No abstract

a total of 1,178 aspirations of lesions of various organs were performed in the Department of Pathology, King Fahad Hospital, Madina, Al-Munawarah. Of these, 383 (35.2%) aspirations were performed on 353 patients with swelling of the thyroid. Solitary thyroid nodule was the presenting feature in 198 patients. Aspirations were repeated whenever the material was found to be inadequate. Respiration was also carried out after cyst aspiration from solid remnant or after reaccumulation. All the aspirations were carried out by a pathologist. In 28 (8%) patients, insufficient material was obtained for cytologic diagnosis only. Eighty percent of these were Saudi nationals and 20% other nationalities. Female to male ratio was 3.5:1. The youngest patient was 14-years-old and oldest 90-years-old.Non-toxic goiter is a very common condition, whereas thyroid malignancies constitute only 0.5% of all malignancies [1]. Although most malignancies present as cold nodules, more than 90% of cold nodules are benign. Fine needle aspiration biopsy (FNAB) has made it possible to group thyroid nodules into "benign", "suspicious", and "malignant" categories with a reasonable degree of certainty [2,3].In our hospital, FNAB has drastically reduced the number of diagnostic surgical procedures for benign lesions. It is diagnostic as well as therapeutic in most of the cystic lesions of thyroid. Cystic lesions were found in 97 patients (27.4%). The amount of fluid obtained varied from 5 to 20 ml. In 30% of cases, the swelling completely disappeared and in the remaining there was considerable reduction in size. In cases involving cystic goiters, there were two false negative diagnoses. A small papillary carcinoma within a cyst and another follicular adenoma with cyst. FNAB is a therapeutic modality for thyroid cysts and a safe and reliable method of follow-up for patients treated conservatively. Cysts larger than 4 cm or prompt reaccumulation following repeated aspirations should raise the suspicion of malignancy [4]. In our study, 28 cases (8%) were diagnosed as thyroiditis and treated medically. In cases involving thyroiditis, there was an intimate admixture of thyroid epithelial cells and lymphocytes (Table 1).The major limitation of the technique has been the inability to differentiate follicular adenoma, early differentiated follicular carcinoma, and follicular hyperplasia in goiter. We have grouped these together as follicular neoplasms, not further categorizing them and have made histological examination manditory. This does not lessen the value of FNAB because an "intermediate" diagnosis is a clear indication for further investigation or surgical exploration. The pathologist and clinician should be aware of the limitations and should not hesitate in obtaining open biopsy when necessary, particularly when clinical suspicion of malignancy is not confirmed by aspiration [5]. Histopathological comparison is done on cases going for surgery, We have diagnosed 11 cases of papillary carcinoma, nine were new cases and two came for follow-up follow...