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Critical Appraisal of the 2017 Bethesda System for Reporting Thyroid Cytopathology with Cytohistological Concordance and Estimation of Risk of Malignancy - An Institutional Study

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Aim

Bethesda System for reporting thyroid cytopathology established in 2009 was updated for the first time in 2017. Since its introduction very few studies have been done on the utility of recently introduced “The 2017 Bethesda System for Reporting Thyroid Cytopathology” (TBSRTC II) and estimation of risk of malignancy in various categories.

Material and methods

This was a prospective study done on thyroid lesions in which lesions were evaluated cytologically and classified according to TBSRTC II. Histopathological correlation was done, wherever possible. ROM was calculated for each Bethesda category in both ways as per TBSRTC II i.e. with NIFTP and excluding NIFTP from the malignant category.

Results

Using 2017 TBSRTC, 190 cases of thyroid FNACs were classified into 6 diagnostic categories. Cytohistological correlation was available in 60 cases. ROM was calculated which changed only in category III and V as only these two categories showed one case each of NIFTP. However there was an overestimation of ROM in category II and III as there are selection biases and not all thyroid nodules underwent surgical resections.

Conclusion

To conclude, the risk of malignancy calculated in two ways in the recent 2017 Bethesda system may have higher clinical relevance as those lesions with high ROM are defined for surgical excision. Thus we recommend that “The 2017 Bethesda system for Reporting Thyroid Cytopathology” should be implemented uniformly in our country as it provides a homogenous and standardised terminology resulting in better management of patients with thyroid nodular disease.

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References

  1. Dhanaram B, Arunachalam J, Muthukumaraswamy B (2017) A clinicopathological study of solitary nodule of thyroid. Int Surg J 4(7):2288–2290

    Article  Google Scholar 

  2. Mehrotra D, Anita AM, Andola SK, Patil AG (2016) Thyroid cytology evaluation based on the Bethesda system with clinico-morphological correlation. Ann Pathol Lab Med 3(4):347–355

    Google Scholar 

  3. Ali SZ, Cibas ES (2009) The Bethesda System for reporting thyroid cytopathology. Am J Clin Pathol 132:658–665

    Article  PubMed  Google Scholar 

  4. Cibas ES, Ali SZ (2017) The 2017 Bethesda system for reporting thyroid cytopathology. Thyroid 27(11):1341–1346

    Article  PubMed  Google Scholar 

  5. Baloch ZW, LiVolsi VA, Asa SL, Rosai J, Merino MJ, Randolph G et al (2008) Diagnostic terminology and morphologic criteria for cytologic diagnosis of thyroid lesions: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration state of the Science Conference. Diagn Cytopathol 36(6):425–437

  6. Haugen BR, Alexander EK, Bible KC et al (2016) 2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 26:1–133. https://doi.org/10.1089/thy.2015.0020

    Article  PubMed  PubMed Central  Google Scholar 

  7. Thewjitcharoen Y, Butadej S, Nakasatien S et al (2018) Incidence and malignancy rates classified by the Bethesda System for reporting thyroid cytopathology (TBSRTC) - an 8-year tertiary center experience in Thailand. J Clin Transl Endocrinol 16:100175 Published 2018 Dec 14. https://doi.org/10.1016/j.jcte.2018.12.004

    Article  PubMed  PubMed Central  Google Scholar 

  8. Naz S, Hashmi AA, Khurshid A, Faridi N, Edhi MM, Kamal A et al (2014) Diagnostic accuracy of Bethesda system for reporting thyroid cytopathology: an institutional perspective. Int Arch Med 7:46

    Article  PubMed  PubMed Central  Google Scholar 

  9. Yassa L, Cibas ES, Benson CB, Frates MC, Doubilet PM, Gawande AA et al (2007) Long-term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluation. Cancer 111:508–516

    Article  PubMed  Google Scholar 

  10. Yang J, Schnadig V, Logrono R, Wasserman PG (2007) Fine-needle aspiration of thyroid nodules: a study of 4703 patients with histologic and clinical correlations. Cancer Cytopathol 111(5):306–315

    Article  Google Scholar 

  11. Sawarkar PR, Mahore SD, Bothale KA, Sharma R, Monpara MK (2016) Cytological evaluation of thyroid lesions based on the Bethesda system. IOSR-JDMS 15:112–117

