Journal of Pathology and Translational Medicine

Original Article

Cytologic Diagnosis of Noninvasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features and Its Impact on the Risk of Malignancy in the Bethesda System for Reporting Thyroid Cytopathology: An Institutional Experience: Milim Kim, Joung Eun Kim, Hyun Jeong Kim, Yul Ri Chung, Yoonjin Kwak, So Yeon Park; J Pathol Transl Med. 2018;52(3):171-178. Published online April 3, 2018; DOI: https://doi.org/10.4132/jptm.2018.04.03

9,378 View
204 Download
23 Web of Science
18 Crossref

Background
This study was performed to analyze cytologic diagnosis of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) and its impact on the risk of malignancy (ROM) in the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC).
Methods
Five thousand five hundred and forty-nine cases of thyroid fine-needle aspiration cytology (FNAC) diagnosed between 2012 and 2014 were included in this study. Diagnostic categories based on TBSRTC were compared with final surgical diagnoses, and the ROM in each category was calculated both when NIFTP was included in malignant lesions and when excluded from malignant lesions.
Results
Of the 5,549 thyroid FNAC cases, 1,891 cases underwent surgical resection. In final diagnosis, 1,700 cases were revealed as papillary thyroid carcinoma (PTC), and 25 cases were reclassified as NIFTP. The cytologic diagnoses of NIFTP were non-diagnostic in one, benign in five, atypia of undetermined significance (AUS) in 14, follicular neoplasm in two, and suspicious for malignancy in three cases. Collectively, NIFTP/encapsulated follicular variant of PTC (EFVPTC) were more frequently classified as benign, AUS, or follicular neoplasm and less frequently categorized as malignant compared to conventional PTCs. Exclusion of NIFTP from malignant diagnoses resulted in a slight decrease in malignancy rates in non-diagnostic, benign, AUS, follicular neoplasm, and suspicious for malignancy categories without any statistical significance.
Conclusions
The decrease in the ROM was not significant when NIFTP was excluded from malignant lesions. In thyroid FNACs, NIFTP/EFVPTCs were mostly classified into indeterminate categories. Therefore, it might be feasible to separate NIFTP/EFVPTC from conventional PTC on FNAC to guide clinicians to conservative management for patients with NIFTP/EFVPTC.

Citations

Citations to this article as recorded by

Spatial transcriptomics reveals prognosis‐associated cellular heterogeneity in the papillary thyroid carcinoma microenvironment
Kai Yan, Qing‐Zhi Liu, Rong‐Rong Huang, Yi‐Hua Jiang, Zhen‐Hua Bian, Si‐Jin Li, Liang Li, Fei Shen, Koichi Tsuneyama, Qing‐Ling Zhang, Zhe‐Xiong Lian, Haixia Guan, Bo Xu
Clinical and Translational Medicine.2024;[Epub] CrossRef
Cytological Features of “Non-invasive Follicular Tumour with Papillary Like Nuclear Features” – A Single Institutional Experience in India
K Amita, HB Rakshitha, M Sanjay, Prashantha Kalappa
Journal of Cytology.2023; 40(1): 28. CrossRef
Detailed fine needle aspiration cytopathology findings of noninvasive follicular thyroid neoplasm with papillary‐like nuclear features with nuclear grading correlated to that of biopsy and Bethesda category and systematic review
Sevgiye Kaçar Özkara, Gupse Turan
Diagnostic Cytopathology.2023; 51(12): 758. CrossRef
Non-Invasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features Is Not a Cytological Diagnosis, but It Influences Cytological Diagnosis Outcomes: A Systematic Review and Meta-Analysis
Elina Haaga, David Kalfert, Marie Ludvíková, Ivana Kholová
Acta Cytologica.2022; 66(2): 85. CrossRef
Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: its updated diagnostic criteria, preoperative cytologic diagnoses and impact on the risk of malignancy
Hee Young Na, So Yeon Park
Journal of Pathology and Translational Medicine.2022; 56(6): 319. CrossRef
Usage and Diagnostic Yield of Fine-Needle Aspiration Cytology and Core Needle Biopsy in Thyroid Nodules: A Systematic Review and Meta-Analysis of Literature Published by Korean Authors
Soon-Hyun Ahn
Clinical and Experimental Otorhinolaryngology.2021; 14(1): 116. CrossRef
Comprehensive DNA Methylation Profiling Identifies Novel Diagnostic Biomarkers for Thyroid Cancer
Jong-Lyul Park, Sora Jeon, Eun-Hye Seo, Dong Hyuck Bae, Young Mun Jeong, Yourha Kim, Ja Seong Bae, Seon-Kyu Kim, Chan Kwon Jung, Yong Sung Kim
Thyroid.2020; 30(2): 192. CrossRef
Differences in surgical resection rate and risk of malignancy in thyroid cytopathology practice between Western and Asian countries: A systematic review and meta‐analysis
Huy Gia Vuong, Hanh Thi Tuyet Ngo, Andrey Bychkov, Chan Kwon Jung, Trang Huyen Vu, Kim Bach Lu, Kennichi Kakudo, Tetsuo Kondo
Cancer Cytopathology.2020; 128(4): 238. CrossRef
Noninvasive follicular neoplasm with papillary like nuclear features: A comprehensive analysis with a diagnostic algorithm
Chanchal Rana, Shreyamsa Manjunath, Pooja Ramakant, Kulranjan Singh, Suresh Babu, Anand Mishra
Diagnostic Cytopathology.2020; 48(4): 330. CrossRef
Noninvasive follicular thyroid neoplasm with papillary‐like nuclear features and the risk of malignancy in The Bethesda System for the Reporting of Thyroid Cytopathology
Danielle Elliott Range, Xiaoyin “Sara” Jiang
Diagnostic Cytopathology.2020; 48(6): 531. CrossRef
Did Introducing a New Category of Thyroid Tumors (Non-invasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features) Decrease the Risk of Malignancy for the Diagnostic Categories in the Bethesda System for Reporting Thyroid Cytopathology?
Janusz Kopczyński, Agnieszka Suligowska, Kornelia Niemyska, Iwona Pałyga, Agnieszka Walczyk, Danuta Gąsior-Perczak, Artur Kowalik, Kinga Hińcza, Ryszard Mężyk, Stanisław Góźdź, Aldona Kowalska
Endocrine Pathology.2020; 31(2): 143. CrossRef
High risk of malignancy in cases with atypia of undetermined significance on fine needle aspiration of thyroid nodules even after exclusion of NIFTP
Sevgiye Kaçar Özkara, Büşra Yaprak Bayrak, Gupse Turan
Diagnostic Cytopathology.2020; 48(11): 986. CrossRef
The importance of risk of neoplasm as an outcome in cytologic‐histologic correlation studies on thyroid fine needle aspiration
Yu‐Hsin Chen, Kristen L. Partyka, Rae Dougherty, Harvey M. Cramer, Howard H. Wu
Diagnostic Cytopathology.2020; 48(12): 1237. CrossRef
Preoperative diagnostic categories of fine needle aspiration cytology for histologically proven thyroid follicular adenoma and carcinoma, and Hurthle cell adenoma and carcinoma: Analysis of cause of under- or misdiagnoses
Hee Young Na, Jae Hoon Moon, June Young Choi, Hyeong Won Yu, Woo-Jin Jeong, Yeo Koon Kim, Ji-Young Choe, So Yeon Park, Paula Soares
PLOS ONE.2020; 15(11): e0241597. CrossRef
How is noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) shaping the way we interpret thyroid cytology?
Michiya Nishino
Journal of the American Society of Cytopathology.2019; 8(1): 1. CrossRef
Cytological Diagnoses Associated with Noninvasive Follicular Thyroid Neoplasms with Papillary-Like Nuclear Features According to the Bethesda System for Reporting Thyroid Cytopathology: A Systematic Review and Meta-Analysis
Massimo Bongiovanni, Luca Giovanella, Francesco Romanelli, Pierpaolo Trimboli
Thyroid.2019; 29(2): 222. CrossRef
Preoperative Diagnostic Categories of Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features in Thyroid Core Needle Biopsy and Its Impact on Risk of Malignancy
Hee Young Na, Ji Won Woo, Jae Hoon Moon, June Young Choi, Woo-Jin Jeong, Yeo Koon Kim, Ji-Young Choe, So Yeon Park
Endocrine Pathology.2019; 30(4): 329. CrossRef
Papillary Thyroid Microcarcinoma: Reclassification to Non-Invasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features (NIFTP): a Retrospective Clinicopathologic Study
Khurram Shafique, Virginia A. LiVolsi, Kathleen Montone, Zubair W. Baloch
Endocrine Pathology.2018; 29(4): 339. CrossRef

