Title: FNAC Vs Histopathology in the Diagnosis of Thyroid Swellings
Authors: Senthil Kumar, Usha, Manivel Ganesan
DOI: https://dx.doi.org/10.18535/jmscr/v5i2.35
Abstract
Background: Fine Needle Aspiration Cytology (FNAC) is important for pre-operative and pre-treatment diagnosis of benign and malignant thyroid lesions, thus decreasing the incidence of unwanted surgeries. FNAC of thyroid swellings is a simple, rapid, patient friendly and inexpensive procedure, which can be repeated in cases of inadequate samples. It has the best predictive value of all currently available diagnostic procedures. Bloch et al had done a comparison study between FNAC and histopathology and then found that the accuracy and FNAC was 91.6%1. Handa et al have a similar study in which FNAC revealed a sensitivity of 97%, specificity 100%, a Positive Predictive Value of 96% and a negative predictive value of 100%7.
Materials and Methods: The present study is a prospective study and was conducted on 100 patients in the Department of General surgery, Kanyakumari Government Medical college from January2016 to December 2016. Various neck swellings presented to General Surgery department, were examined clinically after thorough history taking. They were subjected to FNAC and only those thyroid swelling cases admitted to indoor and subsequently underwent surgery were included in this study. After HP study they were compared with preoperative FNAC report. In all 100 cases, informed consent was taken prior to the surgery.
Results: Out of total 100 cases studied, 96 Cases were females & 4 cases were males. 53 patients (53%) had colloid goitre, 8 patients (8%) were suspicious for follicular neoplasms, 15 patients (15%) had Hashimotos and 11patients (11%) had Papillary carcinoma, 10(10%) were Atypia of undetermined significance and inadequate. Cyto-histopathological correlation of 100 cases was done. Sensitivity and specificity of the study for colloid goiter, Hashimotos, papillary carcinomas & malignant neoplasm were 100%, 86.7% % and 81.8%, 66.67% respectively.
Conclusion: FNAC is a safe, simple, highly accurate, economical and universally accepted modality for evaluation of thyroid lesions. FNAC helps in avoiding unwanted surgeries in patients diagnosed to have a benign pathology based on cytology. Those that are grouped in the suspicious or indeterminate category on cytology include lesions of uncertainty that are finally confirmed on histopathology. However, histopathological analysis is still remaining essential to distinguish follicular adenoma from follicular carcinoma.
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