The first edition of the bethesda system for reporting thyroid cytopathology was published in 2010 and has greatly influenced the practice of thyroid cytopathology. C professor, department of pathology mcgill university director, cytopathology laboratory. The prevalence of thyroid nodules tns increases linearly with age 1 and has been found to be as high as 67%. Bethesda category v is considered 60% 75% likely to be malignant. The new edition has been expanded and revised to take into. The name comes from the location bethesda, maryland of the conference that established the system. F the bethesda system for reporting thyroid cytopathology. The impact of noninvasive follicular variant of papillary thyroid carcinoma on rates of. The bethesda system for reporting thyroid cytopathology tbsrtc established a standardized, categorybased reporting system for thyroid. Proposed modifications and updates for the thyroid. Atypia of undetermined significance or follicular lesion of undetermined significance 3 6% of thyroid fnas broad category of not easily classified fnas, including. Thyroid cytopathology recent advances october 21, 2017 dr. 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. The 2017 bethesda system for reporting thyroid cytopathology.
Reporting by bethesda system is an accurate and precise tool for the diagnosis of thyroid lesion on cytology, which triages the patients for clinical management. It serves as a reference guide not just for pathologists, but also endocrinologists, surgeons, and radiologists. Pdf bethesda categorization of thyroid nodule cytology. Thyroid bethesda system for reporting thyroid cytology from an international panel william c. Bethesda classification of thyroid nodule fine needle aspirations. Nature of the nodule location, size, cystic component skills of operator and reader. The bethesda system for reporting thyroid cyto pathology bsrtc is a standardized reporting system for classifying thyroid fineneedle aspiration results comprising of 6 diagnostic categories with unique risks o malignancy and recommendations for clinical management. Using tbsrtc, cytopathologists can communicate their interpretations to the referring physician in terms that are succinct, unambiguous, and clinically. This can happen when a cyst is aspirated or when the specimen is almost entirely composed of blood. Classification bethesda 2020 bethesda thyroid classification 2017 bin. Description of the book the bethesda system for reporting thyroid cytopathology. Discussion bethesda system is very sensitive and specific in diagnosing pediatric thyroid nodules. Aug 07, 2019 the first edition of the bethesda system for reporting thyroid cytopathology was published in 2010 and has greatly influenced the practice of thyroid cytopathology. 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. The bethesda system for reporting cervical vaginal cytologic diagnoses. An inspiration for the thyroid proposal was the bethesda system for reporting cervical cytology interpretations, first developed at an nci workshop in 1988 and. The bethesda system for reporting thyroid cytopathology will provide the reader with a unified approach to diagnosing and reporting thyroid fna interpretations. Association of thyroid nodule size and bethesda class with. Thyroid nodules are nodules raised areas of tissue or fluid which commonly arise within an otherwise normal thyroid gland. 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 cervical cytology pdf. Bethesda system, cervical cytology, vaginal gynecologic nomenclature. They may be hyperplastic or tumorous, but only a small percentage of thyroid tumors are malignant. The authors are all consultant cellular pathologists, reporting thyroid histology andor cytology, some of. The 2017 revision described herein was inspired by new data and new developments in the field of thyroid pathology. Thyroid cytologybethesda classification part 1 youtub. Repeating fnac with ultrasoundguidance in more than 3 months. Ata initiatives to reduce the extent of surgery for many low risk thyroid cancers 4 cm or smaller, without extra thyroidal extension and lacking regional nodal metastasis and decreased routine use of postoperative radioactive iodine treatment increasingly raise the possibility for lobectomy as initial surgical management. The american thyroid association guidelines task force on thyroid nodules and. Proposed modifications and updates for the thyroid bethesda. To address this, the bethesda system for reporting thyroid cytopathology tbsrtc was recently introduced for unifying the terminology and morphologic criteria along with the corresponding risk of malignancy. Document name guidance on the reporting of thyroid cytology specimens version number 2 produced by dr p cross chair, dr a chandra, dr t giles, dr s johnson, dr g kocjan, dr d poller and professor t stephenson. 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. This can be used as a primary modality in the evaluation of thyroid lesions as the accuracy rate is fairly good.
Despite the frequent occurrence of thyroid nodules, the majority. The bethesda system for reporting thyroid cytopathology. Malignant 3 7% of thyroid fnas papillary thyroid carcinoma poorly differentiated carcinoma medullary thyroid carcinoma undifferentiated anaplastic carcinoma squamous cell carcinoma carcinoma with mixed features specify metastatic carcinoma nonhodgkin lymphoma other risk of malignancy. The bethesda system for reporting thyroid cytopathology the nci conference participants acknowledged the importance of developing a uniform terminology for reporting thyroid fna results. Jan 24, 2017 the bethesda system for reporting thyroid cytopathology moderator dr g k parvathidevi presenter dr dhanya a n 2. Predominant population of microfollicles in an aspirate that does not fulfill criteria for a follicular neoplasm or suspicious for follicular neoplasm. Guidance on the reporting of thyroid cytology specimens. Bethesda classification and cytohistological correlation of thyroid. Full text the bethesda system for reporting thyroid cytopathology. 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 recently introduced and much anticipated bethesda system for reporting thyroid cytopathology.
Unique document number g089 document name guidance on the reporting of thyroid cytology specimens version number 2 produced by dr p cross chair, dr a chandra, dr t giles, dr s johnson, dr g kocjan, dr d poller and professor t stephenson. Thyroid fna suffers from a reporting confusion due to multiplicity of category terminologies. Nodules that grow larger or produce symptoms may eventually need medical care. Bethesda classification of thyroid nodule fine needle aspirations i. 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 bethesda system for reporting thyroid cytopathology is. This atlas is the offspring of the the national cancer institute nci thyroid fine needle aspiration fna state of the science conference, hosted by the nci and organized by dr. Aug 31, 2010 thyroid fna suffers from a reporting confusion due to multiplicity of category terminologies. 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. The bethesda system for reporting thyroid cytopathology tbsrtc established a standardized, categorybased reporting.
