BACKGROUND: The Bethesda classification system for reporting on thyroid fine-needle aspiration (FNA) cytology was recently proposed by the National Cancer Institute, USA. We aimed to report our experience with applying this system for thyroid FNA, with a focus on comparing it with the four categorical system. METHODS: We retrospectively reviewed the 4,966 thyroid FNAs that were performed at the Seoul St. Mary's Hospital between October 2008 and September 2009. All the FNAs were classified according to the Bethesda system and the four tier system. RESULTS: The cytologic diagnoses of the Bethesda system included 10.0% unsatisfactory, 67.7% benign, 3.1% atypia of undetermined significance, 0.6% follicular neoplasm, 0.5% follicular neoplasm, Hurthle cell type, 5.1% suspicious for malignancy and 13.0% malignancy. Using four tier system, 10.1%, 67.6%, 9.3%, and 13% were diagnosed as unsatisfactory, negative for malignancy, atypical cells and malignancy, respectively. Of the 4,966 nodules, 905 were histologically confirmed. The specificity of the Bethesda system and the four tier system for diagnosing malignancy was 99.6% and 82.6%, respectively. CONCLUSIONS: The Bethesda system can classify indeterminate thyroid nodules into more detailed categories and provide clinicians with useful information for management.
Biopsy, Fine-Needle ; Diagnostic Techniques and Procedures ; National Cancer Institute (U.S.) ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule

BACKGROUND: The Bethesda classification system for reporting on thyroid fine-needle aspiration (FNA) cytology was recently proposed by the National Cancer Institute, USA. We aimed to report our experience with applying this system for thyroid FNA, with a focus on comparing it with the four categorical system. METHODS: We retrospectively reviewed the 4,966 thyroid FNAs that were performed at the Seoul St. Mary's Hospital between October 2008 and September 2009. All the FNAs were classified according to the Bethesda system and the four tier system. RESULTS: The cytologic diagnoses of the Bethesda system included 10.0% unsatisfactory, 67.7% benign, 3.1% atypia of undetermined significance, 0.6% follicular neoplasm, 0.5% follicular neoplasm, Hurthle cell type, 5.1% suspicious for malignancy and 13.0% malignancy. Using four tier system, 10.1%, 67.6%, 9.3%, and 13% were diagnosed as unsatisfactory, negative for malignancy, atypical cells and malignancy, respectively. Of the 4,966 nodules, 905 were histologically confirmed. The specificity of the Bethesda system and the four tier system for diagnosing malignancy was 99.6% and 82.6%, respectively. CONCLUSIONS: The Bethesda system can classify indeterminate thyroid nodules into more detailed categories and provide clinicians with useful information for management.
Biopsy, Fine-Needle ; Diagnostic Techniques and Procedures ; National Cancer Institute (U.S.) ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule

Objective: To describe a rare case of Kimura’s disease initially misdiagnosed as malignancy then tuberculosis. Methods: Design: Case report Setting: Tertiary Private Hospital Patient: One Results: A 30-year-old male with a 6-year history of gradually-enlarging right infra-auricular mass revealed an enlarged mass in the right infraauricular area and multiple cervical lymphadenopathies on physical examination. Initial fine-needle aspiration biopsy was interpreted as pleomorphic adenocarcinoma but succeeding work-ups and imaging studies led to treatment for tuberculosis. Subsequent biopsies finally led to the proper histopathologic diagnosis of Kimura’s disease and the patient was shifted to appropriate treatment with oral prednisone. Conclusion Kimura’s disease is rare and may be confused with other diseases such as malignancy or tuberculosis. Histopathologic diagnosis is necessary as its treatment differs from tuberculosis and other diseases.
Human ; Male ; Adult ; ANGIOLYMPHOID HYPERPLASIA WITH EOSINOPHILIA ; TUBERCULOSIS ; PHYSICAL EXAMINATION ; DIAGNOSIS ; DIAGNOSTIC TECHNIQUES AND PROCEDURES BIOPSY, FINE-NEEDLE ; BIOPSY ; PREDNISONE ; Diagnostic Errors ; history ; diagnosis