Reviews

Current Status of Thyroid Fine-Needle Aspiration Practice in Thailand: Somboon Keelawat, Samreung Rangdaeng, Supinda Koonmee, Tikamporn Jitpasutham, Andrey Bychkov; J Pathol Transl Med. 2017;51(6):565-570. Published online November 15, 2017; DOI: https://doi.org/10.4132/jptm.2017.08.12

7,078 View
143 Download
9 Web of Science
6 Crossref

Abstract PDF

Thyroid carcinoma is one of the leading malignancies in Thailand increasingly prevalent in the female population. Fine-needle aspiration (FNA) cytology is a widely used diagnostic tool for evaluation of thyroid nodules and thyroid cancer. Thyroid FNA is a routine procedure universally performed in Thai hospitals by a variety of clinical specialists. Manual guidance is the first-line choice complemented by ultrasound assistance in selected cases. Despite national guidelines recommendations, the diagnostic criteria and terminology of the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was slowly adopted in the local settings. Currently, the Bethesda system is actively promoted by the local professional societies as a uniform reporting system. Experience with thyroid FNA has been rarely reported to date—only a handful of publications are available in local journals. Our review, in addition to presenting various aspects of thyroid FNA in Thailand, established for the first time national references for a certain statistical outputs of TBSRTC based on the original multi-institutional cohort. The risk of malignancy in 2,017 operated thyroid nodules collected from three tertiary thyroid cancer centers was 21.7%, 14.7%, 35.9%, 44.4%, 76.7%, and 92.6% for categories I to VI, respectively. The malignancy risk in several diagnostic categories (II to IV) was higher than the risk estimated by TBSRTC and recent meta-analysis studies. We endorse the use of uniform terminology of the Bethesda system in Thailand, which will help facilitate communication among diverse medical professionals involved in the management of patients with thyroid nodules, to share local experience with the international audience.

Citations

Citations to this article as recorded by

The Asian Thyroid Working Group, from 2017 to 2023
Kennichi Kakudo, Chan Kwon Jung, Zhiyan Liu, Mitsuyoshi Hirokawa, Andrey Bychkov, Huy Gia Vuong, Somboon Keelawat, Radhika Srinivasan, Jen-Fan Hang, Chiung-Ru Lai
Journal of Pathology and Translational Medicine.2023; 57(6): 289. CrossRef
Application of the Bethesda system for reporting thyroid cytopathology for classification of thyroid nodules: A clinical and cytopathological characteristics in Bhutanese population
Sonam Choden, Chimi Wangmo, Sushna Maharjan
Diagnostic Cytopathology.2021; 49(11): 1179. CrossRef
Patient Discomfort in Relation to Thyroid Nodule Fine-Needle Aspiration (FNA) Performed with or without Parenteral and/or Topical Anesthetic
Chenxiang Cao, Sina Jasim, Amrita Cherian, Aziza Nassar, Ana-Maria Chindris, Ana Marcella Rivas, Stephanie Bonnett, Melanie Caserta, Marius N. Stan, Victor J. Bernet
Endocrine Practice.2020; 26(12): 1497. CrossRef
Incidence and malignancy rates classified by The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) – An 8-year tertiary center experience in Thailand
Yotsapon Thewjitcharoen, Siriwan Butadej, Soontaree Nakasatien, Phawinpon Chotwanvirat, Sriurai Porramatikul, Sirinate Krittiyawong, Nampetch Lekpittaya, Thep Himathongkam
Journal of Clinical & Translational Endocrinology.2019; 16: 100175. CrossRef
The Use of Fine-Needle Aspiration (FNA) Cytology in Patients with Thyroid Nodules in Asia: A Brief Overview of Studies from the Working Group of Asian Thyroid FNA Cytology
Chan Kwon Jung, SoonWon Hong, Andrey Bychkov, Kennichi Kakudo
Journal of Pathology and Translational Medicine.2017; 51(6): 571. CrossRef
Thyroid FNA cytology in Asian practice—Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas
K. Kakudo, M. Higuchi, M. Hirokawa, S. Satoh, C. K. Jung, A. Bychkov
Cytopathology.2017; 28(6): 455. CrossRef

Thyroid Cytology: The Japanese System and Experience at Yamashita Thyroid Hospital: Shinya Satoh, Hiroyuki Yamashita, Kennichi Kakudo; J Pathol Transl Med. 2017;51(6):548-554. Published online October 11, 2017; DOI: https://doi.org/10.4132/jptm.2017.09.29

