Abstract
The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) introduced a new category: Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance (AUS/FLUS) comprising of heterogenous lesions with a lesser degree of atypia. Its routine use is a bit controversial. The study cohort included AUS/FLUS thyroid cytopathological diagnoses signed out at Fimlab Laboratories from the period of 1 October 2013 to 31 December 2016. We analyzed all the AUS/FLUS cases, their cytology subclassification, and their cyto-histological correlation, when available. In total, there were 331 AUS/FLUS cases from 252 patients. The mean age was 59.8 years and there were 196 females and 56 males. Repeated AUS/FLUS was diagnosed in 75 (29.8%) cases. Out of 252 patients, 118 (46.8%) were operated on. Sixty-eight were operated on after the first AUS/FLUS diagnosis, 46 after 2 AUS/FLUS diagnoses, and 4 after 3 AUS/FLUS diagnoses. In total, there were 37 (14.7%) malignancies and 40 benign tumors. The risk of malignancy for AUS/FLUS (14.7%) is in agreement with the original TBSRTC risk of malignancy. The risk of neoplasia was 30.6% in our series.
Highlights
Thyroid fine-needle aspiration (FNA) is a key method for evaluating thyroid nodules
We show our institutional analysis of AUS/FLUS cases with subclassification, cyto-histological correlation, risk of malignancy (ROM), and risk of neoplasia (RON)
A search yielded 1698 thyroid FNAs performed between 1 October 2013 to 31 December 2016 and of them 331 (19.5%) FNAs were diagnosed as AUS/FLUS category
Summary
Thyroid fine-needle aspiration (FNA) is a key method for evaluating thyroid nodules. The BethesdaSystem for Reporting Thyroid Cytopathology (TBSRTC) [1], which has been updated via a recently published second edition, is widely adopted in thyroid FNA reporting all around the world [2,3,4,5,6,7,8,9,10].TBSRTC introduced a new category: Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance (AUS/FLUS) comprising of lesions with a lesser degree of atypia.The heterogeneity of the morphological features, both cytological and architectural, encourages the subclassification of the lesions. System for Reporting Thyroid Cytopathology (TBSRTC) [1], which has been updated via a recently published second edition, is widely adopted in thyroid FNA reporting all around the world [2,3,4,5,6,7,8,9,10]. TBSRTC introduced a new category: Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance (AUS/FLUS) comprising of lesions with a lesser degree of atypia. The suggested scenarios from the first edition were further elaborated in the second edition subclassification [1,2]. In a survey from the College of American Pathologists on trends in thyroid FNA, it was the second most common diagnosis after benign cases, comprising 8.6%
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