Published: 2020-04-23

A study of correlation of pre-operative fine needle aspiration cytology and ultrasonography with post-operative histopathology in thyroid swellings

Rajkumar Parameshwar Narayanakar, Darshan Saligrama Govinda Shetty


Background:Diseases of the thyroid gland can be due to inflammatory and neoplastic causes. Many diagnostic tests like ultrasound, thyroid nuclear scan and fine needle aspiration cytology (FNAC) are available for their evaluation. Histopathologically, they can be adenomas, colloid nodules, cysts, infectious nodules, lymphocytic or granulomatous nodules, congenital abnormalities or hyperplasia, or various types of malignancy. It is therefore crucial to have a clear diagnostic approach to ensure patients are managed appropriately and are not over or under-treated. Present study was done to evaluate FNAC and ultrasonography (USG) as a diagnostic method in thyroid swellings and to plan surgery accordingly.

Methods: A prospective observational study was conducted among 60 adult patients undergoing thyroid surgery at Victoria and Bowring and Lady Curzon Hospital. They were investigated with FNAC and USG of thyroid, and were subjected to surgery and subsequent histopathological examination. The histopathological examination reports were correlated with the findings of FNAC and USG in order to evaluate their findings by statistical methods.

Results:The sensitivity and specificity of FNAC was 87.5% and 98% respectively. All malignant lesions on FNAC were confirmed by histopathology indicating its excellence. Therefore FNAC helps in planning the correct management and avoids second surgery. And the sensitivity and specificity of USG was 75% and 86% respectively. Therefore combination of both FNAC and ultrasonography will improve the diagnostic accuracy to higher level and helps in better management.

Conclusions:FNAC has high sensitivity and specificity, so it is closest to ideal test. However, a combination of both FNAC and ultrasound will give desirable results and so that we can avoid mismanagement.


FNAC, Multinodular goitre, Solitary thyroid nodule, Thyroid swelling, Thyroid lesions, USG

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Lal GH, Clark O. Thyroid, parathyroid and adrenal. Schwartz’s principles of surgery. 10th edition. London: Brunicardi. 2015:1531.

Burch HB, Burman KD, Reed HI, Bukner L. Fine needle aspiration of thyroid nodules determinants of insufficiency rate and malignancy yield at thyroidectomy. Am J Surg. 1996;40:1176-83.

Das S. The thyroid and parathyroids; A concise text book of surgery. 9th edition, Kolkata. S Das Publisher. 2016:524.

American Association of Clinical Endocrinologists and medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract. 2006;12:63-102.

Hooper M. Jamieson and Kay‟s: Textbook of Surgical Physiology. 4th edition; Churchill Livingstone. 1990:85-107.

Kant D, Pratap D, Kamal D. Comparative study of preoperative fine needle aspiration cytology and ultrasonography with postoperative histopathology of thyroid nodule. IOSR-JDMS. 2017;16(5);20-25

Fenn AS. Solitary nodules of thyroid gland review of 342 cases. Indian J Surg. 1980;40:175-7.

Rao CS. Ramaskrishna Kakinada Andhra Pradesh – An analysis of 100 cases of thyroid desease –ASI con 1990- abstract of short papers. 1990.

Chaudhary V, Bano S. Thyroid ultrasound. Indian J Endocrinol Metab. 2013;17(2):219-27.

Mundasd B, Mcallister J. Accuracy of fine needle aspiration cytology in diagnosis of thyroid swellings. Inter J Endocrinol. 2006;2(2):44-8.

Gharbi MD. Enricopapini thyroid nodules clinical importance, assessment and treatment. Endocrinol Metabol Clin North Am. 2007;36:707-35.

Watters AK, Ahiya AT. Role of USG in the management of thyroid nodule. Am J Surg. 1998;164:654-7.

Chaudhary V, Bano S. Thyroid ultrasound. Indian J Endocrinol Metabol. 2013;17(2):67-72.

Bonavita JA, Mayo J, Babb J, Bennett G, Oweity T, Macri M, et al. Pattern recognition of benign nodules at ultrasound of the thyroid: which nodules can be left alone? Am J Roentgenol. 2009;193(1);207-13.

Dhanadia A, Shah H, Dave A. Ultrasonographic and FNAC correlation of thyroid lesions. Gujarat Med J. 2014; 69:75-81.