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4 "The Bethesda System for Reporting Thyroid Cytopathology"
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Current Status of Thyroid Fine-Needle Aspiration Practice in Thailand
Somboon Keelawat, Samreung Rangdaeng, Supinda Koonmee, Tikamporn Jitpasutham, Andrey Bychkov
J Pathol Transl Med. 2017;51(6):565-570.   Published online November 15, 2017
DOI: https://doi.org/10.4132/jptm.2017.08.12
  • 6,565 View
  • 135 Download
  • 9 Web of Science
  • 6 Crossref
AbstractAbstract PDF
Thyroid carcinoma is one of the leading malignancies in Thailand increasingly prevalent in the female population. Fine-needle aspiration (FNA) cytology is a widely used diagnostic tool for evaluation of thyroid nodules and thyroid cancer. Thyroid FNA is a routine procedure universally performed in Thai hospitals by a variety of clinical specialists. Manual guidance is the first-line choice complemented by ultrasound assistance in selected cases. Despite national guidelines recommendations, the diagnostic criteria and terminology of the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was slowly adopted in the local settings. Currently, the Bethesda system is actively promoted by the local professional societies as a uniform reporting system. Experience with thyroid FNA has been rarely reported to date—only a handful of publications are available in local journals. Our review, in addition to presenting various aspects of thyroid FNA in Thailand, established for the first time national references for a certain statistical outputs of TBSRTC based on the original multi-institutional cohort. The risk of malignancy in 2,017 operated thyroid nodules collected from three tertiary thyroid cancer centers was 21.7%, 14.7%, 35.9%, 44.4%, 76.7%, and 92.6% for categories I to VI, respectively. The malignancy risk in several diagnostic categories (II to IV) was higher than the risk estimated by TBSRTC and recent meta-analysis studies. We endorse the use of uniform terminology of the Bethesda system in Thailand, which will help facilitate communication among diverse medical professionals involved in the management of patients with thyroid nodules, to share local experience with the international audience.

Citations

Citations to this article as recorded by  
  • The Asian Thyroid Working Group, from 2017 to 2023
    Kennichi Kakudo, Chan Kwon Jung, Zhiyan Liu, Mitsuyoshi Hirokawa, Andrey Bychkov, Huy Gia Vuong, Somboon Keelawat, Radhika Srinivasan, Jen-Fan Hang, Chiung-Ru Lai
    Journal of Pathology and Translational Medicine.2023; 57(6): 289.     CrossRef
  • Application of the Bethesda system for reporting thyroid cytopathology for classification of thyroid nodules: A clinical and cytopathological characteristics in Bhutanese population
    Sonam Choden, Chimi Wangmo, Sushna Maharjan
    Diagnostic Cytopathology.2021; 49(11): 1179.     CrossRef
  • Patient Discomfort in Relation to Thyroid Nodule Fine-Needle Aspiration (FNA) Performed with or without Parenteral and/or Topical Anesthetic
    Chenxiang Cao, Sina Jasim, Amrita Cherian, Aziza Nassar, Ana-Maria Chindris, Ana Marcella Rivas, Stephanie Bonnett, Melanie Caserta, Marius N. Stan, Victor J. Bernet
    Endocrine Practice.2020; 26(12): 1497.     CrossRef
  • Incidence and malignancy rates classified by The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) – An 8-year tertiary center experience in Thailand
