The bethesda system for reporting thyroid cytopathology. The bethesda system for reporting thyroid cytopathology is. Implied risk of malignancy and recommended clinical management diagnostic category risk of malignancy % usual management nondiagnostic or unsatisfactory repeat fna with ultrasound guidance benign 03% clinical followup. Bethesda system for reporting thyroid cytopathology bsrtc was introduced to streamline the reporting of thyroid aspirates. Malignancy rates for bethesda iii and iv thyroid nodules. The bethesda system for reporting thyroid cytopathology tbsrtc established a standardized, categorybased reporting system for thyroid.
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. Pdf the bethesda system for reporting thyroid cytopathology. The name comes from the location bethesda, maryland of the conference that established the system. The terminology proposed and illustrated in this text has been widely adopted not only in the u. It has high predictive value, reproducibility, and improved clinical significance. Twentythree items of feedback were received and the document was. The study was aimed to evaluate the diagnostic utility and reproducibility of tbsrtc at our. To address the terminology and other issues related to thyroid fna, the national cancer institute nci hosted the the nci thyroid fine needle aspiration state of the science conference in 2007 at bethesda, maryland. The bethesda system for reporting thyroid cytopathology is the system used to report whether the thyroid cytological specimen is benign or malignant. The bethesda system for reporting thyroid cytopathology uniform terminology for reporting thyroid cytopathology involved physicians caring for and managing pts with thyroid nodules associated risk of malignancy rom with diagnostic categories atlas published in 2010. One of the major advantages of this framework is its association with defined risks of malignancy, allowing standardized management algorithms for each diagnosis.
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. Comments this document replaces the 1st edition of guidance on the reporting of thyroid cytology specimens, published in 2009. The bethesda system for reporting thyroid cytopathology tbsrtc is a significant step to standardize the reporting of thyroid fine needle aspiration fna. Current status and diagnostic values of the bethesda system. The use of the bethesda system for reporting thyroid. Idris tolgay ocal and mohiedean ghofrani, the bethesda system for reporting thyroid cytopathology bsrtc, management of thyroid nodules and differentiated thyroid cancer, 10. The bethesda system for reporting thyroid cytopathology 2nd edition pdf. The pap test and bethesda 2014 american cancer society. Correlation between ultrasoundbased tirads and bethesda system for reporting thyroidcytopathology. The proposed histologic reclassification of noninvasive follicular variant of papillary thyroid carcinoma as something other than carcinoma will significantly affect the implied risk of malignancy for the indeterminate diagnostic categories in the bethesda system for reporting thyroid cytopathology. The bethesda system for reporting thyroid cytopathology the nci conference participants acknowledged the importance of developing a uniform terminology for reporting thyroid fna results. However, these results may not be generalisable to aus flus or fnsfn cohorts, even though the rates are remarkedly similar to the rates observed in our study. Bethesda system for reporting thyroid cytopathology. Implementation of the bethesda system for reporting.
Pdf correlation between ultrasoundbased tirads and. Implementation of the bethesda system of reporting thyroid cytopathology in a referral center. Updates to the bethesda system for reporting thyroid. We explored the current status of tbsrtc in an area where most thyroid malignancies are papillary carcinomas. The history of the bethesda system tbs for reporting cervical cytology goes back almost 3 decades. Thyroid cytopathology reporting by the bethesda system. Thyroid fna key cytology and histology for clinicians. Jan 24, 2017 the bethesda system for reporting thyroid cytopathology moderator dr g k parvathidevi presenter dr dhanya a n 2. The discussions and conclusions regarding terminology and morphologic criteria 1, 2 from the meeting were summarized in publications by baloch et al. Original research open access diagnostic accuracy of. 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. The bethesda system for reporting thyroid cytopathology tbsrtc provides a 6. The bethesda system 2010 recommendations for thyroid fine needle aspiration fna reporting also include a specimen adequacy component be present on nongyn cytopathology reports.
The bethesda system for reporting thyroid cytopathology tbsrtc, 1 a uniform, 6tiered reporting system with standardized nomenclature and definitions, has been widely used for the assessment and interpretation of thyroid specimens obtained from adult patients. Fineneedle aspiration fna remains the most effective and safe method of evaluating thyroid nodules for potential surgical management. 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. Fine needle aspiration fna cytology is a widely utilized tool for the diagnosis of thyroid lesions with a high degree of sensitivity, specificity and diagnostic accuracy 1, 2. Assessment of the bethesda system for reporting thyroid. In accordance with the colleges prepublications policy, this document was on college website for consultation from 27 october to 24 november 2015. Contents introduction bethesda categories nondiagnostic or unsatisfactory benign atypia of undetermined significance or follicular lesion of undetermined significance follicular neoplasm or suspicious for a. Most studies validating the bethesda system for reporting thyroid cytopathology tbsrtc have been conducted in western countries. Bethesda system for reporting thyroid cytopathology in. Thyroid thyroid cytopathologycytopathology recent advances. Oncology journal of india free full text articles from.
C professor, department of pathology mcgill university director, cytopathology laboratory. What is the bethesda system for thyroid cytopathology used. The bethesda system for reporting thyroid cytopathology 2nd. The bethesda system for reporting thyroid cytopathology tbsrtc has been widely adopted since its introduction. Guidance on the reporting of thyroid cytology specimens.
