IJSR International Journal of Scientific Research 2277 - 8179 Indian Society for Health and Advanced Research ijsr-8-2-17902 Original Research Paper Fine Needle Aspiration Cytopathology (FNAC) of Thyroid Lesions Reporting As Per Guidelines of Recent Bethesda System at a tertiary care teaching medical college & hospital Athiya Munavarah Dr. N Jeybalan Dr. February 2019 8 2 01 02 ABSTRACT


Introduction: Estimation of accuracy of fine needle aspiration cytopathology (FNAC) of thyroid in diagnosis of different thyroid lesions, and evaluation of the value of reporting FNAC per guidelines of Bethesda system in reducing the number of un necessary thyroidectomies. This is a case control prospective study conducted on 54 patients with thyroid nodules. Patient were recruited to Cytopathology Department, KIMS Teaching Hospital in the period from January 2017 to December 2018. Results of FNAC were reported per recent Bethesda System for Reporting of Thyroid Cytopathology (TBSRTC). Reporting of Thyroid Cytopathology (TBSRTC) diagnoses were determined to be very useful for  surgical removal  thyroid tissues. Methods: The current study was a  retrospective study on 54 patients with thyroid swelling referred to the Department of Pathology, Karpaga Vinayaga Hospital in the period from January 2017 to Dec 2018. Cases included in the present study were those with preoperative FNAC and The data of 54 cases with enlarged thyroid glands that were referred to our cytolaboratory in this period. Thyroid swellings were aspirated using disposable needles using standard procedures. The aspirated contents of needles were expelled onto the glass slides. Slides were immediately fixed in methanol and smears were stained with papanicolau and hematoxlin and eosin stains whereas slides were air dried before staining it with giemsa Results: Out of 54 cases, Bethesda category I included 3 cases (5.5%), category II constituted 42 cases(77.7%) out of which 22 cases (52.38%) were benign follicular nodule type II, 13 cases(30.95%) were colloid nodule, 7 cases (16.7%) were hashimoto thyroiditis, category III (AUS) included 2 cases (3.70%), category IV (Follicular Neoplasm) had 4 cases(7.40%), category V (Suspicious of malignancy) included 2 cases (3.70%), category VI (malignant) constituted 1 case (1.85%). Male to female ratio was 1:6.9. Highest prevalence was noted in 30–40 years of age. Conclusion: Fine needle aspiration cytopathology from thyroid nodule(s) is a safe, quick outpatient, cost effective and easy procedure if done by expert hands, but it needs a unified system of interpretation, reporting language and guidelines for proper categorization and management.  Bethesda System for Reporting Thyroid Cytopathology is a comprehensive system for cytopathological diagnosis of thyroid nodule(s) and with strict diagnostic criteria for each category, predicting risk of malignancy and guidelines for planning of further management. Thyroid Fna can play a pivotal role in the management of patients with thyroid nodules by Bethesda system directly confers risk of malignancy in each category which in turn prompts the recommended clinical management of that category thus establishing an excellent clinico–pathological corelation. providing clinicians with a clear and comprehensible cytopathology reports. The Bethesda system is very useful for a standardized system of thyroid cytopathology reporting, best communication between  clinicians and cytopathologists , leading to more consistent management approaches.