Background: Recent Bethesda System (2017) for reporting of thyroid lesion (TBSRTC) in cytopathology (FNAC) has attempted standardize the diagnostic approach. A uniform reporting system for thyroid FNA will facilitate effective communication among health care providers which helps in reducing the number of unnecessary thyroidectomies.

Aims and Objectives:  To evaluate the cases according to Bethesda system and compare the result with conventional system.

Material and Methods: A retrospective study on FNAC thyroid was performed in M.G.M Medical College and M.Y. Hospital which included 500 cases which were reported from May 2013 to May 2018. For cytomorphological analysis of smears with Papanicolaou stain were reviewed and cases were categorized into six Bethesda categories.

Results: Females were more than males with a ratio of 7:1, age ranged between 20 years to 70 years. 26 cases (5.2%) categorized as nondiagnostic/ unsatisfactory samples, 396 (79.2%) as benign, and 28 (5.6%) as atypia of undetermined significance/atypical follicular lesion of undetermined significance (AUS/AFLUS), 8(1.6%) as follicular neoplasm/suspected follicular neoplasm (FN/SFN), 7 (1.4%) as suspicious for malignancy, and 35 cases (7%) as malignant. Reporting thyroid cytopathology per Bethesda system increases sensitivity, specificity, accuracy of thyroid cytopathology, increases understanding of reporting system by clinician, improves management plans, and reducing

Conclusion: Bethesda system of reporting can effectively determine which patients needed surgery/follow-up FNAC.TBSRTC may be used as national standardized terminology for thyroid reporting .The clinicians should be encouraged to embrace this procedure in the initial management of such  patients.

Keywords: Fine needle aspiration cytology, Conventional System, thyroid lesion, Bethesda system.

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Dr Meena Mittal

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