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Related Concept Videos

The Thyroid Gland01:23

The Thyroid Gland

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The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
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Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH...
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Related Experiment Video

Updated: May 4, 2026

Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration
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Assessment of Thyroid Fine-Needle Aspirates Using 2023 Bethesda System.

Niti Sureka1, Charanjeet Ahluwalia1, Sana Ahuja1

  • 1Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.

Acta Cytologica
|February 25, 2025
PubMed
Summary

The 2023 Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) enhances fine-needle aspiration cytology (FNAC) for thyroid nodules. This system improves diagnostic accuracy and risk stratification for thyroid lesions, aiding in clinical decisions.

Keywords:
Atypia of undetermined significanceFine-needle aspiration cytologyNon-invasive follicular thyroid neoplasm with papillary-like nuclear featuresThyroid

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Area of Science:

  • Endocrinology
  • Pathology
  • Cytopathology

Background:

  • Thyroid nodules are prevalent, with a 5% malignancy rate, underscoring the need for precise evaluation to prevent unnecessary surgeries.
  • Fine-needle aspiration cytology (FNAC) is a cornerstone in diagnosing thyroid lesions.
  • The 2023 Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) provides updated guidelines for FNAC interpretation and risk stratification.

Purpose of the Study:

  • To reclassify thyroid FNACs using the 2023 TBSRTC criteria.
  • To evaluate the diagnostic performance of the 2023 TBSRTC compared to histopathological diagnoses.
  • To assess the sensitivity, specificity, and accuracy of the 2023 TBSRTC in evaluating thyroid nodules.

Main Methods:

  • Retrospective analysis of 387 thyroid FNAC cases from January 2023 to June 2024.
  • Reclassification of FNAC slides by two cytopathologists according to the 2023 TBSRTC.
  • Statistical analysis of diagnostic accuracy metrics, including sensitivity and specificity, with histopathological correlation for 190 cases.

Main Results:

  • The study analyzed 387 FNACs, with 61.5% classified as benign and 6% as malignant.
  • Histopathological correlation for 190 cases confirmed 126 benign and 64 malignant lesions.
  • The 2023 TBSRTC demonstrated high diagnostic accuracy, with the highest sensitivity (88.2%) when specific categories were considered positive for malignancy and highest overall accuracy (85.4%) when SFM and malignant categories were considered positive.

Conclusions:

  • Fine-needle aspiration cytology, when interpreted using the 2023 TBSRTC, is a reliable method for evaluating thyroid lesions.
  • The 2023 TBSRTC improves the diagnostic accuracy and risk stratification of thyroid nodules.
  • This updated system aids in better clinical management and reduces unnecessary surgical interventions for thyroid nodules.