The bethesda system is a uniform reporting system for thyroid cytology that facilitates the clarity of communication among cytopathologists, radiologists, and surgeons and facilitates cytohistologic correlation for thyroid diseases. 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. 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. Herein, we summarize the process and rationale by which updates were made to the terminology. 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 recent reclassification of some thyroid neoplasms as noninvasive follicular thyroid neoplasm with papillarylike nuclear features niftp has im plications for. Bethesda classification of thyroid nodule fine needle aspirations i. The bethesda system for reporting thyroid cytology tbsrtc was proposed in 2007 at the national cancer institute thyroid fine needle aspiration state of the art and science conference held in. This terminology and the process that created it have had a profound impact on the practice of cervical cytology for laboratorians and clinicians alike.
The bethesda system tbs is a system for reporting cervical or vaginal cytologic diagnoses, used for reporting pap smear results. The conclusions regarding terminology and morphologic criteria from the nci meeting led to the bethesda thyroid atlas project and form the framework for the bethesda system for reporting thyroid. Definitions, criteria, and explanatory notes syed z. In these biopsies not enough thyroid cells were obtained to render a diagnosis. Jan 24, 2017 the bethesda system for reporting thyroid cytopathology moderator dr g k parvathidevi presenter dr dhanya a n slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Evaluation of thyroid lesions by fineneedle aspiration.
It was first introduced in 1988 and later revised in 1991 and 2001. What is the bethesda system for thyroid cytopathology used. Bethesda classification and cytohistological correlation of thyroid. 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. Guidance on the reporting of thyroid cytology specimens. The bethesda system for reporting thyroid cytopathology is. The bethesda system for reporting thyroid cytopathology bsrtc dr. Presentazione su schermo powerpoint ppt presentation. Thyroid fna bethesda classification scheme the bethesda system for reporting thyroid cytopathology. Ppt bethesda system 2001 powerpoint presentation free. The bethesda system for reporting of thyroid cytopathology. The bethesda system indicates that the final report should indicate what type of specimen was processed.
Sometimes a thyroid nodule presents as a fluidfilled cavity called a thyroid cyst. Implied risk of malignancy and recommended clinical management. Fineneedle aspiration cytology fnac has emerged as an indispensable tool to discriminate thyroid lesions into benign or malignant for appropriate management. History introduced and formed in 2007, nci thyroid fna state of science conference bethesda, maryland, by various cytopathologists and. 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. Malignant risk 9799% suspicious for malignancy risk 6075% follicular neoplasm or suspicious for follicular neoplasm risk 1530%. The bethesda system for reporting thyroid cytopathology tbsrtc established a standardized, categorybased reporting system for thyroid fineneedle aspiration fna specimens. Bongiovanni m, spitale a, faquin wc, mazzucchelli l, baloch zw. The bethesda system 2010 recommendations for thyroid fine needle aspiration fna reporting also include a specimen adequacy component be present on nongyn cytopathology reports. Often these abnormal growths of thyroid tissue are located at the edge of the thyroid gland and can be felt as a lump in the throat.
Classifying your thyroid fna specimens using bethesda. The bethesda system for reporting thyroid cytopathology is effective for clinical management of thyroid nodules jerome m. The bethesda system for reporting thyroid cytopathology nondiagnostic unsatisfactory benign colloid nodule, nodular goiter, hyperplastic nodule, chronic lymphocytic thyroiditis atypia of undetermined significance ausalternatively follicular lesion of undetermined significance follicular neoplasm. Thyroid cytopathology recent advances october 21, 2017 dr. 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 tbsrtc established a standardized, categorybased reporting system for thyroid. The bethesda system for reporting thyroid cytopathology will provide the reader with a unified approach to diagnosing and reporting thyroid fna interpretations. Reproducibility of the bethesda system for reporting. Additionally, the bethesda system is used for cytopathology of thyroid. Bethesda classification of thyroid nodule fine needle aspirations.
Nondiagnostic or unsatisfactory nd uns, thyroid fnas cyst fluid only cfo virtually acellular specimen need at least 6 groups of benign follicular cells, composed of at least 10 cells each for benign other obscuring blood, clotting artifact, overly thick smear, etc. To utilize molecular testing as an adjunctive test in thyroid fna. The bethesda system for reporting thyroid cytopathology, 2017. 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 definition of bethesda system by medical. The bethesda system for reporting thyroid cytopathology tbsrtc1 is now in its second edition. The 2014 bethesda system for reporting cervical cytology dr enrique vicente greco. The bethesda system for reporting thyroid cytopathology tbsrtc is the offspring of the 2007 national cancer institute state of science conference on thyroid fna that defines consensus diagnostic terminology and morphologic criteria.
