Correlation between fine needle aspiration cytology and histopathological examination in thyroid swellings-a pilot study
Abstract
Background: Thyroid swellings are an enigma that necessitates either, a partial thyroidectomy and a tissue diagnosis to be followed by completion surgery or straightaway a radical intervention. A preoperative presumptive diagnosis of a thyroid swelling, solitary or otherwise is correlated with the post-surgical histopathological finding in the present study.
Methods: 30 patients of thyroid nodules were selected from the head-neck tumour clinic of Dayanand medical college hospital, Ludhiana. Pre-operative fine needle aspiration cytology (FNAC) was performed and subjects taken for thyroidectomy, partial or total as the case maybe.
Results: There were 20 (66.6%) females in the age group 25-65 years and 10 males (33.3%) 19-50 years with thyroid nodules. 86.6%, 26 patients were of follicular adenoma, 10% 3 patients of papillary carcinoma and 3.33% 1 patient of follicular carcinoma. No case in this study was reported as medullary carcinoma. In the cytological diagnosis of follicular neoplasm in 5 cases, 3 were diagnosed as thyroid adenoma, 2 were finally found to be papillary carcinoma. Overall sensitivity of fine needle aspiration was 40%. There was 84.6% agreement in follicular adenoma; 33% in papillary carcinoma and 100% in follicular carcinoma, and overall accuracy was 85.7%.
Conclusion: FNAC is an ideal preoperative investigative modality in thyroid swellings with overall accuracy of 85 % and can differentiate preoperatively a benign from a malignant thyromegaly; and thereby plan extent of surgery, with or without a neck dissection, Maximum cases of follicular adenoma could be easily diagnosed with this aspiration modality.
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