CYTOLOGICAL STUDY OF THYROID LESIONS AS CLASSIFIED BY THE BETHESDA SYSTEM WITH HISTOLOGICAL CORRELATION AND MORPHOMETRY

DR. SUMIT RAY; DR. IRA MONDAL

Volume : VIII, Issue : VI, June - 2019

CYTOLOGICAL STUDY OF THYROID LESIONS AS CLASSIFIED BY THE BETHESDA SYSTEM WITH HISTOLOGICAL CORRELATION AND MORPHOMETRY

Dr. Sumit Ray, Dr. Ira Mondal

Abstract :

The thyroid gland is located in the anterior neck, composed of left and right lobes and a small isthmus, weighing approximately 12-20gm in adults. It is composed of follicles ranging from uniform to variable in size and are lined by cuboidal to low columnar epithelium, which is filled with thyroglobulin. Fine needle aspiration cytology (FNAC) of the thyroid is the single best test to aspirate samples for cytological assessment but has been a subject of much debate for last forty years. Now, the Bethesda system has been developed for thyroid FNA diagnosis. FNAC has its limitations in differentiating thyroid follicular lesions between adenoma and carcinoma and in predicting various facets of thyroid papillary lesions. The possibility of morphometric analysis of FNAC smears in overcoming these limitations as a valuable preoperative diagnostic tool was investigated. The Mean Nuclear Area (MNA) was calculated from 100 nuclei in each case. FNA of the thyroid remains the safest and most cost-efficient manner in which to stratify thyroid nodules for surgical excision. The Bethesda system has standardized the reporting nomenclature for thyroid FNAC that corresponds with specific cytomorphologic criteria and risk of malignancy. Morphometric analysis in case of thyroid lesions is of definite benefit to the patient with regard to the future management as it aids an early pre-operative diagnosis with a high rate of accuracy.