In the Bethesda System for Reporting Thyroid Cytopathology (BSRTC), a nodule categorised as Bethesda Category IV (Follicular Neoplasm/Suspicious for Follicular Neoplasm) carries an estimated risk of malignancy of approximately:
- A 10–15%
- B 60–75%
- C 25–40% ✓
- D 1–5%
Correct answer: C. 25–40%
Explanation
According to the BSRTC 2nd edition (2023), Bethesda Category IV (Follicular Neoplasm/Suspicious for Follicular Neoplasm) carries an estimated risk of malignancy of 25–40% in surgical series. Category III (AUS/FLUS) carries ~10–30%, Category V (Suspicious for Malignancy) ~45–75%, and Category VI (Malignant) >97%. Category II (Benign) has a risk of <3% and Category I (Non-diagnostic) carries ~5–10% risk. The management for Category IV is usually diagnostic hemithyroidectomy or molecular testing.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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