Diagnostic Challenges in Indeterminate and Suspicious Thyroid Cytology: A Case Series From A Tertiary Care Center
DOI:
https://doi.org/10.67440/ahj.vi.2367Keywords:
Thyroid cytopathology; Cytomorphological spectrum; Fine-needle aspiration cytology; Bethesda classification; Indeterminate thyroid lesions; Atypia of undetermined significance; Follicular-patterned lesions; Cytological diagnostic pitfalls; Papillary thyroid carcinoma;Abstract
Background: Thyroid nodules are common, with most being benign; however, indeterminate lesions pose diagnostic challenges due to overlapping cytomorphology.
Aim: To describe the cytomorphological spectrum of thyroid lesions with emphasis on indeterminate categories.
Materials and Methods: A retrospective case series of 31 thyroid FNAC cases (January–December 2025) was analyzed. Smears were stained with May–Grünwald–Giemsa and Hematoxylin and Eosin and categorized using TBSRTC (3rd edition, 2023).
Results: Patients ranged from 16–66 years with female predominance (3.3:1). Most presented with neck swelling; one was an incidental PET-CT finding. Distribution was: Category II (61.2%), III (12.9%), IV (19.3%), V (3.2%), and VI (3.2%). Category III showed nuclear atypia with variable background; Category IV showed microfollicular pattern with scant colloid; Category V/VI showed features of papillary carcinoma. Overlapping features were common.
Conclusion: FNAC is valuable, but indeterminate categories remain challenging. Clinicoradiological correlation and adjunctive methods are essential for accurate diagnosis and management.
