A clinical study comparing the accuracy of the clinical examination, ultrasonography, fine needle aspiration cytology with that of histopathology
DOI:
https://doi.org/10.18203/2349-2902.isj20220371Keywords:
Histopathology, FNAC, UltrasoundAbstract
Background: Fine needle aspiration cytology (FNAC) is considered the gold standard diagnostic test for the diagnosis of thyroid nodules. FNAC is a cost-effective procedure that provides specific diagnosis rapidly with minimal complications. Aims was to compare efficacy of Clinical diagnosis, ultrasonography (USG), FNAC with one another and with that of histopathological examination (HPE) diagnosis.
Methods: It is a prospective comparative study in 60 patients admitted with thyroid swellings in the department of General Surgery were taken for study purpose. The clinical diagnosis, ultrasonogram report, FNAC and HPE were included in the study.
Results: Thyroid disease is 4.54 times more common in females. Thyroid disease is more common in the reproductive age group with the mean average age of 37.91±11.02 years. The male:female sex ratio for carcinoma is 1:2.33. Benign thyroid disorders constitute 83.3% of the total thyroid disorders. The overall efficacy of FNAC (88.33%) is far higher than USG (76.66%) and clinical diagnosis (56.66%). Sensitivity for diagnosis of thyroiditis clinically is very poor (45.45%) as compared to diffuse goiter (71.43%). FNAC can reasonably differentiate benign from malignant lesion most of the time with sensitivity of about 90%.
Conclusions: Ultrasonogram alone cannot correctly diagnose different types of benign lesions with accuracy. However, it can most of the time differentiate benign from a malignant lesion. It has an overall efficacy of 76.7%. The efficacy of FNAC is nearly 90% making it an essential diagnostic tool for diagnosing thyroid disease.
References
Pruthi A, Choudhury PS, Gupta M, Taywade S. Does the intensity of diffuse thyroid gland uptake on F-18 fluorodeoxyglucose positron emission tomography/computed tomography scan predict the severity of hypothyroidism? Correlation between maximal standardized uptake value and serum thyroid stimulating hormone levels. Indian J Nucl Med. 2015;30(1):16-20.
Kapur MM, Sarin R, Karmarkar MG, Sarda AK. Solitary thyroid nodule. Indian J Surg. 1982;44:174-6.
Ghoshal B, Pal NC, Majumdar P. FNAB in the diagnosis of cold thyroid nodules: correlative study with histopathology and its application in thyroid surgery. J Indian Med Asso. 1984;82:127-9.
Rajan H. Clinicopathological correlation in thyroid swellings a review of 654 cases. Indian J Pathol. 1985;34-7.
Jarlov AE. Observer variation in the diagnosis of thyroid disorders. criteria for and impact on diagnostic decision-making: Dan Med Bull. 2000;47(5):328-39.
Jarlov AE, Hegedus L, Gjorup T, Hansen JE. Accuracy of the clinical assessment of thyroid size: Dan Med Bull. 1991;38(1):87-9.
Lisboa HR, Gross JL, Orsolin A, Fuchs S. Clinical examination is not an accurate method of defining the presence of goitre in school children. Clin Endocrinal (Oxf). 1996;45(4):471-5.
Moon HG, Jung EJ, Park ST, Ha WS, Choi SK, Hong SC et al. Role of ultrasonography in predicting malignancy in patients with thyroid nodules. World J Surg. 2007;31(7):1410-6.
Katz JF, Kane RA. Thyroid nodules: sonographic pathologic correlation. Bri J Radiol. 1984;151:741-5.
Watters AK, Ahiya AT. Role of USG in the mana-ment of thyroid nodules. Am J Surg. 1992;164:654-7.
Jones AJ, Aitman TJ. Comparison of FNAC, RNS and USG In the Management of Thyroid Nodules. Post Grad Med J. 1990;66:914-7.
Gurumani S. A Comparative Study Of Fine Needle Aspiration Cytology, Ultrasonography And Radionuclide Scan In Management Of Solitary Thyroid Nodule: A Prospective Analysis Of Fifty Cases. J Evolution Med Dental Sci. 2013;2(33):1607-14.
Al-Sayer HM, Krukowski ZH, Williams VMM, Matheson NA. Fine needle aspiration cytology in isolated thyroid swelling s: A prospective two-year evaluation. Bri Med J. 1985;290(6480):1490-2.
Cusick EL, MacIntosh CA, Krukowski ZH, Williams VMM, Ewen SWB, Matheson NA. Management of isolated thyroid swelling: a prospective six-year study of fine needle aspiration cytology in diagnosis. Bri Med J. 1990;301(6747):318-21.
Gupta M, Gupta S. Correlation of fine needle aspiration cytology with histopathology in the diagnosis of solitary thyroid nodule. J Thyroid Res. 2010;4:379051.
Handa U, Mohan H, Nagarkar N. Role of fine needle aspiration cytology in diagnosis and management of thyroid lesions: a study on 434 patients. J Cytol. 2008;25:13-5.
Suen KC. Atlas and text of aspiration biopsy cytology. Williams and Wilkins, London. 1990;33-7.
Tabaqchali MA, Hasan JM, Johnson ST, Wadhera V. Thyroid aspiration cytology in new castle: a six-year cytology/histology correlation study. Amr Coll Surg Engl. 2000;82:149.
