Journal of Isfahan Medical School

Journal of Isfahan Medical School

Evaluation of Malignancy Rate of Thyroid Nodules Classified as Bethesda Category III in Babol City During 2016-2021

Document Type : Original Article(s)

Authors
Youkabed Ghanepour 1
Hosein Ghorbani 2
Hemmat Gholinia 3
Neda Meftah 4
1 Student Committee Research, Babol University of Medical Sciences, Babol, Iran
2 Assistant Professor, Department of Pathology, School of Medicine, Cancer Research Center Health Research Institute, Babol University of Medical Sciences, Babol, Iran
3 Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
4 Assistant Professor of Endocrinology & Metabolism Department of Internal Medicine, School of Medicine Rouhani Hospital Babol University of Medical Sciences mehr: Corresponding: Neda Meftah, Department of Internal Medicine, School of Medicine Rouhani Hospital Babol University of Medical Sciences, Babol, Iran
10.48305/jims.v43.i841.1634
Abstract
Background: Thyroid nodules are among the most common endocrine disorders, with approximately 5–10% of them being malignant. Since surgery is not suitable for all patients, accurate selection of candidates is essential. The aim of this study was to compare the malignancy rate of thyroid nodules classified in the Bethesda III category with their cytological characteristics.
Methods: This cross-sectional study was conducted on 378 FNA samples of thyroid nodules from patients referred to Ayatollah Rouhani and Shahid Beheshti Hospitals in Babol over a five-year period. Samples that were initially reported as AUS/FLUS (Bethesda III group) and had undergone repeat FNA were collected. Complete cytological details (including nuclear features, degree of cellular atypia, etc.) were analyzed for their correlation with malignancy.
Findings: The mean age of patients was 46.20 ± 13.22 years. Among 378 patients with Bethesda III thyroid nodules, 365 underwent repeat FNA, and malignancy was reported in 25 cases (6.8%), all of whom underwent surgery. The mean age of patients diagnosed with malignancy was significantly lower than that of patients with benign diagnosis (P < 0.002). Moderate and severe cellular atypia showed a significant association with malignancy (P < 0.001). Nuclear features such as pseudoinclusion, longitudinal nuclear groove, pleomorphism, and enlargement were also significantly more observed in malignant cases (P < 0.001).
Conclusion: The results of this study indicate that the malignancy rate of thyroid nodules in the BethesdaIII group is similar to that reported by the Bethesda consensus publication. Moreover, certain nuclear characteristics, including pseudoinclusion, longitudinal nuclear groove, pleomorphism, enlargement, and the degree of cellular atypia, are helpful in distinguishing malignant from benign thyroid nodules.

Highlights

Hosein Ghorbani: Google Scholar

Neda Meftah: Google Scholar

Keywords
Thyroid nodule
Neoplasms
Thyroid neoplasms

Subjects

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Journal of Isfahan Medical School
Volume 43, Issue 841
1st Week , February
January and February 2026
Pages 1634-1640

  • Receive Date 10 February 2026
  • Accept Date 18 February 2026