Laterality of the Thyroid Nodules, Anatomic and Sonographic, as an Estimator of Thyroid Malignancy and Its Neoplastic Nature by Comparing the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) and Histopathology

J BUON. Mar-Apr 2020;25(2):1116-1121.


Purpose: To assess the association between the topographic and sonographic laterality of the thyroid nodules and the malignancy for those who had undergone ultrasonography (US)-guided fine-needle aspiration (FNA) (US-FNA) and following relevant indicated thyroidectomy.

Methods: A retrospective analysis from April 2011 to October 2015 was conducted by enrolling the documents of 501 consecutive eligible patients with 601 thyroid nodules who had undergone neck US, Doppler US, and US-FNA. The prediction of malignancy by means of laterality of 95 thyroid nodules with undetermined cytology on the basis of the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was evaluated histopathologically with comparison of three locations, separately.

Results: Six hundred and one nodules in 501 cases were studied and 249 nodules (49.8%) were topographically located at the right lobe (Location 1/Loc1), while 255 (42.4%) at the left lobe (Location 2/Loc2), 46 (7.7%) at the isthmus (Location 3/Loc3), and 1 (0.2%) was an accessory thyroid gland (Location 4/Loc4). Three different comparisons were performed regarding the locations, which revealed that the specificity did not change regarding the locations while the sensitivity of Loc3 was higher than that of Loc1 and Loc2.

Conclusions: The preliminary data of 4.5-year single-center study proved that the isthmus location may be more beneficial to estimate the malignancy on the basis of toposonographic laterality of the nodules with undetermined cytology. This notewothy outcome may be considered particularly for the challenging cases with undetermined cytology in Endocrine Surgery and Thyroidology.