Oct 15, 2015 the bethesda system for reporting thyroid cytopathology bsrtc dr. It represents the results of the multidisciplinary national cancer institute thyroid fine needle aspiration state of the science conference, held in bethesda, md in october, 2007. They may be hyperplastic or tumorous, but only a small percentage of thyroid tumors are malignant. Thyroid cytopathology recent advances october 21, 2017 dr. Click on the thumbnails to see the intermediate images. Ata initiatives to reduce the extent of surgery for many low risk thyroid cancers 4 cm or smaller, without extra thyroidal extension and lacking. Implied risk of malignancy and recommended clinical management open in new tab a repeated aspiration with ultrasound guidance is recommended for nduns and clinically or sonographically worrisome cfo cases and is diagnostic in 50% to 88% of cases, 2, 6, 9, 11, , 14 but some nodules. To assess the usefulness of thyroid imaging reporting and data system tirads for cytological bethesda category iii thyroid nodules tns. Classifying your thyroid fna specimens using bethesda terminology. A twoyear prospective study in an academic institution table 1 the bethesda system for reporting thyroid cytopathology. Jan 24, 2017 the bethesda system for reporting thyroid cytopathology moderator dr g k parvathidevi presenter dr dhanya a n 2. Thyroid association aaceameeta task force combine bethesda.
Subsequently a monograph the bethesda system for reporting thyroid cytopathology tbsrtc which includes definitions, diagnosticmorphologic criteria, explanatory notes, and a brief management plan for each diagnostic category was published. Tbsrtc is a sixcategory scheme of thyroid cytopathology reporting table 1. Comments this document replaces the 1st edition of guidance on the reporting of thyroid cytology specimens, published in 2009. Contents introduction bethesda categories nondiagnostic or unsatisfactory benign atypia of undetermined significance or follicular lesion of undetermined significance follicular neoplasm or suspicious for a. Sporea et al 39 reported combining two elastographic methods could obtain a high. Of note, the cytopathologist cannot combine cells present in two or more nduns. The bethesda system for reporting thyroid cytology tbsrtc was proposed in 2007 at the national cancer institute thyroid fine needle aspiration state of the art and science. This atlas is the offspring of the the national cancer institute nci thyroid fine needle aspiration fna state of the science conference, hosted by. Research article thyroid nodules with atypia or follicular. It serves as a reference guide not just for pathologists, but also endocrinologists, surgeons, and radiologists. Description of the book the bethesda system for reporting thyroid cytopathology. The 2017 bethesda system for reporting thyroid cytopathology.
This accounts for 10 percent of the biopsies, even in the most. Impact of mutational testing on the diagnosis and management of patients with cytologically indeterminate thyroid nodules. Pdf introduction to the second edition of the bethesda system for. Twentythree items of feedback were received and the document was. Bethesda classification of thyroid nodule fine needle aspirations i.
The bethesda system for reporting thyroid cytopathology bsrtc has standardized. The objective of this study is to evaluate the thyroid cytology smear by tbsrtc. Malignancy rates for bethesda iii subcategories in thyroid fine. The conclusions of the meeting led to the bethesda thyroid atlas project and formed the framework for the bethesda system for reporting thyroid cytology tbsrtc. Fineneedle aspiration fna remains the most effective and safe method of evaluating thyroid nodules for potential surgical management. Pdf the 2017 bethesda system for reporting thyroid. The bethesda system for reporting thyroid cytopathology. Nodules that grow larger or produce symptoms may eventually need medical care. An inspiration for the thyroid proposal was the bethesda system for reporting cervical cytology interpretations, first developed at an nci workshop in 1988 and widely adopted in the united states for reporting papanicolaou test results. The bethesda system for reporting thyroid cytopathology tbsrtc was formalized in october 2007 by experts in thyroidology at the national institute of health in bethesda, maryland. The bethesda system for reporting thyroid cytopathology, 2017. The bethesda system for reporting thyroid cytopathology bsrtc is a standardized reporting system for classifying thyroid fineneedle aspiration results comprising of 6 diagnostic categories with unique risks o malignancy and recommendations for clinical management. Ata initiatives to reduce the extent of surgery for many low risk thyroid cancers 4 cm or smaller, without extra thyroidal extension and lacking regional nodal metastasis and decreased routine use of postoperative radioactive iodine treatment increasingly raise the possibility for lobectomy as initial surgical management.
