STUDY OF CORRELATION OF FINE NEEDLE ASPIRATION CYTOLOGY WITH HISTOPATHOLOGY IN THE DIAGNOSIS OF SOLITARY THYROID NODULE: OUR EXPERIENCE.

- 4-post-graduate residents, Deptt. Of Pathology SKIMS, Srinagar.
- post-graduate resident, Deptt. Of ENT and HNS,GMC, Srinagar.
- post-graduate resident, Deptt. Of ANAESTHESIA, GMC, Srinagar.
- Professor and HOD, Deptt. Of Pathology SKIMS, Srinagar.
- Additional Professor, Deptt. Of Pathology SKIMS, Srinagar.
- Abstract
- References
- Cite This Article as
- Corresponding Author
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.
- Wienke JR, Chong WK, Fielding JR, Zou KH, Mittelsteadt CA. Sonographic features of benign thyroid nodules. J Ultrasound Med 2003;22:1027?31.
- Howard RJ. Tumors of the Thyroid and Parathyroid glands. Stell and Maran?s, Head and Neck Surgery. Butterworth and Heinemann, 4th edition, 2000;459?85.
- Grace A Lee, Masharani U. Disorder of the Thyroid Gland. Current Diagnosis and Treatment, Otolaryngology Head and Neck Surgery, Mc Graw Hill, 2nd edition, 2008:548?66.
- Patel N, Gill J, Shammari AL, Khalil HMB, Chowdhary CR. Fine needle aspiration cytology?Are we getting it right? Int Congress Series (1240) 2003;1399?1402.
- Martin HE, Ellis EB. Biopsy by needle puncture and aspiration.Ann Surg 1930;92:169?81.
- Derrick T Lin, Daniel G Deschler. Neck Masses. Current Diagnosis and Treatment, Otolaryngology Head and Neck Surgery, Mc Graw Hill, 2nd edition, 2008:397?407.
- Tilak V, Dhaded AV, Jain Ragini. Fine needle aspiration of head and neck masses. Indian J Pathol Microbiol 2003;45(1):23?30.
- Russ EJ, Scanlon FE, Christ AM. Aspiration cytology of head and neck masses. Am J Surg 1978;36(1):342?7.
- Lampe BH, Crammer MH. Advances in the use of fine needle aspiration cytology in the diagnosis of palpable lesions of head and neck. J Otolaryngol 1991;120(2):108?16.
- Bajaj Y, Thompson A. Fine needle aspiration cytology in diagnosis and management of thyroid disease. J Layrngol Oto 2006;120:467?9.
- Mahar SA, Husain A, Islam N. Fine needle aspiration cytology of thyroid nodule: diagnostic accuracy and pitfalls. J Ayub Med Coll Abbottabad 2006;18(4):26?9.
- Gharib H. Diffuse nontoxic and multinodular goiter. Curr Ther Endocrinal Metab 1994;5:99?101.
- Bugis SP, Young JKE, Archibald SD, Chen VS. Diagnostic accuracy of fine needle aspiration cytology verses frozen section in solitary thyroid nodules. Am J Surg 1986;152(4):411?6.
- Boyd LA, Earnardt RC, Dunn JT, Frierson HF, Hanks JB. Preoperative evaluation and predictive value of fine needle aspiration and frozen section of thyroid nodules. J Am Coll Surg 1998;187(5):494?502.
- Baloch MN, Ali S, Ansari MA, Maher M. Contribution of Fine needle aspiration cytology in the diagnosis of malignant Thyroid nodules. Pak J Surg 2008;24(1):19?21.
- Naggada HA, Musa AB, Gali BM, Khalil MIA. Fine needle aspiration cytology of thyroid nodules. A Nigerian tertiary hospital experience. Internet J Cardiovasc Res 2006:5.
- Humburger JI. Diagnosis of thyroid nodules by fine needle aspiration biopsy: use and abuse. J Clin Endocrinol Metab 1994;79:335?9.
- Agrawal, ?Diagnostic accuracy and role of fine needle aspiration cytology in management of thyroid nodules,? Journal of Surgical Oncology, vol. 58, no. 3, pp. 168?172, 1995.
- Bakhos, S. M. Selvaggi, S. Dejong, et al., ?Fine-needle aspiration of the thyroid: rate and causes of cytohistopathologic discordance,? Diagnostic Cytopathology, vol. 23, no. 4, pp. 233? 237, 2000.
