DOI: 10.36347/sjams.2016.v04i03.056

Pages: 916-923

Fine needle aspiration cytology (FANC) of thyroid is a gold standard used in the initial evaluation of thyroid nodules. The Bethesda system for reporting thyroid Cytopathology (TBSRTC) classifies smears into 6 categories each having a malignancy risk and management guideline. When correlated with sonography findings and thyroid function tests(TFT) its diagnostic accuracy is improved. The objective of this study was to classify the thyroid cytology smears by TBSRTC and to correlate these categories with the thyroid function tests. Malignancy risk was calculated for each category in surgically resected specimens. This was prospective study of 287 patients who underwent thyroid FNAC along with sonography and thyroid function tests. All cases were classified into nondiagnostic, benign, atypia of undetermined significance, follicular neoplasm or suspicious of follicular neoplasm and malignant categories. Statistical analysis was done using SPSS software and chi square test was applied to study the statistical significance between TFT and Bethesda categories. The distribution of various categories from 287 evaluated thyroid nodules was as follows 0.68% Non-Diagnostic, 88% Benign, 3.4% Atypia of undetermined significance (AUS) / Follicular lesion of undetermined of significance (FLUS), 4.5% Follicularneoplasm, 1.4% Suspicious for malignancy and 2.06% malignant. Sensitivity, specificity, positive predictive value and negative predictive value were 96%,78%,76%, 97% and accuracy was 85%. Thyroid function tests were altered in 42.06% cases in the benign category whereas the malignant category had normal thyroid function test. TBSRTC is an excellent reporting system for thyroid fine needle aspirates. It also provides clear management guidelines to clinicians to go for follow up or surgery.