9,674 View
168 Download
22 Web of Science
18 Crossref

Abstract PDF

In Japan, fine-needle aspiration (FNA) cytology is the most important diagnostic modality for triaging patients with thyroid nodules. A clinician (endocrinologist, endocrine surgeon, or head and neck surgeon) generally performs FNA cytology at the outpatient clinic, and ultrasound (US)-guided FNA is widespread because US is extremely common and most clinicians are familiar with it. Although almost all FNA thyroid samples are examined by certified cytopathologists and pathologists, some clinicians assess cytological specimens themselves. In Japan, there are two clinical guidelines regarding the management of thyroid nodules. One is the General Rules for the Description of Thyroid Cancer (GRDTC) published by the Japanese Society of Thyroid Surgery (JSTS) in 2005, and the other is the national reporting system for thyroid FNA cytology published by the Japan Thyroid Association in 2013 (Japanese system). Although the Bethesda System for Reporting Thyroid Cytopathology (Bethesda system) is rarely used in Japan, both the GRDTC and Japanese system tried to incorporate the Bethesda system so that the cytological diagnoses would be compatible with each other. The essential point of the Japanese system is stratification of follicular neoplasm (FN) into three subgroups based on cytological features in order to reduce unnecessary diagnostic thyroidectomy, and this system has been successful in stratifying the risk of malignancy in FN patients at several high-volume thyroid surgery centers. In Japan, the measurement of thyroglobulin and/or calcitonin in FNA needle washings is often used as an adjunct for diagnosis of possible cervical lymph node metastasis when FNA cytology is performed.

Citations

Citations to this article as recorded by

Thyroid FNA cytology: The Eastern versus Western perspectives
Mitsuyoshi Hirokawa, Manon Auger, Chan Kwon Jung, Fabiano Mesquita Callegari
Cancer Cytopathology.2023; 131(7): 415. CrossRef
The Asian Thyroid Working Group, from 2017 to 2023
Kennichi Kakudo, Chan Kwon Jung, Zhiyan Liu, Mitsuyoshi Hirokawa, Andrey Bychkov, Huy Gia Vuong, Somboon Keelawat, Radhika Srinivasan, Jen-Fan Hang, Chiung-Ru Lai
Journal of Pathology and Translational Medicine.2023; 57(6): 289. CrossRef
Criteria for follow‐up of thyroid nodules diagnosed as follicular neoplasm without molecular testing – The experience of a high‐volume thyroid centre in Japan
Mitsuyoshi Hirokawa, Ayana Suzuki, Makoto Kawakami, Takumi Kudo, Akira Miyauchi
Diagnostic Cytopathology.2022; 50(5): 223. CrossRef
The Significance of RAS-Like Mutations and MicroRNA Profiling in Predicting Malignancy in Thyroid Biopsy Specimens
Nicole A. Cipriani, Daniel N. Johnson, David H. Sarne, Peter Angelos, Ward Reeves, Tatjana Antic
Endocrine Pathology.2022; 33(4): 446. CrossRef
Molecular Testing for Thyroid Nodules: The Experience at McGill University Teaching Hospitals in Canada
Mohannad Rajab, Richard J. Payne, Véronique-Isabelle Forest, Marc Pusztaszeri
Cancers.2022; 14(17): 4140. CrossRef
Impact of Molecular Testing on the Management of Indeterminate Thyroid Nodules Among Western and Asian Countries: a Systematic Review and Meta-analysis
Hanh Thi Tuyet Ngo, Truong Phan Xuan Nguyen, Trang Huyen Vu, Chan Kwon Jung, Lewis Hassell, Kennichi Kakudo, Huy Gia Vuong
Endocrine Pathology.2021; 32(2): 269. CrossRef
The Incidence of Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features: A Meta-Analysis Assessing Worldwide Impact of the Reclassification
Chanchal Rana, Huy Gia Vuong, Thu Quynh Nguyen, Hoang Cong Nguyen, Chan Kwon Jung, Kennichi Kakudo, Andrey Bychkov
Thyroid.2021;[Epub] CrossRef
Ultrasound-guided Fine Needle Aspiration Cytological Examination of Thyroid Nodules: A Practical Guideline (2019 edition)

ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY.2021; 5(2): 134. CrossRef
Differences in surgical resection rate and risk of malignancy in thyroid cytopathology practice between Western and Asian countries: A systematic review and meta‐analysis
Huy Gia Vuong, Hanh Thi Tuyet Ngo, Andrey Bychkov, Chan Kwon Jung, Trang Huyen Vu, Kim Bach Lu, Kennichi Kakudo, Tetsuo Kondo
Cancer Cytopathology.2020; 128(4): 238. CrossRef
Exploring the Inter-observer Agreement Among the Members of the Italian Consensus for the Classification and Reporting of Thyroid Cytology
Anna Crescenzi, Pierpaolo Trimboli, Fulvio Basolo, Andrea Frasoldati, Fabio Orlandi, Lucio Palombini, Enrico Papini, Alfredo Pontecorvi, Paolo Vitti, Michele Zini, Francesco Nardi, Guido Fadda
Endocrine Pathology.2020; 31(3): 301. CrossRef
The Current Histologic Classification of Thyroid Cancer
Sylvia L. Asa
Endocrinology and Metabolism Clinics of North America.2019; 48(1): 1. CrossRef
Clinical Impact of Non-Invasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features on the Risk of Malignancy in the Bethesda System for Reporting Thyroid Cytopathology: A Meta-Analysis of 14,153 Resected Thyroid Nodules
Huy Gia Vuong, Thao T.K. Tran, Andre y. Bychkov, Chan Kwon Jung, Tadao Nakazawa, Kennichi Kakudo, R yohei Katoh, Tetsuo Kondo
Endocrine Practice.2019; 25(5): 491. CrossRef
A Multi-institutional Study of Prevalence and Clinicopathologic Features of Non-invasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features (NIFTP) in Korea
Ja Yeong Seo, Ji Hyun Park, Ju Yeon Pyo, Yoon Jin Cha, Chan Kwon Jung, Dong Eun Song, Jeong Ja Kwak, So Yeon Park, Hee Young Na, Jang-Hee Kim, Jae Yeon Seok, Hee Sung Kim, Soon Won Hong
Journal of Pathology and Translational Medicine.2019; 53(6): 378. CrossRef
Noninvasive follicular thyroid neoplasm with papillary‐like nuclear features (NIFTP) in thyroid tumor classification
Kennichi Kakudo, Adel K. El‐Naggar, Steven P. Hodak, Elham Khanafshar, Yuri E Nikiforov, Vania Nosé, Lester D. R. Thompson
Pathology International.2018; 68(6): 327. CrossRef
Diagnostic value of HBME‐1, CK19, Galectin 3, and CD56 in the subtypes of follicular variant of papillary thyroid carcinoma
Haeyon Cho, Ji‐Ye Kim, Young Lyun Oh
Pathology International.2018; 68(11): 605. CrossRef
The Usefulness of Immunocytochemistry of CD56 in Determining Malignancy from Indeterminate Thyroid Fine-Needle Aspiration Cytology
Hyunseo Cha, Ju Yeon Pyo, Soon Won Hong
Journal of Pathology and Translational Medicine.2018; 52(6): 404. CrossRef
Impact of the modification of the diagnostic criteria in the 2017 Bethesda System for Reporting Thyroid Cytopathology: a report of a single institution in Japan
Miyoko Higuchi, Mitsuyoshi Hirokawa, Risa Kanematsu, Aki Tanaka, Ayana Suzuki, Naoki Yamao, Toshitetsu Hayashi, Seiji Kuma, Akira Miyauchi
Endocrine Journal.2018; 65(12): 1193. CrossRef
The Use of Fine-Needle Aspiration (FNA) Cytology in Patients with Thyroid Nodules in Asia: A Brief Overview of Studies from the Working Group of Asian Thyroid FNA Cytology
Chan Kwon Jung, SoonWon Hong, Andrey Bychkov, Kennichi Kakudo
Journal of Pathology and Translational Medicine.2017; 51(6): 571. CrossRef

