Incidence and Malignancy Rate of Bethesda Category III Thyroid Lesions in A Tertiary Hospital
Keywords:
Thyroid, Bethesda system, malignancy rate
Abstract
Background: The introduction of The Bethesda System for Reporting Thyroid Cytopathology in 2010 provided the opportunity to establish worldwide standard reporting and terminology guidelines diagnostic category in reporting of thyroid FNAC. Indeterminate lesion included in the category III are those with insufficient degree of atypia to qualify for any of the suspicious categories. This study was conducted to determine the incidence and malignancy rate of Bethesda category III thyroid lesions. Methods: A two- and half-year retrospective study was conducted in Father muller medical college. Thyroid lesion which were diagnosed as Bethesda category III on fine needle aspiration cytology during the study period were included. The cytology-histopathological correlation was done where ever available to calculate the incidence and malignancy rate of this category. Result: A total of 1397 cases underwent thyroid FNA during the study period. Out of this, 57 cases were reported as Bethesda category III lesion. The incidence rate of Bethesda category III lesions in the study was 4.08%. Twenty-one cases had histopathology correlation. The malignancy rate was found to be 38.09%. Conclusion: The Bethesda category III still remains a very challenging group with a large and varied range of diagnosis. The risk of malignancy might be higher that what is currently estimated for this category. Sub-classification of this category might help in predicting the nature of lesion better and aid patient management more accurately.References
1. Thewjitcharoen Y, Butadej S, Nakasatien S, Chotwanvirat P, Porramatikul S, Krittiyawong S et al. Incidence and malignancy rates classified by The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) – An 8-year tertiary center experience in Thailand. Journal of Clinical & Translational Endocrinology. 2019;16:100175.
2. Ali S, Cibas E. The Bethesda System for Reporting Thyroid Cytopathology. Cham: Springer International Publishing; 2018.
3. Morris L, Sikora A, Tosteson T, Davies L. The Increasing Incidence of Thyroid Cancer: The Influence of Access to Care. Thyroid. 2013;23(7):885-891.
4. Olson E, Wintheiser G, Wolfe K, Droessler J, Silberstein P. Epidemiology of Thyroid Cancer: A Review of the National Cancer Database, 2000-2013. Cureus. 2019;11(2):4127.
5. Garg S, Mohan H, Nagarkar N, Handa U. Role of fine needle aspiration cytology in diagnosis and -management of thyroid lesions: A study on 434 patients. Journal of Cytology. 2008;25(1):13-17.
6. Chandra S, Chandra H, Bisht S. Malignancy rate in thyroid nodules categorized as atypia of undetermined significance or follicular lesion of undetermined significance - An institutional experience. Journal of Cytology. 2017;34(3):144 - 148.
7. Hong S, Lee H, Cho M, Lee J, Sung Y, Hong Y. Malignancy Risk and Related Factors of Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance in Thyroid Fine Needle Aspiration. International Journal of Endocrinology. 2018;2018:1-7.
8. Mosca L, Silva L, Carneiro P, Chacon D, Araujo-Neto V, Araujo-Filho V et al. Malignancy rates for Bethesda III subcategories in thyroid fine needle aspiration biopsy (FNAB). Clinics. 2018;73:370.
9. Ho A, Sarti E, Jain K, Wang H, Nixon I, Shaha A et al. Malignancy Rate in Thyroid Nodules Classified as Bethesda Category III (AUS/FLUS). Thyroid. 2014;24(5):832-839.
10. Garg S, Naik L, Kothari K, Fernandes G, Agnihotri M, Gokhale J. Evaluation of thyroid nodules classified as Bethesda category III on FNAC. Journal of Cytology. 2017;34(1):5-9.
11. Guleria P, Agarwal S, Iyer V, Jain D, Mathur S, Yadav D. Subcategorisation of AUS/FLUS thyroid lesions as per the 2017 Bethesda System for Reporting Thyroid Cytopathology: a retrospective study from a tertiary care centre analysing risk of malignancy (ROM) of the different subcategories. Journal of Clinical Pathology. 2019;72(11):771-777.
2. Ali S, Cibas E. The Bethesda System for Reporting Thyroid Cytopathology. Cham: Springer International Publishing; 2018.
3. Morris L, Sikora A, Tosteson T, Davies L. The Increasing Incidence of Thyroid Cancer: The Influence of Access to Care. Thyroid. 2013;23(7):885-891.
4. Olson E, Wintheiser G, Wolfe K, Droessler J, Silberstein P. Epidemiology of Thyroid Cancer: A Review of the National Cancer Database, 2000-2013. Cureus. 2019;11(2):4127.
5. Garg S, Mohan H, Nagarkar N, Handa U. Role of fine needle aspiration cytology in diagnosis and -management of thyroid lesions: A study on 434 patients. Journal of Cytology. 2008;25(1):13-17.
6. Chandra S, Chandra H, Bisht S. Malignancy rate in thyroid nodules categorized as atypia of undetermined significance or follicular lesion of undetermined significance - An institutional experience. Journal of Cytology. 2017;34(3):144 - 148.
7. Hong S, Lee H, Cho M, Lee J, Sung Y, Hong Y. Malignancy Risk and Related Factors of Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance in Thyroid Fine Needle Aspiration. International Journal of Endocrinology. 2018;2018:1-7.
8. Mosca L, Silva L, Carneiro P, Chacon D, Araujo-Neto V, Araujo-Filho V et al. Malignancy rates for Bethesda III subcategories in thyroid fine needle aspiration biopsy (FNAB). Clinics. 2018;73:370.
9. Ho A, Sarti E, Jain K, Wang H, Nixon I, Shaha A et al. Malignancy Rate in Thyroid Nodules Classified as Bethesda Category III (AUS/FLUS). Thyroid. 2014;24(5):832-839.
10. Garg S, Naik L, Kothari K, Fernandes G, Agnihotri M, Gokhale J. Evaluation of thyroid nodules classified as Bethesda category III on FNAC. Journal of Cytology. 2017;34(1):5-9.
11. Guleria P, Agarwal S, Iyer V, Jain D, Mathur S, Yadav D. Subcategorisation of AUS/FLUS thyroid lesions as per the 2017 Bethesda System for Reporting Thyroid Cytopathology: a retrospective study from a tertiary care centre analysing risk of malignancy (ROM) of the different subcategories. Journal of Clinical Pathology. 2019;72(11):771-777.
Published
2020-07-28
Issue
Section
Original Article
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).
