Abstract :
Aims and Objectives: The Bethesda system for reporting thyroid cytopathology (TBSRTC) was proposed to standardize the reporting of thyroid cytopathology for more effective clinical communication and patient management. This study was undertaken to see the challenges, if any, faced in our center post the implementation of the new system.
Materials and Methods: Retrospective analysis of 250 thyroid aspirates was done wherein all slides were reviewed and reclassified as per TBSRTC.
Results: The mean age of patients was 40.2 years and females comprised 86.4% of the study group. Histological follow-up was available in 19.6% of cases. On reclassification, 6% of cases were put in the category of atypia of unknown significance/follicular lesion of unknown significance (AUS/FLUS). The benign category comprised 80.6% down from 87.6% reported earlier. The non-diagnostic group also increased marginally from 8% to 8.8%. No changes were observed in the following categories: Follicular/Hurthle cell neoplasm, suspicious for malignancy and malignant.
Conclusion: TBSRTC was useful in achieving the goal of improving thyroid cytopathology reporting by adopting a standardized format. However, due to the heterogeneity of the AUS/FLUS category, more cases than warranted were put in this category, which did not correlate with a higher risk of malignancy. More stringent criteria for inclusion of patients in the AUS/FLUS group and further stratification of these patients into high-risk and low-risk categories are suggested.
Keyword :
Bethesda, Thyroid, Cytology