Risk Stratification of Bethesda III Category Thyroid Nodules

Eiman Alseddeeqi, Rawia Mubarak, Ajda Altinoz, Yogesh More, Abdulghani Elomami

Abstract


Background: Atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) carries a malignancy risk reaching up to 50%. Based on the reported malignancy rate in a given population, the clinical practice towards such a category varies. We hereby identify clinical parameters for risk stratification to aid in decision making for either surgical referral or a clinical follow-up. Our aim is to calculate the malignancy risk in Bethesda category III and to identify clinical parameters that guided both clinicians and patients at our institutions to reach a clinical decision.

Methods: A retrospective review of patients with Bethesda category III thyroid nodules from the tertiary centers in the Emirate of Abu Dhabi during January 2011 through December 2015 was carried out. Malignancy risk in Bethesda category III nodules and repeat fine-needle aspiration (FNA) utility were calculated. Parameters guided referral to surgery were studied.

Results: A total of 202 cases were included in the study. Of these, 101 cases underwent surgery initially following the first FNA, and 10 cases following repeat FNA. Histology confirmed malignancy in 41% of cases that went initially to surgery, and in 40% of cases that underwent a repeat FNA. Repeat FNA resulted in 17 (44.74%) cases being re-classified into benign category, 10 (26.3%) being AUS/FLUS category, six (15.7%) being both suspicious and malignant, and five (13.16%) being unsatisfactory. Repeating FNA resulted in a definitive diagnostic utility in 50% of the cases.

Conclusions: The relatively high malignancy rate in our institutions, the suspicious radiographic features and the repeat FNA predictive value stratified Bethesda category III nodules for appropriate referrals to surgery.




J Endocrinol Metab. 2019;9(6):180-185
doi: https://doi.org/10.14740/jem625


Keywords


AUS/FLUS; Thyroid FNA; Thyroid cancer; Bethesda category III

Full Text: HTML PDF
 

Browse  Journals  

     

Journal of clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics

World Journal of Oncology

Gastroenterology Research

Journal of Hematology

Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity

Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research

Journal of Neurology Research

International Journal of Clinical Pediatrics

 

 

 

 

 

Journal of Endocrinology and Metabolism, bimonthly, ISSN 1923-2861 (print), 1923-287X (online), published by Elmer Press Inc.            
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)


This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website: www.jofem.org   editorial contact: editor@jofem.org
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.