    Yotsapon Thewjitcharoen, Siriwan Butadej, Soontaree Nakasatien, Phawinpon Chotwanvirat, Sriurai Porramatikul, Sirinate Krittiyawong, Nampetch Lekpittaya, Thep Himathongkam
    Journal of Clinical & Translational Endocrinology.2019; 16: 100175.     CrossRef
  • The Use of Fine-Needle Aspiration (FNA) Cytology in Patients with Thyroid Nodules in Asia: A Brief Overview of Studies from the Working Group of Asian Thyroid FNA Cytology
    Chan Kwon Jung, SoonWon Hong, Andrey Bychkov, Kennichi Kakudo
    Journal of Pathology and Translational Medicine.2017; 51(6): 571.     CrossRef
  • Thyroid FNA cytology in Asian practice—Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas
    K. Kakudo, M. Higuchi, M. Hirokawa, S. Satoh, C. K. Jung, A. Bychkov
    Cytopathology.2017; 28(6): 455.     CrossRef
Thyroid Cytology: The Japanese System and Experience at Yamashita Thyroid Hospital
Shinya Satoh, Hiroyuki Yamashita, Kennichi Kakudo
J Pathol Transl Med. 2017;51(6):548-554.   Published online October 11, 2017
DOI: https://doi.org/10.4132/jptm.2017.09.29
  • 8,865 View
  • 158 Download
  • 22 Web of Science
  • 18 Crossref
AbstractAbstract PDF
In Japan, fine-needle aspiration (FNA) cytology is the most important diagnostic modality for triaging patients with thyroid nodules. A clinician (endocrinologist, endocrine surgeon, or head and neck surgeon) generally performs FNA cytology at the outpatient clinic, and ultrasound (US)-guided FNA is widespread because US is extremely common and most clinicians are familiar with it. Although almost all FNA thyroid samples are examined by certified cytopathologists and pathologists, some clinicians assess cytological specimens themselves. In Japan, there are two clinical guidelines regarding the management of thyroid nodules. One is the General Rules for the Description of Thyroid Cancer (GRDTC) published by the Japanese Society of Thyroid Surgery (JSTS) in 2005, and the other is the national reporting system for thyroid FNA cytology published by the Japan Thyroid Association in 2013 (Japanese system). Although the Bethesda System for Reporting Thyroid Cytopathology (Bethesda system) is rarely used in Japan, both the GRDTC and Japanese system tried to incorporate the Bethesda system so that the cytological diagnoses would be compatible with each other. The essential point of the Japanese system is stratification of follicular neoplasm (FN) into three subgroups based on cytological features in order to reduce unnecessary diagnostic thyroidectomy, and this system has been successful in stratifying the risk of malignancy in FN patients at several high-volume thyroid surgery centers. In Japan, the measurement of thyroglobulin and/or calcitonin in FNA needle washings is often used as an adjunct for diagnosis of possible cervical lymph node metastasis when FNA cytology is performed.

Citations

Citations to this article as recorded by  
  • Thyroid FNA cytology: The Eastern versus Western perspectives
    Mitsuyoshi Hirokawa, Manon Auger, Chan Kwon Jung, Fabiano Mesquita Callegari
    Cancer Cytopathology.2023; 131(7): 415.     CrossRef
  • The Asian Thyroid Working Group, from 2017 to 2023
    Kennichi Kakudo, Chan Kwon Jung, Zhiyan Liu, Mitsuyoshi Hirokawa, Andrey Bychkov, Huy Gia Vuong, Somboon Keelawat, Radhika Srinivasan, Jen-Fan Hang, Chiung-Ru Lai
    Journal of Pathology and Translational Medicine.2023; 57(6): 289.     CrossRef
