Journal of Cytology
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Diagnostic efficacy of ultrasound-guided fine needle aspiration combined with the Bethesda system of reporting

1 Department of Pathology, Believers Church Medical College, Thiruvalla, Kerala, India
2 Department of Pathology, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
3 Department of Community Medicine, Government Medical College, Idukki, Kerala, India

Correspondence Address:
K Ajitha Kumari,
Department of Pathology, Believers Church Medical College, Thiruvalla, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JOC.JOC_168_16

Background: Image-guided fine needle aspiration cytology (FNAC) is emerging as an important diagnostic tool in the evaluation of thyroid swellings. Aim: This study aims to assess the efficacy of ultrasound (US)-guided FNAC combined with “The Bethesda system' of reporting as a primary screening test for all thyroid lesions. Settings and Design: A prospective cohort study was made and all the US-guided FNACs done were followed up to find out the histopathological diagnoses wherever surgery was done. Materials and Methods: In all, 1050 patients who underwent US-guided FNAC were studied during a period of 1 year. Age, sex, cytological features, and histological diagnoses were analyzed. Statistical analyses of all the findings were done to derive conclusions. Results: Of the 1050 patients, only 10.5% underwent surgery. Higher than expected rate (as per the Bethesda system) of malignancy was noted with the so-called grey zone lesions. The test results revealed a high level of sensitivity, specificity, and diagnostic accuracy. Conclusion: The study showed that The Bethesda System of Reporting Thyroid Cytology provides effective communication between clinician and pathologists thereby enabling clear management strategies. We also concluded that US-guided FNACs offer better results compared with palpation-guided FNACs.

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