Thyroid Fine-Needle Aspiration Cytology Practice in Korea: Yoon Jin Cha, Ju Yeon Pyo, SoonWon Hong, Jae Yeon Seok, Kyung-Ju Kim, Jee-Young Han, Jeong Mo Bae, Hyeong Ju Kwon, Yeejeong Kim, Kyueng-Whan Min, Soonae Oak, Sunhee Chang; J Pathol Transl Med. 2017;51(6):521-527. Published online October 11, 2017; DOI: https://doi.org/10.4132/jptm.2017.09.26

7,936 View
245 Download
20 Web of Science
10 Crossref

Abstract PDF

We reviewed the current status of thyroid fine-needle aspiration cytology (FNAC) in Korea. Thyroid aspiration biopsy was first introduced in Korea in 1977. Currently, radiologists aspirate the thyroid nodule under the guidance of ultrasonography, and cytologic interpretation is only legally approved when a cytopathologist makes the diagnosis. In 2008, eight thyroid-related societies came together to form the Korean Thyroid Association. The Korean Society for Cytopathology and the endocrine pathology study group of the Korean Society for Pathologists have been updating the cytologic diagnostic guidelines. The Bethesda System for Reporting Thyroid Cytopathology was first introduced in 2009, and has been used by up to 94% of institutions by 2016. The average diagnosis rates are as follows for each category: I (12.4%), II (57.9%), III (10.4%), IV (2.9%), V (3.7%), and VI (12.7%). The malignancy rates in surgical cases are as follows for each category: I (28.7%), II (27.8%), III (50.6%), IV (52.3%), V (90.7%), and VI (100.0%). Liquid-based cytology has been used since 2010, and it was utilized by 68% of institutions in 2016. The categorization of thyroid lesions into “atypia of undetermined significance” or “follicular lesion of undetermined significance” is necessary to draw consensus in our society. Immunocytochemistry for galectin-3 and BRAF is used. Additionally, a molecular test for BRAF in thyroid FNACs is actively used. Core biopsies were performed in only 44% of institutions. Even the institutions that perform core biopsies only perform them for less than 3% of all FNACs. However, only 5% of institutions performed core biopsies up to three times more than FNAC.

Citations

Citations to this article as recorded by

State of the art of thyroid pathology: FNA diagnostic accuracy in an intermediate center in Ibagué
Daniel Javier Velez Bohorquez, Nohora Bibiana Varon Arce, Sandra Milena Tellez Olaya, Sebastian Camilo Mora Garcia, Anggi Margarita Velez Bohorquez, Mabel Elena Bohorquez Lozano
Universitas Médica.2023;[Epub] CrossRef
The Asian Thyroid Working Group, from 2017 to 2023
Kennichi Kakudo, Chan Kwon Jung, Zhiyan Liu, Mitsuyoshi Hirokawa, Andrey Bychkov, Huy Gia Vuong, Somboon Keelawat, Radhika Srinivasan, Jen-Fan Hang, Chiung-Ru Lai
Journal of Pathology and Translational Medicine.2023; 57(6): 289. CrossRef
Diagnostic value of thyroid imaging reporting and data system combined with BRAFV600E mutation analysis in Bethesda categories III–V thyroid nodules
Liuxi Wu, Hua Shu, Wenqin Chen, Yingqian Gao, Ya Yuan, Xiao Li, Wenjuan Lu, Xinhua Ye, Hongyan Deng
Scientific Reports.2022;[Epub] CrossRef
Contribution of cytologic examination to diagnosis of poorly differentiated thyroid carcinoma
Na Rae Kim, Jae Yeon Seok, Yoo Seung Chung, Joon Hyop Lee, Dong Hae Chung
Journal of Pathology and Translational Medicine.2020; 54(2): 171. CrossRef
Systematic thyroid screening in myotonic dystrophy: link between thyroid volume and insulin resistance
Adrien Ben Hamou, Stéphanie Espiard, Christine Do Cao, Miriam Ladsous, Camille Loyer, Alexandre Moerman, Samuel Boury, Maéva Kyheng, Claire-Marie Dhaenens, Vincent Tiffreau, Pascal Pigny, Gilles Lebuffe, Robert Caiazzo, Sébastien Aubert, Marie Christine V
Orphanet Journal of Rare Diseases.2019;[Epub] CrossRef
The History of Korean Thyroid Pathology
Soon Won Hong, Chan Kwon Jung
International Journal of Thyroidology.2018; 11(1): 15. CrossRef
BRAFV600E Mutation is a Strong Preoperative Indicator for Predicting Malignancy in Thyroid Nodule Patients with Atypia of Undetermined Significance Identified by Fine Needle Aspiration
Hye Rang Choi, Bo-Yoon Choi, Jae Hoon Cho, Young Chang Lim
Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2018; 61(11): 600. CrossRef
The Usefulness of Immunocytochemistry of CD56 in Determining Malignancy from Indeterminate Thyroid Fine-Needle Aspiration Cytology
Hyunseo Cha, Ju Yeon Pyo, Soon Won Hong
Journal of Pathology and Translational Medicine.2018; 52(6): 404. CrossRef
Thyroid FNA cytology in Asian practice—Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas
K. Kakudo, M. Higuchi, M. Hirokawa, S. Satoh, C. K. Jung, A. Bychkov
Cytopathology.2017; 28(6): 455. CrossRef
The Use of Fine-Needle Aspiration (FNA) Cytology in Patients with Thyroid Nodules in Asia: A Brief Overview of Studies from the Working Group of Asian Thyroid FNA Cytology
Chan Kwon Jung, SoonWon Hong, Andrey Bychkov, Kennichi Kakudo
Journal of Pathology and Translational Medicine.2017; 51(6): 571. CrossRef

