For more than 20 years, the incidence of thyroid cancer has steadily increased globally , exhibiting the most rapid rise of all major human cancer types. There is a strong suggestion that it is the increased detection of papillary carcinomas (PTCs), especially small PTCs, that is primarily responsible for this rising incidence . Cancer of the thyroid gland usually presents as a nodule, and thyroid nodules may either represent the presenting complaint or be an incidental finding. Fortunately, the majority (95%) of all thyroid nodules are benign. Nonetheless, thyroid nodule detection raises concerns regarding the possibility of an underlying malignancy and usually requires further investigation. The gold standard for thyroid nodule investigation is fine needle aspiration biopsy (FNAB). It is a critically important diagnostic method for distinguishing benign from malignant nodules and guiding their further treatment . In 2007, in order to reduce variation between pathologists in the reporting of cytopathological findings, and also to standardize diagnostic terminology, the National Cancer Institute held a consensus conference and developed recommendations for standardized reporting of thyroid cytopathological diagnoses. Having been named after the location of this conference, these thyroid cytopathology reporting guidelines have become known as the Bethesda System for Reporting Thyroid Cytopathology (BSRTC) . As stated in the 2015 American Thyroid Association (ATA) Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer, it is now a strong recommendation that all centers utilize the BSRTC for the reporting of thyroid nodule cytopathology . The BSRTC is a six-tiered classification system, with each diagnostic category having a specific associated risk of malignancy (ROM), as well as recommended management. These six BSRTC diagnostic categories are: unsatisfactory, benign, atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), suspicious for follicular neoplasm/follicular neoplasm (sFN), suspicious for malignancy (sM), and malignant. The quoted ROM for each of these six BSRTC diagnostic categories are: 1%–4%, 0%–3%, 5%–15%, 15%–30%, 60%–75% and 97%–99%, respectively .