Correlation study of thyroid nodule cytopathology and histopathology at two institutions in Jordan

Abstract

Background:Fine-needle aspiration (FNA) plays a fundamental role in determining the appropriate management for patients presenting with thyroid nodules.Aims:The aims of this study are to evaluate thyroid FNA test performance parameters through a cytohistological correlation.Materials and Methods:A retrospective analysis of all thyroid FNAs received over a period of 18 months was carried out. The findings were compared to their subsequent definite diagnoses on surgical specimens as well as to their follow-up repeat FNA results. A total of 499 thyroid FNAs were collected and reviewed against The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). The percentage of each diagnostic category was calculated, and the implied risk of malignancy was determined by comparing the cytology results to their definite diagnoses obtained on the resection specimens. Analytical procedures were performed using Microsoft Excel.Results:Out of 499 thyroid FNAs, a benign interpretation was found in 273 patients (54.7%), atypia of undetermined significance in 81 (16.2%), follicular neoplasm in 20 (4%), suspicious for malignancy in 36 (7.2%), malignant in 32 (6.4%) and were nondiagnostic in 57 patients (11.4%). Only 101 patients (20.2%) underwent surgical resection and 47 (9.4%) underwent a follow-up FNA. After cytohistological correlation, FNA test performance, calculated by excluding the inadequate and undetermined categories revealed test sensitivity, specificity, and diagnostic accuracy of 95.6%, 54.8%, and 78.9%, respectively. The positive predictive value was 75.4%, and the negative predictive value was 89.5%.Conclusions:Our results are comparable to those previously published figures. The rate of atypia of undetermined significance/follicular lesion of undetermined significance is higher than what is currently recommended in TBSRTC.

Thyroid cancer among patients with thyroid nodules in Yemen: a three-year retrospective study in a tertiary center and a specialty clinic

“…A high prevalence of thyroid cancer was seen in our patients with thyroid nodules (13.4% of the females and 18.4% of the males), and there was no significant difference in the rate of cancer among those with single nodules and multiple nodules (P value = 0.07); this is similar to what was reported by Frates et al [16], and the highest rate of cancer was among those with nodules 1-2 cm in size; this is similar to a study that showed the highest malignancy rate among nodules < 2 cm in size [17]. The overall prevalence of cancer among patients with thyroid nodules was 13.8%, which is higher than that in neighboring countries, which is reported to be approximately 9-10% [8][9][10]. TSH level was significantly associated with thyroid cancer (P -value 0.01), which is consistent with studies that showed an increased risk of thyroid cancer with an increase in TSH level [12,18].…”

“…Other countries with high incidence rates include the USA (13.2), Canada (12.7), Turkey (10.9) and Italy (10.8) [6,7]. Other studies from the Middle East showed thyroid cancer in 10.5% of patients with thyroid nodules in Jordan [8] and rates of 5% in Saudi Arabia in one study [9] and 10.4% in another [10]. In the United Arab Emirates, the prevalence was 9% among those of Emirati origin [11] and 5% among those with thyroid nodules in Pakistan [12].…”

Analysis of Fine Needle Aspirations of the Thyroid: Cytological-Histopathological Correlation and Outcomes of the Bethesda System

“…The classification systems provides to use the same terminology which predicts the correct malignancy rates. There were numerous study in the literature about the using TBSRTC (1,(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33).…”

“…Three of them had lower rates for B3 and seven of them for B4. The remaining of them were in normal rates (1,(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33). The current study's malignancy rates were 6.8% 32.8% (high), 52.1% (high), 66.8% (normal) and 97.5% (normal).…”

Prueba diagnóstica entre la citología, biopsia por congelación e histopatología en el diagnóstico del Nódulo Tiroideo en pacientes atendidos en Solca desde el año 2009 – 2017.

“…Arul et al realiza un estudio con 528 pacientes que presentaron nódulo tiroideo y fueron puncionados,403 casos fueron diagnosticados como benignos (Bethesda II 76%), 67 fueron Bethesda III (12.6%), 36 casos como Bethesda IV (6%) mientras que 22 casos fueron categorizados ya sea maligno o sospechoso de malignidad (Bethesda V y VI que representa el 4%) [15]. Sughaver en el 2018 publica un estudio con 499 casos de nódulos tiroideos que fueron puncionados; se encontró una interpretación benigna en 273 pacientes (54.7%), atipia de importancia indeterminada en 81 (16.2%), neoplasia folicular en 20 (4%), sospechosa de malignidad en 36 (7.2%), maligna en 32 (6.4%) y no diagnósticos en 57 pacientes (11.4%) [16] Malukani et al en el 2018 realiza un estudio con 606 casos y cuyos resultados son: Categoría I: 26 (4.29%), Categoría II: 501 casos (82.67%), Categoría III: 5 (0.82%), Categoría IV: 55 (9.07%), Categoría V: 7 (1.15%) y Categoría VI: 12 (1.98%) [17].…”