‘Suspicious for a Follicular Neoplasm' before and after the Bethesda System for Reporting Thyroid Cytopathology: Impact of Standardized Terminology

2013 ◽  
Vol 57 (5) ◽  
pp. 455-463 ◽  
Author(s):  
Thiraphon Boonyaarunnate ◽  
Matthew T. Olson ◽  
Syed Z. Ali
Keyword(s):  
Follicular Neoplasm ◽  
Before And After ◽  
Standardized Terminology ◽  
Bethesda System ◽  
Thyroid Cytopathology ◽  
The Bethesda System

scholarly journals The Bethesda System for Reporting Thyroid Cytopathology: A Cytohistological Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Bakiarathana Anand ◽  
Anita Ramdas ◽  
Marie Moses Ambroise ◽  
Nirmal P. Kumar
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Follicular Neoplasm ◽  
Risk Of Malignancy ◽  
Bethesda System ◽  
Sensitivity Specificity ◽  
Thyroid Cytopathology ◽  
The Bethesda System ◽  
Undetermined Significance

Introduction. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is a significant step to standardize the reporting of thyroid fine needle aspiration (FNA). It has high predictive value, reproducibility, and improved clinical significance. Aim. The study was aimed to evaluate the diagnostic utility and reproducibility of “TBSRTC” at our institute. Methods and Material. The study included 646 thyroid FNAs which were reviewed by three pathologists and classified according to TBSRTC. Cytohistological correlation was done for 100 cases with surgical follow-up and the sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy, and risk of malignancy (ROM) were calculated. The interobserver variation among three pathologists was also assessed. Results. The distribution of cases in various TBSRTC categories is as follows: I—nondiagnostic 13.8%, II—benign 75.9%, III—atypia of undetermined significance (AUS)/follicular lesion of undetermined significance (FLUS) 1.2%, IV—follicular neoplasm (FN)/suspicious for follicular neoplasm (SFN) 3.7%, V—suspicious for malignancy (SM) 2.6%, and VI—malignant 2.8%. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy are 72.4%, 94.3%, 84%, 89.2%, and 87.9%, respectively. The ROM of various TBSRTC categories were II—8.5%; III—66.7%; IV—63.6%; and V and VI—100%. Cohen’s Weighted Kappa score was 0.99 which indicates almost perfect agreement among the three pathologists. Conclusions. Our study substantiates greater reproducibility among pathologists using TBSRTC to arrive at a precise diagnosis with an added advantage of predicting the risk of malignancy which enables the clinician to plan for follow-up or surgery and also the extent of surgery.

scholarly journals TO STUDY THYROID CYTOLOGY BY CONVENTIONAL METHOD AND APPLYING BETHESDA SYSTEM TO SAME SMEARS.

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Krishan Kumar Sharma ◽  
Ashik Mullik
Keyword(s):  
Benign Lesion ◽  
Follicular Neoplasm ◽  
Predictive Values ◽  
Medical College ◽  
Thyroid Cytology ◽  
Prospective Group ◽  
Bethesda System ◽  
Sensitivity Specificity ◽  
Thyroid Cytopathology ◽  
The Bethesda System

Method: The thyroid cytology smears reported at the Department of Pathology Index medical College over a two year period from May 2015 to June 2017 and a prospective thyroid FNAC smears from Sep 2017 to Aug 2019 were studied at the Department of Pathology Index Medical College. The conventional and Bethesda system for reporting thyroid cytopathology were followed for reporting. A comparison of old conventional reporting system and Bethesda system were then analyzed.      Result: In Bethesda System None of the patients in both the group showed Inadequate diagnosis which was seen in the retrospective group using conventional system. Bethesda System has revealed that out of 81 patients with Benign Lesion, 41 (50.6%) were in retrospective group and 40 (49.4%) were in prospective group. Malignant was present in 2 (40%) and 3 (60%) patients in Retrospective and prospective group. Similarly out of 4 patients with Follicular Neoplasm, 3 (75%) and 1 (25%) were in retrospective and prospective group. However the distribution was comparable between both the groups. Conclusion: Adapting the Bethesda system of reporting has led to a high to sensitivity, specificity and high negative predictive values. Use of Bethesda systems helps in the prognosis, management and minimizes the unnecessary surgical procedures of thyroid swelling. Keywords: Thyroid, Cytology, Bethesda & Smears.

scholarly journals Assessment of The Bethesda System for Reporting Thyroid Cytopathology

