid nodules. Pathol Annual. 1991;26:63-91.

Clark DP, Faquin WC. Thyroid Cytopathology. Springer publication. 2nd ed. 2010:26.

Demay R. The art and science of cytopathology Vol-II. Aspiration cytology. Chicago, ASCP Press; 1996;703-778.

Diagnostic cytopathology. In: Gray W, Kocjan G. Thyroid Gland. 3rd ed. 2010:498-506.

Koss LG, Melamed MR. Koss' Diagnostic Cytology and Its Histopathologic Bases. Techniques of Fine-Needle Aspiration, Smear Preparation, and Principles of Interpretation. 5th ed. 2005:1057-1080.

Nayar R, Ivanovic M. The indeterminate thyroid fine‐needle aspiration. Cancer Cytopathol. 2009 Jun 25;117(3):195-202.

Mondal SK, Sinha S, Basak B, Roy DN, Sinha SK. The Bethesda system for reporting thyroid fine needle aspirates: A cytologic study with histologic follow-up. J Cytology/Indian Acad Cytologists. 2013 Apr;30(2):94.