DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20164532

Diagnostic accuracy of fine-needle aspiration cytology in diagnosis of thyroid nodules

Gopal Krishna Damle, Ajit Vikram Daharwal

Abstract


Background: Thyroid nodules are a common clinical problem Epidemiologic studies have shown the prevalence of palpable thyroid nodules to be approximately 5% in women and 1% in men living in iodine- sufficient parts of the world. The prevalence of thyroid nodules ranges from 4% to 10% in the general adult population and from 0.2% to 1.2% in children. Currently, many investigations including diagnostic imaging studies, serologic and cytogenetic tests as well as histopathological techniques are available to evaluate to evaluate thyroid nodules out. Of all these investigations, fine needle aspiration cytology (FNAC) has become the diagnostic tool of choice for the initial evaluation of solitary thyroid nodule.

Methods: A present prospective study was conducted in department of ENT, Dr. BRAM hospital, Pt. JNM Medical College, Raipur, Chhattisgarh, India during study period November 2011 to October 2012. Patients with thyroid nodule were selected for the study. After taking a detailed clinical history, all cases were underwent a thorough ENT and head and neck examination. The clinical findings were recorded. Thyroid function tests and other necessary investigations were also done. Then the patients were referred for fine needle aspiration cytology to the department of Pathology. Depending on the nature of the lesion, decision had taken regarding need for surgery and the extent of surgery. All fine needle aspiration cytology (FNAC) reports were correlated with histopathology diagnosis.

Results: Male and female ratio was 1:3.5. Preoperatively FNAC done in 54 cases out of which 36 (66.66%) results were goiter followed by 4 (7.40%) hurthle cell thyroiditis and 2 (3.87%) chronic thyroditis Among 54 cases 1.85% results were follicular neoplasia followed by 3 (5.55%). Fine needle aspiration cytology was 87.5% sensitive in detection of neoplastic lesion and 95.65% sensation of neoplastic lesion and 95.65% specific. Accuracy was 94.44%.

Conclusions: Fine needle aspiration cytology is a simple, rapid, inexpensive, well tolerated and harmless method of evaluation mass lesions of the neck especially when there is a close cooperation between the clinician and cytopathologist.

Keywords


FNAC, Histopathology, Thyroid nodules

Full Text:

PDF

References


Khanzada TW, Sanmad A, Kumar B, Memon W. The diagnostic value of fine needle aspiration cytology in thyroid nodules. Pak J Otolaryngol. 2009;25:39-41.

Ahuja A, Ying M, King W, Metreweli C. A practical approach to ultra sound of cervical lymphnodes; JLO. 1997;111(3):245-56.

All H, Scanas QJ. Fine Needle Aspiration Biopsy of Salivary Glands. Year Book of Cancer, Acta. Cytol. 1986,439-40.

Van Herle AJ, Rich P, Ljung BE, Ashcraft MW, Solomon DH, Keeler EB. The Thyroid Nodule. Ann Intern Med. 1982;96:221-32.

Dejmek A, Lindholm K. Fine Needle Aspiration Biopsy of cystic lesions of the head and neck excluding the thyroid. Acta cytological. 1990;34:443-8.

Applins D, Miller RH. Mycobacterial Cervical Lymphadenopathy 1981, Update Laryngoscope, 1981;1259-66.

Ari Sisamanis M, Strong S. Fine Needle Aspiration Biopsy, Diagnosis of Neck Masses. Otos Clinics of North America. 1990;13(3).

Ashcraft MW, Van Herle AJ. Management of thyroid nodules. II: Scanning techniques, thyroid suppressive therapy, and fine needle aspiration. Head Neck Surg. 1981;3;297-322.

Atala TS, Grenman R, Varpula MJ. Palpation, USG and USG guided FNAC in the assessment in Cx LN. Status in Head and Neck Cencer patient. Head and Neck. 1996;18(6):545-51.

Handa U, Garg S, Mohan H, Nagarkar N. Role of fine needle aspiration cytology in diagnosis and ­management of thyroid lesions: A study on 434 patients. J Cytol 2008;25:13-7

Wahid FI, Khan SF, Rehman HU, Khan IA. Role of Fine Needle Aspiration Cytology in Diagnosis of Solitary Thyroid Nodules. Iran J Otorhinolaryngol. 2011;23(65):111-8.

Goellner JR, Gharib H, Grant CS, Johnson DA. Fine needle aspiration cytology of the thyroid, 1980 to 986. Acta Cytol. 1987;31:587-90.

Gharib H, Goellner JR. Fine-needle aspiration biopsy of the thyroid: an appraisal. Ann Inte Med. 1993;118(4):282-9.

Cusick EL, MacIntosh CA, Krukowski ZH, Williams VM, Ewen SW, Matheson NA et al. Management of isolated thyroid swellings: a prospective six year study of fine needle aspiration cytology in diagnosis. BMJ. 1990;301:318.

Gupta M, Gupta S, Gupta VB. Correlation of fine needle aspiration cytology with histopathology in the diagnosis of solitary thyroid nodule. J Thyroid Res. 2010;2010:379051.

Al-Sayer HM, Krukowski ZH, Williams VM, Matheson NA. Fine needle aspiration cytology in isolated thyroid swellings: a prospective two year evaluation. BMJ. 1985;290(6480):1490-2.

Bouvet M, Feldman JI, Gill GN, Dillmann WH, Nahum AM, Russack V, et al. Surgical management of the thyroid nodule: patient selection based on the results of fine-needle aspiration cytology. Laryngoscope. 1992;102(12 Pt 1):1353-6.

Khanzada TW, Sanmad A, Kumar B, Memon W. The diagnostic value of fine needle aspiration cytology in thyroid nodules. Pak J Otolaryngol. 2009;25:39-41.