DIAGNOSTIC ACCURACY OF FINE NEEDLE ASPIRATION OF THYROID NODULE VERSES BIOPSY IN THYROID LESIONS
Abstract
Bakground: FNA biopsy of thyroid is a rapid, minimally invasive, and cost effective first lineprocedure in the evaluation of thyroid nodule. This study was conducted to evaluate the cytological
accuracy, sensitivity and specificity of fine needle aspiration (FNA) of solitary thyroid nodules in
correlation with post-surgical histological findings. Methods: This retrospective study was carried
out at Department of Pathology, Abbottabad International Medical College, Abbottabad from
January 2009 to December 2010. A total of 81 patients with clinically palpable solitary thyroid
nodule were included in the study. Thyroid function tests were initially performed followed by
FNA of thyroid nodules later operated and histopathological examination was conducted on the
excised nodules. FNA diagnoses were correlated with the histological findings. The accuracy,
sensitivity and specificity of the procedure were determined. Results: Out of 81 cases, 5 (6.2%)
were unsatisfactory and 76 cases were satisfactory for cytological evaluation. