The Bethesda systemThe Bethesda system for reporting thyroidfor reporting thyroid
cytopathologycytopathology
Mansour Mehzad, MD, FIACMansour Mehzad, MD, FIAC
The Bethesda system for reporting thyroid cytopathology I. Non-diagnostic or Unsatisfactory - Cyst fluid only ( macrophages only ) - Virtually acellular specimen - Other (obscuring blood, clotting artefact,etc)
II. Benign - Consistent with a benign follicular nodule ( includes adenomatous nodule,colloid nodule) - Consistent with lymphocytic (Hashimoto’s) thyroiditis in the proper clinical context - Consistent with granulomatous (subacute) thyroiditis - Other
III. Atypia of undetermined significance or follicular lesion of undetermined significance
IV. Follicular neoplasm or suspicious for a follicular neoplasm - Specify if Hurthle cell (oncocytic) type
V. Suspicious for malignancy - Suspicious for papillary carcinoma - Suspicious for medullary carcinoma - Suspicious for metastatic carcinoma - Suspicious for lymphoma - Other
VI. Malignant - Papillary carcinoma - Poorly differentiated carcinoma - Medullary thyroid carcinoma - Undifferentiated (anaplastic) carcinoma - Squamous cell carcinoma - Carcinoma with mixed features (specify) - Metastatic carcinoma - Non-Hodgkin’s lymphoma - Other
Macrophages only
Adenomatous nodule
Adenomatous nodule
Colloid nodule
Focal hurthle cell metaplasia in goiter
Hashimoto’s thyroiditis
Subacute thyroiditis
Radioactive iodine effect
Follicular neoplasm
Follicular neoplasm,trabecular type
Hurthle cell neoplasm
Papillary carcinoma
Papillary carcinoma
Papillary carcinoma,follicular variant, Giemsa stain
Papillary carcinoma,follicular variant , Pap.stain
Poorly differentiated carcinoma
Medullary carcinoma, Pap stain
Medullary carcinoma, Giemsa stain
Medullary carcinoma, immunoreactive for calcitonin
Anaplastic carcinoma
Squamous cell carcinoma
Metastatic renal cell carcinoma
MALT lymphoma
ReferencesReferences: : 11 . .National Cancer Institute (NCI), Thyroid Fine needleNational Cancer Institute (NCI), Thyroid Fine needle
aspiration state of the science, conference in 2007aspiration state of the science, conference in 2007 . .
22 . .Edmond S. Cibas, Barbara S. Ducathman. CYTOLOGYEdmond S. Cibas, Barbara S. Ducathman. CYTOLOGY , ,
diagnostic principles and clinical correlates, saundersdiagnostic principles and clinical correlates, saunders , ,
33rd rd edition,2009edition,2009..
33 . .Marluce Bibbo, Acta Cytologica, volume 53, 489-490, 2009Marluce Bibbo, Acta Cytologica, volume 53, 489-490, 2009
For more study on cytopathology of For more study on cytopathology of the thyroid gland refer to the CD inthe thyroid gland refer to the CD in
this subject prepared by the Societythis subject prepared by the Society . .
The Members may call for a free copyThe Members may call for a free copy
from ISCC office in Isfahanfrom ISCC office in Isfahan . .