Thyroid Cytology in India: Contemporary Review and Meta-analysis: Shipra Agarwal, Deepali Jain; J Pathol Transl Med. 2017;51(6):533-547. Published online October 5, 2017; DOI: https://doi.org/10.4132/jptm.2017.08.04

9,403 View
206 Download
14 Web of Science
16 Crossref

Abstract PDF

Fine-needle aspiration cytology (FNAC) is a screening test for triaging thyroid nodules, aiding in subsequent clinical management. However, the advantages have been overshadowed by the multiplicity of reporting systems and a wide range of nomenclature used. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was formulated in 2007, to give the world a uniform thyroid cytology reporting system, facilitating easy interpretation by the clinicians. Here, we review the status of thyroid FNAC in India in terms of various reporting systems used including a meta-analysis of the previously published data. An extensive literature search was performed using internet search engines. The reports with detailed classification system used in thyroid cytology were included. The meta-analysis of published data was compared with the implied risk of malignancy by TBSRTC. More than 50 studies were retrieved and evaluated. TBSRTC is currently the most widely used reporting system with different studies showing good efficacy and interobserver concordance. Ancillary techniques have, as of now, limited applicability and acceptability in thyroid cytology in India. Twenty-eight published articles met the criteria for inclusion in the meta-analysis. When compared with TBSRTC recommendations, the meta-analysis showed a higher risk of malignancy for categories I and III. Thyroid FNAC is practiced all over India. TBSRTC has found widespread acceptance, with most institutions using this system for routine thyroid cytology reporting. However, reasons for a high malignancy risk for categories I and III need to be looked into. Various possible contributing factors are discussed in the review.

Citations

Citations to this article as recorded by

Thermal imaging based pre-diagnostics tool for Graves’ disease
Vaishali Sharma, Vandana K Dhingra, Snehlata Shakya, Ashok Kumar, Mayank Goswami
Measurement Science and Technology.2024; 35(3): 035702. CrossRef
High Malignancy Risk and Its Predictors in South Indian Patients With Bethesda II Thyroid Nodules
Sunanda Tirupati, Pradeep Puthenveetil, Shilpa Lakkundi, Anudeep Gaddam, Vijaya Sarathi
Cureus.2024;[Epub] CrossRef
Nuclear features in thyroid cytology: features helpful for a morphological diagnosis in routine practice
Priya Bhagwat, Sabine Pomplun
Diagnostic Histopathology.2024; 30(6): 312. CrossRef
Evaluation of Thyroid Lesions by the Bethesda System for Reporting Thyroid Cytopathology
Syed Asif Hashmi, Monika Aggrawal, Rahul Pandey, Deepika Gulati, Inam Danish Khan
Journal of Marine Medical Society.2023; 25(1): 73. CrossRef
Incidence and Malignancy Rates in Thyroid Nodules in North-East Indian Population by Bethesda System: A Single Institutional Experience of 3 Years
Suvamoy Chakraborty, Manu C. Balakrishnan, Vandana Raphael, Prachurya Tamuli, Anuradha Deka
South Asian Journal of Cancer.2023; 12(02): 166. CrossRef
Evaluation of Concordance of Ultrasound, Cytology, and Histopathology in Solitary Thyroid Nodules
Sunil Chumber, Surabhi Vyas, Kamal Kataria, Shipra Agarwal, Yashwant S Rathore, Gopal Puri, Sushma Yadav, Kanika Sharma, Amit Patidar
Indian Journal of Endocrine Surgery and Research.2023; 18(1): 17. CrossRef
Cytomorphological Spectrum of Head and Neck Lesions by Fine Needle Aspiration Cytology in a Tertiary Care Center
Amandeep Kaur, Sonali Poonia, Karandeep Singh, Dalbir Kaur, Mohit Madhukar, Ravish Godara
Journal of Pharmacy and Bioallied Sciences.2023; 15(Suppl 1): S315. CrossRef
The Asian Thyroid Working Group, from 2017 to 2023
Kennichi Kakudo, Chan Kwon Jung, Zhiyan Liu, Mitsuyoshi Hirokawa, Andrey Bychkov, Huy Gia Vuong, Somboon Keelawat, Radhika Srinivasan, Jen-Fan Hang, Chiung-Ru Lai
Journal of Pathology and Translational Medicine.2023; 57(6): 289. CrossRef
Cytomorphological Categorization of Thyroid Lesions according to The Bethesda System for Reporting Thyroid Cytology and Correlation with their Histological Outcome
Meenakshi Kamboj, Anurag Mehta, Sunil Pasricha, Gurudutt Gupta, Anila Sharma, Garima Durga
Journal of Cytology.2022; 39(1): 44. CrossRef
Is Surgery Necessary in Benign Thyroid Lesions?
Pushkar Chaudhary, Naseem Noorunnisa
Journal of Datta Meghe Institute of Medical Sciences University.2022; 17(3): 799. CrossRef
Effect of the Noninvasive Follicular Thyroid Neoplasm With Papillary-Like Nuclear Features (NIFTP) Nomenclature Revision on Indian Thyroid Fine-Needle Aspiration Practice
Chanchal Rana, Pooja Ramakant, Divya Goel, Akanksha Singh, KulRanjan Singh, Suresh Babu, Anand Mishra
American Journal of Clinical Pathology.2021; 156(2): 320. CrossRef
The combination of ACR‐Thyroid Imaging Reporting and Data system and The Bethesda System for Reporting Thyroid Cytopathology in the evaluation of thyroid nodules—An institutional experience
Shanmugasundaram Sakthisankari, Sreenivasan Vidhyalakshmi, Sivanandam Shanthakumari, Balalakshmoji Devanand, Udayasankar Nagul
Cytopathology.2021; 32(4): 472. CrossRef
Differentiated Thyroid Cancer
Anita M. Borges
Journal of Head & Neck Physicians and Surgeons.2021; 9(2): 69. CrossRef
Risk of malignancy in Thyroid “Atypia of undetermined significance/Follicular lesion of undetermined significance” and its subcategories – A 5-year experience
Abha Thakur, Haimanti Sarin, Dilpreet Kaur, Deepak Sarin
Indian Journal of Pathology and Microbiology.2019; 62(4): 544. CrossRef
Thyroid FNA cytology in Asian practice—Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas
K. Kakudo, M. Higuchi, M. Hirokawa, S. Satoh, C. K. Jung, A. Bychkov
Cytopathology.2017; 28(6): 455. CrossRef
The Use of Fine-Needle Aspiration (FNA) Cytology in Patients with Thyroid Nodules in Asia: A Brief Overview of Studies from the Working Group of Asian Thyroid FNA Cytology
Chan Kwon Jung, SoonWon Hong, Andrey Bychkov, Kennichi Kakudo
Journal of Pathology and Translational Medicine.2017; 51(6): 571. CrossRef