  • Criteria for follow‐up of thyroid nodules diagnosed as follicular neoplasm without molecular testing – The experience of a high‐volume thyroid centre in Japan
    Mitsuyoshi Hirokawa, Ayana Suzuki, Makoto Kawakami, Takumi Kudo, Akira Miyauchi
    Diagnostic Cytopathology.2022; 50(5): 223.     CrossRef
  • The Significance of RAS-Like Mutations and MicroRNA Profiling in Predicting Malignancy in Thyroid Biopsy Specimens
    Nicole A. Cipriani, Daniel N. Johnson, David H. Sarne, Peter Angelos, Ward Reeves, Tatjana Antic
    Endocrine Pathology.2022; 33(4): 446.     CrossRef
  • Molecular Testing for Thyroid Nodules: The Experience at McGill University Teaching Hospitals in Canada
    Mohannad Rajab, Richard J. Payne, Véronique-Isabelle Forest, Marc Pusztaszeri
    Cancers.2022; 14(17): 4140.     CrossRef
  • Impact of Molecular Testing on the Management of Indeterminate Thyroid Nodules Among Western and Asian Countries: a Systematic Review and Meta-analysis
    Hanh Thi Tuyet Ngo, Truong Phan Xuan Nguyen, Trang Huyen Vu, Chan Kwon Jung, Lewis Hassell, Kennichi Kakudo, Huy Gia Vuong
    Endocrine Pathology.2021; 32(2): 269.     CrossRef
  • The Incidence of Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features: A Meta-Analysis Assessing Worldwide Impact of the Reclassification
    Chanchal Rana, Huy Gia Vuong, Thu Quynh Nguyen, Hoang Cong Nguyen, Chan Kwon Jung, Kennichi Kakudo, Andrey Bychkov
    Thyroid.2021;[Epub]     CrossRef
  • Ultrasound-guided Fine Needle Aspiration Cytological Examination of Thyroid Nodules: A Practical Guideline (2019 edition)

    ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY.2021; 5(2): 134.     CrossRef
  • Differences in surgical resection rate and risk of malignancy in thyroid cytopathology practice between Western and Asian countries: A systematic review and meta‐analysis
    Huy Gia Vuong, Hanh Thi Tuyet Ngo, Andrey Bychkov, Chan Kwon Jung, Trang Huyen Vu, Kim Bach Lu, Kennichi Kakudo, Tetsuo Kondo
    Cancer Cytopathology.2020; 128(4): 238.     CrossRef
  • Exploring the Inter-observer Agreement Among the Members of the Italian Consensus for the Classification and Reporting of Thyroid Cytology
    Anna Crescenzi, Pierpaolo Trimboli, Fulvio Basolo, Andrea Frasoldati, Fabio Orlandi, Lucio Palombini, Enrico Papini, Alfredo Pontecorvi, Paolo Vitti, Michele Zini, Francesco Nardi, Guido Fadda
    Endocrine Pathology.2020; 31(3): 301.     CrossRef
  • The Current Histologic Classification of Thyroid Cancer
    Sylvia L. Asa
    Endocrinology and Metabolism Clinics of North America.2019; 48(1): 1.     CrossRef
  • Clinical Impact of Non-Invasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features on the Risk of Malignancy in the Bethesda System for Reporting Thyroid Cytopathology: A Meta-Analysis of 14,153 Resected Thyroid Nodules
    Huy Gia Vuong, Thao T.K. Tran, Andre y. Bychkov, Chan Kwon Jung, Tadao Nakazawa, Kennichi Kakudo, R yohei Katoh, Tetsuo Kondo
    Endocrine Practice.2019; 25(5): 491.     CrossRef
  • A Multi-institutional Study of Prevalence and Clinicopathologic Features of Non-invasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features (NIFTP) in Korea
    Ja Yeong Seo, Ji Hyun Park, Ju Yeon Pyo, Yoon Jin Cha, Chan Kwon Jung, Dong Eun Song, Jeong Ja Kwak, So Yeon Park, Hee Young Na, Jang-Hee Kim, Jae Yeon Seok, Hee Sung Kim, Soon Won Hong
    Journal of Pathology and Translational Medicine.2019; 53(6): 378.     CrossRef
