Fine needle aspiration cytology of the thyroid: a comparison of 5469 cytological and final histological diagnoses

INTRODUCTIONThyroid gland is unique among endocrine organs. It is the largest endocrine gland in the body and the first to develop in fetal life.1 Thyroid swelling are very frequent. It is estimated 4-7% adults have palpable enlargement of thyroid and 10 times more have impalpable nodules. Most of them are benign and fewer than 5% are actually malignant. 2A multitude of diagnostic tests like ultrasound, thyroid nuclear scan, fine needle aspiration cytology (FNAC) and many more are available to evaluate goitre. Final diagnosis requires morphological examination of lesions for which FNAC and histopathological examination (HPE) becomes mandatory tests. 3FNAC as a method was first published by Leyden in 1883. 4 The diagnosis of thyroid lesions using aspiration cytology was first reported by Martin and Ellis in 1930. 5 Practice guidelines set forth by American Thyroid Association and National Comprehensive Cancer Network states that FNAC should be used as initial ABSTRACT Background: Even if non-surgical and non-invasive techniques can provide a diagnosis, the ultimate answer rests in the histopathological examination of the excised thyroid tissue. This study was carried out with the objective of comparing the findings of the two tests namely FNAC and HPE and suggestions for the future. Methods: This two year prospective study involved 295 outdoor cases with thyroid lesions at UPRIMS & R, Saifai, Etawah, U.P. The preoperative FNAC and postoperative histopathology reports were correlated and conclusions drawn after statistical analysis. Results: More than half (65.4% cases) the number of thyroid FNACs were diagnosed as colloid goitre. Diagnostic categorization of 295 thyroid FNACs based on Bathesda classification showed that 239 (81.01%) cases were cytologically benign, 2 cases (0.68 %) were under atypia of undetermined significance (AUS) while six cases (2.03%) under the neoplasm category-follicular. Suspicious for malignancy category included two cases (0.68%)-hyalinizing trabecular adenoma/columnar variant of papillary carcinoma and medullary carcinoma/oncocytic neoplasm. Under the malignant category, there were fourteen cases (4.05%) cytologically diagnosed and in the inadequate/non-diagnostic category there were 32 cases (10.85%) of cases. Conclusions: FNAC is a simple, safe and cost effective modality in investigation of thyroid disease with high accuracy and specificity.

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“…It was comparable to the previous studies. 7,9,10 Our findings are comparable to those reported by Bhargav et al…”

Section: Discussionsupporting

confidence: 79%

Comparative study of FNAC and histopathology of thyroid swellings, diagnostic accuracy and role in its management

Kumar

Bhadouriya

Narain

et al. 2017

Int J Otorhinolaryngol Head Neck Surg

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“…In the present study mean age was 39.84 years which is close to the mean age in the study of Rangaswamy M et al (40.57years) 6 .In the various other studies of Aahna Gupta et al 7 and Singh P et In our study female patients were more affected with male to female ratio being 1:4.5 which is close to the study by Singh P et al (1:4.7), Sangali G et al 11 (1:4.21) and Mandal S et al 12 (1:5).…”

Section: Discussionsupporting

confidence: 78%

Study of Imprint Smears of various Thyroid Lesions with Histopathological Correlation

Bos¹

2017

JMSCR

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“…The differences described above in epidemiological situations of examined populations result in significant differences in the reported data on FP and FN results, as well as sensitivity (from 65 to 99%) and specificity (from 72 to 100%) of thyroid FNAB (30,(35)(36)(37)(38)(39)(40).…”

Section: Second Version (%)mentioning

confidence: 99%

The fine-needle aspiration biopsy efficacy of small thyroid nodules in the area of recently normalized iodine supply

Słowińska-Klencka

Popowicz²,

Lewiński³

et al. 2008

European Journal of Endocrinology

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Objective: To evaluate the incidence of focal lesions in the thyroid in the area of recently normalized iodine supply as well as to compare the efficacy of fine-needle aspiration biopsy (FNAB) of small (infracentimetric) and large thyroid lesions in this area. Methods: The outcomes of 13 646 ultrasound (US) examinations, 13 437 US-guided FNABs of the thyroid and 1694 results of post-operative histopathological examinations were analysed. Results: Infracentimetric nodules (INs %10 mm) were revealed by US examinations in 43.5% of patients; in the majority of the cases (82.2%) INs were multiple. The percentage of revealed carcinomas by aspiration of INs is similar to that observed when large nodules (LNs O10 mm) are examined cytologically. However, the efficiency of preoperative diagnosis of INs is lower than LNs with respect to both US selection of lesions for FNAB and the percentage of false negative results of FNAB (29.8 vs 5.4%, P!0.001). In post-operative histopathological examination, extrathyroidal extension of thyroid cancers was observed in nearly 30% of microcarcinomas. Conclusions: In endemic or post-endemic areas, the efficiency of FNAB is lower in the case of small lesions than larger ones. In spite of this, the percentage of cytologically revealed carcinomas among small lesions is not lower than larger ones. Thus, it is particularly indicated to follow up small thyroid lesions with repeated US examinations in such areas.European Journal of Endocrinology 159 747-754

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Fine needle aspiration cytology of the thyroid: a comparison of 5469 cytological and final histological diagnoses

Cited by 128 publications

References 21 publications

Comparative study of FNAC and histopathology of thyroid swellings, diagnostic accuracy and role in its management

Comparative study of FNAC and histopathology of thyroid swellings, diagnostic accuracy and role in its management

Study of Imprint Smears of various Thyroid Lesions with Histopathological Correlation

The fine-needle aspiration biopsy efficacy of small thyroid nodules in the area of recently normalized iodine supply

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