RT Journal Article
SR Electronic
T1 Risk of malignancy in thyroid nodules Bethesda III sub classification into nuclear atypia and architectural atypia. <em>A retrospective study</em>
JF Saudi Medical Journal
JO Saudi Med J
FD Prince Sultan Military Medical City
SP 425
OP 428
DO 10.15537/smj.2025.46.4.202040805
VO 46
IS 4
A1 Alwadi, Fahad
A1 Alessa, Mohammed
A1 Abdulkarim Alamer, Elaf
A1 Alrabiah, Hamad F.
A1 Alaraifi, Abdulaziz
A1 Alsalem, Abdulaziz
A1 Mohamed Pharaon, Majed
A1 Khalid Alhabib, Rahaf
YR 2025
UL http://smj.org.sa/content/46/4/425.abstract
AB 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