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Review of atypical cytology of thyroid nodule according to the Bethesda system and its beneficial effect in the surgical treatment of papillary carcinoma.
MedLine Citation:
PMID:  22066105     Owner:  NLM     Status:  PubMed-not-MEDLINE    
PURPOSE: For the atypical cases of fine needle aspiration (FNA) cytology of thyroid nodules, ultrasonographic findings are a primary guideline for the surgical treatment. However, they have the intrinsic risk of overtreatment, as well. In this study we examined whether the Bethesda system could provide a real effect on the diagnostic rate of atypical cytology, and thereby reduce the number of cases diagnosed as atypical from FNA cytology.
METHODS: We reviewed 166 cases diagnosed as atypical by FNA cytology at this institute between the years 2005 to 2010. We classified these cases on the basis of ultrasonographic and cytological findings and compared them with the histological results.
RESULTS: Ultrasonographically, findings suspicious for malignancy and indeterminate were associated with 83.7% and 47.2% of malignancy rates, respectively. Cytopathologically, the malignancy rates varied according to the main cytological features and the highest malignancy rate was 77.3%. Based on the Bethesda system, 39.2% of the cases diagnosed as atypical could be grouped into the category of suspicious for malignancy and yielded a malignancy rate of 76.9%.
CONCLUSION: Although ultrasonography provides an excellent guideline for the surgical treatment of atypical cases, it also showed considerable risk of overtreatment. The Bethesda system did not offer definitive effects on the rate of atypical cytology, but this system seemed to provide stricter boundaries for the atypical cytology and to aid in reducing the rates thereof. This in turn may permit that more limited cases are allotted to ultrasonographic decision making.
Yoo Seung Chung; Changyoung Yoo; Ji Han Jung; Hyun Joo Choi; Young-Jin Suh
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Publication Detail:
Type:  Journal Article     Date:  2011-08-03
Journal Detail:
Title:  Journal of the Korean Surgical Society     Volume:  81     ISSN:  2093-0488     ISO Abbreviation:  J Korean Surg Soc     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-11-08     Completed Date:  2011-11-10     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101564795     Medline TA:  J Korean Surg Soc     Country:  Korea (South)    
Other Details:
Languages:  eng     Pagination:  75-84     Citation Subset:  -    
Department of Surgery, Gachon University Gil Hospital, Gachon University of Medicine and Science, Incheon, Korea.
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