Thyroid Cytopathology: Bethesda and Beyond
Open Access
- 26 November 2010
- journal article
- review article
- Published by S. Karger AG in Acta Cytologica
- Vol. 55 (1), 4-12
- https://doi.org/10.1159/000322365
Abstract
Thyroid nodules are commonly encountered in clinical practice. Although the overwhelming majority of them turn out to be benign, the small subset of cancerous nodules needs to be accurately identified for optimal and timely surgical management. Fine-needle aspiration has proven to be the most valuable diagnostic modality for pre-operative distinction of benign from malignant nodules. The recently introduced and much anticipated Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has standardized our diagnostic approach to reporting and cytomorphological criteria. TBSRTC has well-defined and rational management algorithms with implicit risk of malignancy in each of the 6 diagnostic categories. Recently published data supports the clinical utility and wide acceptance of TBSRTC by both practicing pathologists and clinicians. The problematic category of ‘indeterminate’ cytopathologic diagnoses has led to the discovery and development of unique and useful molecular markers, such as BRAF, which have displayed promising potential in recently published studies. As a result of the publication of TBSRTC, in 2009 the American Thyroid Association revised its clinical guidelines for the management of patients with thyroid disease and TBSRTC offers a useful source of information for the pathologist as well.Keywords
This publication has 17 references indexed in Scilit:
- Should “atypical follicular cells” in thyroid fine-needle aspirates be subclassified?Cancer Cytopathology, 2010
- BRAFV600E Mutation Analysis of Thyroid Nodules Needle Aspirates in Relation to Their Ultrasongraphic Classification: A Potential Guide for Selection of Samples for Molecular AnalysisThyroid®, 2010
- Revised American Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid CancerThyroid®, 2009
- The Bethesda System for Reporting Thyroid CytopathologyAmerican Journal of Clinical Pathology, 2009
- The Updated American Thyroid Association Guidelines for Management of Thyroid Nodules and Differentiated Thyroid Cancer: A Surgical PerspectiveThyroid®, 2009
- Highlights of the American Thyroid Association Guidelines for Patients with Thyroid Nodules or Differentiated Thyroid Carcinoma: The 2009 RevisionThyroid®, 2009
- Implications of the proposed thyroid fine‐needle aspiration category of “follicular lesion of undetermined significance”: A five‐year multi‐institutional analysisDiagnostic Cytopathology, 2009
- Utilization of ancillary studies in thyroid fine needle aspirates: A synopsis of the National Cancer Institute Thyroid Fine Needle Aspiration State of the Science ConferenceDiagnostic Cytopathology, 2008
- Long-term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluationCancer, 2007
- Fine-needle aspiration of thyroid nodules: A study of 4703 patients with histologic and clinical correlationsCancer, 2007