A Cytohistopathological Correlation of Thyroid Lesions with Critical Evaluation Of Discordant Cases: An Experience At A Tertiary Care Hospital

Abstract

Background: Fine Needle Aspiration Cytology (FNAC) is important for pre-operative diagnosis of benign and malignant thyroid lesions. It is usually the first line of investigation and a minimally invasive diagnostic procedure whose essential role is to diagnose and distinguish benign from malignant lesions. Thus the present study was undertaken to determine sensitivity, specificity and accuracy of FNAC in the diagnosis of thyroid lesions and to correlate cytological findings with histopathology. Methods:A prospective study was conducted in a tertiary care centre to study FNAC of thyroid lesions along with its histopathological correlation over a period of 2 years starting from June 2013 to June 2015Result: 56(93%) patients were females and 4(7%) patients were males. Patients age ranged from 15 to 65 years .Commonest lesion encountered in thyroid gland was colloid goitre, while papillary carcinoma was the most frequent malignant lesion. Cyto-histopathological correlation of 60 cases was done. Sensitivity ,specificity and diagnostic accuracy of the study for malignant lesions was 96.36%,100%,and 96.66% respectively. Conclusion:FNAC is a safe, simple, highly accurate, economical method for evaluation of palpable thyroid lesions. There is almost perfect cyto-histopathological concordance and the results are consistent with those available in the literature. FNAC helps in avoiding unnecessary surgeries in patients diagnosed to have a benign pathology based on cytology. Thus FNAC serves as a useful screening test to triage thyroid lesions before surgery.

Cytological evaluation of thyroid lesions and its correlation with histopathology in a teaching hospital

“…In our study, on histopathology, benign thyroid lesions were more common at 91.3% and malignant lesions were 8.6% which is comparable with the findings of Kantasueb et al 16 [9] 2015 96.3% 100% 96.6% Pandey et al [17] 2012 57.1% 90% 80.2% Gupta et al [18] 2010 80% 86% 84% Hathila et al [11] 2016…”

“…Aramani et al 9 studied 60 patients with thyroid lesions and observed the age range from 15 to 65years with predominance of female patients. The male to female ratio was 1:14.…”

Thyroid Cytology in India: Contemporary Review and Meta-analysis

“…However, there were others who have just mentioned “blood only/lack of cellularity/poor quality smears/presence of obscuring factors” as the reason for calling a sample unsatisfactory [ 15 , 22 , 24 ]. Still, some studies have not specified the criteria used for adequacy [ 27 , 28 , 57 ].…”

A Study of Cytohistopathological Correlation of Various Thyroid Lesion in Hadoti Region

“…Cystic change and/or hemorrhage in neoplasms is seen in up to 25% of papillary carcinomas, 20% of follicular neoplasms and in 26% of follicular carcinomas. 6 This is due to typical appearances of follicular cells with moderate variation in size. Such a change can be observed in benign lesions also as hyperplastic reaction of thyroid cells.…”

“…3 Despite the improvement in the diagnosis of thyroid lesions using ultrasonography and radio nucleotide scanning, fine needle aspiration cytology (FNAC) has emerged as the first step in the diagnostic management of thyroid nodules. 4,5 It has proven to be a cost-effective tool 6,7 in the selection of patients requiring surgical intervention, halving the number of patients undergoing thyroid surgery and doubling the incidence of malignancy in the resected specimens 4. However, interpretive or sampling errors account for false diagnoses in FNAC. 2 Hashimoto's thyroiditis is the most common cause of false-positive cytology for malignancy.…”