IJAR - Indian Journal of Applied Research

Dr. Gulhane Sushma R.; Dr. Ghanghurde Swati B.; Dr. Kate Madhuri S.; Dr. Akhtar Javed M.

Volume : X, Issue : III, March - 2020

Cytopathological Evaluation of Thyroid Lesions with Implementation Of Bethesda System: A 6.5 Years Study

Dr. Gulhane Sushma R. , Dr. Ghanghurde Swati B. , Dr. Kate Madhuri S. , Dr. Akhtar Javed M.

Abstract :

Thyroid nodules are commonly encountered in clinical practice. Fine needle aspiration (FNA) of these nodules is widely accepted, cost–effective and simple method for diagnosis. This study aims at determining the distribution of diagnostic categories according to The Bethesda system for reporting thyroid cytopathology (TBSRTC), to analyze cytological features and correlate them with histopathology. We report retrospective and prospective analysis of 869 FNA of thyroid nodules using the Bethesda system. FNA were performed in prospective cases (554), whereas in retrospective cases (315) all smears were reviewed. All cases were categorized into six Bethesda categories. The sensitivity, specificity, positive predictive value, negative predictive value was calculated. The distribution of 869 evaluated thyroid nodules was as follows: 3.68% Nondiagnostic / unsatisfactory, 86.77% benign, 1.73% atypia of undetermined significance, 3.2% follicular neoplasm, 2.53% suspicious for malignancy and 2.07% malignant. In 141 cases, histopathological correlation was available and of these cytohistological concordance was found in 94% cases. The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy were 76%, 96%, 84%, 95% and 93% respectively. The risk of malignancy in categories II, III, IV, V and VI was 1.8%, 25%, 29%, 70%, & 100% respectively. Use of TBSRTC in well–defined and consistent manner especially in grey zone areas of thyroid cytopathology, allow appropriate evaluation of thyroid lesions cytologically.