Benefits and limitations of FNAC in thyroid diseases: our institutional experience

Mohammed Arif editor1, Sunil H

Abstract


Background: To assess sensitivity and specificity of FNAC as a preoperative diagnostic tool for thyroid pathology.

Methods: Relevant clinical data (demographic- age, sex, place, occupation) including history was obtained from the patient. A detailed clinical examination was performed. All these patients were subjected to various investigations which include thyroid function test and FNAC. Then the patients were subjected to routine line of management and followed up. The main component of this study FNAC was performed as per prescribed standard technique; these findings were then correlated with histopathological diagnosis.

Results: Out of 150 patients, Eighty eight percent of the patients (132 cases) in our study were females and the rest 12% of the patients were males (18 cases). 72.73% of the females had benign swellings and 27.27% had malignant tumours of thyroid gland whereas 61.11% of male patients in our study had benign swellings and 38.89 % had malignant tumours of thyroid gland. The sensitivity and specificity of FNAC were 84.48%and 78.26%respectively. The positive and negative predictive values were 90.74%and 66.67% respectively.

Conclusion: FNAC is safe, simple with economical and cost effective procedure. It gives a reliable pre-operative cytological diagnosis based on which surgical procedures can be confidently executed. An attempt is made hereby to compare our results with worldwide documented literature. The primary purpose is to avoid the false negative cytological reports in thyroid carcinoma as negative report gives a clinician a false sense of security that is harmful in the interest of both the patient and surgeon.

 


Keywords


FNAC, Thyroid diseases, Sensitivity, Specificity, HPE

Full Text:

PDF

References


Luis H. Lopez, Jorge A. Canto, Miguel F. Herrera, Armando Gamboa-Dominguez, et al; Efficacy of Fine-Needle Aspiration Biopsy of Thyroid Nodules: Experience of a Mexican Institution; World J. Surg. 21, 408–411, 1997.

dsMojghanAmrikachi, Ibrahim Ramzy, Sheldon Rubenfeld, Thomas M Wheeler, Accuracy of Fine-Needle Aspiration of Thyroid .A Review of 6226 Cases and Correlation With Surgical or Clinical Outcome, Arch Pathol Lab Med. 125;484–488; 2001.

Muhammad saddique, Umair-ul-islam, Pervez iqbal, Qamaruddinbaloch; Fnac: A reliable diagnostic tool in solitary thyroid nodule and multinodulargoiter; patients. Journal of surgery, 24(3);2008.

Ikram M, Hyder J, Muzaffar S, Hasan SH. Fine Needle Aspiration cytology (FNAC) in the management of thyroid pathology – the Aga Khan University Hospital experience. J Pak Med Assoc 1999;49(6):133-5.

Ashcraft, M.W., Van Herle, A.J.: Management of thyroid nodules. II. Scanning techniques, thyroid suppressive therapy, and fine needle aspiration. Head Neck Surg. 3:297, 1981.

Block Reeves. Ronald White – Role of FNAC in management of Thyroid Nodule. World journal of Surgery 1980;4:737-745.

Lowhagen T, Eillems J, Lundell G, Sundblad R, Granberg P. Aspiration biopsy cytology in diagnosis of thyroid cancer.World J Surg 1981; 5: 61-73.

Silverman J F, West R E, Larkin E W, Park H M, Finley J L, Swanson M S. The role of FNAC in the rapid diagnosis and management of thyroid neoplasm Cancer 1986; 57: 1164-1170.

BackDahls M., Wallin G., LowHagen T et al ., Fine Needle biopsy cytology and DNA analysis, Surgical Clinics of North America 67: 197; 1987.

Mazzaferri, E.L., de los Santos, E.T., Rofagha-Keyhani, S.: Solitary thyroid nodule: diagnosis and management. Med. Clin. North Am.72:1177, 1988.

Van Herle, A.J., Rich, P., Ljung, B-M.E., Ashcraft, M.W., Solomon, D.H., Keeler, E.B.: The thyroid nodule. Ann. Intern. Med. 96:221, 1982.

Einhorn J., and Franzen S., Thin needle biopsy in diagnosis of thyroid disease. Acta Radiol, 58, 321-336; 1962.

Hamburger B et al, Fine needle aspiration biopsy of thyroid nodules, Impact on thyroid practice and cost of care, Am. J. Medicine, 73 : 381, 1982.

George Crile JR, Cald Well B Esselstyn, William A. Hawk. Needle biopsy in diagnosing of thyroid Nodules appearing after radiation. The New England Journal of Medicine 1979;301(18):997-8.

Hilal M Al-Sayer,Zygmunt H Krukawski Valerie MM Williams. FNAC is Isolated thyroid swellings, British Medical Journal 1985;290:1490-92.

Chow T.L, Venu. V. Kwok S.P. Use of FNAC and frozen section in diagnosis of thyroid nodules. Australia – New Zealand Journal of Surgery 1999;69(2):131-133.

FaribaBinesh, Ali Akbar Salari comparative evaluation of the diagnostic results of fine-needle aspiration (fnac) cytology and pathology in assessment of thyroid nodules. Pak J Med Sci 24(part II); 382-385; june 2008.

Al-hureibi Khalid A, Al-hureibiabdulla A, AbdulmughniyasserAulaqiSaleh M, salmanMusleh S, Al-zoobaEissa M, The diagnostic value of fine needle aspiration cytology in thyroid swellings in a University Hospital, Yemen. Saudi medical journal codensamjdi, 24; 499-503;2003.

SangalliG, Serio, G Zampatti, C Bellotti, M Lomuscio, G. Fine needle aspiration cytology of the thyroid: a comparison of 5469 cytological and final histological diagnoses. Cytopathology: official journal of the British Society for Clinical Cytology, 17(5);245-250;oct-2006.

Chowdhury, Jyothi; Das, Sulekha; Maji, Debasis; A study on thyroid nodules: diagnostic correlation between fine needle aspiration cytology and histopathology. Journal of the Indian Medical Association 2008;106(6):389-90.

OktayIrkorucu, et al; Frozen section and fine needle aspiration biopsy in thyroid surgery — needles and sections. Indian Journal of Surgery, 69(4);140-144; aug-2007.

dsMojghanAmrikachi, Ibrahim Ramzy, Sheldon Rubenfeld, Thomas M Wheeler, Accuracy of Fine-Needle Aspiration of Thyroid. A Review of 6226 Cases and Correlation With Surgical or Clinical Outcome, Arch Pathol Lab Med. 125;484–488; 2001.

Bakhos R, Selvaggi SM, Dejong S, et al. Fine-needle aspiration of the thyroid: rate and causes of cytohistopathologic discordance. Diagnostic Cytopathology. 2000;23(4):233-237.