Thyroid Fine-Needle Aspiration Practice in the Philippines: Agustina D. Abelardo; J Pathol Transl Med. 2017;51(6):555-559. Published online October 5, 2017; DOI: https://doi.org/10.4132/jptm.2017.07.14

7,481 View
140 Download
7 Web of Science
6 Crossref

Abstract PDF

Fine-needle aspiration (FNA) is a well accepted initial approach in the management of thyroid lesions. It has come a long way since its introduction for nearly a century ago. In the Philippines, FNA of the thyroid was first introduced 30 years ago and has been utilized until now as a mainstay in the diagnosis of thyroid malignancy. The procedure is performed by pathologists, endocrinologists, surgeons, and radiologists. Most pathologists report the cytodiagnosis using a combination of the aspiration biopsy cytology method that closely resembles the histopathologic diagnosis of thyroid disorders and the six-tier nomenclature of The Bethesda System for Reporting Thyroid Cytopathology. Local endocrinologists and surgeons follow the guidelines of the 2015 American Thyroid Association in the management of thyroid disorders. There is still a paucity of local research studies but available data deal with cytohistologic correlations, sensitivity, specificity, and accuracy rates as well as usefulness of ultrasound-guided FNA. Cytohistologic correlations have a wide range of sensitivity from 30.7% to 73% and specificity from 83% to 100%. The low sensitivity can be attributed to poor tissue sampling since a majority of the thyroid FNA is done by palpation only. The reliability can be improved if FNA is guided by ultrasound as attested in both international and local studies. Overall, FNA of the thyroid has enabled the diagnosis of thyroid disorders with an accuracy of 72.8% to 87.2% and it correlates well with histopathology.

Citations

Citations to this article as recorded by

Combining radiomics and molecular biomarkers: a novel economic tool to improve diagnostic ability in papillary thyroid cancer
Qingxuan Wang, Linghui Dai, Sisi Lin, Shuwei Zhang, Jing Wen, Endong Chen, Quan Li, Jie You, Jinmiao Qu, Chunjue Ni, Yefeng Cai
Frontiers in Endocrinology.2024;[Epub] CrossRef
Agreement between Sonographic Features and Fine Needle Aspiration Cytology in the Diagnosis of Thyroid Nodules in a Tertiary Hospital
Danette Pabalan, Ricardo Victorio Quimbo
PJP.2024; 9(1): 37. CrossRef
The Asian Thyroid Working Group, from 2017 to 2023
Kennichi Kakudo, Chan Kwon Jung, Zhiyan Liu, Mitsuyoshi Hirokawa, Andrey Bychkov, Huy Gia Vuong, Somboon Keelawat, Radhika Srinivasan, Jen-Fan Hang, Chiung-Ru Lai
Journal of Pathology and Translational Medicine.2023; 57(6): 289. CrossRef
Application of the Bethesda System for Reporting Thyroid Cytopathology in the Pediatric Population
Huy Gia Vuong, Ayana Suzuki, Hee Young Na, Pham Van Tuyen, Doan Minh Khuy, Hiep Canh Nguyen, Tikamporn Jitpasutham, Agustina Abelardo, Takashi Amano, So Yeon Park, Chan Kwon Jung, Mitsuyoshi Hirokawa, Ryohei Katoh, Kennichi Kakudo, Andrey Bychkov
American Journal of Clinical Pathology.2021; 155(5): 680. CrossRef
Thyroid FNA cytology in Asian practice—Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas
K. Kakudo, M. Higuchi, M. Hirokawa, S. Satoh, C. K. Jung, A. Bychkov
Cytopathology.2017; 28(6): 455. CrossRef
The Use of Fine-Needle Aspiration (FNA) Cytology in Patients with Thyroid Nodules in Asia: A Brief Overview of Studies from the Working Group of Asian Thyroid FNA Cytology
Chan Kwon Jung, SoonWon Hong, Andrey Bychkov, Kennichi Kakudo
Journal of Pathology and Translational Medicine.2017; 51(6): 571. CrossRef

Original Articles

The Use of the Bethesda System for Reporting Thyroid Cytopathology in Korea: A Nationwide Multicenter Survey by the Korean Society of Endocrine Pathologists: Mimi Kim, Hyo Jin Park, Hye Sook Min, Hyeong Ju Kwon, Chan Kwon Jung, Seoung Wan Chae, Hyun Ju Yoo, Yoo Duk Choi, Mi Ja Lee, Jeong Ja Kwak, Dong Eun Song, Dong Hoon Kim, Hye Kyung Lee, Ji Yeon Kim, Sook Hee Hong, Jang Sihn Sohn, Hyun Seung Lee, So Yeon Park, Soon Won Hong, Mi Kyung Shin; J Pathol Transl Med. 2017;51(4):410-417. Published online June 14, 2017; DOI: https://doi.org/10.4132/jptm.2017.04.05

9,164 View
221 Download
21 Web of Science
20 Crossref

Abstract PDF

Background
The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has standardized the reporting of thyroid cytology specimens. The objective of the current study was to evaluate the nationwide usage of TBSRTC and assess the malignancy rates in each category of TBSRTC in Korea.
Methods
Questionnaire surveys were used for data collection on the fine needle aspiration (FNA) of thyroid nodules at 74 institutes in 2012. The incidences and follow-up malignancy rates of each category diagnosed from January to December, 2011, in each institute were also collected and analyzed.
Results
Sixty out of 74 institutes answering the surveys reported the results of thyroid FNA in accordance with TBSRTC. The average malignancy rates for resected cases in 15 institutes were as follows: nondiagnostic, 45.6%; benign, 16.5%; atypical of undetermined significance, 68.8%; suspicious for follicular neoplasm (SFN), 30.2%; suspicious for malignancy, 97.5%; malignancy, 99.7%.
Conclusions
More than 80% of Korean institutes were using TBSRTC as of 2012. All malignancy rates other than the SFN and malignancy categories were higher than those reported by other countries. Therefore, the guidelines for treating patients with thyroid nodules in Korea should be revisited based on the malignancy rates reported in this study.