2019 ◽  
Vol 152 (4) ◽  
pp. 502-511 ◽  
Author(s):  
Jennifer L Sauter ◽  
Heidi Lehrke ◽  
Xiaotun Zhang ◽  
Osamah T Al Badri ◽  
Rene Rodriguez-Gutierrez ◽  
...  
Keyword(s):  
Predictive Value ◽  
Needle Aspiration ◽  
Performance Characteristics ◽  
Follicular Neoplasm ◽  
Bethesda System ◽  
Thyroid Fna ◽  
Thyroid Cytopathology ◽  
The Bethesda System ◽  
The Impact

Abstract Objectives Long-term follow-up is important for determining performance characteristics of thyroid fine-needle aspiration (FNA). Methods Histologic or 3 or more years of clinical follow-up was used to calculate performance characteristics of thyroid FNA before and after implementation of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). The impact of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) classification was also investigated. Results Follow-up was obtained for 1,277/1,134 and 1,616/1,393 aspirates/patients (median clinical follow-up, 9.9 and 4.4 years, pre- and post-TBSRTC, respectively). Nondiagnostic, suspicious for follicular neoplasm, and suspicious for malignancy (SFM) diagnoses decreased and benign diagnoses increased post-TBSRTC, while atypical rate remained less than 1%. Negative predictive value for benign nodules and positive predictive value (PPV) for SFM increased significantly. Eleven nodules were reclassified as NIFTP, slightly decreasing PPV/risk of malignancy (ROM). Conclusions Appropriate ROM for thyroid FNA can be achieved through application of TBSRTC terminology with minimal use of atypical category.

Cytological Diagnosis of Follicular Variant of Papillary Thyroid Carcinoma before and after the Bethesda System for Reporting Thyroid Cytopathology

2016 ◽  
Vol 60 (1) ◽  
pp. 14-18 ◽  
Author(s):  
Roghayeh Fazeli ◽  
Christopher J. VandenBussche ◽  
Justin A. Bishop ◽  
Syed Z. Ali
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Surgical Resection ◽  
Follicular Neoplasm ◽  
Papillary Thyroid ◽  
Follicular Variant ◽  
Bethesda System ◽  
Thyroid Cytopathology ◽  
The Bethesda System ◽  
The Impact

Background: The follicular variant of papillary thyroid carcinoma (FVPTC) is the second most common subtype of papillary carcinoma after the classical variant. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has been introduced to standardize the practice of thyroid fine needle aspiration (FNA) reporting. We evaluated the impact of TBSRTC on the FNA interpretation of histologically proven FVPTCs. Method: Cytology reports of 455 histologically proven FVPTCs were reviewed. The rate of each TBSRTC category was compared between pre- and post-TBSRTC eras. Results: The distribution of FNA diagnoses for pre-TBSRTC cases included suspicious for follicular neoplasm (SFN; n = 51, 28.7%), papillary thyroid carcinoma (PTC; n = 47, 26.4%), suspicious for malignancy (SFM; n = 32, 18%), atypia of undetermined significance (AUS; n = 23, 13%), benign (n = 18, 10.1%), and nondiagnostic (ND; n = 7, 4%). Post-TBSRTC diagnoses were: AUS (n = 68, 24.6%), PTC (n = 64, 23.1%), SFM (n = 50, 18%), SFN and benign (n = 42, 15.2%) and ND (n = 11, 4%). SFN rate decreased significantly from 28.7 to 15.2% (p = 0.001) and AUS increased from 12.9 to 24.5% (p = 0.003). Conclusion: Following implementation of TBSRTC, the frequency of AUS diagnoses on FNA prior to surgical resection increased. Given that the rate of FVPTC diagnoses on thyroidectomy increased over the same period, this suggests that the use of AUS has resulted in greater surgical resection of FVPTC.

scholarly journals Fine Needle Aspiration of Thyroid Nodules Using the Bethesda System for Reporting Thyroid Cytopathology: An Institutional Experience in a Rural Setting

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Aili Guo ◽  
Yuuki Kaminoh ◽  
Terra Forward ◽  
Frank L. Schwartz ◽  
Scott Jenkinson
Keyword(s):  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Rural Setting ◽  
Follicular Neoplasm ◽  
Fine Needle ◽  
Bethesda System ◽  
Thyroid Fna ◽  
Thyroid Cytopathology ◽  
The Bethesda System

Background. Fine needle aspiration (FNA) remains the first-line diagnostic in management of thyroid nodules and reduces unnecessary surgeries. However, it is still challenging since cytological results are not always straightforward. This study aimed to examine the results of thyroid FNA using the Bethesda system for reporting thyroid cytopathology (TBSRTC) to establish the level of accuracy of FNA procedures in a rural practice setting. Method. A retrospective chart review was conducted on existing thyroid FNA performed in a referral endocrine center between December 2011 and November 2015. Results. A total of 159 patients (18–88 years old) and 236 nodule aspirations were performed and submitted for evaluation. 79% were benign, 3% atypia/follicular lesion of unknown significance (AUS/FLUS), 5% follicular neoplasm/suspicious for follicular neoplasm (FN/SFN), 4% suspicious for malignancy (one case was indeed an atypical parathyroid neoplasm by surgical pathology), 2% malignant, and 7% nondiagnostic. Two cases also had advanced molecular analysis on FNA specimens before thyroidectomy. Conclusion. The diagnostic yield of FNA cytology from our practice in a rural setting suggests that accuracy and specificity are comparable to results from larger centers.

