Review of Three Cytology Reporting Systems in the Diagnosis of Thyroid Lesions: A Study of Fifty Cases

Abstract

Background: The various reporting systems such as conventional system, UK/RC Path system, and The Bethesda System for Reporting Thyroid Cytology (TSBRTC) have been used to help create a standard reporting format for evaluating thyroid cytology smears. However, there is still an ongoing dispute as to which classification system is the best for the management of the patient with thyroid lesions. The aim of this study is to review the utility of three reporting systems in cytological evaluation of thyroid swellings. Materials and Methods: A total of 50 cases were included in study. Only adequate smears were included in the study. Cytology smears of all cases were reported and categorized as per three reporting systems. In cases in which surgical specimens were received for histopathological examination, diagnosis was correlated with cytology diagnosis. Results: Maximum patients (n = 27) were in the age group of 20–40 years. The comparison of conventional, TSBRTC, and UK/RC Path reporting systems of 50 thyroid cytology smears showed equivocal cases in the benign category (Category II). Conclusion: In the vast majority of the cases, it showed that TBSRTC and UK/RC Path system lead to better diagnostic yield, high sensitivity, and timely treatment of patients. TBSRTC has diagnostic accuracy of almost 98%. One of the most challenging categories was the Category III in TSBRTC or Thy3a which are heterogeneous category. The smears in these categories include features which do not permit them to be classified as either benign or malignant.