Accuracy of fine needle aspiration cytology of thyroid lesion with corresponding histopathology: A single institutional experience

Alwahaibi, Nasar; Alsalami, Jawhara; Bai, Usha Rani; Lakhtakia, Ritu

doi:10.4103/0973-0354.193136

Cited by 4 publications

(4 citation statements)

References 1 publication

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“…One small study conducted in a tertiary care center showed that although FNAC is a sensitive method for diagnosing thyroid lesions, many patients (37.3%) showed inconclusive (unsatisfactory) test results. 14 Another local study also showed low FNAC accuracy; however, this study included patients with multinodular goiter only. 15 FNAC is usually operator-dependent, and hence, its accuracy may differ in different settings.…”

Section: Introductionmentioning

confidence: 92%

Features and diagnostic accuracy of fine needle aspiration cytology of thyroid nodules: retrospective study from Oman

et al. 2022

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BACKGROUND: Fine needle aspiration cytology (FNAC) of the thyroid has been a reliable and cost-effective method for diagnosing thyroid disorders. Since FNAC results are usually operator dependent, there is a compelling need to explore FNAC accuracy among Omanis. OBJECTIVE: Describe cytological features of FNAC and assess FNAC accuracy compared to the postsurgical histopathology report. DESIGN: Retrospective diagnostic accuracy study SETTING: Tertiary care center. PATIENTS AND METHODS: Our study included adult Omani adult patients with thyroid nodules who underwent FNAC from 2014 to 2017 and had final pathology results for patients who underwent thyroid surgery. The results were classified according to the UK Royal college of Pathologists ‘Thy’ categories. Accuracy of FNAC was calculated by determining false and true positive and negative results based on histopathology findings. MAIN OUTCOME MEASURES: FNAC accuracy (sensitivity and specificity) compared to the postsurgical histopathology. SAMPLE SIZE: 867 patients with 1359 ultrasound guided FNACs of thyroid nodule; 137 underwent surgery. RESULTS: The mean age of the 867 patients was 43.7 (13.3) years, with a median of 42 years, and 87.8% were females. Out of 1359 FNACs, 1001 (73.7%) were benign (Thy2), 119 (8.8%) were atypia of undetermined significance or follicular lesion of undetermined significance (Thy3a), 31 (2.3%) were follicular neoplasm or suspicious for a follicular neoplasm (Thy3f), 52 (3.8%) were suspicious for malignancy (Thy4), 55 (4%) were malignant (Thy5), 101 (7.4%) as Unsatisfactory (Thy1). Only 137 patients underwent thyroid surgery, and the FNAC reports were compared with their final histopathology reports. The sensitivity, specificity and total accuracy of FNAC were 80.2%, 98.9% and 89.9%, respectively. The positive and negative predictive values of FNAC were 98.6% and 84.3%, respectively. CONCLUSION: Our study findings confirmed that FNAC of the thyroid is a sensitive, specific, and accurate initial tool for the diagnosis of thyroid lesions. Most of the FNACs were benign with a very low malignancy rate. Due to the minimal chance of false negative results and the slow-growing nature of thyroid malignancy, it is important that patients with benign FNAC should have periodic clinical and radiological follow-up. LIMITATIONS: Retrospective design and single-center study, and thyroid nodule size unavailable. CONFLICT OF INTEREST: None.

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Section: Introductionmentioning

confidence: 92%

Features and diagnostic accuracy of fine needle aspiration cytology of thyroid nodules: retrospective study from Oman

et al. 2022

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“…FNAC is accepted as an accurate, relatively inexpensive and rapid to diagnose thyroid lesions preoperatively. Its overall sensitivity and specificity are reported to be 95% and 98% respectively (3). By using adequately sampled, well prepared smears, diffuse changes such as thyroiditis, colloid goitres as well as malignant lesions like papillary carcinoma, medullary thyroid carcinoma, anaplastic carcinoma and thyroid lymphoma can often be diagnosed.…”

Section: Identifying Thyroid Follicular Proliferations That Need Lobectomy; Value Of the Bethesda Categorymentioning

confidence: 99%

Identifying thyroid follicular proliferations that need lobectomy; value of the Bethesda category 4

