Thyroid Bethesda reporting category, 'suspicious for papillary thyroid carcinoma', pitfalls and clues to optimize the use of this category

Cytopathology : Official Journal of the British Society for Clinical Cytology
A MahajanR Nayar

Abstract

The Bethesda System of Reporting Thyroid Cytopathology classifies the indeterminate categories based on their differing risks of malignancy, as atypia of undetermined significance (AUS), follicular neoplasm/suspicious for follicular neoplasm (FLUS) and suspicious for malignancy. The vast majority of cases of the last category are suspicious for papillary thyroid carcinoma (PTC). The aim of the present study was to identify the pitfalls and clues to improve the usage of the suspicious category as well as improve its outcome of malignancy. We reviewed the cytological features on air dried Diff-Quik® and alcohol-fixed Papanicolaou smears from 54 thyroid fine needle aspirates (FNAs) with surgical follow-up that were originally diagnosed as suspicious. Procedure data/specimen adequacy was correlated and follow-up histology reports were reviewed after our cytological review was completed. Incidental PTC that was not the target of the FNA was excluded from the calculations for correlation. In our cytological review, we retained a diagnosis of suspicious in 18 of the 54 cases and the remaining 36 were re-categorized as follows: 6 malignant, 10 neoplasm (which is used in our centre instead of FLUS) and 20 AUS. The reasons for overcall o...Continue Reading

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Citations

Oct 16, 2015·Diagnostic Cytopathology·Betul CelikAziza Nassar
Jun 4, 2014·Cancer Cytopathology·Marc P PusztaszeriWilliam C Faquin
May 17, 2018·Cytopathology : Official Journal of the British Society for Clinical Cytology·D C MalheirosF Schmitt
Oct 2, 2019·Head and Neck Pathology·Esther Diana RossiLiron Pantanowitz
Sep 19, 2012·Cytopathology : Official Journal of the British Society for Clinical Cytology·S GorlaF Pagni
Aug 11, 2020·Journal of the American Society of Cytopathology : JASC·Sayanan ChowsilpaSyed Z Ali

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