COVID-19 Update - This is to inform you that the Government of India has announced a complete lockdown in India 22nd March 2020 to 3rd May 2020. As a result, our offices will now be closed till 3rd May 2020 and all our employees will be working from home. Office telephones will not be answered, and therefore you are requested to direct all your queries related to manuscript submission, review process, publication etc. at below mentioned details.,, Mob. 8826373757, 8826859373, 9910947804

Covid Alert

Print ISSN:-2394-6784

Online ISSN:-2394-6792


Current Issue

Year 2020

Volume: 7 , Issue: 2

Article Access statistics

Viewed: 110

Emailed: 0

PDF Downloaded: 90

Indian Journal of Pathology and Oncology

The interobserver variability of thyroid fine needle aspirates using The Bethesda System for Reporting Thyroid Cytopathology

Full Text PDF Share on Facebook Share on Twitter

Research Article

Author Details : Chhavi Gupta*, Subhash Bhardwaj, Sindhu Sharma

Volume : 7, Issue : 1, Year : 2020

Article Page : 76-82

Suggest article by email


Introduction: The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is a six category
scheme for reporting thyroid Fine Needle Aspirates (FNAs) and represents a major step towards a
uniform reporting system for thyroid FNAs, enabling better understanding of thyroid cytopathology
report by referring clinicians and providing rational management guidelines. The present study was
carried out to analyse cytological features of thyroid FNAs and categorise them by The Bethesda System
for Reporting Thyroid Cytopathology; and to assess interobserver variability between two independent
reporting pathologists using the Bethesda system.
Materials and Methods: The study was conducted over three years from Nov. 2015 to Oct. 2018
in the Department of Pathology, Government Medical College, Jammu. The thyroid FNAs were
categorized according to the Bethesda system by two independent pathologists in a double blinded
fashion. Interobserver variability was assessed by calculating percentage of agreement, disagreement and
statistically using Cohen’s kappa.
Results: A total of 610 cases were categorized as Nondiagnostic-51 cases (8.36%), 50 cases (8.20%);
Benign-524 cases (85.90%), 510 cases (83.61%); Atypia of Undetermined Significance-2 cases (0.33%),
12 cases(1.97%); Follicular Neoplasm-15 cases (2.46%), 16 cases (2.62%); Suspicious for Malignancy-
1 case (0.16%), 6 cases (0.98%); Malignant-17 cases (2.79%), 16 cases (2.62%) by two pathologists
respectively. The two pathologists agreed in 548 cases (89.84%) and disagreed in 62 cases (10.16%)
with Cohen’s kappa=0.628 (62.8%). Agreement was highest in Benign category-95.68%, followed by
Malignant-87.5%, Follicular Neoplasm -75%, Nondiagnostic-68%. No agreement was seen in Atypia of
Undetermined Significance and Suspicious for Malignancy categories.
Conclusion: The present study thus encourages the use of The Bethesda System for Reporting Thyroid
Cytopathology as a standardized reporting system with relative ease of reproducibility for effective
communication among pathologists and clinicians with regard to thyroid Fine Needle Aspiration Cytology
reporting and management.

Keywords: Bethesda system, Thyroid fine needle aspiration, Cytology, Interobserver variability.

Doi : 10.18231/j.ijpo.2020.015

How to cite : Gupta C, Bhardwaj S, Sharma S, The interobserver variability of thyroid fine needle aspirates using The Bethesda System for Reporting Thyroid Cytopathology. Indian J Pathol Oncol 2020;7(1):76-82

Copyright © 2020 by author(s) and Indian J Pathol Oncol. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (CC-BY-NC 4.0) (