Analysis of pattern of thyroid disorders in a tertiary care hospital and evaluating the accuracy of preoperative fine needle aspiration with postoperative histopathological examination
DOI:
https://doi.org/10.18203/2349-2902.isj20171018Keywords:
Postoperative histopathology, Preoperative FNAC, ThyroidAbstract
Background: Thyroid swelling is a common disease in India. It is very important to differentiate malignant thyroid swellings from benign swellings for definitive planning of appropriate surgery and relevant patient counselling. The present study is undertaken to analyse the pattern of thyroid disease in patients coming to Department of General Surgery and to evaluate the accuracy of thyroid FNA and its correlation with histopathological examination following thyroid surgery, thereby its role in the preoperative diagnosis of thyroid swellings.
Methods: A total of 114 thyroid patients were evaluated for a period of one year. The demographic data, clinical features were documented. FNAC was done in 77 patients and results were correlated with 47post operative histopathology reports and diagnostic accuracy of preoperative Fine needle aspiration cytology (FNAC) was evaluated.
Results: Age of the patients ranged from 14-70 years. Females were higher than males. Most patients presented with Multinodular goitre and most were in euthyroid state. Sensitivity of FNA was found to be 67% and Specificity was found to be 100%: Accuracy was found to be 93.6% in present study. Positive predictive value was found to be 100%. Negative predictive value (NPV) was found to be 92.7%.
Conclusions: Fine needle aspiration cytology has essential role in the evaluation of thyroid patients. We wish to stress the importance of doing multiple aspirations at different sites and usage of USG guidance for representative areas of suspected pathology. The diagnostic accuracy can be improved when combined with advanced imaging techniques.
References
Burch HB, Burman KD, Reed HI, Buckner L, Raber T, Ownbey Jl. Fine needle aspiration of thyroid nodules. Determinants of insufficiency rate and malignancy yield at thyroidectomy. ActaCytol. 1996;40:1176-83.
Gharib H, Goellner JR. Fine-needle aspiration biopsy of the thyroid: an appraisal. Ann Intern Med. 1993;118:282-9.
Martin HE, Ellis EB. Biopsy by needle puncture andaspiration. Ann Surg. 1930;92:169-81.
Dipanwita D, Sarma MC, Sharma A, Datta TK, Lahiri SK. A Comparative study between fine needle aspiration cytology and histopathological examination indiagnosis of neoplastic and non-neoplastic lesions of the thyroid gland. Indian J. Prev. Soc. Med. 2012;43(1).
Al-Sayer HM, Krukowski ZH, Williams VMM, Matheson NA. Fine needle aspiration cytology in isolated thyroid swellings: a prospective two-year evaluation. BMJ. 1985;290:1490-2.
Anderson JB, Webb AJ. Fine-needle aspiration biopsy and the diagnosis of thyroid cancer. Br J Surg. 1987;74:292-6.
Leonard N, Melcher DH. To operate or not to operate? The value of fine needle aspiration cytology in the assessment of thyroid swellings. J ClinPathol. 1997;50:941-3.
Gardner HA, Ducatman BS, Wang HH. Predictive value of fine-needle aspiration of the thyroid in the classification of follicular lesions. Cancer. 1993;71:2598-603.
Miller JM, Kini SR, Hamburger JI. The diagnosis of malignant follicular neoplasms of the thyroid by needle biopsy. Cancer. 1985;55:2812-7.
Suresh K, Shakil A, Abdullah D. Role of fine needle aspiration cytology in Thyroid diseases. J Surg Pakistan. 2008;13(1).
Md. Shafiqul I, Belayat HS, Nasima A, Kazi SS, Mohammad A. Comparative study of FNAC and histopathology in the diagnosis of thyroid swelling. Bangladesh J Otorhinolaryngol. 2010;16(1).
Lewis CM, Chang KP, Pitman M, WC Faquin, Randolph GW. Thyroid fine-needle aspiration biopsy: variability in reporting. Thyroid. 2009;19(7):717-23.
Srirangaprasad K, Nagaraj TM, Madav D, Mahajan R, Kumar P, George GK et al. A Study of Correlation of Preoperative Fine needle aspiration cytology with histopathological examination in Goitre. J Evol Med Den Scie. 2015;4(89):15414-7.
