Abstract
Aim and Objectives: To analyze the epidemiology of thyroid swellings and to correlate the role of FNAC with Post Operative HPE report in diagnosis of thyroid swelling.
Materials and Methods: This study is a prospective study conducted on patients presenting to Department of General Surgery in Govt. Stanley Medical College Chennai. All cases of thyroid swelling who attended our institute for treatment purpose has been evaluated between Jan 2016 to Jan 2017 were included in the study. They were subjected to TFT/ USG/ FNAC and subsequently underwent surgery. Totally 89 patients evaluated out of which 60 cases were operated. Post Operative HPE reports were compared with preoperative FNAC report.
Results and Discussions: This study shows most common age group distribution is 21 – 40 yrs, with mean age of 34.5yrs. Most common clinical presentation is Multi Nodular Goitre and Most of the them are in euthyroid state. FNAC identified 9 malignant cases (13%) preoperatively. Sensitivity was 70%. Specificity was 100%. Positive predictive value is 100%, Negative predictive value is 92%.
Conclusion: There is Increasing trend of carcinoma thyroid among middle age group. In conclusion the results of this study are compared with available published data shows FNAC is a very safe, cost effective, simple OPD basis procedure for all thyroid swellings in Euthyroid state with high accuracy and specificity except for follicular neoplasm. So FNAC is a good preoperatively diagnostic technique for thyroid swellings in all developing countries. The Sensitivity of FNAC can be further increased by using USG guided FNAC because it is useful to take sample from suspicious areas/lesions.
Keywords: Thyroid , FNAC, HPE, Malignancy, MNG.
References
- Mundasad, B., Mcallidter, I., Carson, J. 2006. Accuracy of fine needle aspiration cytology in diagnosis of thyroid swelling. J. Endocrinol., 2(2): 23-25.
- Handa, U., Garg, S., Mohan, H. 2008. Role of fine needle aspiration cytology in diagnosis and management of thyroid lesion. Indian J. Pediatr., 25(1): 13-17.
- 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.
- 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.
- Ds Mojghan Amrikachi, 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.
- 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.
- Shafiqul I, Belayat HS, Nasima A, Kazi SS, Mohammad A. Comparative study of FNAC and histopathology in the diagnosis of thyroid swelling. Bangladesh J Otorhinolaryngol. 2010;16(1).
- Lewis CM, Chang KP, Pitman M, WC Faquin, Randolph GW. Thyroid fine-needle aspiration biopsy: variability in reporting. Thyroid. 2009;19(7):717-23.
- Srirangaprasad K, Nagaraj TM, Madav D, Mahajan R, Kumar P, George GK et al. A Study of Correlation of Preoperative Fine needle aspiration cytology with histopathological examination in Goitre. J Evol Med Den Scie. 2015;4(89):15414-7.
- 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.
- Back Dahls 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.
- N. 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. 1996;94 (2); 50–2.
Corresponding Author
Dr Mathan Sankar .S MS
Senior Resident, Dept Of General Surgery, Chettinad Hospital & Research Institute (CHRI), Chennai, Tamil Nadu, India
Mobile Number: 9976424918, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.