Interobserver and intraobserver variation in thyroid cytopathology by conventional method and the Bethesda system
2020
Introduction: Fine needle aspiration cytology (FNAC) is the most sensitive, correct and price effective
initial technique for the clinical management of patient with thyroid nodules. Majority of the thyroid
nodules are benign, with cancer accounting for less than 1% of all the lesions. Surgeons should understand
the type of lesion before operation. Follicular patterned lesions is a grey zone area. If uniform standards are
applied while reporting thyroid FNAC, thyroid lesions can be accurately categorized.
Materials and Methods: It is a retrospective observational, comparative hospital based study. Previous
archived slides of thyroid FNAC ranging from a spectrum of benign to malignant lesions, belonging to
different categories which can be classified according to Bethesda system over a period of 2 years. 20 FNA
slides will be selected from different categories. The conventional system and the Bethesda system was
used for reporting.
Result: Bethesda system clearly defines risk of malignancy. Good interobserver correlation is found in Cat
I and Cat VII while category IV, V and VI shows poor correlation by conventional method. While good
correlation is found by the observers in category I, II and VI, Moderate correlation is found in category V
by Bethesda system.
Conclusion: Bethesda system of reporting thyroid cytopathology has high sensitivity as compared to
conventional method and by this technique the interobserver and intraobserver variability can be reduced.
Keywords: Bethesda system, Thyroid, FNAC.
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