Accuracy of fine needle aspiration cytology in diagnosis of thyroid swelling

Abstract

Accuracy of fine needle aspiration cytology in diagnosis of thyroid swelling. Keywords:Fine needle aspiration cytology; Thyroid lesions; Histopathology. Correspondence:Dr. Suspana Hirachand, MD Department of Pathology, Kathmandu Medical College and TeachingHospital, Kathmandu, Nepal Email: suspi1974@hotmail.com Background: Fine needle aspiration cytology has been shown to be simple, safe, cost effective and quick to perform procedure with excellent patient compliance. It is a well established technique for preoperative investigation of thyroid gland swellings with high sensitivity, specificity and accuracy. The aim of this study was to determine the accuracy of fine needle aspiration cytology of thyroid swellings performed at our institution. Materials and Methods:This study was carried out at Kathmandu Medical College and Teaching hospital, department of Pathology over a period of 3 years (January 2010 to December 2012). Two hundred and seventy three patients of all age groups and both sexes who underwent fine needle aspiration cytology for thyroid swelling were evaluated. Out of 273 patients, histopathological diagnosis was available in 45 patients.Results: Fine needle aspiration cytology result revealed 245 cases (89.7%) as non-neoplastic, 21 cases (7.7%) as neoplastic and 7 cases (2.6%) inadequate due to lack of cellularity. The commonest lesion in the thyroid gland was colloid goiter. Among the malignant neoplasms the commonest was papillary carcinoma. Out of 273 patients, histopathological diagnosis was available in 45 patients. Statistical analysis of our data shows the diagnostic accuracy of fine needle aspiration cytology to be 95.7%. Fine needle aspiration cytology showed a sensitivity of 96.4% and a specificity of 94.4%. Conclusion:Fine needle aspiration cytology is a well established technique for pre operative investigation of thyroid gland swellings with high sensitivity, specificity and accuracy.

Study of Spectrum of Benign Thyroid Lesions on Fnac at Tertiary Care Centre

“…Most common age group affected in our study was 41-50 years followed by 31-40 years. Our study is consistent with the studies done by Yassa et al Females outnumbered males with female to male ratio was found to be 16.9:1 which is comparable to studies done by Hirachand S et al 12 Colloid goiter is the most common diagnosis encountered in our study (53%) which is similar to studies of Jain D et al 6 De Quervains Thyroiditis is the third most common diagnosis, the diagnostic picture of multinucleate giant cells, granulomas may also be seen in Hashimoto's thyroiditis and thus differentiation may be difficult. One differentiating point is lymphocytic impingement which is seen in Hashimoto's but not in De Quervain's thyroiditis, only one case of Graves disease was reported and it is the least common diagnosis.…”

Preoperative thyroid stimulating hormone level as risk factor for differentiated thyroid cancer

“…11 Also, Hirachand et al, found in their study that the most common lesion in the thyroid gland was colloid goiter. 12 Among the malignant neoplasms the commonest was papillary carcinoma which coincides with our results.…”

A comparative study of fine-needle aspiration and nonaspiration cytology diagnosis in thyroid lesions

“…This is similar to findings observed in studies conducted by Sinna and Ezzat, Kasper et al ., and Hirachand et al . [ 1 2 3 ] In a study conducted by Carvalho et al ., they found that FNAC and FNNAC provided similar cytological diagnosis, respectively (malignant: 3.8% vs. 3.8%, P = 0.871; suspicious: 10.4% vs. 10.8%, P = 0.913; and nondiagnostic: 10.0% vs. 11.2%, P = 0.598). [ 5 ] However, as in our study, the follicular neoplasm and nondiagnostic cases were more in nonaspiration cytology than in aspiration cytology.…”

“…In a study conducted by Hirachand et al ., the nondiagnostic smears were more (2.6%) in FNAC, but the percentage of colloid goiter (72.53%) and papillary carcinoma (4.76%) was similar to this study. [ 3 ]…”

“…Few studies favored FNNAC, and few studies concluded that the techniques were comparable. [ 1 2 3 ] This study was done to compare the efficacy of FNAC and FNNAC with respect to thyroid malignancies and also the quality of the smears.…”