- L. Morgan, J. W. Serpell, and M. S. P. Cheng, ?Fine-needle aspiration cytology of thyroid nodules: how useful is it?? ANZ Journal of Surgery, vol. 73, no. 7, pp. 480?483, 2003.
- Dorairajan and N. Jayashree, ?Solitary nodule of the thyroid and the role of fine needle aspiration cytology in diagnosis,? Journal of the Indian Medical Association, vol. 94, no. 2, pp. 50?52, 1996.
- Bouvet, J. I. Feldman, G. N. Gill, et al., ?Surgical management of the thyroid nodule: patient selection based on the results of fine-needle aspiration cytology,? Laryngoscope,vol. 102, no. 12, pp. 1353?1356, 1992.
- C. Hamaker, M. I. Singer, R. V. DeRossi, and W. W. Shockley, ?Role of needle biopsy in thyroid nodules,? Archives of Otolaryngology, vol. 109, no. 4, pp. 225?228, 1983.
- Radetic, Z. Kralj, and I. Padovan, ?Reliability of aspiration biopsy in thyroid nodes: study of 2190 operated patients.,?Tumori, vol. 70, no. 3, pp. 271?276, 1984.
- M.Al-Sayer, Z. H. Krukowski, V. M. M.Williams, andN. A. Matheson, ?Fine needle aspiration cytology in isolated thyroid swellings: a prospective two year evaluation,? British Medical Journal, vol. 290, no. 6480, pp. 1490?1492, 1985.
- L. Cusick, C. A. MacIntosh, Z. H. Krukowski, V. M. M. Williams, S. W. B. Ewen, and N. A. Matheson, ?Management of isolated thyroid swelling: a prospective six year study of fine needle aspiration cytology in diagnosis,? British Medical Journal, vol. 301, no. 6747, pp. 318?321, 1990.
- Kessler, H. Gavriel, S. Zahav, et al., ?Accuracy and consistency of fine-needle aspiration biopsy in the diagnosis and management of solitary thyroid nodules,? Israel Medical Association Journal, vol. 7, no. 6, pp. 371?373, 2005.
- J. De Vos Tot Nederveen Cappel, N. D. Bouvy, H. J. Bonjer, J. M. Van Muiswinkel, and S. Chadha, ?Fine needle aspiration cytology of thyroid nodules: how accurate is it and what are the causes of discrepant cases?? Cytopathology, vol. 12, no. 6, pp. 399?405, 2001.
- D. Brooks, A. R. Shaha, W. DuMornay, et al., ?Role of fine needle aspiration biopsy and frozen section analysis in the surgical management of thyroid tumors,? Annals of Surgical Oncology, vol. 8, no. 2, pp. 92?100, 2001.
- Basolo, C. Ugolini, A. Proietti, P. Iacconi, P. Berti, and P. Miccoli, ?Role of frozen section associated with intraoperative cytology in comparison to FNA and FS alone in the management of thyroid nodules,? European Journal of Surgical Oncology, vol. 33, no. 6, pp. 769?775, 2007.
- Lumachi, S. Borsato, A. Tregnaghi, et al., ?FNA cytology and frozen section examination in patients with follicular lesions of the thyroid gland,? Anticancer Research, vol. 29, no. 12, pp. 5255?5257, 2009.
- Gharib and J. R. Goellner, ?Fine-needle aspiration biopsy of the thyroid: an appraisal,? Annals of Internal Medicine, vol. 118, no. 4, pp. 282?289, 1993.
- Ravetto, L. Colombo, and M. E. Dottorini, ?Usefulness of fine-needlein the diagnosis of thyroid carcinoma: a retrospective study in 37,895 patients,? Cancer, vol. 90, no. 6, pp. 357?363, 2000.
[Salma Gull, Jasif Nisar, Tahleel Mohd Jeelani, Asima Aijaz, Syed Besina Yasin and Mohd Iqbal Lone. (2017); STUDY OF CORRELATION OF FINE NEEDLE ASPIRATION CYTOLOGY WITH HISTOPATHOLOGY IN THE DIAGNOSIS OF SOLITARY THYROID NODULE: OUR EXPERIENCE. Int. J. of Adv. Res. 5 (Oct). 1649-1654] (ISSN 2320-5407). www.journalijar.com
government medical collage ,srinagar ,jammu and kashmir