The Bethesda System for Reporting Thyroid Cytopathology: Proposed Modifications and Updates for the Second Edition from an International Panel

Marc Pusztaszeri, Esther Diana Rossi, Manon Auger, Zubair Baloch, Justin Bishop, Massimo Bongiovanni, Ashish Chandra, Beatrix Cochand-Priollet, Guido Fadda, Mitsuyoshi Hirokawa, Soon Won Hong, Kennichi Kakudo, Jeffrey F. Krane, Ritu Nayar, Sareh Parangi, Fernando Schmitt, William C. Faquin

Research output: Contribution to journalArticlepeer-review

66 Scopus citations


The Bethesda System for Reporting Thyroid Cytology (TBSRTC) was proposed in 2007 at the National Cancer Institute Thyroid Fine Needle Aspiration State of the Art and Science Conference held in Bethesda, Maryland. The aim was to address the inconsistent and sometimes confusing reporting terminologies used for thyroid FNA throughout the world. The TBSRTC consists of 6 diagnostic categories, each associated with an implied risk of malignancy that translates directly into a clinical management algorithm. Since the publication of the TBSRTC cytology Atlas in January 2010, considerable experience has been gained regarding its application in cytology practice, clinical impact, and limitations. In conjunction with the International Academy of Cytology (IAC), an international panel composed of sixteen cytopathologists and an endocrinologist with special interest in thyroid cytology, including several co-authors of the 2010 TBSRTC Atlas, was created to: (1) analyze the current worldwide impact of TBSRTC, (2) report on the current state of TBSRTC based upon a review of the published literature, and (3) provide possible recommendations for a future update of TBSRTC. Herein, we summarize the panel's deliberations and key recommendations that our panel hopes will be useful during the preparation of the second edition of TBSRTC.

Original languageEnglish (US)
Pages (from-to)399-405
Number of pages7
JournalActa Cytologica
StateAccepted/In press - Oct 21 2016


  • Bethesda system
  • Classification systems
  • Diagnostic categories
  • Thyroid lesion

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

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