The conclusions regarding terminology and morphologic criteria from the nci meeting led to the bethesda thyroid atlas project and form the framework for the bethesda. The terminology proposed and illustrated in this text has been widely adopted not only in the u. Thyroid fna can be used as a prognostic indicator if specific gene mutations or phenotypic alterations can be identified. The first edition of the bethesda system for reporting thyroid cytopathology was published in 2010 and has greatly influenced the practice of thyroid cytopathology. According to a 1993 article, such nodules need to be treated only if they become toxic. 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. Nov 22, 2017 thyroseq v2 can be used as a highly effective rule. Thyroid cytopathology recent advances october 21, 2017 dr. 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. In these biopsies not enough thyroid cells were obtained to render a diagnosis. Objective to address terminology and other issues related to thyroid fineneedle aspiration fna, the national cancer institute nci hosted the nci thyroid fna state of the science conference. Past, present, and future held at the october 2016 international congress of cytology in yokohama, japan. The bethesda system for reporting cervical cytology. Thyroseq v2 can be used as a highly effective rule.
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. Predominant population of microfollicles in an aspirate that does not fulfill criteria for a follicular neoplasm or suspicious for follicular neoplasm. The bethesda system for reporting thyroid cytopathology the nci conference participants acknowledged the importance of developing a uniform terminology for reporting thyroid fna results. Bethesda and bethesda classification systems in the differentiation of benign and malignant thyroid nodules. Comparison of thyroid fine needle aspiration biopsy results. This can happen when a cyst is aspirated or when the specimen is almost entirely composed of blood. The reference numbers of the included articles are listed in the parentheses. 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. The 2017 revision described herein was inspired by new data and new developments in the field of thyroid pathology. The 2017 revision reaffirms that every thyroid fna report should begin. Bethesda system for reporting thyroid cytopathology.
The copresence of follicular nonhurthle cells and hurthle cells in a same sample strongly favours benign rather than aus. Bethesda classification of thyroid nodule fine needle aspirations. Forest plot of metaanalysis on the risk of malignancy of bethesda classification i for thyroid fineneedle aspiration i2. This accounts for 10 percent of the biopsies, even in the most. 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. Application of the bethesda classification for thyroid fine. The system is widely accepted in the united states and globally.
The bethesda system for reporting thyroid cytopathology. 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. The 2017 revision of the bethesda system was simultaneously published in thyroid 2017. Thyroid thyroid cytopathologycytopathology recent advances. The bethesda system for reporting thyroid cytopathology tbsrtc was designed with a mission to standardize the process of diagnosis and management of thyroid. Fineneedle aspiration fna remains the most effective and safe method of evaluating thyroid nodules for potential surgical management. 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. The bethesda system for reporting thyroid cytopathology tbsrtc established a standardized, categorybased reporting system for thyroid. Pdf the bethesda system for reporting thyroid cytopathology. Subcategorisation of ausflus thyroid lesions as per the 2017 bethesda system for reporting thyroid cytopathology.
The bethesda system for reporting thyroid cytopathology, 2017 laila khazai 11417. Bethesda category iii represents a heterogeneous group in terms of lesion characteristics and the malignancy rates reported in the literature. The 2017 revision reaffirms that every thyroid fna report should begin with 1 of 6 diagnostic categories. The bethesda classification was introduced in 2008 to provide standardisation in the evaluation of thyroid fine needle aspiration cytology fnac. Updates to the bethesda system for reporting thyroid. Pdf the 2017 bethesda system for reporting thyroid.
Thyroid nodules ata guideline 2017 linkedin slideshare. What is the bethesda system for thyroid cytopathology used. The objective of the present study was to evaluate the. The use of the bethesda system for reporting thyroid. The most appropriate cytological classification of malignancy risk is the bethesda system for thyroid. Fine needle aspiration of thyroid nodules using the bethesda system for reporting thyroid cytopathology.