The bethesda system for reporting thyroid cytopathology thyroid. The bethesda system for reporting cervical cytology. The bethesda system for reporting thyroid cytopathology tbsrtc established a standardized, categorybased reporting system for thyroid fineneedle aspiration fna specimens. Definitions, criteria, and explanatory notes ebook description the first edition of the bethesda system for reporting thyroid cytopathology was published in 2010 and has greatly influenced the practice of thyroid cytopathology. A uniform reporting system for thyroid fna will facilitate effective communication among cytopathologists, endocrinologists, surgeons. Thyroid fna bethesda classification scheme the bethesda system for reporting thyroid cytopathology. It serves as a reference guide not just for pathologists, but also endocrinologists, surgeons, and radiologists. The bethesda system for reporting of thyroid cytopathology. 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. According to the bethesda system for reporting thyroid cytopathology, a specimen is defined as nondiagnostic if it fails to meet the adequacy criteria at least 6 groups. With its inception, the bethesda system for report ing thyroid cytopathology tbsrtc established a standardized reporting system with a limited number of di agnostic categories for thyroid. The clinical team is faced with different risk of malignancies rom associated with for bethesda categories iii to vi, especially iii and iv.
An inspiration for the thyroid proposal was the bethesda system for reporting cervical cytology interpretations, first developed at an nci workshop in 1988 and. May 2018surgical pathologists take their tumor nomenclature from the who classification of tumours, but cytopathologists take their terminology from where the consensus groups convenedbethesda, paris, milan, and yokohamato formulate. The bethesda system for reporting thyroid cytopathology edmund s. The bethesda system for reporting thyroid cytopathology bsrtc 3, 4 tried to modulate the risk of malignancy by dividing the indeterminate category into atypia of undetermined significance or. In this study, we aimed to report our experience using this reporting system at a college of american pathologists cap. Pdf the 2017 bethesda system for reporting thyroid. The bethesda system for reporting thyroid cytopathology is effective for clinical management of thyroid nodules jerome m. 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 american thyroid association guidelines task force on thyroid nodules and.
As a response to the need for standardization, the bethesda system for reporting thyroid cytopathology. The 2017 bethesda system for reporting thyroid cytopathology. The bethesda system for reporting thyroid cytopathology tbsrtc1 is now in its second edition. What is the bethesda system for thyroid cytopathology used in. The bethesda system for reporting thyroid cytopathology tbsrtc, which attempts to standardize reporting and cytological criteria for. In addition, other published cohorts with a smaller size have reported a malignancy risk for ausflus nodules as high as 46% 15, 17. The bethesda system for reporting thyroid cytopathology, 2017. The bethesda system for reporting thyroid cytopathology tbsrtc has attempted to standardize reporting and cytological criteria in aspiration smears. Incidentally detected lesions in the surgical specimens that were not the target of the thyroid fna were excluded from the analysis. Using tbsrtc, cytopathologists can communicate their interpretations to the referring physician in terms that are succinct, unambiguous, and clinically.
This article is jointly published in journal of the american society of cytopathology, cancer cytopathology, journal of lower genital tract disease, and. We aimed to evaluate the disease spectrum of thyroid cytopathology and correlation of bsrtc with final histopathology in our setup. It will serve as a reference guide not just for pathologists, but also endocrinologists, surgeons, and radiologists. 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. It is expected that the many benefits, clinical and investigational, of the bethesda cervical terminology will also apply to the bethesda thyroid terminology. The bethesda system tbs is a system for reporting cervical or vaginal cytologic diagnoses, used for reporting pap smear results. The atlas format is similar to that of the bethesda system for reporting thyroid cytopathology. Definitions, criteria and explanatory notes 2010th edition, kindle edition by syed z. Original research open access diagnostic accuracy of bethesda.
The first edition of the bethesda system for reporting thyroid cytopathology was published in 2010 and has greatly influenced the practice of thyroid cytopathology. 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. This book emphasizes on the basic ultrasound characteristics of thyroid nodules, the cytology of common and uncommon neoplastic and nonneoplastic processes according to the bethesda system for reporting thyroid cytopathology, and provides a technical guide for how to perform ultrasoundguided fna of thyroid nodules to obtain adequate material. The bethesda system for reporting thyroid cytopathology is the system used to report whether the thyroid cytological specimen is benign or malignant on fineneedle aspiration cytology fnac. F the bethesda system for reporting thyroid cytopathology. For clarity of communication, the bethesda system for reporting thyroid cytopathology recommends that each report begin with one of the six general diagnostic categories. Each of the categories has an implied cancer risk that links it to an appropriate clinical management guideline. Improved imaging techniques and increased surveillance for nonthyroid malignancies have increased the detection of incidental nodules. The bethesda system 2001 recommendations include a specimen adequacy component be present on gyn cytopathology reports.
The bethesda system for reporting thyroid cytopathology, 2017 laila khazai 11417. 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. Bethesda system category description risk of malignancy recommendation. Impact of mutational testing on the diagnosis and management of patients with cytologically indeterminate thyroid nodules. The most appropriate cytological classification of malignancy risk is the bethesda system for thyroid cytopathology. Thyroid cytopathology recent advances october 21, 2017 dr. Definitions, criteria, and explanatory notes kindle edition by nayar, ritu, wilbur, david c download it once and read it on your kindle device, pc, phones or tablets. The bethesda system for reporting thyroid cytopathology will provide the reader with a unified approach to diagnosing and reporting thyroid fna interpretations. Preoperative diagnosis of thyroid nodules using the bethesda system for reporting thyroid cytopathology. The meeting took place on october 22 and 23, 2007 in bethesda, maryland and was comoderated by susan j.
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