Fineneedle aspiration fna remains the most effective and safe method of evaluating thyroid nodules for potential surgical management. Click on document the bethesda system for reporting thyroid cytopathology. Rapid on site evaluation helps assess adequacy after sampling. Bethesda system for thyroid free download as powerpoint presentation. The bethesda system for reporting thyroid cytopathology moderator dr g k parvathidevi presenter dr dhanya a n 2. Contents introduction bethesda categories nondiagnostic or unsatisfactory benign atypia of undetermined significance or follicular lesion of undetermined significance follicular neoplasm or suspicious for a. Bethesda system for thyroid pathology diseases and. The bethesda system for reporting cervical cytology.
Cancer institute, bethesda, maryland, united states published guidelines known as bethesda system of reporting thyroid cytopathology tbsrtc. The bethesda system tbs is a system for reporting cervical or vaginal cytologic diagnoses, used for reporting pap smear results. 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. An update to the bethesda system for reporting thyroid nodule cytopathology is set to alter clinical practice, with the primary aim of reducing the number of unnecessary thyroid surgeries. This book offers clear, uptodate guidance on how to report cytologic findings in cervical, vaginal and anal samples in accordance with the 2014 bethesda system update. This atlas is the offspring of the the national cancer institute nci thyroid fine needle aspiration fna state of the science conference, hosted by. The format of the original, and now the 2017, tbsrtc follows the familiar format first established by the bethesda system for reporting cervical. Summaries for patients from clinical thyroidology from recent articles in clinical thyroidology table of contents pdf file for saving and printing. To utilize molecular testing as an adjunctive test in thyroid fna. This accounts for 10 percent of the biopsies, even in the most.
The sensitivity and specificity of thyroid fna in pediatric population is 100% and 94. Bethesda classification of thyroid nodule fine needle. The bethesda system for reporting thyroid cytopathology definitions, criteria, and explanatory notes, 2e original publisher pdf june 7, 2019 endocrinology, histology, medical. It was introduced in 1988 and revised in 1991, 2001, and 2014.
The bethesda system for reporting thyroid cytopathology, 2017. The bethesda system has been used to classify thyroid cytology in 6 categories besides presenting. Classification bethesda 2020 bethesda thyroid 2020 free. The terminology proposed and illustrated in this text has been widely adopted not only in the u. To advise clinicians on the implications of the each diagnostic category of the bethesda classification system and the results of molecular testing. Faquin, md, phd director, head and neck pathology massachusetts eye and ear massachusetts general hospital professor of pathology harvard medical school. 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. Classifying your thyroid fna specimens using bethesda. Classification of thyroid fineneedle aspiration cytology into bethesda. 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. Notably, aus qualifiers of cannot exclude papillary thyroid carcinoma and cannot exclude follicular neoplasm appear to carry a higher risk of.
Classification of thyroid fineneedle aspiration cytology into. It is a six category scheme with individual risks of malignancy that influence management paradigms. Oct 15, 2015 the bethesda system for reporting thyroid cytopathology bsrtc dr. The discussions and conclusions regarding terminology and morphologic criteria 1, 2 from the meeting were summarized in publications by baloch et al. Classification bethesda 2020 bethesda thyroid 2020. The bethesda system for reporting thyroid cytopathology, 2nd edition, 2018. The recent reclassification of some thyroid neoplasms as noninvasive follicular thyroid neoplasm with papillarylike nuclear features niftp has im plications for. Fine needle aspiration has been widely accepted as diagnostic procedure of choice in assessment of nontoxic thyroid nodule find. Scribd is the worlds largest social reading and publishing site. In these biopsies not enough thyroid cells were obtained to render a diagnosis. Thyroid nodules the bethesda classification for thyroid biopsies is effective for clinical management of thyroid nodules. According to a 1993 article, such nodules need to be treated only if they become toxic.
Thyroid cytopathology reporting by bethesda system. The bethesda system for reporting of thyroid cytopathology. History introduced and formed in 2007, nci thyroid fna state of science conference bethesda, maryland, by various cytopathologists and summarised by baloch et al. Ptc is the most common malignancy in pediatric thyroid nodules.
V, and vi with the clinical and pathological features of thyroid nodules surgically confirmed as conventional. Additionally, the bethesda system is used for cytopathology of thyroid nodules. The bethesda system for reporting cervical cytology pdf file. The bethesda system for reporting thyroid cytopathology bsrtc dr. Ceff 200116 4 v5 final 1 introduction about 40% of the general population have single or multiple thyroid nodules, whereas the incidence of thyroid malignancy is 24%. The first draft of the committees summary documents. Impact of mutational testing on the diagnosis and management of patients with cytologically indeterminate thyroid nodules. Small, asymptomatic nodules are common, and often go unnoticed. Bethesda made a series of questionable choices at its e3 press conference, like holding the event at 9pm local share all sharing options for. The bethesda system for reporting thyroid cytopathology tbsrtc was designed with a mission to standardize the process of diagnosis and management of thyroid lesions by fna cytology fnac. W ith its inception, the bethesda system for reporting thyroid cytopathology tbsrtc established a standardized reporting system with a limited number of diagnostic categories for thyroid fineneedle aspiration fna specimens. Papillary thy carcinoma bethesda category v suspicious. It will serve as a reference guide not just for pathologists, but also endocrinologists, surgeons, and radiologists.
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