Use of The Bethesda System for Reporting Thyroid Cytopathology in Thyroid Nodules Incoordination to the Appropriate Surgical Intervention

Kareem, Rusul A.; Ghadhban, Basim Rassam

doi:10.52573/ipmj.2026.166913

	Use of The Bethesda System for Reporting Thyroid Cytopathology in Thyroid Nodules Incoordination to the Appropriate Surgical Intervention
Iraqi Postgraduate Medical Journal
Volume 25, Issue 3, July 2026, Pages 320-330 PDF (563.21 K)
Document Type: Research Paper
DOI: 10.52573/ipmj.2026.166913
Authors
Rusul A. Kareem^* ¹; Basim Rassam Ghadhban²
¹General and laparoscopic surgeon Iraq / Baghdad/
²Baghdad
Abstract
Background: The thyroid nodule refers to an abnormal growth of thyroid cells. Although the vast majority of thyroid nodules are benign, a small proportion of thyroid nodules are malignant. In order to diagnose and treat malignant thyroid nodules at the earliest stage, most of them need radiological and cytological evaluation. Fine-needle aspiration (FNA) using The Bethesda System for reporting thyroid cytopathology. Aim of study: To evaluate the significance of the Bethesda classification in detecting malignant thyroid nodule and relate the appropriate surgical intervention accordingly. Methods: prospective, case control study was conducted in Baghdad teaching hospital, 2nd floor. from 1st of December 2021 to 1st of December 2022. 70 cases were included. all the patients had thyroid nodules and presented to assess their complaint and manage it, so they underwent TFT and U/S exam then FNAC testing and identify their Bethesda score. the operated cases had histopathological study results which obtained for each case and compared with the FNAC result. Results: The mean age of patients who underwent thyroid surgery was 38.9 ± 10.5 years. Patients were 90% females, males constituted only 10%. Preoperative FNA evaluation revealed high risk lesion Bethesda IV, V and VI in only 9 (12.9%) of all excised cases, border line Beth III constituted 38 (54.3%). 23 FNA of the excised thyroid had benign cytology Bethesda II. Total thyroidectomy was the dominate surgical procedure performed for 58 (82.9%) while lobectomy was attempted for 11 (15. 8%).So in reference to histopathology, the performance of Bethesda system was calculated by considering Beth II as benign and IV-VI as high-risk lesions. The sensitivity was 87.5%, the specificity was 91.7%. Conclusion: Bethesda system for reporting thyroid cytology can predict malignancy with 90.6% accuracy.
Keywords
thyroid nodule; Bethesda system; thyroidectomy

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