Usefulness of Preoperative FNAC of Thyroid Swelling Along with Application of Bethesda System of Reporting

Abstract

Introduction: Fine needle aspiration cytology (FNAC) is the commonly used test for diagnosis of thyroid swellings. FNAC is a cost-effective procedure that provides specific diagnosis rapidly with minimal complications. Based on the cytology findings, patients can be subjected to surgery, thereby decreasing the rate of surgery and its consequent complications. Aims and Objective: Study is aimed to accuracy of FNAC in thyroid as compare with histopathology and classify various cytomorphological lesions of thyroid according to The Bethesda System for Reporting of Thyroid Cytopathology (TBSRTC). Material and Methods: This prospective study was done at our department from January 2013 to June 2015. Total 411 cases presented with thyroid swelling were subjected to thyroid fine needle aspiration cytology (FNAC) and the smears were made followed by routine staining and reporting. The categorization according to the Bethesda system of reporting thyroid cytology was done. The cytological diagnosis was correlated with the histological diagnosis wherever it was available. The accuracy of FNAC for the diagnosis of nonneoplastic and neoplastic lesions was determined using histopathology as the gold standard. Results: Out of total 411 cases, 387 (94.16%) were benign, 15 (3.52%) were Follicular neoplasm, 7(1.70%) cases were malignant and 2 (0.48%) were inadequate. Most frequently encountered lesion was colloid goitre in 217 (52.79%) cases

A Comparative Study of Thyroid Cytology Reporting by Bethesda System and Routine Cytology in a Teaching Institute of Sub Himalayan Region

“…Though BSRTC were better in relation to conventional reporting system for thyroid cytodiagnosis, it also had some grey zone-mostly related to "Category III" and "Category IV" BSRTC lesions. Similar to Kasliwal et al [19] and Cibas et al [20] in our study, some false positive cases in BSRTC were also related with "Category IV" lesions e.g two cases of biopsy confirmed "Adenomatoid goitre" were categorized into "Category IV" lesions preoperatively and grouped into "Positive for neoplasia". Similarly, one case of the "Thyroglossal cyst with coexistance of Papillary carcinoma thyroid" which was diagnosed on biopsy, was preoperatively categorized under "Category III" and treated as "Negative for neoplasia" for statistical assessment which caused one false negative case.…”

Thyroid Cytology in India: Contemporary Review and Meta-analysis

“… Forest plot of meta-analysis on the risk of malignancy for Bethesda category IV (follicular neoplasm/suspicious for a follicular neopla sm)[ 14 - 17 , 21 , 23 , 30 - 35 , 37 , 38 , 42 , 44 , 45 ,; 46 , 49 , 50 , 52 - 54 , 56 , 60 , 61 , 63 ]. ES, effect size ; CI, confidence interval.…”