Risk of malignancy in thyroid nodules Bethesda III sub classification into nuclear atypia and architectural atypia. A retrospective study

Authors

Abstract

ABSTRACT 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

Article Type

In Brief

First Page

425

Last Page

428

Recommended Citation

(2025) "Risk of malignancy in thyroid nodules Bethesda III sub classification into nuclear atypia and architectural atypia. A retrospective study," Saudi Medical Journal: Vol. 46: Iss. 4, Article 14.
DOI: https://doi.org/10.15537/smj.2025.46.4.202040805