Cytological Analysis of Thyroid lesions According to the Bethesda System for Reporting Thyroid Cytology and their Correlation with Histopathology: A Prospective Study

Abstract

Introduction: Fine-needle aspiration cytology (FNAC) has a crucial role in differentiating between nonneoplastic
and neoplastic lesions of the thyroid. It is a quick outpatient department (OPD) procedure. It greatly
affects the treatment decision. The current study was done to evaluate the role of FNAC as a diagnostic tool in
thyroid lesions and establish a clinico-cytological and histological correlation.
Aim: To study efficacy of Bethesda system for reporting (TBSRTC) FNAC of thyroid in view of offering guidance
for patient management, for review of distribution of diagnostic categories and correlation with histopathology.
Materials and Methods: It is a prospective study of thyroid lesions carried out at the Department of Pathology, CAIMS,
Karimnagar over a period of 3 years (January 2020 to January 2023) A total of 303 patients of neck swelling (thyroid),
with satisfactory cases on 290 patients in cytology were undertaken for histopathology. Their clinico-cytological,
biochemical, and histological correlation was done only in 133 patients only. Their statistical analysis was done.
Results: Majority of cases were non neoplastic. The accuracy of cytodiagnosis was 89.3% and overall malignancy
rate on histopathology was 16% (37 cases).
Conclusion: FNAC of lesions in thyroid gland has a high accuracy in differentiating between malignant and
benign lesions. It is safe cost effective, minimally invasive, and OPD procedure. Using FNAC as the first line of
investigation which streamline the reporting terminologies and the number of surgeries on thyroid lesion has
reduced greatly.