Saudi medical journal · 2025
Risk of malignancy in thyroid nodules Bethesda III sub classification into nuclear atypia and architectural atypia. A retrospective study.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Alwadi Fahad, Alessa Mohammed, Abdulkarim Alamer Elaf, Alrabiah Hamad F, Alaraifi Abdulaziz, Alsalem Abdulaziz, Mohamed Pharaon Majed, Khalid Alhabib Rahaf
Аннотация
OBJECTIVES: To identify the risk of malignancy in the Bethesda III category based on histopathological subclassification.
METHODS: We retrospectively analyzed 193 patients with Bethesda III thyroid nodules who underwent surgical resection. The primary outcome was the malignancy risk associated with each histopathological sub-classification.
RESULTS: Of 193 patients, final histopathology revealed malignant nodules in 96 (49.7%). The malignancy rates varied among the Bethesda III subcategories, with Hürthle cell atypia of undetermined significance demonstrating the highest rate (55.6%), followed by cytological atypia (55.4%), architectural atypia (50.6%), and combined cytological and architectural atypia (33.3%). However, no significant difference in malignancy rates was observed among the Bethesda III subcategories (p=0.240). Papillary thyroid carcinoma was the most common malignant tumor in all Bethesda III subcategories.
CONCLUSION: Bethesda III nodules pose a clinical challenge. Our findings indicate a higher risk of malignancy in patients with cytologic atypia. Bethesda III subclassification may improve clinical decisions and interdisciplinary communication.
METHODS: We retrospectively analyzed 193 patients with Bethesda III thyroid nodules who underwent surgical resection. The primary outcome was the malignancy risk associated with each histopathological sub-classification.
RESULTS: Of 193 patients, final histopathology revealed malignant nodules in 96 (49.7%). The malignancy rates varied among the Bethesda III subcategories, with Hürthle cell atypia of undetermined significance demonstrating the highest rate (55.6%), followed by cytological atypia (55.4%), architectural atypia (50.6%), and combined cytological and architectural atypia (33.3%). However, no significant difference in malignancy rates was observed among the Bethesda III subcategories (p=0.240). Papillary thyroid carcinoma was the most common malignant tumor in all Bethesda III subcategories.
CONCLUSION: Bethesda III nodules pose a clinical challenge. Our findings indicate a higher risk of malignancy in patients with cytologic atypia. Bethesda III subclassification may improve clinical decisions and interdisciplinary communication.