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Background: Thyroid fine needle aspiration cytology (FNAC) is an important diagnostic tool for thyroid disorders. The Bethesda technique for Reporting Thyroid Cytopathology (TBSRTC) is an unambiguous, six-category reporting system for thyroid fine needle aspiration (FNA) that is widely acknowledged as a standard reporting guideline for institutes across continents which can minimize needless surgeries. Material and Methods: The study was carried out at the Pathology Department of the Assam Medical College and Hospital, Dibrugarh, Assam, India, from March 2023 to February 2024. The aim is to study the different cytological pattern in thyroid lesion by FNAC The results are interpreted using the features and categories specified in the TBSRTC. A total of 182 cases were studied. The distribution of the various categories from evaluated thyroid FNAs are as follows: nondiagnostic/unsatisfactory-8.2%, benign-75.9%, atypia of undetermined significance-6.0%,follicular neoplasm (FN) or suspicious for a FN-4.3%,suspicious for malignancy - 1%, malignant - 4.3%.Conclusion: The results of a FNA according to The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) give a standard and systematic approach to managing these nodules. Its standardized nomenclature enhanced thyroid FNAC reporting by facilitating communication and interlaboratory agreement among cytopathologists and clinicians, potentially leading to more standardized patient care management. [ABSTRACT FROM AUTHOR]

Objectives: To correlate the screening ability of ultrasound-based TIRADS with the FNAC-based Bethesda system when the latter is kept as a gold standard. Material and methods: A cross-sectional study was conducted in the Histopathology department, Rehman Medical Institute, Peshawar 15th June 2022-14th June 2023. A total of 363 patients from any age group of either gender diagnosed with thyroid nodules were included in the trial. All the participants underwent ultrasound followed by ultrasound-guided fine needle aspiration of thyroid nodules. TIRADS and Bethesda grading was done for each participant. Demographics and grading scores were recorded. Keeping Bethesda scoring as gold standard diagnostic performance of TIRADS grading was calculated. Results: Mean age of the patients was 46.68 ± 12.28 years with a female-to-male ratio of 2.3:1. TIRADS grading revealed 210 (69.8%) from TIRADS 2 while 70(82.4%), 12(50%), and 09(23.7%) patients were from TIRADS 3, 4 and 5 categories respectively. Bethesda grades were 301(82.9%), 21(5.8%), 09(2.5%), 28(7.7%), and 04(1.1%) from Bethesda 2, 3, 4, 5, and 6 categories respectively. The sensitivity of the TIRADS was 93.8%, specificity 89.1%, positive predictive value 45%, negative predictive value 99.3%, and a diagnostic accuracy of 89.5%. Conclusion: TIRADS grading has a high diagnostic ability when Bethesda scoring is kept as the gold standard. It can be used effectively in segregating benign from malignant nodules and is recommended for screening patients presenting with thyroid nodules. [ABSTRACT FROM AUTHOR]

The Bethesda system for reporting thyroid cytopathology (TBSRTC) has attempted to standardize thyroid fine needle aspiration cytology (FNAC) reporting internationally into six diagnostic categories and help in clinical decision making. But there exists a significant variation in the reporting percentage and rates of malignancies in each category across the centres which complicates clinical decision making. To study the usefulness of TBSRTC in surgical planning of thyroid nodules and to correlate TBSRTC with final histopathology. 85 patients with thyroid nodules who underwent surgery were evaluated prospectively. Preoperatively FNAC and TBSRTC reporting was done and following surgery histopathology was correlated with cytology. Distribution of 85 patients amongst the six categories of TBSRTC was as follows: 2.35% in Category I, 68.23% II, 7.05% III, 16.47% IV, 2.35% V and 3.52% VI. In 93% (79) of patients TBSRTC correlated with histopathology whereas in 7% (6) it did not. Risk of malignancy calculated was 0% in II, 33.33% in III, 7.14% in IV and 100% in V and VI categories. Sensitivity, specificity, Positive Predictive Value and Negative Predictive Value of TBSRTC was 100% for V, VI categories, whereas it was 100%, 78%, 15% and 100% respectively for III, IV. The diagnostic accuracy in our study is 100% for Category V and VI whereas it is 79% for Category III and IV. TBSRTC proved to be a very good screening platform for triaging patients with thyroid nodules into benign and malignant groups, as it is directly related to risk of malignancy in each category. It has helped in appropriate surgical planning in 96.4% of our patients. [ABSTRACT FROM AUTHOR]

Background: FNAC is considered as an excellent non-invasive technique for diagnosis of thyroid lesions. FNAC also help in guiding the clinician for further management of patient with thyroid lesions. Aim: This study was carried out for classifying various thyroid lesions on the basis of "The Bethesda System for Reporting Thyroid Cytopathology". Materials and Methods: This retrospective study was performed on 81 patients in the Department of Pathology, Maharaja Agrasen Medical College, Agroha. FNAC was performed by using non-aspiration technique. The smears were prepared, processed with routine stains and classified them according to the Bethesda system. Results: The ratio of male to female was 1:4.4 and most common affected age group was 30- 50 years. According to the Bethesda system, out of 81 cases 2.46% (n=2) were diagnosed as non-diagnostic/unsatisfactory, 86.41% (n=70) were benign, 1.23% (n=1) were AUS/FLUS, 4.93% (n=4) were FN/SFN, 1.23% (n=1) were suspicious for malignancy and 3.7% (n=3) were reported as malignant. Conclusion: FNAC is simple, easy to perform and painless procedure for diagnosis of thyroid lesion. "The Bethesda system for Reporting Thyroid Cytopathology" is useful in classifying benign and malignant lesions and also allows standardization in reporting which further provides medical and surgical management. [ABSTRACT FROM AUTHOR]

