A comparative study between conventional and the Bethesda System for Reporting Thyroid Cytology of 240 cases
Pinki Pandey1, Alok Dixit2, Anshul Sawhney3, Megha Ralli4, Vineet Chaturvedi1, Savita Agarwal1, Jitendra Pratap Singh5, Shalini Gupta6
1 Department of Pathology, Uttar Pradesh University of Medical Sciences, Etawah, Uttar Pradesh, India
2 Department of Clinical Pharmacology, Uttar Pradesh University of Medical Sciences, Etawah, Uttar Pradesh, India
3 Department of Dentistry, Maharaja Suhel Dev Autonomous State Medical College and Mahrishi Balark Hospital, Bahraich, Uttar Pradesh, India
4 Department of Pathology, Maharaja Suhel Dev Autonomous State Medical College and Mahrishi Balark Hospital, Bahraich, Uttar Pradesh, India
5 Department of ENT, Uttar Pradesh University of Medical Sciences, Etawah, Uttar Pradesh, India
6 Insurance Medical Officer, ESI Hospital, Lucknow, Uttar Pradesh, India
Department of Pathology, Maharaja Suhel Dev Autonomous State Medical College and Mahrishi Balark Hospital, Bahraich - 271 801, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
Introduction: Thyroid nodule is a common disorder of thyroid. Despite their benign nature, they can be associated with multiple pathologic conditions including thyroid cancer. Fine-needle aspiration plays an essential role in evaluating thyroid nodules. The Bethesda System for Reporting Thyroid Cytology (TBSRTC) has attempted to standardize reporting and cytological criteria in aspiration smears.
Aim: The aim of this study is to compare the conventional and TBSRTC and to compare and correlate the cases with histological findings wherever available.
Materials and Methods: The present study was a retrospective study undertaken in the department of pathology from January 2018 to December 2018 to access the validity of TBSRTC considering histopathology as the gold standard. May Grünwald Giemsa and Papanicolaou stained thyroid FNA smears of 240 patients were collected which were reported by the conventional system for reporting thyroid cytology and also categorized as per current Bethesda nomenclature for thyroid cytology. Diagnosis of both the reporting systems was then compared and correlated with the histological diagnosis wherever possible.
Results: A total of 240 cases were examined on cytology, out of which histopathological correlation was possible in 110 cases. For benign thyroid lesions, sensitivity and specificity with conventional system were 69.91% and 40.25%, respectively, while with TBSRTC, sensitivity and specificity were 84.04% and 29.94%, respectively. Sensitivity and specificity of conventional system for malignant thyroid lesions were 58.56% and 69.91%, respectively, while with TBSRTC, sensitivity and specificity were 73.69% and 95.12%, respectively. The Bethesda system found to be highly sensitive for benign thyroid lesions and highly specific for malignant thyroid lesions as compared to the conventional method of reporting of thyroid cytology.
Conclusion: Bethesda system was found to be superior for reporting thyroid cytology over the conventional system of reporting for thyroid cytology.