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Not All Bethesda 1 Thyroid Nodules Were Created Equal: Different B1 Subgroups.

Authors :
Raveh Gildin N
Cohen H
Ronen O
Source :
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists [Endocr Pract] 2021 Mar; Vol. 27 (3), pp. 223-227. Date of Electronic Publication: 2020 Dec 14.
Publication Year :
2021

Abstract

Objective: The Bethesda System for Reporting Thyroid Cytopathology is a uniform method used worldwide to report thyroid fine-needle aspiration (FNA) outcomes. This study focuses on the Nondiagnostic/Unsatisfactory category, designated as Bethesda1 (B1). The documented risk of malignancy for B1 nodules can vary significantly, implying this category is not homogenous and might be composed of different subtypes. Our hypothesis was that B1 subgroups (blood only, insufficient thyrocytes, cyst content) will vary in their malignancy rate.<br />Methods: The study design was observational and retrospective. The study population included 154 patients in the Galilee Medical Center who underwent FNA examination of the thyroid gland from 2013-2018 and had a B1 result. We looked at the final diagnosis of malignant or benign for patients who underwent surgery and calculated the malignancy rate for each subgroup.<br />Results: Malignancy rates were higher in the Blood subgroup than in the other subgroups, and higher in the Thyrocytes subgroup than in the Cyst subgroup (P < .05). All malignancies were papillary thyroid carcinomas. There was no significant difference in the malignancy rate when we further divided the B1 samples into 2 groups based on the presence of epithelial cells. Many repeat FNA tests resulted in a different B1 subgroup.<br />Conclusion: The different malignancy rates suggest that individual management approaches should be considered for each B1 subgroup.<br /> (Copyright © 2020 AACE. Published by Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1530-891X
Volume :
27
Issue :
3
Database :
MEDLINE
Journal :
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
Publication Type :
Academic Journal
Accession number :
33779555
Full Text :
https://doi.org/10.1016/j.eprac.2020.09.017