Comparing Pre-Operative Fine Needle Aspiration Cytology to Paraffin Section Post-Operative for Solitary Thyroid Nodule

Abstract

Background: Fine needle aspiration cytology (FNAC) is considered the gold standard diagnostic test for the diagnosis of thyroid nodules. FNAC is a cost effective procedure that provides specific diagnosis rapidly with minimal complications. Based on the cytology findings, patients could be followed in cases of benign diagnosis and subjected to surgery in cases of malignant diagnosis therefore decreasing the rate of unnecessary surgery. Aim of work:To correlate pre-operative fine needle aspiration cytology (FNAC) to post-operative paraffin section results in diagnosis of solitary thyroid nodule (STN).Patients and methods: This is a prospective study, it was performed on 30 patients diagnosed as solitary thyroid nodule; the results for FNAC and histopathological examination were reviewed, evaluated and correlated.Results: On FNAC, out of 30 cases there were 19 benign lesions; 17 (56.66%) cases were true negative (TN) and 2 (6.67%) cases were false negative (FN).There were 11 (36.67%) of undetermined significance or suspicious neoplastic lesions diagnosed by FNAC; 10 (33.33%) cases were true positive (TP) and only one (3.33%) case was false positive (FP). After comparison of results of FNAC with histopathology, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 83.33%, 94.44%, 90%, 90.91% and 89.47%, respectively. Conclusion:Fine needle aspiration was a significantly better predictor of malignancy, we recommend this procedure in the light of other investigations as a primary investigation of thyroid lesions in a patient with solitary thyroid nodules as it should be advised for exclusion of malignancy.