Taking into consideration the reclassification of some ptcs as niftp, when a definitive diagnosis of ptc is made by fna, 9496% prove to be ptc on histologic followup drop from previous 99% ppv. Malignant papillary thyroid carcinoma poorly differentiated carcinoma medullary thyroid carcinoma. Bethesda system for reporting thyroid cytopathology the. When they are large, they can sometimes be seen as a lump in the front of the neck.
The most appropriate cytological classification of malignancy risk is the bethesda system for thyroid cytopathology, which comprises the following categories. It was introduced in 1988 and revised in 1991, 2001, and 2014. The need for simplicity of communication and standardization of terminology for thyroid fnac reporting led to introduction of the bethesda system for reporting thyroid cytopathology tbsrtc in a. 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. The bethesda system for reporting thyroid cytopathology 1. This can happen when a cyst is aspirated or when the specimen is. The 2017 revision reaffirms that every thyroid fna report should begin with one of six diagnostic categories, the names of which remain unchanged since they were first introduced. The bethesda system 1988 the term squamous intraepithelial lesion is characterized by a high spontaneous regression rate and the lack of predictable progression of sil to invasive cancer the bethesda system replaced 3 levels of cin with 2 levels, lsil and hsil, which could be used to describe any squamous abnormality of the. 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 2017 bethesda system for reporting thyroid cytopathology. Incidentally detected lesions in the surgical specimens that were not the target of the thyroid fna were excluded from the analysis.
The cervical epithelial cell abnormalities originate in the squamous or glandular cells and in the pap smears range from atypia and mildtosevere dyskaryosis to invasive cancer. An autonomous thyroid nodule or hot nodule is one that has thyroid function independent of the homeostatic control of the hpt axis hypothalamicpituitary thyroid axis. Diagnostic terminology and morphologic criteria for cytologic diagnosis of thyroid lesions. A primary objective was to develop a new approach to broaden participation in the consensus process. According to a 1993 article, such nodules need to be treated only if they become toxic. The terminology proposed and illustrated in this text has been widely adopted not only in the u. View bethesda system for reporting thyroid cytopathology from medical med at stratford university. Objective to address terminology and other issues related to thyroid fineneedle aspiration fna, the national cancer institute nci hosted the nci thyroid fna state of the science conference. The bethesda system for reporting thyroid cytopathology tbsrtc is the offspring of the 2007 national cancer institute state of science. In accordance with the colleges prepublications policy, this document was on college website for consultation from 27 october to 24 november 2015.
Presentazione di powerpoint author last modified by. Implied risk of malignancy and recommended clinical management diagnostic category risk of malignancy % usual management nondiagnostic or unsatisfactory repeat fna with ultrasound guidance benign 03% clinical followup. For clarity of communication, tbsrtc recommends that each report begin with 1 of 6 general diagnostic categories. The bethesda system for reporting thyroid cytopathology tbsrtc is a significant step to standardize the reporting of thyroid fine needle aspiration fna. The bethesda system for reporting thyroid cytopathology. Assessment of the bethesda system for reporting thyroid. 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. Updates to the bethesda system for reporting thyroid. Thyroid thyroid cytopathologycytopathology recent advances. It was developed during a workshop sponsored by the national cancer institute at bethesda, maryland in the united states. Comments this document replaces the 1st edition of guidance on the reporting of thyroid cytology specimens, published in 2009. The history of the bethesda system for reporting cervical cytology goes back almost 3 decades. History introduced and formed in 2007, nci thyroid fna state of science conference bethesda, maryland, by various cytopathologists and summarised by baloch et al. The bethesda system for reporting cervical cytology.
The bethesda system for reporting thyroid cytopathology syed z. Fineneedle aspiration cytology fnac of thyroid is the initial screening test for thyroid nodules. 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. For clarity of communication, the bethesda system for reporting thyroid cytopathology recommends that each report begin with one of the six general diagnostic categories. 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.
