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Categorization of thyroid lesions FNAC in Bethesda system: An institutional study in southern Rajasthan

Background: Fine needle aspiration cytology (FNAC) is an important screening test for thyroid lesions. The Bethesda system for reporting thyroid cytopathology 2016 (TBSRTC) was revised by International Congress of cytology in Yokohama, Japan which is a standardized category-based reporting system of FNA specimens. There are six categories each of which predicts malignancy risk and recommends clinical management. Aim of this study was to analyze the diagnostic utility of Bethesda system in reporting of thyroid FNAC. Method: In an institution based cross sectional study of FNAC done on 410 patients from 2017 to 2019 presenting with thyroid lesion were examined and categorized as per TBSRTC. Results: The distribution of patients in the six categories was 4.63% were Category I (nondiagnostic), 90.0% Category II (benign), 0.73% were Category III (atypia of undetermined significance), 2.44% were Category IV (suspicious for follicular neoplasm), 0.49% were Category V (suspicious for malignancy), and 1.71% were Category VI (malignant). Conclusion: The Bethesda system is standardized system of reporting thyroid cytopathology; therefore, prompts the recommended clinical management of that category. These data extend the utility of TBS classification by fostering an improved understanding of the risk posed by any confirmed malignancy.