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Category: Volume 08 Issue 07 July 2020
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Title: Diagnostic Utility of Fine Needle Aspiration Cytology and Cell Block Technique in Thyroid Lesions

Authors: Dr Shobhana J Agrawal, Dr Suwarna B Patil, Dr Pradeep S Umap, Dr Jasleenkaur S Oberoi, Dr Shailesh S Agrawal

 DOI: https://dx.doi.org/10.18535/jmscr/v8i7.72

Abstract

Introduction: Thyroid diseases are among the commonest endocrine disorders worldwide. In order to avoid misdiagnosis and hence unnecessary surgery in patients with benign thyroid nodules, it is essential to distinguish between benign and malignant lesions. Despite the proven clinical importance of thyroid FNAC, it still has limitations. To overcome these limitations to some extent Cell Block technique can be used. It has a pivotal role in diagnosis and ancillary studies. In this study, we evaluated the role of Cell Block as a useful adjunct to cytological smears for establishing a more definitive Cytopathological diagnosis.

Material and Methods: Present study was a prospective cross sectional study conducted from Nov 2017 to Oct 2019. 334 cases with thyroid swelling underwent FNAC. Of these 334, Cell Blocks were prepared by plasma thromboplastin method for 273 cases and histopathology was available for 66 cases.

Results: In this study, the age range was 8-76 years. Maximum number of cases were 96 (28.75%) in age group of 31-40 years. Female to male ratio was 10.1:1.The Sensitivity, Specificity, Positive predictive value, Negative predictive value and Diagnostic Accuracy of Cell Block in categorising neoplastic and non-neoplastic thyroid lesions was more than FNAC and when these two techniques were used together all statistical indices increased further.

Conclusion: Cell Block is a complimentary technique to cytological smears to increase the Sensitivity, Specificity and Diagnostic Accuracy in thyroid lesions.

Keywords: Thyroid lesion, FNAC, Cell Block, Adequacy, Diagnostic Accuracy.

References

  1. Unnikrishnan A, Menon U. Thyroid disorders in India: An epidemiological perspective. Indian J Endocrinol Metab. 2011;15(6):78.
  2. Furlanetto TW, Peccin S, Schneider M de O, Zimmer A dos S, dos Reis PS, Genro SK, et al. Prevalence of thyroid nodules in 40 years-old or old women. Rev Assoc Médica Bras. 2000;46(4):331–334.
  3. Amrikachi M, Ramzy I, Rubenfeld S, Wheeler TM. Accuracy of fine-needle aspiration of thyroid: a review of 6226 cases and correlation with surgical or clinical outcome. Arch Pathol Lab Med. 2001;125(4):484–488.
  4. Fischer S, Asa SL. Application of immunohistochemistry to thyroid neoplasms. Arch Pathol Lab Med. 2008;132(3):359–372.
  5. Galera-Davidson H. Diagnostic problems in thyroid FNAs. Diagn Cytopathol 1997; 17(6):422–428.
  6. Fagelman D, Chess Q. Nonaspiration fine-needle cytology of the liver: a new technique for obtaining diagnostic samples. AJR Am J Roentgenol. 1990;155(6):1217–1219.
  7. Yue XH, Zheng SF. Cytologic diagnosis by transthoracic fine needle sampling without aspiration. ActaCytol. 1989;33(6):805–808.
  8. Koss L, Melamed M. Laboratory Techniques. In: Koss’ Diagnostic cytology & its Histopathologic Bases.5th ed. Philadelphia: Lippincott Williams & Wilkins; 2006. p. 1590–3.
  9. Goswami D, Agrawal P, Shinde P. Accuracy of fine needle aspiration cytology (FNAC) in comparison to histopathological examination for the diagnosis of thyroid swellings. Int J Med Sci Public Health. 2017;6(1):6–11.
  10. Pandit AA, Kinare SG. Fine needle aspiration cytology of thyroid.Indian J Cancer. 1986;23(1):54–58.
  11. Hegazy RA, Hegazy AA. FNAC and Cell-block Study of Thyroid Lesions. Univers J Med Sci. 2013;8.
  12. Kuo F-Y, Chen W-J, Lu S-N, Wang J-H, Eng H-L.Fine needle aspiration cytodiagnosis of liver tumors. Acta Cytol. 2004;48(2):142–148.
  13. Ceyhan K, Kupana SA, Bektaş M, Coban S, Tuzun A, Cınar K, et al. The diagnostic value of on-site cytopathological evaluation and cell block preparation in fine-needle aspiration cytology of liver masses. Cytopathology. 2006;17(5):267–274.
  14. Ahmed Z, Medhi P, Das D. DIAGNOSTIC UTILITY OF CELL BLOCKS IN THYROID ASPIRATES. J Evol Med Dent Sci. 2015 Sep 21;4(76):13221–32.
  15. Goswami D, Agrawal P, Shinde P. Accuracy of fine needle aspiration cytology (FNAC) in comparison to histopathological examination for the diagnosis of thyroid swellings. Int J Med Sci Public Health. 2017;6(1):6–11.
  16. Thanigaimani GD, Murali P. FNAC and Cell Block Study in Thyroid Lesions. Sch J App Med Sci. 2016;4(6C):2070–3.
  17. Cristo AP de, Goldstein HF, Faccin CS, Maia AL, Graudenz MS. Increasing diagnostic effectiveness of thyroid nodule evaluation by implementation of cell block preparation in routine US-FNA analysis. Arch Endocrinol Metab. 2016;60(4):367–373.

Corresponding Author

Dr Jasleenkaur S Oberoi

Junior Resident Ⅲ, Department of Pathology, GMC, Akola, Maharashtra, India