International Journal of Endocrinology and Metabolism

Published by: Kowsar

Malignancy Rates in Thyroid Nodules Classified as Bethesda Categories III and IV: Retrospective Data from a Tertiary Center

Beatriz Godoi Cavalheiro 1 , Ana Kober Nogueira Leite 1 , * , Leandro Luongo de Matos 1 , Aline Palermo Miazaki 1 , Jan Marcel Ientile 2 , Marco Aurelio V. Kulcsar 1 and Claudio Roberto Cernea 1
Authors Information
1 Head and Neck Surgery Department, Instituto do Cancer do Estado de Sao Paulo/Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brasil
2 Medical Student, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brasil
Article information
  • International Journal of Endocrinology and Metabolism: January 2018, 16 (1); e12871
  • Published Online: December 13, 2017
  • Article Type: Research Article
  • Received: May 8, 2017
  • Revised: November 14, 2017
  • Accepted: November 22, 2017
  • DOI: 10.5812/ijem.12871

To Cite: Godoi Cavalheiro B, Kober Nogueira Leite A, Luongo de Matos L, Palermo Miazaki A, Marcel Ientile J, et al. Malignancy Rates in Thyroid Nodules Classified as Bethesda Categories III and IV: Retrospective Data from a Tertiary Center, Int J Endocrinol Metab. 2018 ; 16(1):e12871. doi: 10.5812/ijem.12871.

