Cytological Evaluation of Thyroid Lesion on The Basis Of Bethesda System

Fine needle aspiration cytology (FNAC) has emerged as one of the well-established first-line diagnostic techniques in the evaluation of thyroid lesions as well as solitary thyroid nodule. Until 2007,various competing reporting systems using variable number of diagnostic criteria and diagnostic terminology, causing a discordance among clinician and pathologist. To address the variability in terminology and other issues related to thyroid FNA, the National Cancer Institute proposed the six tiered “Bethesda System for reporting of thyroid cytopathology”. The current study is done to perform uniform reporting system for thyroid cytopathology based on Bethesda system and to reduce surgical procedure of those thyroid lesions, which can easily be treated medically. The present study was undertaken on fifty patients with clinically enlarged thyroid during a period of approximately two years who attended the Cytology section of Pathology Department, S.P. Medical College, Bikaner. All fine needle aspiration cytology (FNAC) diagnoses were classified according to the features given in the monograph of TBSRTC into nondiagnostic/unsatisfactory (ND/UNS), benign, atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), follicular neoplasm/suspicious of a follicular neoplasm (FN/SFN), suspicious for malignancy (SFM), and malignant. The distribution of various categories from 50 evaluated thyroid nodules was as follows: 6% ND/UNS, 74% benign, 2% AUS/FLUS, 10% FN, 2 SFM, and 6% malignant. TBSRTC is an excellent reporting system for thyroid FNA. It also provides clear management guidelines to clinicians to go for follow-up FNA or surgery and also the extent of surgery.