RESUMO
Background: The Bethesda system for reporting thyroid cytology (TSBRTC) was devised by the National Cancer Institute (NCI) to obtain uniformity, reproducibility and a defined management protocol while dealing with thyroid lesions. This study was undertaken with the aim to see the benefits of adopting TBSRTC in the diagnosis of thyroid FNAC, and identify the malignancy risk of each category.Methods: This cross-sectional study was conducted in Indira Gandhi Medical College, Shimla, Himachal Pradesh from June 2016 to July 2017 on 181 thyroid FNACs which were reported according to the Bethesda system for reporting thyroid cytopathology (TBSRTC) under six categories: (I) non-diagnostic/unsatisfactory (II) benign (III) atypia of undetermined significance/follicular lesion of undetermined significance (IV) follicular neoplasm/suspicious for follicular neoplasm (specify if Hurthle cell (oncocytic) type (V) suspicious for malignancy (VI) malignant. Histopathological diagnosis was available for 65 cases where thyroidectomy was performed. Malignancy risk was calculated for each category. Sensitivity, specificity, positive and negative predictive values for TBSRCT were also calculated. All the data was analyzed in SPSS software version 22.0 (IBM, USA).Results: Benign lesions constituted the major bulk. After the use of TBSRTC, there was increased ability to look for follicular neoplasms, improvement in making definitive diagnosis of the cases, an improvement in diagnostic accuracy, and we were in line with the implied risk outlined by TBSRTC in most of the cases.Conclusions: Application of TBSRTC results in uniformity in reporting among pathologists and better interdisciplinary communication and patient management.
RESUMO
En la última revisión de la Organización Mundial de la Salud (OMS) en relación a los tumores del sistema nervioso central (SNC), se describieron nuevas entidades, como el Tumor Papilar de la Glándula Pineal. Esta lesión de rara aparición, se ha identificado en adultos jóvenes. El diagnóstico de estos tumores es complejo ya que depende de su ubicación, edad de aparición y el aspecto histológico; éste último tiene similitudes con otras lesiones como el ependimoma papilar o el papiloma/carcinoma de plexos coroides. Citológicamente presentan características claras que pueden ayudar al diagnóstico a través de la impronta en el estudio intraoperatorio; reconocer ciertos criterios con éste importante y sencillo método diagnóstico ha sido la motivación principal para el estudio de entidades poco frecuentes del SNC, además de corroborar el necesario trabajo de un equipo multidisciplinar.
In the latest revision of the central nervous system tumors (CNS) of the World Health Organization (WHO), new entities has been described, as papillary tumor of the pineal region. This rare lesion has been identified in young adults. The diagnosis of these tumors is complex, depends on the location, age of onset and histological appearance. Histological characteristics have similarities with other lesions such as papillary ependymoma, papiloma / choroid plexus carcinoma. Cytologically have clear characteristics that can aid in the diagnosis through the smears on the intraoperative study. Certain criteria for recognize this important and simple diagnostic method has been the main motivation for the study of CNS rare entities, as our case, in addition to corroborating the necessary work of a multidisciplinary team.