Introduction Fine needle aspiration cytopathology (FNAC) is widely used for the stratification of thyroid nodules. Objective The objective of the present study is to validate FNAC reporting based on The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) at our institution and to calculate the risk of malignancy in each category. Methods This was a descriptive cross-sectional study conducted jointly at the Department of Ear, Nose and Throat and at the Department of Pathology for a period of 1.5 years (May 2018 to November 2018). All cases presenting with thyroid swelling in the outpatient department were investigated with ultrasonography (USG) of the neck, thyroid function test, and FNAC. All FNAC reporting was done according to TBSRTC. Results A total of 134 thyroidectomies were performed during the study period. The female tomale ratiowas 5.3:1. The age ranged from11 to 74 years old. with amean age of 51 years old. The FNAC has a specificity of 84.9%, a sensitivity of 89.4%, a positive predictive value of 86.4%, a negative predictive value of 88.2%, and an accuracy of 87.3% in detecting thyroid cancer. The implied risk of malignancy (ROM) in Bethesda II, III, IV, V and VI is 11.7%, 25%,40%,76.6% & 96%, respectively. Conclusion The four studied categories had a ROM comparable to other studies, except for the Bethesda III category. Further studies with larger sample sizes and with the use of USG guidance for the aspiration from the thyroid swelling may give better results by reducing the number of false negative and false positive cases. [ABSTRACT FROM AUTHOR]

Objective: Bethesda System for Reporting Thyroid Cytopathology (BSRTC) categories I, III, and V account for a significant proportion of fine needle aspiration cytology (FNAC) diagnoses. This study aimed to compare the diagnostic efficacy of BRAFV600E mutation and the Thyroid Imaging Reporting and Data System (TIRADS) classification in differentiating papillary thyroid cancers (PTCs) from benign lesions among BSRTC I, III, and V nodules. Methods: A total of 472 patients with 479 nodules were enrolled in this prospective study. Ultrasound, BRAFV600E mutation testing, and FNAC were performed in each nodule, followed by surgery or regular ultrasound examination. Results: In the BSRTC I category, BRAFV600E showed similar sensitivity, higher specificity, and lower accuracy when compared with TIRADS. In the BSRTC III/V category, the sensitivity, specificity, and accuracy of BRAFV600E were similar to those of TIRADS. In comparison to BRAFV600E alone, the combination of the two methods significantly improved sensitivity (BSRTC I: 93.6% vs. 67.7%, P < 0.01; BSRTC III: 93.8% vs. 75.0%, P < 0.01; BSRTC V: 96.0% vs. 85.3%, P < 0.001). When compared with TIRADS alone, the combination improved sensitivity in BSRTC I nodules (93.6% vs. 74.2%, P < 0.05), increased sensitivity and decreased accuracy in BSRTC III nodules (93.8% vs. 75.0%, P < 0.01, 91.0% vs. 93.6%, P < 0.01), and improved both sensitivity and accuracy in BSRTC V nodules (96.0% vs. 82.0%, P < 0.001; 94.2% vs. 81.3%, P < 0.001). Conclusions: BRAFV600E exhibited higher specificity and lower accuracy compared with TIRADS in BSRTC I nodules, while the two methods showed similar diagnostic value in BSRTC III/V nodules. The combination of the two methods distinctly improved sensitivity in the diagnosis of PTCs in BSRTC I, III, and V nodules. [ABSTRACT FROM AUTHOR]

The potential complimentary role of various molecular imaging modalities [fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT), ultrasound (US)-elastography, and diffusion weighted imaging-magnetic resonance imaging (DWI-MRI)] in characterizing thyroid nodules, which have been designated as "intermediate risk category" on the Bethesda thyroid cytopathology reporting system (BTCRS), is illustrated in this communication. The clinical cases described (category III thyroid nodules on BTCRS) show the imaging features and the final diagnostic impressions rendered by the interpreting physicians with the modalities that have been independently compared in a tabular format at the end; of particular note is the high negative predictive value of these (specifically FDG-PET/CT), which could aid in enhancing the diagnostic confidence in the reported "intermediate risk category" thyroid nodules, a "gray zone" from the patient management viewpoint. [ABSTRACT FROM AUTHOR]

Since Noninvasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features (NIFTP) was introduced as a new thyroid tumour entity, many studies, and meta-analyses on diagnosing NIFTP have been published. NIFTP-revised histopathological criteria emerged in 2018. NIFTP is defined as a histological entity and its diagnosis requires a careful histological examination. Its molecular profile is similar to follicular-like tumours. Ultrasound features are unable to differentiate NIFTP. NIFTP is not a cytological diagnosis, but it influences the risk of malignancy in several categories of The Bethesda System for Reporting Thyroid Cytopathology terminology. [ABSTRACT FROM AUTHOR]