The bethesda system for reporting thyroid cytopathology, 2017 laila khazai 11417. Thoroughly revised and updated, the bethesda system for reporting thyroid cytopathology, second edition will provide the reader with a unified approach to diagnosing and reporting thyroid fna interpretations. Fine needle aspiration fna remains the firstline diagnostic in management of thyroid nodules and reduces unnecessary surgeries. The bethesda system for reporting thyroid cytolopathology. Rapid on site evaluation helps assess adequacy after sampling.
According to a 1993 article, such nodules need to be treated only if they become toxic. The 2017 revision reaffirms that every thyroid fna report should begin with one of six diagnostic categories, the names of which remain unchanged since they were first introduced. An update to the bethesda system for reporting thyroid nodule cytopathology is set to alter clinical practice, with the primary aim of reducing the number of unnecessary thyroid surgeries. History introduced and formed in 2007, nci thyroid fna state of science conference bethesda, maryland, by various cytopathologists and summarised by baloch et al. Update on the bethesda system for reporting thyroid cytology. Using tbsrtc, cytopathologists can communicate their interpretations to the referring physician in terms that are succinct, unambiguous, and clinically.
The bethesda system for reporting thyroid cytopathology is the standard. The recent reclassification of some thyroid neoplasms as noninvasive follicular thyroid neoplasm with papillarylike nuclear features niftp has im plications for. The introduction of the bethesda system for reporting thyroid cytopathology tbsrtc, following the national cancer institute thyroid fine needle aspiration state of the science conference held in bethesda, md, in 2007, offered the opportunity to establish a uniform sixtiered reporting system for thyroid fna 1the. Nature of the nodule location, size, cystic component skills of operator and reader. Fine needle aspiration of thyroid nodules using the. Table 1 thyroid cytopathology reporting by the bethesda. Thyroid cytopathology reporting by the bethesda system. To compare the conventional and the bethesda system for reporting thyroid. A comparative study between conventional system and the.
The bethesda system for reporting thyroid cytopathology tbsrtc is considered standard reporting system for categorization of thyroid lesions in cytology. The objective of this study was to analyze the thyroid cytology smears by tbsrtc, to determine the distribution of diagnostic categories and subcategories, to analyze cytological features, and to correlate the cytopathology. This can happen when a cyst is aspirated or when the specimen is almost entirely composed of blood. The adoption of the system will facilitate communication among the cytopathologist, surgeon, endocrinologist and radiologist and also allow easy and reliable sharing of data from. The bethesda system for reporting thyroid fineneedle aspiration. Classifying your thyroid fna specimens using bethesda. In the bethesda classification system for thyroid lesions, bethesda iii is the most heterogeneous category because it merges follicular lesions. Click on document the bethesda system for reporting thyroid cytopathology. The bethesda system for reporting thyroid cytopathology is effective for clinical management of thyroid nodules jerome m. The bethesda system for reporting thyroid cytopathology, 2nd edition, 2018. Review the bethesda system for reporting thyroid cytopathology tbsrtc the pathologists perspective individual categories with case examples emphasis on the indeterminate category and potential options the dawn of noninvasive follicular thyroid neoplasm with papillarylike nuclei niftp the updated bethesda system 2017. This study aimed to examine the results of thyroid fna using the bethesda system for reporting thyroid cytopathology tbsrtc to establish the level of accuracy. Proposed modifications and updates for the thyroid.
Tendency to report a high percentage of benign hurthlecell nodules as. Evaluation of thyroid nodules classified as bethesda category iii on. The bethesda system for reporting thyroid cytopathology will provide the reader with a unified approach to diagnosing and reporting thyroid fna interpretations. The bethesda system for reporting of thyroid cytopathology. Bethesda system for reporting thyroid cytopathology. The aim was to address the inconsistent and sometimes confusing reporting terminologies used for thyroid fna throughout the world. Incidentally detected lesions in the surgical specimens that were not the target of the thyroid fna were excluded from the analysis. Proposed modifications and updates for the thyroid bethesda. In accordance with the colleges prepublications policy, this document was on college website for consultation from 27 october to 24 november 2015. Application of the bethesda classification for thyroid fineneedle.