Copyright © 2017, International Journal of Endocrinology and Metabolism. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Methods
3. Results
4. Discussion
  • 1. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26(1):1-133. doi: 10.1089/thy.2015.0020. [PubMed: 26462967].
  • 2. Cibas ES, Ali SZ. The Bethesda System for Reporting Thyroid Cytopathology. Thyroid. 2009;19(11):1159-65. doi: 10.1089/thy.2009.0274. [PubMed: 19888858].
  • 3. Baloch ZW, Cibas ES, Clark DP, Layfield LJ, Ljung BM, Pitman MB, et al. The National Cancer Institute Thyroid fine needle aspiration state of the science conference: a summation. Cytojournal. 2008;5:6. doi: 10.1186/1742-6413-5-6. [PubMed: 18394201].
  • 4. Bongiovanni M, Crippa S, Baloch Z, Piana S, Spitale A, Pagni F, et al. Comparison of 5-tiered and 6-tiered diagnostic systems for the reporting of thyroid cytopathology: a multi-institutional study. Cancer Cytopathol. 2012;120(2):117-25. doi: 10.1002/cncy.20195. [PubMed: 21998003].
  • 5. Yassa L, Cibas ES, Benson CB, Frates MC, Doubilet PM, Gawande AA, et al. Long-term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluation. Cancer. 2007;111(6):508-16. doi: 10.1002/cncr.23116. [PubMed: 17999413].
  • 6. Ho AS, Sarti EE, Jain KS, Wang H, Nixon IJ, Shaha AR, et al. Malignancy rate in thyroid nodules classified as Bethesda category III (AUS/FLUS). Thyroid. 2014;24(5):832-9. doi: 10.1089/thy.2013.0317. [PubMed: 24341462].
  • 7. Gharib H, Papini E, Garber JR, Duick DS, Harrell RM, Hegedus L, et al. American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules--2016 Update. Endocr Pract. 2016;22(5):622-39. doi: 10.4158/EP161208.GL. [PubMed: 27167915].
  • 8. Olson MT, Boonyaarunnate T, Aragon Han P, Umbricht CB, Ali SZ, Zeiger MA. A tertiary center's experience with second review of 3885 thyroid cytopathology specimens. J Clin Endocrinol Metab. 2013;98(4):1450-7. doi: 10.1210/jc.2012-3898. [PubMed: 23436916].
  • 9. Nikiforov YE, Seethala RR, Tallini G, Baloch ZW, Basolo F, Thompson LD, et al. Nomenclature Revision for Encapsulated Follicular Variant of Papillary Thyroid Carcinoma: A Paradigm Shift to Reduce Overtreatment of Indolent Tumors. JAMA Oncol. 2016;2(8):1023-9. doi: 10.1001/jamaoncol.2016.0386. [PubMed: 27078145].
  • 10. Mathur A, Najafian A, Schneider EB, Zeiger MA, Olson MT. Malignancy risk and reproducibility associated with atypia of undetermined significance on thyroid cytology. Surgery. 2014;156(6):1471-6. doi: 10.1016/j.surg.2014.08.026. [PubMed: 25218896].
  • 11. Bongiovanni M, Spitale A, Faquin WC, Mazzucchelli L, Baloch ZW. The Bethesda System for Reporting Thyroid Cytopathology: a meta-analysis. Acta Cytol. 2012;56(4):333-9. doi: 10.1159/000339959. [PubMed: 22846422].
  • 12. Deniwar A, Hambleton C, Thethi T, Moroz K, Kandil E. Examining the Bethesda criteria risk stratification of thyroid nodules. Pathol Res Pract. 2015;211(5):345-8. doi: 10.1016/j.prp.2015.02.005. [PubMed: 25796296].
  • 13. Theoharis CG, Schofield KM, Hammers L, Udelsman R, Chhieng DC. The Bethesda thyroid fine-needle aspiration classification system: year 1 at an academic institution. Thyroid. 2009;19(11):1215-23. doi: 10.1089/thy.2009.0155. [PubMed: 19888859].
  • 14. VanderLaan PA, Marqusee E, Krane JF. Clinical outcome for atypia of undetermined significance in thyroid fine-needle aspirations: should repeated fna be the preferred initial approach?. Am J Clin Pathol. 2011;135(5):770-5. doi: 10.1309/AJCP4P2GCCDNHFMY. [PubMed: 21502433].
  • 15. Jo VY, Stelow EB, Dustin SM, Hanley KZ. Malignancy risk for fine-needle aspiration of thyroid lesions according to the Bethesda System for Reporting Thyroid Cytopathology. Am J Clin Pathol. 2010;134(3):450-6. doi: 10.1309/AJCP5N4MTHPAFXFB. [PubMed: 20716802].
  • 16. Rosario PW. Thyroid nodules with atypia or follicular lesions of undetermined significance (Bethesda Category III): importance of ultrasonography and cytological subcategory. Thyroid. 2014;24(7):1115-20. doi: 10.1089/thy.2013.0650. [PubMed: 24684285].
  • 17. Choi YJ, Baek JH, Ha EJ, Lim HK, Lee JH, Kim JK, et al. Differences in risk of malignancy and management recommendations in subcategories of thyroid nodules with atypia of undetermined significance or follicular lesion of undetermined significance: the role of ultrasound-guided core-needle biopsy. Thyroid. 2014;24(3):494-501. doi: 10.1089/thy.2012.0635. [PubMed: 23947771].
  • 18. Pezzolla A, Marzaioli R, Lattarulo S, Docimo G, Conzo G, Ciampolillo A, et al. Incidental carcinoma of the thyroid. Int J Surg. 2014;12 Suppl 1:98-102. doi: 10.1016/j.ijsu.2014.05.041. [PubMed: 24866072].
  • 19. Dunki-Jacobs E, Grannan K, McDonough S, Engel AM. Clinically unsuspected papillary microcarcinomas of the thyroid: a common finding with favorable biology?. Am J Surg. 2012;203(2):140-4. doi: 10.1016/j.amjsurg.2010.12.008. [PubMed: 21600560].
  • 20. Bramley MD, Harrison BJ. Papillary microcarcinoma of the thyroid gland. Br J Surg. 1996;83(12):1674-83. [PubMed: 9038540].

Featured Image:

Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .

Search Relations:



Create Citiation Alert
via Google Reader

Readers' Comments