New Concept of the Encapsulated Follicular Variant of Papillary Thyroid Carcinoma and Its Impact on the Bethesda System for Reporting Thyroid Cytopathology: A Single-Institute Experience

2016 ◽  
Vol 60 (3) ◽  
pp. 198-204 ◽  
Author(s):  
Sule Canberk ◽  
Pembegul Gunes ◽  
Mine Onenerk ◽  
Murat Erkan ◽  
Emine Kilinc ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Follicular Neoplasm ◽  
Papillary Thyroid ◽  
Follicular Variant ◽  
Bethesda System ◽  
The Subject ◽  
Thyroid Cytopathology ◽  
The Bethesda System

Background: The encapsulated follicular variant (EFV) of papillary thyroid carcinoma (PTC) is the most discussed entity in thyroid pathology. Recently, the question of whether or not EFV-PTC is a malignant entity has been the subject of renewed discussion in the light of recent molecular and clinical studies. The aim of this study was to analyze the malignancy ratios of each category of the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) if EFV-PTC is no longer considered as a malignant entity. Materials and Methods: Data on thyroid fine-needle aspirations (n = 1,886) with surgical follow-up between 1999 and 2014 were studied. EFV-PTC cases constituted 27% (94/343) of the malignant cases. Results: Malignancy ratios were determined as nondiagnostic, benign, atypia/follicular lesion of undetermined significance, suspicious for follicular neoplasm/follicular neoplasm, suspicious for malignancy, and malignant categories of the TBSRTC in 13, 7, 45, 30, 72 and 98%, respectively. If EFV-PTC was not regarded as malignant, malignancy ratios would decrease to 6.5, 6, 30, 10, 48, and 87% for each category in the same order. Conclusions: The current study showed that the most significant decrease in relative malignancy ratios was seen in the suspicious for follicular neoplasm/follicular neoplasm category (66% relative decrease), but all categories represented a considerable decrease.

scholarly journals The Role of Cytology in the Diagnosis of Subcentimeter Thyroid Lesions

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1043
Author(s):  
Vincenzo Fiorentino ◽  
Marco Dell’ Aquila ◽  
Teresa Musarra ◽  
Maurizio Martini ◽  
Sara Capodimonti ◽  
...  
Keyword(s):  
Follicular Neoplasm ◽  
Control Series ◽  
Bethesda System ◽  
A Minor ◽  
Thyroid Cytopathology ◽  
The Bethesda System ◽  
Thyroid Lesions ◽  
Undetermined Significance

Thyroid nodules are common and typically detected by palpation and/or ultrasound (US). Guidelines have defined the management of large nodules, but controversy exists regarding nodules ≤ 1 cm. We evaluated a cohort of patients with subcentimeter nodules to determine their rate of malignancy (ROM). A total of 475 thyroid FNAs of lesions ≤ 1 cm with available follow-up were identified from January 2015–December 2019. For comparative analysis, we added a control series of 606 thyroid lesions larger than 1 cm from the same reference period. All aspirates were processed with liquid-based cytology and classified according to The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). Subcentimeter nodules were stratified as 35 category I—non-diagnostic cases (ND; 7.3%), 144 category II—benign lesions (BL; 30.3%), 12 category III—atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS; 2.5%), 12 category IV—follicular neoplasm/suspicious for follicular neoplasm (FN/SFN; 2.5%), 124 category V—suspicious for malignancy (SM; 26.1%), and 148 category VI—positive for malignancy (PM; 31.1%). A total of 307 cases (64.6%) underwent subsequent surgery. Only one ND and three BLs had a malignant outcome. ROM for indeterminate lesions (III + IV) was 3.2%; with 1.6% for category III and 3.2% for category IV. ROM for the malignant categories (V + VI) was 88.2%. The control cohort of lesions demonstrated a higher number of benign histological diagnoses (67.3%). We documented that 57.2% of suspected subcentimeter lesions were malignant, with a minor proportion that belonged in indeterminate categories. There were very few ND samples, suggesting that aspirates of subcentimeter lesions yield satisfactory results. Suspected US features in subcentimeter lesions should be evaluated and followed by an interdisciplinary team for appropriate patient management.

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