2021

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Introduction: Thyroid follicular proliferations (TFPs) identified on fine needle aspiration cytology can be either follicular lesions of undetermined significance; Bethesda category 3 or follicular neoplasms and lesions suspicious for a follicular neoplasm; Bethesda category 4. The purpose of categorizing to Bethesda category 4 is to identify a thyroid nodule that might be a follicular carcinoma and triage it for thyroid lobectomy. This study was designed to determine the predictive value of categorizing TFPs to Bethesda category 4 in deciding on lobectomy for cytologically identified TFPs.Methods: This retrospective study included all patients with TFPs identified on cytology, and had a subsequent histological diagnosis, at our unit, over a period of two years. TFPs were categorized into either Bethesda category 3 or 4 on cytology, according to the Bethesda system. Sensitivity, specificity and positive (PPV) and negative predictive values (NPV) for Bethesda category 4 in identifying neoplastic TFPs and implied risk of malignancy for Bethesda category 3 and 4 were calculated taking histopathology as the gold standard. A total of 52 TFPs (Bethesda category 3; n = 39, Bethesda category 4; n = 13) were included. Subsequent histology has confirmed 18 neoplastic and 34 non-neoplastic TFPs. Sensitivity and specificity of Bethesda category 4 in identifying neoplastic TFPs were 66.66% and 97.05% respectively. PPV and NPV of Bethesda category 4 were 92.3% and 84.6% respectively. Implied risk of malignancy for Bethesda category 3 and 4 were 5.12% and 15.38% respectively. Conclusions:Bethesda category 4 predicts the TFPs that need thyroid lobectomy to triage for follicular carcinoma. The Bethesda category 3 and 4 carry an implied risk of malignancy comparable to the expected values given in Bethesda system.

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“…However, FNAC has some limitation such as specimen inadequacy and inaccurate sampling techniques. 5 This study was aimed to identify the accuracy of FNAC in differentiating between benign and malignant thyroid lesions by comparing it with subsequent histopathology.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy of Fine Needle Aspiration Cytology of Thyroid Pathologies

Kunwar

Bajracharya

Karmacharya

et al. 2020

Med. J. Shree Birendra Hosp.

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Introduction: Fine needle aspiration cytology is considered as the gold standard for the diagnosis of thyroid nodules. This study aimed to evaluate and compare the accuracy of fine-needle aspiration cytology in the diagnosis of thyroid lesion by comparing it with the corresponding histopathologic diagnosis after thyroidectomy. Methods: This is a retrospective study conducted over five years at a teaching hospital in Kathmandu. Eighty-nine cases of FNAC of thyroid nodule with subsequent histopathological reports were reviewed. The corresponding reports were compared and the accuracy of FNAC diagnosis was evaluated. Results: 87% of the cases were females and the majority of cases were in the age group 41 to 50 years. Among 89 cases, 55 were reported as benign on cytology and 34 were reported as malignant. On histopathological examination, out of 55 cases diagnosed as benign on cytology, 47 cases were diagnosed as benign whereas eight cases were diagnosed as malignant. HPE of 34 cases diagnosed as malignant on cytology showed that 29 were malignant and five were benign. The false-positive rate was 9.6% and the false-negative rate was 21.6%. The sensitivity was 78.3% and specificity was 90.3%. The positive predictive value and negative predictive value were 85.2% and 85.4% respectively. The accuracy of FNAC in differentiating benign from malignant thyroid lesions was 85.3%. Conclusions: The findings of this study showed that FNAC is a sensitive method for the diagnosis of a solid thyroid lesion

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Accuracy of fine needle aspiration cytology of thyroid lesion with corresponding histopathology: A single institutional experience

Cited by 4 publications

References 1 publication

Features and diagnostic accuracy of fine needle aspiration cytology of thyroid nodules: retrospective study from Oman

Features and diagnostic accuracy of fine needle aspiration cytology of thyroid nodules: retrospective study from Oman

Identifying thyroid follicular proliferations that need lobectomy; value of the Bethesda category 4

Diagnostic Accuracy of Fine Needle Aspiration Cytology of Thyroid Pathologies

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