    Google Scholar 

  12. Mondal SK, Sinha S, Basak B, Roy DN, Sinha SK (2013) The Bethesda system for reporting thyroid fine needle aspirates: a cytologic study with histologic follow-up. J Cytol 30:94–99

    Article  PubMed  PubMed Central  Google Scholar 

  13. Jo VY, Stelow EB, Dustin SM, Hanley KZ (2010) Malignancy risk for fine-needle aspiration of thyroid lesions according to the Bethesda system for reporting thyroid cytopathology. Am J Clin Pathol 134:450–456

    Article  PubMed  Google Scholar 

  14. Mehra P, Verma AK (2015) Thyroid cytopathology reporting by the bethesda system: a two-year prospective study in an academic institution. Pathology research international. https://doi.org/10.1155/2015/240505

  15. Anand B, Ramdas A, Ambroise MM, Kumar NP (2020) The Bethesda System for Reporting Thyroid Cytopathology: A Cytohistological Study. J Thyroid Res. https://doi.org/10.1155/2020/8095378

  16. Ho AS, Sarti EE, Jain KS et al (2014) Malignancy rate in thyroid nodules classified as Bethesda category III (AUS/FLUS). Thyroid 24(5):832–839. https://doi.org/10.1089/thy.2013.0317

    Article  PubMed  PubMed Central  Google Scholar 

  17. Nayar R, Ivanovic M (2009) The indeterminate thyroid fine-needle aspiration: experience from an academic center using terminology similar to that proposed in the 2007 national cancer institute thyroid fine needle aspiration state of the science conference. Cancer 117:195–202

    PubMed  Google Scholar 

  18. Nandedkar SS, Dixit M, Malukani K, Varma AV, Gambhir S (2018) Evaluation of thyroid lesions by fine-needle aspiration cytology according to bethesda system and its histopathological correlation. Int J App Basic Med Res 8:76–82

    Article  Google Scholar 

  19. Gupta M, Gupta S, Gupta VB (2010) Correlation of fine needle aspiration cytology with histopathology in the diagnosis of solitary thyroid nodule. J Thyroid Res. https://doi.org/10.4061/2010/379051

  20. Ramteke DJ, Mulay PS (2017) Cyto-histopathological correlation of thyroid lesions. Int J Res Med Sci 5:1425–1429

    Article  Google Scholar 

  21. Mahajan S, Manjula BV, Vaishnavi R, John N, Babu B (2022) Usefulness of the Bethesda System of reporting thyroid cytopathology in Surgical Planning. Indian J Otolaryngol Head Neck Surg 74(Suppl 2):S2623–S28

    Article  Google Scholar 

  22. Faquin WC, Wong LQ, Afrogheh AH, Ali SZ, Bishop JA, Bongiovanni M et al (2016) Impact of reclassifying noninvasive follicular variant of papillary thyroid carcinoma on the risk of malignancy in the Bethesda System for reporting thyroid cytopathology. Cancer Cytopathol 124:181–187

    Article  PubMed  Google Scholar 

  23. Vuong HG, Tran TT, Bychkov AY, Jung CK, Nakazawa T, Kakudo K, Katoh RY, Kondo T (2019) Clinical impact of non-invasive follicular thyroid neoplasm with Papillary-Like Nuclear features on the risk of Malignancy in the Bethesda System for reporting thyroid cytopathology: a Meta-analysis of 14,153 resected thyroid nodules. Endocr Pract 25:491–502

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pathology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, 110062, India

    Sayika Hameed & Sabina Khan

  2. Department of Pathology, JN Medical College AMU, Aligarh, India

    Mohd Jaseem Hassan

  3. Department of Surgery, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, 110062, India

    Musharraf Husain

  4. Department of Otorhinolaryngology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, 110062, India

    Arun Prakash

Authors
  1. Sayika Hameed
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  2. Sabina Khan
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  3. Mohd Jaseem Hassan
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  4. Musharraf Husain
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Correspondence to Sabina Khan.

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Hameed, S., Khan, S., Hassan, M.J. et al. Critical Appraisal of the 2017 Bethesda System for Reporting Thyroid Cytopathology with Cytohistological Concordance and Estimation of Risk of Malignancy - An Institutional Study. Indian J Otolaryngol Head Neck Surg (2024). https://doi.org/10.1007/s12070-024-04744-2

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