An autonomous thyroid nodule or hot nodule is one that has thyroid function independent of the homeostatic control of the hpt axis hypothalamicpituitary thyroid axis. The present study evaluates the risk of malignancy rom and risk of neoplasm ron among these. Guo a, kaminoh y, forward t, schwartz fl, jenkinson s. Jun 10, 2019 thyroid nodules tns assigned to the bethesda system categories iii and iv include numerous clinical characteristics, which increase or decrease the risk of malignancy. Thyroid fna key cytology and histology for clinicians. Subcategorisation of ausflus thyroid lesions as per the 2017. The second edition bethesda system for reporting thyroid. Thyroid sonography recommendation thyroid sonography with survey of the cervical lymph nodes should be performed in all patients with known or suspected thyroid nodules. Aug 27, 2011 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. 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. Bethesda classification of thyroid nodule fine needle.
The bethesda system for reporting thyroid cytopathology, 2017. Oct 04, 2017 thyroid nodule fna cytology should be reported using diagnostic groups outlined in the. Thyroid fna bethesda classification scheme the bethesda system for reporting thyroid cytopathology. Volume 6, issue 6, novemberdecember 2017, pages 217222. Malignancy rates for bethesda iii subcategories in thyroid.
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. N2 the bethesda system for reporting thyroid cytopathology tbsrtc established a standardized, categorybased reporting system for thyroid fineneedle aspiration fna specimens. April 5, 2017 corresponding author mi kyung shin, md, phd department of pathology, hallym university. In fact, these indeterminate categories rarely include aggressive variants of papillary thyroid cancer because more than 90% are reported in categories 5 and 6, 46 and the rate of follicular thyroid cancer is low. C professor, department of pathology mcgill university director, cytopathology laboratory. Atypia of undetermined significance or follicular lesion of undetermined significance 3 6% of thyroid fnas broad category of not easily classified fnas, including. Patients with iii and iv category of the bethesda system. The american thyroid association guidelines task force on thyroid nodules and. The conclusions regarding terminology and morphologic criteria from the nci meeting led to the bethesda thyroid atlas project and form the framework for the bethesda system for reporting thyroid. Examining the bethesda criteria risk stratification of thyroid nodules. The 2017 bethesda system for reporting thyroid cytopathology. Thyroid nodules tns assigned to the bethesda system categories iii and iv include numerous clinical characteristics, which increase or decrease the risk of malignancy.
Arch pathol lab medvol 140, october 2016 bethesda classification for thyroid fnakrauss et al. Bethesda classification of thyroid nodule fine needle aspirations i. Most thyroid diseases are nodular and have been investigated using ultrasoundguided fine needle aspiration biopsy fnab, the reports of which are standardized by the bethesda system. Bethesda system for reporting thyroid cytopathology 37. The bethesda system for reporting thyroid cytopathology tbsrtc, a uniform and standardized reporting system for thyroid fine needle aspiration fna, was originally established in 2009 and updated in 2017. The bethesda system for reporting of thyroid cytopathology. Malignancy rates for bethesda iii and iv thyroid nodules. 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. 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 thyroid cytopathology tbsrtc established a standardized, categorybased reporting system for thyroid fineneedle aspiration fna specimens.
The bethesda system for reporting thyroid cytopathology 2nd edition pdf. Nov 01, 2017 the bethesda system for reporting thyroid cytopathology tbsrtc established a standardized, categorybased reporting system for thyroid fineneedle aspiration fna specimens. An inspiration for the thyroid proposal was the bethesda system for reporting cervical cytology interpretations, first developed at an nci workshop in 1988 and. Blood and lymphatic system disorders ctcae term grade 1 grade 2 grade 3 grade 4 grade 5. Nondiagnostic cytology recommendation a for a nodule with an initial nondiagnostic cytology result, fna should be repeated with us guidance and, if available, onsite cytologic evaluation strong. Common terminology criteria for adverse events ctcae. Aims the 2017 bethesda system for reporting thyroid cytopathology tbsrtc recommends subclassification of atypia of undetermined significance ausfollicular lesion of undetermined significance flus into six subcategories. Comparison of thyroid fine needle aspiration biopsy.
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. Methods all thyroid aspirates reported as ausflus over a 4. The bethesda system for reporting thyroid cytopathology, 2nd ed. T1 the 2017 bethesda system for reporting thyroid cytopathology. The 2017 revision reaffirms that every thyroid fna report should begin with 1. Feb 06, 2018 the most appropriate cytological classification of malignancy risk is the bethesda system for thyroid. Of the 2630 patients diagnosed with ausflus on initial fnac, 510 19. Application of the bethesda classification for thyroid. Subcategorisation of ausflus thyroid lesions as per the.
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