Type of Article: Original Research

Volume 5; Issue 1: 2018

Page No.: 561-564

DOI: 10.16965/ijims.2017.122

 

CATEGORISATION OF FINE NEEDLE ASPIRATES OF THYROID ACCORDING TO THE BETHESDA SYSTEM FOR REPORTING THYROID CYTOPATHOLOGY AND HISTOLOGIC CORRELATION

Shwetha Jose *1 , Jinu Abraham 2.

*1 Assistant Professor of Pathology, Al Azhar Medical College and Super specialty Hospital, Ezhalloor Road, Thodupuzha, Idukki, Kerala, India.

2  Assistant Professor of Pathology, Sree Gokulam Medical College and Research foundation, Venjaramoodu Trivandrum, 695607, Kerala, India.

Corresponding author: Dr. Shwetha Jose, Assistant Professor (Pathology), Al Azhar Medical College and Super specialty Hospital, Ezhalloor Road, Thodupuzha Distt. – Idukki, Kerala, India. Pin-685584, Phone-+918111845287 E-Mail: docscholar.dr@gmail.com

ABSTRACT:

Background: Fine-needle aspiration (FNA) is the procedure of choice in the preoperative evaluation of thyroid nodules. But it suffers as a modality both because of variability in its diagnostic terminology. The 2007 National Cancer Institute Thyroid Fine-Needle Aspiration Conference helped instigate the recent publication of The Bethesda System for Reporting Thyroid Cytopathology. The objective of this study was to report our experience in using this new reporting system to review the distribution of diagnostic categories and to evaluate the specificity of the system based on the cytologic–histologic correlation.

Materials and Methods: The study was done in Yenepoya Medical College, Deralakatte, Mangalore, Karnataka during the two year period from May 2010 to April 2012. 200 patients with thyroid enlargement were included in the study. FNA of the thyroid gland was done using a 23-guage needle and smears were prepared which were stained and studied under light microscope. The cytologic findings were categorized under The Bethesda System. Histologic correlation was done wherever possible.

Results: The distribution of categories from 200 evaluated nodules was as follows: 12.5% unsatisfactory (I), 79.5% benign (II), 0.5% atypia of undetermined significance (III), 3% follicular neoplasm or suspicious for follicular neoplasm (IV), 2% suspicious for malignancy (V), and 2.5% malignant (VI). The specificity for diagnosing neoplastic thyroid nodules was 97% and the overall diagnostic accuracy of FNAC was 88.095%. The malignancy risk for categories V and VI is 100%.

Conclusion: These data demonstrate that the new classification system is excellent for reporting thyroid FNAs. Application of this nomenclature will lead to less ambiguity in diagnosis and consistent therapeutic approach.

Key words: Thyroid cytopathology, The Bethesda System.

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