Background: Bethesda system of reporting thyroid cytopathology is a standardized system,improving communication between pathologists and clinicians,leading to more consistent management approaches.The aim of the research work was to study the efficacy of Bethesda System for reporting thyroid fine-needle aspirations in view of offering guidance for patients management and to evaluate the specificity of the system based on the cytology and histopathological correlation. Methods: All the patients referred for FNAC of thyroid lesions were studied for 2 years and classified them according to Bethesda system. Histopathological correlation was done for all cases which underwent surgical resection. Results: Out of 280 cases, 64 (22.86%) were of category I, 144 (51.43%) were of category II, 11 (3.93%) were of category III, 43 (15.35%) were of category IV, 09 (3.21%) were of category V, 09 (3.21%) were of category VI. Statistical analysis of this study showed that the sensitivity, specificity, diagnostic accuracy were 95.5%, 84.3%, 89.3%, respectively. The positive predictive value and negative predictive value were 83% and 95.8%, respectively. Conclusions: The six diagnostic categories of Bethesda system were beneficial for triaging patients for either clinical follow-up or surgical management. Each diagnostic category conveys specific risks of malignancy, which offers guidance for patients management.

Keywords: Bethesda; Cytology; Thyroid.