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. Forest plot of metaanalysis on the risk of malignancy of bethesda classification i for thyroid fineneedle aspiration i2. The reference numbers of the included articles are listed in the parentheses. 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 present study evaluates the risk of malignancy rom and risk of neoplasm ron among these. 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. Subcategorisation of ausflus thyroid lesions as per the. The bethesda system for reporting thyroid cytopathology, 2017.
Bethesda system for reporting thyroid cytopathology. Thyroid fna can be used as a prognostic indicator if specific gene mutations or phenotypic alterations can be identified. Past, present, and future held at the october 2016 international congress of cytology in yokohama, japan. The bethesda system for reporting thyroid cytopathology will provide the reader with a unified approach to diagnosing and reporting thyroid fna interpretations. 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 tbsrtc, a uniform and standardized reporting system for thyroid fine needle aspiration fna, was originally established in 2009 and updated in 2017. The american thyroid association guidelines task force on thyroid nodules and. The 2017 revision reaffirms that every thyroid fna report should begin with 1.
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. The 2017 revision reaffirms that every thyroid fna report should begin with 1 of 6 diagnostic categories. 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. 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.
The bethesda system for reporting thyroid cytopathology 2nd edition pdf. The bethesda system for reporting thyroid cytopathology the nci conference participants acknowledged the importance of developing a uniform terminology for reporting thyroid fna results. Nov 22, 2017 thyroseq v2 can be used as a highly effective rule. This accounts for 10 percent of the biopsies, even in the most. Bethesda classification of thyroid nodule fine needle aspirations.
Bethesda classification of thyroid nodule fine needle. Guo a, kaminoh y, forward t, schwartz fl, jenkinson s. Patients with iii and iv category of the bethesda system. Bethesda and bethesda classification systems in the differentiation of benign and malignant thyroid nodules. Bethesda category iii represents a heterogeneous group in terms of lesion characteristics and the malignancy rates reported in the literature. C professor, department of pathology mcgill university director, cytopathology laboratory. 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. Methods all thyroid aspirates reported as ausflus over a 4. Thyroid nodules ata guideline 2017 linkedin slideshare. Feb 06, 2018 the most appropriate cytological classification of malignancy risk is the bethesda system for thyroid. Comparison of thyroid fine needle aspiration biopsy results. Subcategorisation of ausflus thyroid lesions as per the 2017. 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.
Arch pathol lab medvol 140, october 2016 bethesda classification for thyroid fnakrauss et al. The 2017 revision of the bethesda system was simultaneously published in thyroid 2017. 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 classification was introduced in 2008 to provide standardisation in the evaluation of thyroid fine needle aspiration cytology fnac. Predominant population of microfollicles in an aspirate that does not fulfill criteria for a follicular neoplasm or suspicious for follicular neoplasm. The most appropriate cytological classification of malignancy risk is the bethesda system for thyroid. The bethesda system for reporting of thyroid cytopathology. The bethesda system for reporting thyroid cytopathology tbsrtc established a standardized, categorybased reporting system for thyroid fineneedle aspiration fna specimens. The copresence of follicular nonhurthle cells and hurthle cells in a same sample strongly favours benign rather than aus. 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. 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 system for reporting thyroid cytopathology 37. Examining the bethesda criteria risk stratification of thyroid nodules.
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. The objective of the present study was to evaluate the. Pdf the bethesda system for reporting thyroid cytopathology. 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. What is the bethesda system for thyroid cytopathology used. Updates to the bethesda system for reporting thyroid. Comparison of thyroid fine needle aspiration biopsy. Of the 2630 patients diagnosed with ausflus on initial fnac, 510 19. 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. The 2017 revision described herein was inspired by new data and new developments in the field of thyroid pathology. Subcategorisation of ausflus thyroid lesions as per the 2017 bethesda system for reporting thyroid cytopathology. 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. According to a 1993 article, such nodules need to be treated only if they become toxic.
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. Thyroid fna bethesda classification scheme the bethesda system for reporting thyroid cytopathology. The first edition of the bethesda system for reporting thyroid cytopathology was published in 2010 and has greatly influenced the practice of thyroid cytopathology. This can happen when a cyst is aspirated or when the specimen is almost entirely composed of blood.
The 2017 bethesda system for reporting thyroid cytopathology. April 5, 2017 corresponding author mi kyung shin, md, phd department of pathology, hallym university. Thyroid thyroid cytopathologycytopathology recent advances. Blood and lymphatic system disorders ctcae term grade 1 grade 2 grade 3 grade 4 grade 5. 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. Thyroid sonography recommendation thyroid sonography with survey of the cervical lymph nodes should be performed in all patients with known or suspected thyroid nodules. The bethesda system for reporting cervical cytology. 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 system is widely accepted in the united states and globally. The 2017 revision reaffirms that every thyroid fna report should begin. The bethesda system for reporting thyroid cytopathology tbsrtc established a standardized, categorybased reporting system for thyroid. 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. The bethesda system for reporting thyroid cytopathology, 2nd ed.
Recently, the nci, in 2017, has published a revision and update on the reporting for thyroid cytology based on the symposium entitled the bethesda system for reporting thyroid cytopathology tbsrtc. 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. Volume 6, issue 6, novemberdecember 2017, pages 217222. Fineneedle aspiration fna remains the most effective and safe method of evaluating thyroid nodules for potential surgical management. The terminology proposed and illustrated in this text has been widely adopted not only in the u. Nov 01, 2017 the bethesda system for reporting thyroid cytopathology tbsrtc established a standardized, categorybased reporting system for thyroid fineneedle aspiration fna specimens. Application of the bethesda classification for thyroid. The bethesda system for reporting thyroid cytopathology tbsrtc was designed with a mission to standardize the process of diagnosis and management of thyroid. The bethesda system for reporting thyroid cytopathology. Application of the bethesda classification for thyroid fine. Malignancy rates for bethesda iii and iv thyroid nodules. Atypia of undetermined significance or follicular lesion of undetermined significance 3 6% of thyroid fnas broad category of not easily classified fnas, including. Bethesda classification of thyroid nodule fine needle aspirations i.
The bethesda system for reporting thyroid cytopathology, 2017 laila khazai 11417. An inspiration for the thyroid proposal was the bethesda system for reporting cervical cytology interpretations, first developed at an nci workshop in 1988 and. Pdf the 2017 bethesda system for reporting thyroid. 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. The second edition bethesda system for reporting thyroid. In these biopsies not enough thyroid cells were obtained to render a diagnosis. T1 the 2017 bethesda system for reporting thyroid cytopathology. Malignancy rates for bethesda iii subcategories in thyroid. Oct 04, 2017 thyroid nodule fna cytology should be reported using diagnostic groups outlined in the.
N2 the bethesda system for reporting thyroid cytopathology tbsrtc established a standardized, categorybased reporting system for thyroid fineneedle aspiration fna specimens. Thyroseq v2 can be used as a highly effective rule. Thyroid cytopathology recent advances october 21, 2017 dr. Fine needle aspiration of thyroid nodules using the bethesda system for reporting thyroid cytopathology. The use of the bethesda system for reporting thyroid.
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