title: A Different Perspective on Evaluating the Malignancy Rate of the Non-Diagnostic Category of the Bethesda System for Reporting Thyroid Cytopathology: A Single Institute Experience and Review of the Literature.
abstract: OBJECTIVE
  To determine the malignancy rate in the non-diagnostic (ND) category of the Bethesda System for Reporting Thyroid Cytopathology (BSRTC) based on a different approach in relation to histopathology diagnoses.
  
  
  METHODS
  All ND fine needle aspirations (FNAs) that were performed under ultrasound guidance by an interventional radiologist with rapid on-site evaluation were included in the study. Slides were reevaluated to identify the cause of inadequacy as "qualitative" or "quantitative." The malignancy rate of the ND category was assessed. Nodule/patient characteristics were compared between benign and malignant cases within the study cohort.
  
  
  RESULTS
  The study cohort consisted of 192 ND aspirations. Overall there were 156 (81.3%) women and 36 (18.7%) men with a mean age of 50.6 years (range 24-82 years). The malignancy rate was 4.7%. None of the nodules (size, consistency, and number) or patient characteristics (gender and age) were found to be predictive of malignancy.
  
  
  CONCLUSIONS
  The malignancy rate of the ND category was high when compared to BSRTC predictions, but at the low end of the reported malignancy rates in the literature. Our results revealed that cyto-histopathologic correlation and method of malignancy rate estimation could have an effect on a wide range of reported malignancy rates. Furthermore, patient/nodule dependent factors were not statistically found to be predictive of malignancy.
authors.affiliation: Department of Pathology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey.
authors.forename: Pembegul
authors.initials: P
authors.lastname: Gunes
authors.affiliation: Department of Pathology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey.
authors.forename: Sule
authors.initials: S
authors.lastname: Canberk
authors.affiliation: Department of Pathology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey.
authors.forename: Mine
authors.initials: M
authors.lastname: Onenerk
authors.affiliation: Department of Pathology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Erkan
authors.affiliation: Department of Pathology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey.
authors.forename: Nilufer
authors.initials: N
authors.lastname: Gursan
authors.affiliation: Department of Pathology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey.
authors.forename: Emine
authors.initials: E
authors.lastname: Kilinc
authors.affiliation: Department of Interventional Radiology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey.
authors.forename: Gamze Zeynep
authors.initials: GZ
authors.lastname: Kilicoglu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D013961:Thyroid Gland / Q000473:pathology; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy; D055815:Young Adult