  • Noninvasive follicular thyroid neoplasm with papillary‐like nuclear features (NIFTP) in thyroid tumor classification
    Kennichi Kakudo, Adel K. El‐Naggar, Steven P. Hodak, Elham Khanafshar, Yuri E Nikiforov, Vania Nosé, Lester D. R. Thompson
    Pathology International.2018; 68(6): 327.     CrossRef
  • Diagnostic value of HBME‐1, CK19, Galectin 3, and CD56 in the subtypes of follicular variant of papillary thyroid carcinoma
    Haeyon Cho, Ji‐Ye Kim, Young Lyun Oh
    Pathology International.2018; 68(11): 605.     CrossRef
  • The Usefulness of Immunocytochemistry of CD56 in Determining Malignancy from Indeterminate Thyroid Fine-Needle Aspiration Cytology
    Hyunseo Cha, Ju Yeon Pyo, Soon Won Hong
    Journal of Pathology and Translational Medicine.2018; 52(6): 404.     CrossRef
  • Impact of the modification of the diagnostic criteria in the 2017 Bethesda System for Reporting Thyroid Cytopathology: a report of a single institution in Japan
    Miyoko Higuchi, Mitsuyoshi Hirokawa, Risa Kanematsu, Aki Tanaka, Ayana Suzuki, Naoki Yamao, Toshitetsu Hayashi, Seiji Kuma, Akira Miyauchi
    Endocrine Journal.2018; 65(12): 1193.     CrossRef
  • The Use of Fine-Needle Aspiration (FNA) Cytology in Patients with Thyroid Nodules in Asia: A Brief Overview of Studies from the Working Group of Asian Thyroid FNA Cytology
    Chan Kwon Jung, SoonWon Hong, Andrey Bychkov, Kennichi Kakudo
    Journal of Pathology and Translational Medicine.2017; 51(6): 571.     CrossRef
Thyroid Cytology in India: Contemporary Review and Meta-analysis
Shipra Agarwal, Deepali Jain
J Pathol Transl Med. 2017;51(6):533-547.   Published online October 5, 2017
DOI: https://doi.org/10.4132/jptm.2017.08.04
  • 8,721 View
  • 188 Download
  • 12 Web of Science
  • 14 Crossref
AbstractAbstract PDF
Fine-needle aspiration cytology (FNAC) is a screening test for triaging thyroid nodules, aiding in subsequent clinical management. However, the advantages have been overshadowed by the multiplicity of reporting systems and a wide range of nomenclature used. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was formulated in 2007, to give the world a uniform thyroid cytology reporting system, facilitating easy interpretation by the clinicians. Here, we review the status of thyroid FNAC in India in terms of various reporting systems used including a meta-analysis of the previously published data. An extensive literature search was performed using internet search engines. The reports with detailed classification system used in thyroid cytology were included. The meta-analysis of published data was compared with the implied risk of malignancy by TBSRTC. More than 50 studies were retrieved and evaluated. TBSRTC is currently the most widely used reporting system with different studies showing good efficacy and interobserver concordance. Ancillary techniques have, as of now, limited applicability and acceptability in thyroid cytology in India. Twenty-eight published articles met the criteria for inclusion in the meta-analysis. When compared with TBSRTC recommendations, the meta-analysis showed a higher risk of malignancy for categories I and III. Thyroid FNAC is practiced all over India. TBSRTC has found widespread acceptance, with most institutions using this system for routine thyroid cytology reporting. However, reasons for a high malignancy risk for categories I and III need to be looked into. Various possible contributing factors are discussed in the review.

