World Congress on Thyroid Cancer 3.5
June 20 – 22, 2019
World Congress on Thyroid Cancer 4.0
July 29 – August 1, 2021
WCTC3.5 Steering Committee:
Rocco Bellatone, Co-Chair
Celestino Lombardi, Co-Chair
Gregory W. Randolph, MD
Bryan McIver, MD
Jeremy Freeman, MD
Ian J. Witterick, MD
Ashok R. Shaha, MD
Jatin P. Shah, MD
EP89 – The Bethesda system for reporting thyroid cytopathology: a 10-year study from a single Asia institute
Ahmad, Nor Safariny1; Liew, Sarah1; Basro, Sarinah1; Baghawi, Anita1; Hisham, A. Noor1; Gopal, Navarasi S. Raja2
1 Department of Surgery, Putrajaya Hospital, Putrajaya, Malaysia
2 Department of Pathology, Putrajaya Hospital, Putrajaya, Malaysia
Introduction: Bethesda system for reporting thyroid cytopathology (BSRTC) was introduced to standardize report and improve clinical management. A few studies done in western countries showed a good diagnostic relationship between BSRTC and the final histopathological (HP) result, however, there is limited study done from Asia country.
Aim: To evaluate the accuracy of BSRTC with final histopathology result at our center; Hospital Putrajaya, Malaysia
Method: A retrospective study of 594 patients who underwent fine needle aspiration cytology (FNAC) of thyroid gland at Hospital Putrajaya, Malaysia from 2008-2017. Results of FNAC were compared with final HP result after surgical excision.
Results: A total of 594 patients with thyroid nodule underwent FNAC at our center (505 female and 89 male) with the median age and thyroid nodule size of 41 years and 30mm respectively. FNAC cytology were reported according to Bethesda criteria: 59(10%) non-diagnostic or unsatisfactory, 429(72%) benign, 88(15%) atypia of unknown significant/follicular lesion of undetermined significance (AUS/FLUS), 4(1%) follicular neoplasm/suspicious for follicular neoplasm (FN/SFN), 6(1%) suspicious for malignancy (SM) and 8(1%) malignant. 309 patients underwent excision of thyroid nodule and malignancy rate from the surgical pathology specimens in non-diagnostic or unsatisfactory, benign, AUS/FLUS, FN/SFN, SM and malignant groups were 16%, 18%, 38%, 33%, 50% and 80% respectively.
Conclusions: In our cohort, malignancy rate for non-diagnostic/unsatisfactory, benign, AUS/FLUS and FN/ SFN are higher than current BSRTC while for SM and malignant groups are lower than BSRTC. BSRTC underestimated malignancy rates in non-diagnostic/unsatisfactory, benign, AUS/FLUS and FN/SFN groups in our centre and some other reported studies.
- Ali, Syed Z., and Edmund S. Cibas. The Bethesda system for reporting thyroid cytopathology. New York, NY: Springer, 2010.
- Nayar, Ritu, and Marina Ivanovic. “The indeterminate thyroid fine?needle aspiration.” Cancer Cytopathology 117.3 (2009): 195-202
- Bongiovanni, Massimo, et al. “Comparison of 5?tiered and 6?tiered diagnostic systems for the reporting of thyroid cytopathology.” Cancer cytopathology 120.2 (2012): 117-125.
- Bongiovanni, Massimo, et al. “The Bethesda system for reporting thyroid cytopathology: a meta-analysis.” Acta cytologica 56.4 (2012): 333-339.
- Deniwar, Ahmed, et al. “Examining the Bethesda criteria risk stratification of thyroid nodules.” Pathology-Research and Practice 211.5 (2015): 345-348.
- Park, Ji Hye, et al. “Incidence and malignancy rates of diagnoses in the bethesda system for reporting thyroid aspiration cytology: an institutional experience.” Korean journal of pathology 48.2 (2014): 133.
- Jo, Vickie Y., et al. “Malignancy risk for fine-needle aspiration of thyroid lesions according to the Bethesda System for Reporting Thyroid Cytopathology.” American journal of clinical pathology 134.3 (2010): 450-456
- Her?Juing Wu, Howard, Crystal Rose, and Tarik M. Elsheikh. “The Bethesda system for reporting thyroid cytopathology: an experience of 1,382 cases in a community practice setting with the implication for risk of neoplasm and risk of malignancy.” Diagnostic cytopathology 40.5 (2012): 399-403.
- Theoharis, Constantine GA, et al. “The Bethesda thyroid fine-needle aspiration classification system: year 1 at an academic institution.” Thyroid19.11 (2009): 1215-1223.
- Bohacek, Linda, et al. “Diagnostic accuracy of surgeon-performed ultrasound-guided fine-needle aspiration of thyroid nodules.” Annals of surgical oncology 19.1 (2012): 45-51.