ABSTRACT
Fine-needle aspiration cytology of thyroid is a simple, minimally invasive, cost effective, readily available, reliable, time saving and an easy to perform outpatient procedure.1 The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is a six category scheme of thyroid cytopathology reporting.2 FNAC in conjunction with thyroid hormonal profile helps in assessing stage of the disease as hyperthyroid, hypothyroid or euthyroid3. It is very helpful in deciding the treatment options for the patient.METHODSThis is a prospective study of 125 fine needle aspirations (FNA) of thyroid nodules. All fine needle aspiration cytology (FNAC) diagnosis were classified according to age and gender, cytological findings and TBSRTC categories. All TBSRTC categories were correlated with thyroid function test results.RESULTSThe distribution of various categories from 125 evaluated thyroid nodules was as follows: 6.4% Non-Diagnostic or Unsatisfactory (ND/UNS), 80% benign, 2.4% Atypia of Undetermined Significance or Follicular Lesion of Undetermined Significance (AUS/FLUS), 4% Follicular Neoplasm (FN), 4% Suspicious for Malignancy (SFM), and 3.2% Malignant. Maximum cases with altered TFT were found in category II. Whereas in category V (5/5) & in category VI (4/4), all cases were euthyroid & not a single case of altered Thyroid Function Test (TFT) was found. Among the 16 cases of thyroiditis, majority of the cases was hypothyroid.CONCLUSIONSTBSRTC is an excellent reporting system for thyroid FNA. It also provides clear management guidelines to clinicians to go for follow-up FNAC or surgery. Diagnostic challenges arise when aspirate samples are quantitatively or qualitatively suboptimal and, in such situations, clinical and TFT correlations are immensely helpful. Alteration in thyroid function tests is associated with benign conditions mostly in thyroiditis in which hypothyroid state can aid in the diagnosis of the benign lesions.