Citations

Citations to this article as recorded by  
  • Thermal imaging based pre-diagnostics tool for Graves’ disease
    Vaishali Sharma, Vandana K Dhingra, Snehlata Shakya, Ashok Kumar, Mayank Goswami
    Measurement Science and Technology.2024; 35(3): 035702.     CrossRef
  • High Malignancy Risk and Its Predictors in South Indian Patients With Bethesda II Thyroid Nodules
    Sunanda Tirupati, Pradeep Puthenveetil, Shilpa Lakkundi, Anudeep Gaddam, Vijaya Sarathi
    Cureus.2024;[Epub]     CrossRef
  • Evaluation of thyroid lesions by the bethesda system for reporting thyroid cytopathology
    SyedAsif Hashmi, Monika Aggrawal, Rahul Pandey, Deepika Gulati, InamDanish Khan
    Journal of Marine Medical Society.2023; 25(1): 73.     CrossRef
  • Incidence and Malignancy Rates in Thyroid Nodules in North-East Indian Population by Bethesda System: A Single Institutional Experience of 3 Years
    Suvamoy Chakraborty, Manu C. Balakrishnan, Vandana Raphael, Prachurya Tamuli, Anuradha Deka
    South Asian Journal of Cancer.2023; 12(02): 166.     CrossRef
  • Evaluation of Concordance of Ultrasound, Cytology, and Histopathology in Solitary Thyroid Nodules
    Sunil Chumber, Surabhi Vyas, Kamal Kataria, Shipra Agarwal, Yashwant S Rathore, Gopal Puri, Sushma Yadav, Kanika Sharma, Amit Patidar
    Indian Journal of Endocrine Surgery and Research.2023; 18(1): 17.     CrossRef
  • Cytomorphological Spectrum of Head and Neck Lesions by Fine Needle Aspiration Cytology in a Tertiary Care Center
    Amandeep Kaur, Sonali Poonia, Karandeep Singh, Dalbir Kaur, Mohit Madhukar, Ravish Godara
    Journal of Pharmacy and Bioallied Sciences.2023; 15(Suppl 1): S315.     CrossRef
  • The Asian Thyroid Working Group, from 2017 to 2023
    Kennichi Kakudo, Chan Kwon Jung, Zhiyan Liu, Mitsuyoshi Hirokawa, Andrey Bychkov, Huy Gia Vuong, Somboon Keelawat, Radhika Srinivasan, Jen-Fan Hang, Chiung-Ru Lai
    Journal of Pathology and Translational Medicine.2023; 57(6): 289.     CrossRef
  • Cytomorphological categorization of thyroid lesions according to the bethesda system for reporting thyroid cytology and correlation with their histological outcome: An indian oncology centre experience
    Meenakshi Kamboj, Anurag Mehta, Sunil Pasricha, Gurudutt Gupta, Anila Sharma, Garima Durga
    Journal of Cytology.2022; 39(1): 44.     CrossRef
  • Is surgery necessary in benign thyroid lesions?
    Pushkar Chaudhary, Naseem Noorunnisa
    Journal of Datta Meghe Institute of Medical Sciences University.2022; 17(3): 799.     CrossRef
  • Effect of the Noninvasive Follicular Thyroid Neoplasm With Papillary-Like Nuclear Features (NIFTP) Nomenclature Revision on Indian Thyroid Fine-Needle Aspiration Practice
    Chanchal Rana, Pooja Ramakant, Divya Goel, Akanksha Singh, KulRanjan Singh, Suresh Babu, Anand Mishra
    American Journal of Clinical Pathology.2021; 156(2): 320.     CrossRef
  • The combination of ACR‐Thyroid Imaging Reporting and Data system and The Bethesda System for Reporting Thyroid Cytopathology in the evaluation of thyroid nodules—An institutional experience
    Shanmugasundaram Sakthisankari, Sreenivasan Vidhyalakshmi, Sivanandam Shanthakumari, Balalakshmoji Devanand, Udayasankar Nagul
    Cytopathology.2021; 32(4): 472.     CrossRef
  • Risk of malignancy in Thyroid “Atypia of undetermined significance/Follicular lesion of undetermined significance” and its subcategories – A 5-year experience
    Abha Thakur, Haimanti Sarin, Dilpreet Kaur, Deepak Sarin
    Indian Journal of Pathology and Microbiology.2019; 62(4): 544.     CrossRef
  • Thyroid FNA cytology in Asian practice—Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas
