Cytomorphological Assessment and Thyroid Function Analysis – A Dual Approach to Diagnose Thyroid Lesions

Abstract

Introduction: Thyroid lesions are a commonly encountered clinical problem in all age groups. Accurate preoperative assessment guides the clinical management and improves the patient outcome. Aim: To describe the cytomorphological features of palpable thyroid nodules using fine needle aspiration cytology (FNAC) along with the assessment of thyroid hormonal status of the patient. The study also tried to assess the sensitivity, specificity and diagnostic accuracy of FNAC as an initial diagnostic modality for thyroid lesions. Materials and Methods: The study was conducted in the Department of Pathology of a teaching hospital during July 2013 to December 2014 and included 350 patients with thyroid lesions. Cytological assessment was done using FNAC along with serological assessment of thyroid hormones and cytohistopathological correlation. Results: A total of 350 patients underwent cytomorphological assessment using FNAC, of which most were females with most patients being in the age group of 21 to 40 years. Nonneoplastic lesions were more common, with colloid goitre being the most common diagnosis. Among the neoplastic lesions, follicular adenoma was the most common diagnosis. Thyroid hormone profile was done in 327 patients. Same thyroid disease showed different thyroid status in different patients. Cyto-histopathological correlation was done in 28 patients. The sensitivity of FNAC in the present study was 87.5%, specificity was 91.7%, positive predictive value (PPV) was 93% and negative predictive value (NPV) was 85%. The diagnostic accuracy of FNAC in diagnosing thyroid lesions was 89.3%. Conclusion: FNAC is a sensitive and specific technique for the diagnosis of thyroid lesions. FNAC in conjunction with hormonal analysis helps in proper patient assessment and management.

Keywords

• cyto-histopathological correlation
• hashimoto’s thyroiditis
• nodular colloid goitre
• tsh