Abstract

Background: The Bethesda system of reporting thyroid cytopathology is a standardised system, improving communication between cytopathologists and clinicians, leading to more consistent management approaches. The aim of the research work was to study the utility of Bethesda system in reporting thyroid cytology with histopathological correlation of all the cases undergoing surgical resection.

Methods: We studied all the thyroid cytology cases received between January 2017 to June 2018, and classified them according to the Bethesda system. Histopathological correlation was done for all the cases which underwent surgical resection with evaluation of cyto-histological discrepancies.

Results: Out of 423 cases studied on FNAC, 152 cases available for histopathological follow-up, cyto-histological discrepancies were noted in 11 cases.  132 (86.84%) were benign lesions, 13 (8.55%) were Follicular neoplasm/Suspicious for neoplasm, 3 (1.97%) were suspicious for malignancy, and 04 (2.63%) were malignant, 0 case in Unsatisfactory/ Non diagnostic & Atypia of undetermined significance. Statistical analysis of the present study showed that cytological analysis of thyroid lesions by Bethesda system has got high sensitivity (73.68%), high specificity (95.48%) with a positive predictive value of 70% and negative predictive value of 96.24% and a high efficacy (97.55%).

Conclusions: Reviewing the thyroid FNAs (fine needle aspirates) using Bethesda system allowed a more specific cytological diagnosis with better inter laboratory agreement. As evidenced by its high sensitivity and specificity, Bethesda system has proven to be a very effective guide for the clinical management of thyroid nodules.

Keywords: Bethesda, Cytology, Thyroid.