The Bethesda system for reporting thyroid cytopathology: into the clinic

Abstract

Background -FNAC has become the most prominent, and the easiest way, to morphologically evaluate lesions of the thyroid and may be the procedure of choice in the preoperative evaluation of thyroid nodules. In the past, ambiguous and inconsistent diagnostic criteria and terminology have hampered sample interpretation and patient management. The TBSRTC will have effect in transforming, unifying, and improving the reporting of thyroid FNA results Aims – The aim of our study to evolve uniform reporting system for thyroid cytopathology, facilitate effective cytological & histological correlation, reduce the unnecessary surgical management of thyroid lesions, which can easily be treated medically. Materials and Methods – FNAC was performed on two hundred patients diagnosed with thyroid lesion during a period of two years (2010-2012). The smears were prepared, stained by May-Grunewald-Giemsa stain and reported according to Bethesda system reporting of thyroid lesions. The cytological diagnosis was compared with histopathological diagnosis, wherever possible to find out the diagnostic accuracy. Results -The statistical analysis in the present study revealed sensitivity of 95.24 percent, specificity of 78.72 percent, positive predictive value of 66.66 percent, negative predictive value of 97.37 percent and diagnostic accuracy of 83.82 percent. Sensitivity and specificity of pre-Bethesda reporting system was 75 percent and 97.95 percent respectively. Positive predictive value was 85.71 percent, negative predictive value was 95.92 percent and diagnostic accuracy was 94.64 percent. Conclusion -After analyzing the results of the present study, it was concluded that the Bethesda System for Reporting Thyroid Cytopathology represents a reliable and valid reporting system for thyroid cytology. Key words – FNAC – Fine Needle Aspiration Cytology, TBSRTC – The Bethesda System Reporting of Thyroid Cytopathology. www.jmscr.igmpublication.org Impact Factor 3.79