Study of Correlation of Fine Needle Aspiration Cytology With Histopathology in the Diagnosis of Solitary Thyroid Nodule: Our Experience.

Abstract

Background: Thyroid nodules are common,thyroid cancer is uncommon and the most common way for it to present is as a solitary thyroid nodule. FNAC has high sensitivity in picking up malignancy in thyroid. The main aim of FNAC is to identify nodules that require surgery and those benign nodules that can be observed clinically and decrease the overall thyroidectomy rate in patients with benign diseases. Objective: To Correlate The FNAC Findings With Histopathology So That Rate Of Unnecessary Thyoidectomies In Benign Pathologies Should Be Avoided. Method: This is a prospective analysis of sixty eight consecutive patients of clinically diagnosed solitary thyroid nodule . All patients who were referred to our department were evaluated. Pre-operative FNAC results were compared with final histopathological diagnosis in all 68 patients. Results: 38 cases were diagnosed as colloid nodular goitre and benign cystic lesions by FNAC. 34 of these cases were nonneoplastic lesions, 2 as papillary carcinoma and 2 as follicular adenoma in histopathological examination . 30 cases were diagnosed as neoplastic lesions (follicular neoplasm, hurthle cell lesions, papillary carcinoma, and suspected malignancy) by FNAC. Statistical analysis of neoplastic lesions showed sensitivity, specificity, false positive rate, false negative rate, positive predictive value, and negative predictive value of FNAC to be 85.7%, 85%, 15%, 14.3%, 85.7%, and 85%, respectively .A total of 12 cases of solitary thyroid nodules were diagnosed as having malignant and the most common malignant lesion detected was papillary carcinoma, 8 out of 12 (66.66%). Conclusion:We concluded that FNAC diagnosis of malignancy is highly significant and such patients should be subjected to surgery. A benign FNAC diagnosis should be viewed with caution as false negative results do occur and these patients should be followed up and any clinical suspicion of malignancy even in the presence of benign FNAC requires surgery.