Thyroid FNA: Challenges and Opportunities

Cibas, Edmund S.; Bibbo, Marluce

doi:10.1159/000334321

Cited by 10 publications

(5 citation statements)

References 18 publications

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“…Benign thyroid lesions have been given as colloid goiter, adenomatous goiter, hyperplastic nodule and colloid cyst. 6 Multiple organizations have proposed diagnostic guidelines for reporting thyroid FNAC to standardize the thyroid cytology reporting. In 2007, National Cancer Institute (NCI) organized the NCI Thyroid Fine Needle Aspiration State of the science Conference which led to formation of universal reporting system-The Bethesda System for Reporting Thyroid Cytopathology.…”

Section: Discussionmentioning

confidence: 99%

“…There had been variability in the terminology used from one pathologist to other and also from one institution to other. 5,6 In 2007, the National Cancer Institute (NCI) organized the NCI Thyroid Fine Needle Aspiration State of the Science Conference and proposed the Bethesda System for reporting Thyroid Cytopathology (TBSRTC). 7 TBSRTC describes 6 diagnostic categories of lesions: DC-I: Non diagnostic, DC-II: Benign, DC-III: atypia/follicular lesion of undetermined significance (AUS/FLUS), DC-IV: Follicular neoplasm/suspicion for a follicular neoplasm (FN/SFN), DC-V: suspicious for malignancy and DC-VI: Malignant.…”

Section: Introductionmentioning

confidence: 99%

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A Cell Pattern Approach for Interpretation of Fine Needle Aspiration Cytology of Thyroid Lesions Using the Bethesda System: A Tertiary Care Centre Study With Literature

Sharma¹,

Kaur²,

Madan³

et al. 2015

jemds

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INTRODUCTION:Fine needle aspiration of thyroid lesions has proven to be an important, simple, safe, cost effective and accurate method for diagnosing the various thyroid lesions. Multiple organizations have proposed diagnostic guidelines for reporting thyroid cytology. National Cancer Institute (NCI) organized the NCI Thyroid Fine Needle Aspiration State of the Science conference in 2007 and proposed the Bethesda System for reporting Thyroid Cytopathology (TBSRTC). The aim of the study is to highlight the application of new nomenclature which can improve inter-laboratory agreement thus leading to more consistent management approach. MATERIALS AND METHODS:The present study was done on 91 random FNAC cases of thyroid lesions in Pathology Department, SGRDIMSAR. The cases were classified according to 6 levels of TBSRTC which are DC-I: Non diagnostic, DC-II: Benign, DC-III: atypia/follicular lesion of undetermined significance (AUS/FLUS), DC-IV: Follicular neoplasm/suspicion for a follicular neoplasm (FN/SFN), DC-V: suspicious for malignancy and DC-VI: Malignant RESULTS: In the present study females outnumbered males with the ratio of 5:1. The age group varied from 13-80 years with maximum number of cases in 3 rd and 4 th decade. Maximum numbers of the cases (48.5%) were benign followed by FN/SFN and malignant category constituting 20.8% and 12.2% respectively. 8.7% were classified under AUS/FLUS category, 6.5% as non-diagnostic and 3.3% as suspicious of malignancy. CONCLUSION: The management of thyroid lesions has been complicated by the lack of universal terminology. TBSTRC is an effective thyroid FNA classification to guide clinical management of patients with thyroid nodules. Its implementation should be encouraged in our country because of its easy understandability and reproducibility. KEYWORDS: Thyroid, Fine needle aspiration, FNA, Bethesda classification. INTRODUCTION:Fine needle aspiration (FNA) of thyroid gland is a widely accepted, simple, safe, cost-effective and accurate method for the evaluation of thyroid lesions. 1 Clinical evaluation, imaging including ultrasound and FNA are mainstay for evaluation of thyroid lesions patients. Among all, highest rate of detection of thyroid neoplasm arising in solitary nodule is achieved by cytological studies thus forming FNAC the most sensitive and specific test. 2 So FNAC provides information that guides the management of the patients with thyroid nodules by identifying the patients who require the surgical intervention. 3 Various cyto morphological features including predominant cell pattern, cell morphology, background and marginal vacuoles are taken into account for diagnosing various lesions. 4 The clinical management of lesions has been complicated by the lack of universal terminology.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Cell Pattern Approach for Interpretation of Fine Needle Aspiration Cytology of Thyroid Lesions Using the Bethesda System: A Tertiary Care Centre Study With Literature

