ABSTRACT
Introduction: Thyroid swellings are a common clinical problem. The Bethesda system of FNAC has been used for the past 5-6 decades for the investigation of thyroid lesions. This system helps in categorising thyroid lesions and also suggests possible management. Histopathology is the gold standard for confirming diagnosis. Aims and Objectives: To determine the incidence of thyroid lesions according to age and sex. To compare cytological diagnosis according to the Bethesda system of reporting with histological diagnosis and determine accuracy. Materials and methods: This is a study done over a period of 5 years from January 2016 to December 2020 in the department of pathology in a medical college in a rural area. The number of thyroid aspirations done were 232. Smears were classified as per The Bethesda system. Cytological and histopathological findings were correlated in 50 cases that underwent surgery. Cases with diagnostic discrepancy were reviewed. The sensitivity and specificity, negative predictive value, positive predictive value and diagnostic accuracy values were calculated using standard statistical formulae. Results: The thyroid lesions on cytology in the nondiagnostic, Benign, Atypia of unknown significance, Follicular neoplasia, Suspicious for malignancy and malignant category were 3.4%, 81.89%, 1.72%, 7.7%, 0.8% and 4.3% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy in our study was 78%, 84%, 78%, 87% and 84% respectively Conclusion: The Bethesda system of classification of thyroid lesions on cytology helps in the diagnosis of thyroid lesions and their further management. Histopathological correlation helps in evaluating diagnostic accuracy and helps in quality assurance.