Spectrum of thyroid lesions in FNAC - diagnostic implications and pitfalls

Thyroid nodule is one of the most common clinical presentations with annual incidence of 4% in general population. For clear communication between treating surgeon and cytopathologist the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) established a uniform, tiered reporting system for thyroid Fine needle aspiration (FNAC) specimens. Retrospective descriptive study was conducted for the duration of three years on all cases of thyroid FNAC.481 thyroid FNAC were performed, patients age ranged from 16 years to 78 years, with mean age of 39 years, majority of them in 4th decade 158 cases (32.8%).Male female ratio of 1: 8.6, with female predominance 443 cases (92%).Observation based on TBSRTC categories as follows category I - unsatisfactory – 36 cases (7.5%),Category II – Benign – 419 cases (87.1%),Category III - Atypia of Undetermined Significance or Follicular Lesion of Undetermined Significance 2 cases (0.4%), Category IV of Follicular Neoplasm or Suspicious for a Follicular Neoplasm 05 cases (1%), category V - suspicious of malignancy 5 cases (1%).The Bethesda system for reporting of thyroid cytology will give uniform categorization of thyroid smear globally among cytopathologist, and give clear communication to treating surgeon regarding decision on further treatment.