The Bethesda System For Reporting Thyroid Cytopathology

Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
Thyroid: official journal of the American Thyroid Association (Impact Factor: 4.49). 11/2009; 19(11):1159-65. DOI: 10.1089/thy.2009.0274
Source: PubMed


To address terminology and other issues related to thyroid fine-needle aspiration (FNA), the National Cancer Institute (NCI) hosted The NCI Thyroid FNA State of the Science Conference. 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.
Participants of the Atlas Project were selected from among the committee members of the NCI FNA State of the Science Conference and other participants at the live conference. The terminology framework was based on a literature search of English language publications dating back to 1995 using PubMed as the search engine; online forum discussions ( ); and formal interdisciplinary discussions held on October 22 and 23, 2007, in Bethesda, MD.
For clarity of communication, the Bethesda System for Reporting Thyroid Cytopathology recommends that each report begin with one of the six general diagnostic categories. Each of the categories has an implied cancer risk that links it to an appropriate clinical management guideline.
The project participants hope that the adoption of this framework will facilitate communication among cytopathologists, endocrinologists, surgeons, and radiologists; facilitate cytologic-histologic correlation for thyroid diseases; facilitate research into the understanding of thyroid diseases; and allow easy and reliable sharing of data from different laboratories for national and international collaborative studies.

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    • "All thyroid fine needle aspiration cytology (FNAC) was performed under ultrasound guidance by experienced radiologists and processed with the ThinPrep preparation method. We classified the FNAC samples according to the Bethesda system for reporting thyroid cytopathology [11] "
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    ABSTRACT: Background. The Warthin-like variant of papillary thyroid (WLPTC) is a rare subtype of papillary thyroid carcinoma (PTC) resembling Warthin tumors of the salivary glands. Due to its rarity, the clinicopathologic and molecular features of WLPTC remain unclear. Methods. Of the 2,139 patients who underwent surgical treatment for PTC from 2012 to 2013, 40 patients with WLPTC were identified and compared to 200 consecutive patients with classic PTC. BRAF mutation was tested with pyrosequencing. Results. There were no significant differences in age, predilection for women, multifocality, extrathyroidal extension, or lymph node metastasis between WLPTC and classic PTC. However, WLPTCs were more commonly associated with Hashimoto’s thyroiditis than classic PTCs (93% versus 36%, resp., P < 0.001) and showed significantly lower rate of BRAF mutation when compared to classic PTCs (65% versus 84%, resp., P = 0.007). In classic PTC, the frequency of BRAF mutations was negatively correlated with coexisting Hashimoto’s thyroiditis. When we compared WLPTC and classic PTC in the patients with coexisting Hashimoto’s thyroiditis, there were no significant differences in clinicopathologic characteristics or the BRAF mutational rate between the two groups. Conclusions. Patients with WLPTC have similar demographic, clinical, pathologic, and molecular characteristics to those with classic PTC coexisting with Hashimoto’s thyroiditis.
    International Journal of Endocrinology 05/2015; 2015:1-8. DOI:10.1155/2015/456027 · 1.95 Impact Factor
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    • "This is a retrospective study of the 2-year follow-up results of 64 patients with Thy2 thyroid nodules and 6 patients with Thy3 nodules who underwent RFA. Before the procedure, nodules were evaluated by fine needle aspiration biopsy (FNAB) twice and classified according to the British and Italian reporting systems for thyroid cytopathology [9] [10], where Thy2 corresponds to Bethesda Category II (benign nodules), and Thy3 corresponds to Bethesda Categories III and IV nodules (follicular lesions/follicular neoplasms) [11]. A single session of RFA was performed on 64 Thy2 solitary nodules, according to current recommendations [12]. "
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    ABSTRACT: . Radiofrequency ablation (RFA) has been recently advocated as an effective technique for the treatment of symptomatic benign thyroid nodules. It is not known to what extent it may affect any subsequent thyroid surgery and/or histological diagnosis. Materials and Methods . RFA was performed on 64 symptomatic Thy2 nodules (benign nodules) and 6 symptomatic Thy3 nodules (follicular lesions/follicular neoplasms). Two Thy3 nodules regrew after the procedure, and these patients accepted to undergo a total thyroidectomy. Here we present how RFA has affected the operation and the final pathological features of the surgically removed nodules. Results and Conclusions . RFA is effective for the treatment of Thy2 nodules, but it should not be recommended as first-line therapy for the treatment of Thy3 nodules (irrespective of their mutational status), as it delays surgery in case of malignancy. Moreover, it is unknown whether RFA might promote residual tumor progression or neoplastic progression of Thy3 lesions. Nevertheless, here we show for the first time that one session of RFA does not affect subsequent thyroid surgery and/or histological diagnosis.
    05/2015; 2015(2). DOI:10.1530/endoabs.37.EP960
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    • "Fine-needle aspiration (FNA) cytology is a simple, rapid, inexpensive, and minimally invasive procedure which plays an important role in decision-making regarding clinical management of patients with thyroid nodules. Nowadays , the Bethesda system for reporting thyroid cytology [15] is generally accepted. It has six diagnostic categories, which correlate with risk of malignancy, and provides clear management guidelines to clinicians to go for follow-up FNA or surgery [16]. "
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    ABSTRACT: Thyroid cancer is the most common endocrine malignancy with four major types distinguished on the basis of histopathological features: papillary, follicular, medullary, and anaplastic. Classification of thyroid cancer is the primary step in the assessment of prognosis and selection of the treatment. However, in some cases, cytological and histological patterns are inconclusive; hence, classification based on histopathology could be supported by molecular biomarkers, including markers identified with the use of high-throughput “omics” techniques. Beside genomics, transcriptomics, and proteomics, metabolomic approach emerges as the most downstream attitude reflecting phenotypic changes and alterations in pathophysiological states of biological systems. Metabolomics using mass spectrometry and magnetic resonance spectroscopy techniques allows qualitative and quantitative profiling of small molecules present in biological systems. This approach can be applied to reveal metabolic differences between different types of thyroid cancer and to identify new potential candidates for molecular biomarkers. In this review, we consider current results concerning application of metabolomics in the field of thyroid cancer research. Recent studies show that metabolomics can provide significant information about the discrimination between different types of thyroid lesions. In the near future, one could expect a further progress in thyroid cancer metabolomics leading to development of molecular markers and improvement of the tumor types classification and diagnosis.
    International Journal of Endocrinology 03/2015; 2015. DOI:10.1155/2015/258763 · 1.95 Impact Factor
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