Sharma¹,

Kaur²,

Madan³

et al. 2015

jemds

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“…В октябре 2007 г. в Национальном институте ра ка г. Бетесда (США) проводилось обсуждение вопро сов, касающихся интерпретации результатов ТАБ ЩЖ [10]. Результатом кропотливого труда специа листов стала усовершенствованная Бетестовская классификационная система интерпретации резуль татов ТАБ, состоящая из 6 пунктов [11], цель кото рой заключается в оценке риска злокачественности.…”

Section: классификацияunclassified

Comparative analysis of cytological findings and diagnostic categories of independent сytopathologists

Semkina¹,

Abrosimov²,

Abdulhabirova³

et al. 2013

Clinical and Experimental Thyroidology

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“…In the past, in many cases, ambiguity, lack of standardization, and the failure of the treating physician to interpret cytological findings led to confusion and frustration in the sharing of clinically meaningful data between physicians, and even between and within institutions, as the terminology tended to differ from one pathologist to another and between different laboratories [ 2 , 3 ]. In 2007, a conference was held in Bethesda, MD, USA, with one of the objectives being to standardize the diagnostic terminology for the reporting of thyroid cytopathology results.…”

Section: Introductionmentioning

confidence: 99%

Malignancy Rates of Thyroid Cytology: Cyst Fluid Benign or Non-Diagnostic?

Güney

Şahiner

2017

Med Sci Monit

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BackgroundWe sought to investigate subgroup distribution using Bethesda classification and risks for malignancy. We also compared the malignancy risk of cases that were denoted as non-diagnostic due to cystic contents, with cases that were denoted as non-diagnostic due to presence of other features.Material/MethodsThe study included pathology test results of 1,440 thyroid nodule samples diagnosed using Bethesda classification. Results of 305 thyroidectomy excision specimens from these patients were also compared with cytology results to determine the frequency of malignancy. The non-diagnostic group was divided into two categories: those with cystic contents, and others. Malignancy rates were separately calculated for the two groups, and compared with the other classification groups.ResultsDistribution of malignancy rates by Bethesda classification were as follows: non-diagnostic 12.5% (6/48), benign 1.5% (3/198), atypia of undetermined significance/follicular lesion of undetermined significance (AFLUS) 9% (1/11), suspicious for follicular neoplasm (SFN) 37.5% (3/8), suspicious malignancy 70% (8/26), malignancy 100% (14/14).ConclusionsDespite the limited number of cases, our study concluded that cystic content was closer to the benign category than the non-diagnostic category if the assessment was based on malignancy rates. In this group, similar to aspirations containing plenty of lymphocytes that indicates colloid or lymphocytic thyroiditis, it is still controversial whether criterion for adequacy of follicular epithelial cells should be sought, or if they should be regarded as benign in order to prevent unnecessarily performance of repeat aspirations.

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Thyroid FNA: Challenges and Opportunities

Cited by 10 publications

References 18 publications

A Cell Pattern Approach for Interpretation of Fine Needle Aspiration Cytology of Thyroid Lesions Using the Bethesda System: A Tertiary Care Centre Study With Literature

A Cell Pattern Approach for Interpretation of Fine Needle Aspiration Cytology of Thyroid Lesions Using the Bethesda System: A Tertiary Care Centre Study With Literature

Comparative analysis of cytological findings and diagnostic categories of independent сytopathologists

Malignancy Rates of Thyroid Cytology: Cyst Fluid Benign or Non-Diagnostic?

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