Bethesda guidelines for Cytology
Reviewer: Michael Constantinescu, M.D. (see Reviewers page)
Revised: 10 March 2011, last major update March 2011
Copyright: (c) 2010-2011, PathologyOutlines.com, Inc.
● Definition of adequacy (minimum number of follicular cells present) depends on the nature of the lesion
● Solid nodules: at least 6 well-preserved, undistorted and well-stained follicular groups, each containing at least 10 cells; preferably follicular groups contained on the same slide
● Any sample with significant cytologic atypia, regardless of cellularity, is considered adequate
● For solid nodules that have numerous inflammatory cells (e.g. Hashimoto, abscess, granulomatous thyroiditis), there is no minimum number of follicular cells required
● Colloid nodules with abundant thick colloid: no requirement for a minimum number of follicular cells
● Thyroid cysts with histiocytes, with little or no follicular cells: non-diagnostic and interpreted as “cyst fluid only"; no strict requirement for a minimum number of groups of follicular cells for these lesions; may add a comment: “cystic papillary carcinoma cannot be ruled out”
● In other cases, less than 6 well-preserved, undistorted and well-stained follicular groups, each containing at least 10 cells is unsatisfactory
● Obscured (e.g. due to blood, gel), poorly visualized, poorly preserved or poorly preserved stains are unsatisfactory
● Presence of only nonthyroid tissue (e.g. muscle, cartilage) with no follicular cells is unsatisfactory
End of Thyroid gland > Bethesda guidelines for Cytology > Adequacy
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