Cytological Spectrum and Bethesda Classification of Thyroid Lesions at a Tertiary Care Hospital in Central India

Background and aim: Fine-needle aspiration cytology (FNAC) is widely used to evaluate thyroid lesions and guide further management.This study aimed to describe the cytological spectrum and Bethesda category distribution of thyroid lesions, patients' demographic and clinical characteristics, and available thyroidfunction and histopathological findings at a tertiary care hospital in Central India.Methods: This prospective observational study included 103 patients evaluated in the Department of Pathology at Amaltas Institute of Medical Sciences, Dewas, over 18 months.Clinical findings were recorded, and thyroid aspirates were examined using Papanicolaou and May-Grünwald-Giemsa staining.Diagnoses were categorized according to the 2023 Bethesda System for Reporting Thyroid Cytopathology.Available thyroid-function and histopathological findings were assessed.Categorical data were summarized as frequencies and percentages.Results: Women constituted 92 (89.3%) patients, and the largest age group was 38-47 years, comprising 29 (28.2%)patients.Anterior neck swelling was the predominant symptom in 91 (88.3%) patients.Colloid goiter and follicular neoplasm were each reported in 21 (20.4%)patients, followed by colloid cyst in 19 (18.4%) and lymphocytic thyroiditis in 13 (12.6%).Bethesda category II predominated in 74 (71.8%) patients, followed by category IV in 23 (22.3%) patients.Histopathology was available for 32 (31.1%) patients, with goitrous lesions accounting for 14 (43.8%)patients in this subgroup.Both concordant and discordant cytological-histopathological findings were observed.Conclusions: Benign thyroid lesions predominated, while follicular-patterned lesions represented a substantial diagnostic group.FNAC supported diagnostic categorization, but findings require integration with clinical and ultrasonographic assessment.Limited histopathological verification precluded firm conclusions regarding diagnostic accuracy.