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Research Article | Volume 13 Issue:4 (, 2023) | Pages 1152 - 1158
Classification of Thyroid Fine Needle Aspiration Cytology into Bethesda Categories - An Institutional Experience
Under a Creative Commons license
Open Access
Received
Nov. 17, 2023
Revised
Nov. 28, 2023
Accepted
Dec. 14, 2023
Published
Nov. 30, 2023
Abstract

In the recent years, FNAC Thyroid has been increasingly utilised for the investigation of thyroid lesions. Preoperative diagnosis of benign thyroid lesions is of paramount importance to avoid unnecessary surgery. Hence FNAC thyroid being simple, safe, cost effective retains the status of first line diagnostic test in preoperative evaluation of thyroid lesions. According to Orell and Sterrett’s, FNAC thyroid has a sensitivity of 93.4%, specificity of 74.9% and positive predictive value of malignancy is 98.6%. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) established a standardized, category based reporting system for thyroid fine-needle aspiration (FNA) specimens. The 2017 revision reaffirms that every thyroid FNA report should begin with one of six diagnostic categories, the names of which remain unchanged since they were first introduced: (i) Non-diagnostic or unsatisfactory; (ii) benign; (iii) Atypia of undetermined significance (AUS) or follicular lesion of undetermined significance (FLUS); (iv) follicular neoplasm or suspicious for a follicular neoplasm; (v) suspicious for malignancy; and (vi) malignant. Each category has an implied cancer risk that ranges from 0% to 3% for the ‘‘benign’’ category to virtually 100% for the ‘‘malignant’’ category. As a function of their risk associations, each category is linked to updated, evidence-based clinical management recommendations also. Materials and Methods: This is a retrospective study, FNAC thyroid 344 cases were collected from January 2022 to October 2023, categorized according to Bethesda categories, assessment of malignancy risk in each category is done and histopathological correlation done in 82 cases. Accuracy, Sensitivity, Specificity and predictive values are calculated and analysed statistically. Results: A Total of 344 cases of thyroid FNAC, out of which majority 294 cases belongs to category II benign, 2 cases belongs to category I, 1 case belongs to category III, 30 cases belongs to category IV, 3 cases belongs to category V, 14 cases belongs to category VI. Accuracy, Sensitivity and Specificity are 95%, 84.61%, 98.14% respectively. Conclusions: Since our study results correlate well with other studies, applying TBSRTC to thyroid FNAC reporting allows more standardization, also provides clear guidelines to clinicians regarding treatment protocols.

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