Association of Fine-Needle Aspiration of Thyroid Nodules With Final Histopathology in Diagnosing Thyroid Malignancy: A Single Institute Retrospective Study

Abstract

BackgroundFine needle aspiration cytology (FNAC) is the gold standard for detecting thyroid nodules. It is a costefficient approach that affords prompt and accurate evaluation. It is crucial in deciding to treat patients with suspected malignancy of thyroid nodules that might have thyroid surgery. According to findings in cytology, patients may be observed when the cytology is benign, and surgery can be performed if the cytology is malignant, which leads to a reduction in the incidence of unneeded surgery. AimThe current study aims to assess the concordance between FNAC of thyroid nodules with final histopathology and identify the different types of detected thyroid lesions. MethodologyA retrospective record-based study reviewed the medical files of all patients presenting to the Armed Forces Hospital, Southern region, with suspected thyroid nodules from April 2018 to January 2020. Data were extracted using pre-structured data extraction sheet to avoid inconsistency. Data extracted included patients' demographic data, swelling laterality, size, ultrasound, and histopathological findings. ResultsThe baseline characteristics of studied samples in the present study: Forty-seven samples had a mean age of 44.27 (SD=±13.5) years, and 85.1% were female gender. The study showed that 12.5% of benign samples were lymphocytic in histopathology, 25% suspicious for follicular neoplasm samples were benign multi-nodular goiter in histopathology, and all 100% of samples suspicious for malignancy were malignant in final histopathology. ConclusionsThe current study showed that the malignancy rate of the examined nodules was not uncommon in FNAC and histopathology. Where papillary carcinoma was the most detected malignancy, the diagnosis of malignancy using FNAC is a cost-efficient approach that affords prompt and accurate evaluation. Once diagnosed, these cases should be subjected to surgery.

Utilidad diagnóstica de citopatología para diagnóstico de nódulos tiroideos malignos en un hospital peruano

“…La PAAF es reconocida como una técnica útil para detectar nódulos tiroideos malignos, dado que es económica, rentable, confiable y mínimamente invasiva, además de la posibilidad de aplicarse ambulatoriamente. Se ha descubierto que la biopsia por PAAF tiene la mayor precisión diagnóstica, acercándose al 95%, y su uso ha permitido una selección mucho mejor de los pacientes que necesitan cirugía, reduciendo la tasa de cirugías tiroideas innecesarias [11,12] . No obstante, se pueden presentar algunos falsos positivos y falsos negativos, producto de inconvenientes en las técnicas de muestreo, interpretación o inadecuación de la muestra [13] .…”

“…En el presente estudio la sensibilidad fue alta (91,92%) y la especificidad moderada (71,67%), la precisión fue de 84,28% lo que concuerda con otros estudios que evaluaron Bethesda V y VI como maligno, encontrando en estos el rango de la sensibilidad entre 60,28 a 98,40% y la especificidad entre 31,40 a 98,05% [12,27] . Por otro lado, al considerar solo Bethesda VI, la sensibilidad permaneció casi igual (90,70%), aunque la especificidad subió considerablemente a 89,58%, la precisión alcanzó 90,30% y los falsos positivos disminuyeron de 16 a 5 casos.…”

Cancer gene analysis of liquid‐based cytology specimens using next‐generation sequencing: A technical report of bimodal DNA‐ and RNA‐based panel application

“…Cytological examination is a valuable diagnostic tool for thyroid and salivary gland malignancies; however, cytopathologists often encounter indeterminate cases 1–3 . In particular, thyroid follicular tumors are difficult to diagnose in cytology, and the differential diagnosis includes thyroid follicular nodular disease, follicular adenoma, and follicular carcinoma 4 .…”

“…In particular, thyroid follicular tumors are difficult to diagnose in cytology, and the differential diagnosis includes thyroid follicular nodular disease, follicular adenoma, and follicular carcinoma 4 . Thus, the diagnostic accuracy varies from 75% to 97% in thyroid gland cytology, even when evaluated by a skilled cytopathologist 2 . In thyroid and salivary gland tumor cases, cytological specimens are excellent sources of molecular examinations that can provide important information pertaining to diagnosis and treatment 5 …”

“…to 97% in thyroid gland cytology, even when evaluated by a skilled cytopathologist. 2 In thyroid and salivary gland tumor cases, cytological specimens are excellent sources of molecular examinations that can provide important information pertaining to diagnosis and treatment. 5 We have recently verified that liquid-based cytology (LBC) specimens carry high-quality DNA available for genomic analysis, including gene methylation studies using NGS-based cancer gene panels.…”