The bethesda system for reporting thyroid cytopathology is a standardized reporting system for classifying thyroid fineneedle aspiration results comprising of 6 diagnostic categories with unique risks of malignancy and recommendations for clinical management. A comparative study between conventional system and the bethesda system applied for reporting thyroid cytopathology available online at received on. Guidance on the reporting of thyroid cytology specimens. C professor, department of pathology mcgill university director, cytopathology laboratory. Thyroid nodules are nodules raised areas of tissue or fluid which commonly arise within an otherwise normal thyroid gland. Present 3 uk rcpath 2015 italy 2014 usa bethesda 2008 australasia classification 2014 japan thyroid association 20 diagnostic category diagnostic category terminology categories terminology. The thyroid web atlas contains 300 images of key thyroid lesions in an easytosearch format. It is expected that the many benefits, clinical and investigational, of the bethesda cervical terminology will. Request pdf the bethesda system for reporting thyroid fineneedle aspiration specimens reply the bethesda system for reporting. Pdf the bethesda system for reporting thyroid cytopathology. The bethesda system for reporting thyroid cytopathology bsrtc dr. Thyroid imaging reporting and data system in assessment of.
This retrospective study included 121 patients with 121 tns classified as bethesda category iii at fine needle aspiration fna cytology and thereafter underwent surgery. Pdf the bethesda system for reporting thyroid cytopathology tbsrtc is an evidencebased standardized reporting system for thyroid. The bethesda system for reporting thyroid fineneedle aspiration fna specimens 1 undoubtedly represents a major step toward standardization, reproducibility, and ultimately improved clinical significance, usefulness, and predictive value of thyroid fna during the past decade, several classification schemes for thyroid gland fna have been proposed by various professional. Apr 25, 2018 the 2017 bethesda system for reporting thyroid cytopathology. Indeed, combining our suspicious for papillary carcinoma. Use of adjunct molecular reflex testing constantine theoharis, md assistant professor david chhieng, md, mba, mshi professor director of cytology department of pathology yale university new haven ct. Small, asymptomatic nodules are common, and often go unnoticed.
However, it is still challenging since cytological results are not always straightforward. Thyroid association aaceameeta recommend to combine. The bethesda system for reporting thyroid cytopathology tbsrtc established a standardized, categorybased reporting system for thyroid fineneedle aspiration fna specimens. The bethesda system for reporting thyroid cytopathology moderator dr g k parvathidevi presenter dr dhanya a n 2. Pdf bethesda categorization of thyroid nodule cytology. Aug 27, 2011 the conclusions of the meeting led to the bethesda thyroid atlas project and formed the framework for the bethesda system for reporting thyroid cytology tbsrtc.
The bethesda system for reporting thyroid cyto pathology bsrtc is a standardized reporting system for classifying thyroid fineneedle aspiration results comprising of 6 diagnostic categories with unique risks o malignancy and recommendations for clinical management. The bethesda system for reporting thyroid cytopathology is. The american thyroid association guidelines task force on thyroid nodules and. The bethesda system for reporting thyroid cytopathology tbsrtc has attempted to standardize reporting and cytological criteria in aspiration smears.
It will serve as a reference guide not just for pathologists, but also endocrinologists, surgeons, and radiologists. The bethesda system for reporting thyroid cytology tbsrtc was proposed in 2007 at the national cancer institute thyroid fine needle aspiration state of the art and science conference held in bethesda, maryland. An autonomous thyroid nodule or hot nodule is one that has thyroid function independent of the homeostatic control of the hpt axis hypothalamicpituitarythyroid axis. How to interpret thyroid fineneedle aspiration biopsy. Risk stratification of thyroid nodules with bethesda category iii. The bethesda system for reporting thyroid cytopathology categorizes thyroid cytology findings into six groups, with each group assigned a putative malignancy risk. In these biopsies not enough thyroid cells were obtained to render a diagnosis. The bethesda system for reporting thyroid cytopathology is one of the main. Definitions, criteria and explanatory notes 2010th edition, kindle edition by syed z. Malignancy rate in thyroid nodules classified as bethesda. The bethesda system for reporting thyroid cytopathology book. Bethesda classification of thyroid nodule fine needle.
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