Diagnostic Efficacy of Fnac in Thyroid Lesions, Classified According to Bethesda System With Cytohistological Correlation

Abstract

Objective: The objective of the study is to estimate the diagnostic accuracy (DA) of fine needle aspiration cytology (FNAC) in thyroid lesions with cytohistological correlation. Methods: The study was a cross-sectional study which was conducted in the Department of Pathology, Rabindranath Tagore Medical College, M.B.G. Hospital, Udaipur, Rajasthan, from December 2022 to December 2023. A total of 201 thyroid aspirations were performed, and the smears were classified according to The Bethesda system. Cytological and histopathological findings were compared in 132 cases that proceeded to surgery. Sensitivity, specificity, negative predictive value (NPV), positive predictive value, and DA were calculated using standard statistical methods. Results: The distribution of thyroid lesions on cytology was as follows: Non-diagnostic (1%), benign (92%), atypia of unknown significance (1%), follicular neoplasia (3%), suspicious for malignancy (2%), and malignant (1%). The sensitivity, specificity, positive predictive value, NPV, and DA in our study were 78.94%, 100%, 100%, 96%, and 96.9%, respectively. Conclusion: FNAC’s cost-effectiveness, patient-friendly nature, swift results, and high sensitivity, specificity, and accuracy render it a primary diagnostic tool for assessing patients with thyroid swelling preoperatively. The Bethesda system categorizes thyroid lesions cytologically, aiding in their diagnosis and subsequent management. Histopathological correlation facilitates the assessment of DA and ensures quality assurance.