Citations

Citations to this article as recorded by

Improved Diagnostic Accuracy of Thyroid Fine-Needle Aspiration Cytology with Artificial Intelligence Technology
Yujin Lee, Mohammad Rizwan Alam, Hongsik Park, Kwangil Yim, Kyung Jin Seo, Gisu Hwang, Dahyeon Kim, Yeonsoo Chung, Gyungyub Gong, Nam Hoon Cho, Chong Woo Yoo, Yosep Chong, Hyun Joo Choi
Thyroid®.2024; 34(6): 723. CrossRef
Welcoming the new, revisiting the old: a brief glance at cytopathology reporting systems for lung, pancreas, and thyroid
Rita Luis, Balamurugan Thirunavukkarasu, Deepali Jain, Sule Canberk
Journal of Pathology and Translational Medicine.2024; 58(4): 165. CrossRef
Predictors of Malignancy in Thyroid Nodules Classified as Bethesda Category III
Xiaoli Liu, Jingjing Wang, Wei Du, Liyuan Dai, Qigen Fang
Frontiers in Endocrinology.2022;[Epub] CrossRef
Risk stratification of indeterminate thyroid nodules by novel multigene testing: a study of Asians with a high risk of malignancy
Chunfang Hu, Weiwei Jing, Qing Chang, Zhihui Zhang, Zhenrong Liu, Jian Cao, Linlin Zhao, Yue Sun, Cong Wang, Huan Zhao, Ting Xiao, Huiqin Guo
Molecular Oncology.2022; 16(8): 1680. CrossRef
CD56 Expression in Papillary Thyroid Carcinoma Is Highly Dependent on the Histologic Subtype: A Potential Diagnostic Pitfall
Uiju Cho, Yourha Kim, Sora Jeon, Chan Kwon Jung
Applied Immunohistochemistry & Molecular Morphology.2022; 30(5): 389. CrossRef
Malignancy rates in thyroid nodules: a long-term cohort study of 17,592 patients
M Grussendorf, I Ruschenburg, G Brabant
European Thyroid Journal.2022;[Epub] CrossRef
Subclassification of the Bethesda Category III (AUS/FLUS): A study of thyroid FNA cytology based on ThinPrep slides from the National Cancer Center in China
Huan Zhao, HuiQin Guo, LinLin Zhao, Jian Cao, Yue Sun, Cong Wang, ZhiHui Zhang
Cancer Cytopathology.2021; 129(8): 642. CrossRef
Effect of the Noninvasive Follicular Thyroid Neoplasm With Papillary-Like Nuclear Features (NIFTP) Nomenclature Revision on Indian Thyroid Fine-Needle Aspiration Practice
Chanchal Rana, Pooja Ramakant, Divya Goel, Akanksha Singh, KulRanjan Singh, Suresh Babu, Anand Mishra
American Journal of Clinical Pathology.2021; 156(2): 320. CrossRef
Comprehensive DNA Methylation Profiling Identifies Novel Diagnostic Biomarkers for Thyroid Cancer
Jong-Lyul Park, Sora Jeon, Eun-Hye Seo, Dong Hyuck Bae, Young Mun Jeong, Yourha Kim, Ja Seong Bae, Seon-Kyu Kim, Chan Kwon Jung, Yong Sung Kim
Thyroid.2020; 30(2): 192. CrossRef
Differences in surgical resection rate and risk of malignancy in thyroid cytopathology practice between Western and Asian countries: A systematic review and meta‐analysis
Huy Gia Vuong, Hanh Thi Tuyet Ngo, Andrey Bychkov, Chan Kwon Jung, Trang Huyen Vu, Kim Bach Lu, Kennichi Kakudo, Tetsuo Kondo
Cancer Cytopathology.2020; 128(4): 238. CrossRef
Thyroid cancer among patients with thyroid nodules in Yemen: a three-year retrospective study in a tertiary center and a specialty clinic
Butheinah A. Al-Sharafi, Jamila A. AlSanabani, Ibraheem M. Alboany, Amani M. Shamsher
Thyroid Research.2020;[Epub] CrossRef
Is Bethesda classification sufficient to predict thyroid cancer in endemic regions?
Gamze ÇITLAK, Bahar CANBAY TORUN
Journal of Surgery and Medicine.2020; 4(9): 794. CrossRef
Preoperative diagnostic categories of fine needle aspiration cytology for histologically proven thyroid follicular adenoma and carcinoma, and Hurthle cell adenoma and carcinoma: Analysis of cause of under- or misdiagnoses
Hee Young Na, Jae Hoon Moon, June Young Choi, Hyeong Won Yu, Woo-Jin Jeong, Yeo Koon Kim, Ji-Young Choe, So Yeon Park, Paula Soares
PLOS ONE.2020; 15(11): e0241597. CrossRef
Nuclear features of papillary thyroid carcinoma: Comparison of Core needle biopsy and thyroidectomy specimens
Jae Yeon Seok, Jungsuk An, Hyun Yee Cho, Younghye Kim, Seung Yeon Ha
Annals of Diagnostic Pathology.2018; 32: 35. CrossRef
Clinical utility of EZH1 mutations in the diagnosis of follicular-patterned thyroid tumors
Chan Kwon Jung, Yourha Kim, Sora Jeon, Kwanhoon Jo, Sohee Lee, Ja Seong Bae
Human Pathology.2018; 81: 9. CrossRef
The History of Korean Thyroid Pathology
Soon Won Hong, Chan Kwon Jung
International Journal of Thyroidology.2018; 11(1): 15. CrossRef
Thyroid FNA cytology in Asian practice—Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas
K. Kakudo, M. Higuchi, M. Hirokawa, S. Satoh, C. K. Jung, A. Bychkov
Cytopathology.2017; 28(6): 455. CrossRef
Thyroid Fine-Needle Aspiration Cytology Practice in Korea
Yoon Jin Cha, Ju Yeon Pyo, SoonWon Hong, Jae Yeon Seok, Kyung-Ju Kim, Jee-Young Han, Jeong Mo Bae, Hyeong Ju Kwon, Yeejeong Kim, Kyueng-Whan Min, Soonae Oak, Sunhee Chang
Journal of Pathology and Translational Medicine.2017; 51(6): 521. CrossRef
Current Practices of Thyroid Fine-Needle Aspiration in Asia: A Missing Voice
Andrey Bychkov, Kennichi Kakudo, SoonWon Hong
Journal of Pathology and Translational Medicine.2017; 51(6): 517. CrossRef
Current Status of Thyroid Fine-Needle Aspiration Practice in Thailand
Somboon Keelawat, Samreung Rangdaeng, Supinda Koonmee, Tikamporn Jitpasutham, Andrey Bychkov
Journal of Pathology and Translational Medicine.2017; 51(6): 565. CrossRef

