Study of cytomorphological spectrum of various thyroid lesions and reporting under bethesda system in tertiary care centre

Abstract

Background: This study has attempted to standardize reporting and cytological criteria in aspiration smears of thyroid swellings with the help of Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). Aims: The objective of this study is to categorise the thyroid cytology smears by TBSRTC, to analyze cytological features in details and to correlate the cytopathology with histopathology, wherever surgery is done. Materials and Methods: This was a retrospective study of 617 fine needle aspirations (FNA) of thyroid swellings. All fine needle aspiration cytology (FNAC) diagnoses were classified according to the features given in the monograph of TBSRTC into non diagnostic/unsatisfactory (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 619 evaluated thyroid swellings was as follows: 9.5% ND/UNS, 74% benign, 4.9% AUS/FLUS, 3.2% FN, 0.6% SFM, and 6.1% malignant. 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. Thyroid cytology can provide a definite diagnosis of malignancy, with tumour type, enabling appropriate therapeutic surgery in one stage.