The bethesda conferences and their ensuing output have also set the stage for. This can happen when a cyst is aspirated or when the specimen is almost entirely composed of blood. The study was aimed to evaluate the diagnostic utility and reproducibility of tbsrtc at our. Objectives the bethesda 2001 workshop was convened to evaluate and update the 1991 bethesda system terminology for reporting the results of cervical cytology. The bethesda system for reporting thyroid cytopathology tbsrtc, which attempts to standardize reporting and cytological criteria for. With 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. C professor, department of pathology mcgill university director, cytopathology laboratory. Discuss the key modifications of the bethesda system for reporting. To advise clinicians on the implications of the each diagnostic category of the bethesda classification system and the results of molecular testing. The aim of this study is to determine the accuracy of fna cytology fnac in the diagnosis of thyroid lesion using the bethesda system for reporting thyroid cytopathology nomenclature.
Full text the bethesda system for reporting thyroid cytopathology. Thyroid fna key cytology and histology for clinicians. 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%. It serves as a reference guide not just for pathologists, but also endocrinologists, surgeons, and radiologists. Niftp comprises approximately 2025% of all thyroid tumors previously classified as malignant. One of the major advantages of this framework is its association with defined risks of malignancy, allowing standardized management algorithms for each diagnosis. It has high predictive value, reproducibility, and improved clinical significance. Cibas the first edition of the bethesda system for reporting thyroid cytopathology was published in 2010 and has greatly influenced the practice of thyroid.
The following is a description of these recommendations. Pdf the bethesda system for reporting thyroid cytopathology. Bethesda system for reporting cervical and vaginal cytology. The bethesda system for reporting thyroid cytopathology slideshare.
The 2014 bethesda system for reporting cervical cytology. Bethesda system for reporting thyroid cytopathology. The bethesda system has been used to classify thyroid cytology in 6 categories besides presenting malignancy rates and. The bethesda system for reporting thyroid cytopathology tbsrtc provides a 6tier diagnostic framework using uniform criteria in reports of thyroid aspirates. For thyroid cytopathology, the 2017 bethesda system cap today. Participants forum groups composed of 6 to 10 individuals were responsible for. Enter your mobile number or email address below and well send you a. Cytojournal classification of thyroid fineneedle aspiration. It will serve as a reference guide not just for pathologists, but also endocrinologists, surgeons, and radiologists. Fineneedle aspiration fna remains the most effective and safe method of evaluating thyroid nodules for potential surgical management. The bethesda system and guidelines for the management of. Introduction fineneedle aspiration fna has an essential role in the evaluation of euthyroid patients with a thyroid nodule. The bethesda system for reporting thyroid cytopathology 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.
The terminology proposed and illustrated in this text has been widely adopted not only in. The national cancer institute thyroid fineneedle aspiration fna state of the science conference bethesda conference suggests the following six major cytologic categories, each of which indicates a different subsequent evaluation and management table 1 1,2. The name comes from the location bethesda, maryland of the conference that established the system. We aim to see the benefits of adopting tbsrtc, seek the cytological pitfalls in the diagnosis of thyroid fnac, and identify the spectrum of thyroid. Pdf the 2017 bethesda system for reporting thyroid. The bethesda system for reporting thyroid cytopathology tbsrtc provides a 6. The bethesda system for reporting thyroid cytopathology uniform terminology for reporting thyroid cytopathology involved physicians caring for and managing pts with thyroid nodules associated risk of malignancy rom with diagnostic categories atlas published in 2010. Buy the bethesda system for reporting cervical cytology. Each of the categories has an implied cancer risk that links it to an appropriate clinical management guideline. Twentythree items of feedback were received and the document was. Thyroid cytopathology cytopathology recent advances and.
The bethesda system for reporting cervical cytology, with its userfriendly format, is a must have for pathologists, cytopathologists, pathology residents, cytotechnologists, and clinicians. The bethesda system for reporting thyroid cytopathology moderator dr g k parvathidevi presenter dr dhanya a n slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. In comparison with adults, thyroid nodules in the pediatric population are. The new edition has been expanded and revised to take into account the advances and experience of the past decade. Thyroid fna state of the art and science conference in bethesda main aim to address the inconsistent reporting terminologies used throughout the world 2010. Bethesda system for reporting thyroid cytopathology in.
Niftp and invasive follicular variant of papillary thyroid carcinomas. Bethesda classification of thyroid nodule fine needle. Thyroid biopsy techniques including core needle biopsies and an. The conclusions regarding terminology and morphologic criteria from the nci meeting led to the bethesda thyroid atlas project and form the framework for the bethesda system for reporting thyroid cytopathology tbsrtc. To apply the bethesda thyroid fna classification system in the evaluation of thyroid fna. The bethesda system for reporting thyroid cytopathology the nci conference participants acknowledged the importance of developing a uniform terminology for reporting thyroid fna results.
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