MRIMS Journal of Health Sciences (Jan 2024)
Fine-needle aspiration cytology in thyroid lesions: A diagnostic evaluation study
Abstract
Background: Thyroid disorders are prevalent worldwide, with India being at high risk for iodine deficiency disorders. Fine-needle aspiration cytology (FNAC) is a first-line diagnostic tool for evaluating thyroid nodules, which has significantly reduced the number of thyroid surgeries performed. Objective: The objective of the study was to evaluate the role of FNAC in the diagnosis of thyroid swellings. Materials and Methods: Diagnostic evaluation study of patients with thyroid swelling whose FNAC is carried out over a period of 1 year. The patient's demographic and clinical details, as well as relevant investigations, were obtained. FNAC results were classified into four groups: benign, suspicious for malignancy, malignant, and unsatisfactory/insufficient for diagnosis. Based on FNAC results, 22 patients underwent thyroid surgery, and the specimens were examined histologically. The study assessed the sensitivity and specificity of FNAC by comparing cytological diagnosis with histopathological diagnosis. Results: Out of 228 patients with thyroid swelling, 190 (83.34%) were females and 38 (16.66%) were males. Average age of presentation was 39.89 years. Clinically, 108 (47.36%) cases presented with the diffuse involvement of the thyroid gland. FNAC results showed 201 (88.15%) were benign, 15 (6.57%) were malignant, and 12 (5.26%) were unsatisfactory. Colloid goiter was the most common thyroid lesion found on FNAC. Among 22 cases that underwent surgery, 17 were benign and 5 were malignant on histopathology examination. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 100%, 94.44%, 80%, 100%, and 95.45%, respectively. Conclusion: FNAC is a simple, quick, and useful first-line tool for evaluating thyroid swelling and can help differentiate neoplastic from non-neoplastic lesions. It also helps surgeons in decision-making and patient management.
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