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

  • 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


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


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Original Article