A Prospective Study of Malignancies rate for Bethesda Grade 3 & 4 Thyroid swelling and its correlation between FNAC and Histopathology

The aim of this study is to establish an association between these 2 Cytological Categories and Malignancy Rates in Patients treated In A Referral Tertiary Cancer Center in Bihar.A Total of 100 Thyroid Nodules (582 Patients) were included in this Retrospective Study. There Were 78 Nodules that were classified as Bethesda Category III And 22 Nodules as Bethesda Category IV. Electronic Records were reviewed to establish a correlation between The FNA Cytological Results And The Final Histopathological Analyses. Incidentally Detected Carcinomas were considered separately.Among The Bethesda Category III Group, 12 Malignant Nodules (15.7%) were coincident with the target nodule (12 Patients, 16.2%). Incidental Carcinomas were found In 13.8% of these Patients. The Remaining 66 (84.3%) target nodules were benign. Among the Bethesda Category IV Nodules, 4 Malignant Nodules (16.8%) Were Coincident With The Target Nodule. Incidental Carcinomas Were Found In 4 Patients (19.7%). The Other 14 Target Nodules Were Benign. A Total Of 12 Patients (52.3%) Had Carcinomas In The Thyroid Lobe Contralateral To The One Containing The Target Nodule, And 10 Patients (45.5%) had Carcinomas exclusively in the Contralateral lobe.We observed a 16% Rate of Malignancy In Nodules Classified As Bethesda Category III And 17% Among Bethesda Category IV. When Incidental Carcinomas were Included,the rates of malignancy doubled.