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.   References:
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