The Bethesda System for Reporting Thyroid Cytopathology

Abstract

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Thyroid Atypia of Undetermined Significance or Follicular Lesion of Undetermined Significance: An Indispensable Bethesda 2010 Diagnostic Category or Waste Garbage?

“…The AUS/FLUS category is widely discussed in the literature [9,11,23,29,34]. It is a heterogeneous category including mainly sparse and compromised samples with suspicious atypical cytological or architectural features, nevertheless not sufficient to be diagnosed as FN or suspicious for malignancy [2,34]. …”

“…AUS/FLUS interpretation is appropriate in situations with a predominant or exclusive occurrence of a prominent population of microfollicles or oncocytes in paucicellular aspirates with scant colloid, in the presence of clotting and air-drying artefacts, features suggestive of papillary carcinoma, atypical cyst-lining cells, focally enlarged nuclei, atypical lymphoid infiltrate, and not otherwise specified changes [2]. The below paragraphs include the most common options in this heterogeneous category.…”

“…The below paragraphs include the most common options in this heterogeneous category. The most important criterion for AUS/FLUS is a technically compromised sample, which is either sparse in atypical features or bloody [2]. Overall, the atypical features are not completely sufficient for another diagnostic category.…”

“…The AUS/FLUS category has been newly introduced in the BSRTC [2]. This category was derived from the preceding category ‘indeterminate for malignancy', which was separated into suspicious for FN/FN (SFN/FN), suspicious for malignancy and AUS/FLUS categories [33].…”

“…BSRTC categories include a morphologic description, risk of malignancy and follow-up suggestions in each group (table 1). The system has standardised the reporting and management of thyroid gland fine-needle aspirations (FNA) [2]. Up to 6 years of experience has been cumulated at several centres (table 2) [3,4,5,6,7,8].…”