    K. Kakudo, M. Higuchi, M. Hirokawa, S. Satoh, C. K. Jung, A. Bychkov
    Cytopathology.2017; 28(6): 455.     CrossRef
  • The Use of Fine-Needle Aspiration (FNA) Cytology in Patients with Thyroid Nodules in Asia: A Brief Overview of Studies from the Working Group of Asian Thyroid FNA Cytology
    Chan Kwon Jung, SoonWon Hong, Andrey Bychkov, Kennichi Kakudo
    Journal of Pathology and Translational Medicine.2017; 51(6): 571.     CrossRef
Thyroid Fine-Needle Aspiration Practice in the Philippines
Agustina D. Abelardo
J Pathol Transl Med. 2017;51(6):555-559.   Published online October 5, 2017
DOI: https://doi.org/10.4132/jptm.2017.07.14
  • 6,951 View
  • 133 Download
  • 6 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Fine-needle aspiration (FNA) is a well accepted initial approach in the management of thyroid lesions. It has come a long way since its introduction for nearly a century ago. In the Philippines, FNA of the thyroid was first introduced 30 years ago and has been utilized until now as a mainstay in the diagnosis of thyroid malignancy. The procedure is performed by pathologists, endocrinologists, surgeons, and radiologists. Most pathologists report the cytodiagnosis using a combination of the aspiration biopsy cytology method that closely resembles the histopathologic diagnosis of thyroid disorders and the six-tier nomenclature of The Bethesda System for Reporting Thyroid Cytopathology. Local endocrinologists and surgeons follow the guidelines of the 2015 American Thyroid Association in the management of thyroid disorders. There is still a paucity of local research studies but available data deal with cytohistologic correlations, sensitivity, specificity, and accuracy rates as well as usefulness of ultrasound-guided FNA. Cytohistologic correlations have a wide range of sensitivity from 30.7% to 73% and specificity from 83% to 100%. The low sensitivity can be attributed to poor tissue sampling since a majority of the thyroid FNA is done by palpation only. The reliability can be improved if FNA is guided by ultrasound as attested in both international and local studies. Overall, FNA of the thyroid has enabled the diagnosis of thyroid disorders with an accuracy of 72.8% to 87.2% and it correlates well with histopathology.

Citations

Citations to this article as recorded by  
  • The Asian Thyroid Working Group, from 2017 to 2023
    Kennichi Kakudo, Chan Kwon Jung, Zhiyan Liu, Mitsuyoshi Hirokawa, Andrey Bychkov, Huy Gia Vuong, Somboon Keelawat, Radhika Srinivasan, Jen-Fan Hang, Chiung-Ru Lai
    Journal of Pathology and Translational Medicine.2023; 57(6): 289.     CrossRef
  • Application of the Bethesda System for Reporting Thyroid Cytopathology in the Pediatric Population
    Huy Gia Vuong, Ayana Suzuki, Hee Young Na, Pham Van Tuyen, Doan Minh Khuy, Hiep Canh Nguyen, Tikamporn Jitpasutham, Agustina Abelardo, Takashi Amano, So Yeon Park, Chan Kwon Jung, Mitsuyoshi Hirokawa, Ryohei Katoh, Kennichi Kakudo, Andrey Bychkov
    American Journal of Clinical Pathology.2021; 155(5): 680.     CrossRef
  • Thyroid FNA cytology in Asian practice—Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas
    K. Kakudo, M. Higuchi, M. Hirokawa, S. Satoh, C. K. Jung, A. Bychkov
    Cytopathology.2017; 28(6): 455.     CrossRef
  • The Use of Fine-Needle Aspiration (FNA) Cytology in Patients with Thyroid Nodules in Asia: A Brief Overview of Studies from the Working Group of Asian Thyroid FNA Cytology
    Chan Kwon Jung, SoonWon Hong, Andrey Bychkov, Kennichi Kakudo
    Journal of Pathology and Translational Medicine.2017; 51(6): 571.     CrossRef

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