The Bethesda System(TBS): A New Reporting System of Cervicovaginal Smear.: Hy Sook Kim; Korean J Cytopathol. 1995;6(2):85-98.

1,747 View
26 Download

Abstract PDF: In 1989, the Bethesda System(TBS) was introduced as an attempt to standardize cervical/vaginal reporting systems. TBS nomenclature was created for reporting cytologic diagnoses to replace the currently used Cervical Intraepithelial Neoplasia(CIN) and Papanicolaou Class System which are deemed less reproducible. The name for preinvasive squamous lesions was changed to squamous intraepithelial lesion(SIL), subdivided into low-grade and high-grade type. TBS recommends a specific format for cytologic report, starting with explicit statement on the adequacy of the specimen, followed by general categorization and descriptive diagnosis. Pathologic and epidemiologic studies performed over last 10 years have provided evidence that human, papillomavirus(HPV) plays a significant role in the development of cervical neoplasia. TBS corresponds not only to currently held views of the behavior of preinvasive lesions and their HPV distribution, but also to the current guidelines for clinical management.

Histologic and Cytologic Follow-up in Atypical Squamous Cells of Undetermined Significance(ASCUS) on Cervical Smears.: Mi Kyung Shin; Korean J Cytopathol. 1998;9(1):29-36.

1,776 View
14 Download

Abstract PDF: In 1988, The Bethesda System for reporting cervical and vaginal cytologic diagnoses was introduced and this was revised in 1991. The new diagnostic category "atypical squamous cells of undetermined significance(ASCUS)" introduced by The Bethesda System is an area of controversy about the diagnostic category, clinical significance and appropriate treatment. A retrospective 2 years and 9 months study(April,1994-December,1996) was performed to evaluate the significance of reporting ASCUS on cervical smears. Sixtyseven(1.17%) of 5,730 smears were diagnosed as ASCUS and 21 cases were followed by cervical biopsies and/or endocervical curettages in 4 cases(19%), and repeat cervical smears in 17 cases (81%). Tissue diagnoses were benign in 2 cases and squamous cell carcinoma in situ in 2 cases. Cytologic diagnosis of follow up smear were negative in 14 cases (82.4%) and persistent ASCUS in 3 cases(17.6%).

Editorial

The Bethedsa System 2001 Workshop Report.: Eun Kyung Hong, Jong Hee Nam, Moon Hyang Park; Korean J Cytopathol. 2001;12(1):1-15.

1,499 View
15 Download

Abstract PDF: The Bethesda System (TBS) was first developed in 1988 for the need to enhance the communication of the cytopathologic findings to the referring physician in unambiguous diagnostic terms. The terminology used in this reporting system should reflect current understanding of the pathogenesis of cervical/vaginal disease, so the framework of the reporting system should be flexible enough to accommodate advances in medicine, including virology, molecular biology, and pathology. Three years after the introduction of TBS, the second Bethesda workshop was held to set or amend diagnostic criteria for each categories of TBS. TBS 1991 is now widely used. The third Bethesda workshop, The Bethesda System 2001 Workshop, was held in National Cancer Institute, Bethesda, Maryland from April 30 to May 2, 2001. Again, the goals of this workshop were to promote effective communication and to clarify in reporting cervical cytopathology results to clinicians and to provide with the information to make appropriate decisions about diagnosis and treatment. Nine forum groups were made and there were Web-based bulletin board discussions between October, 2000 and the first week of April, 2001. On the basis of bulletin board comments and discussions, the forum moderators recommended revised terminologies in the Workshop. Hot discussions were followed after the presentation by forum moderators during the workshop. Terminologies confusing clinicians and providing no additional informations regarding patient management were deleted in the workshop to clarify the cervicovaginal cytology results. Any informations related to the patient management were encouraged to add. So 'Satisfactory for evaluation but limited by' of 'Specimen Adequacy' catergory was deleted. Terminology of 'Unsatisfactory' was further specified as 'Specimen rejected' and 'Specimen processed and examined, but unsatisfactory'. Terminologies of 'Benign Cellular Change' and 'Within Normal Limits' were combined and terminology was changed to 'Negative for intraepithelial lesion

Original Article

Qualification of Atypical Squamous Cells of Undetermined Significance - "ASCUS, R/O HSIL": Cytologic Features and Histologic Correlation.: Hye Sun Kim, Bock Man Kim, Yee Jung Kim, Hy Sook Kim; Korean J Cytopathol. 2002;13(1):14-20.

2,108 View
25 Download

Abstract PDF: Cytologic and histopathologic features and human papillomavirus (HPV) DNA detection associated with 101 cervicovaginal smears which are classified as 'atypical squamous cells of undetermined significance, rule out high grade squamous intraepithelial lesion(ASCUS, R/O HSIL)' were reviewed and compared to 89 smears of 'ASCUS, not otherwise specified(NOS)' . Cytologic fieatures of ASCUS, R/O HSIL included atypical single small cells(36.6%), hyperchromatic tissue fragments(35.6%), atypical metaplastic cells(18.8%), endometrial cell-like clusters(5.9%), and atypical parakeratotic cells(3.0%). A final diagnosis of HSIL on biopsy was assigned to 47(54.0%) of 87 women with ASCUS, R/O HSIL and to 13(14.6%) of 89 women with ASCUS, NOS ( p=0.000). There was no difference in HPV DNA detection rate between ASCUS, R/O HSIL and ASCUS, NOS smears. These data suggest that subclassification of ASCUS is helpful to manage patients because ASCUS, R/O HSIL is more often associated with an underlying HSIL on biopsy. Therefore, women with ASCUS, rule out HSIL should be actively managed with colposcopic examination.

First
Prev
Page of 1
Next
Last

Search