The Bethesda system for thyroid cytopathology reporting: a single centre study Contributors

Background: The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has attempted to standardize reporting and cytological criteria in aspiration smears. Aim: The objective of this study was to analyze the thyroid cytology smears by TBSRTC, to determine the distribution of diagnostic categories and subcategories, to analyze cytological features, and to correlate the cytopathology with histopathology, wherever surgery was done. Materials and Methods: This was a prospective study of 100 fine needle aspirations (FNA) of thyroid nodules. All fine needle aspiration cytology (FNAC) diagnoses were classified according to the features given in the monograph of TBSRTC into nondiagnostic/ un satisfactory (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. Cytohistological correlation was done, when surgical material was available. Results: The distribution of various categories from 100 evaluated thyroid nodules was as follows: 7% ND/UNS, 20% benign, 3% AUS/FLUS, 23% FN, 3% SFM, and 44% malignant. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated. Conclusion.: 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. Use of TBSRTC for thyroid FNAC reporting helps to highlight increased malignancy risk associated with FN, SM and malignant categories as well as provide data in a standardize pattern to ompare between different studies related to cytology of thyroid lesions.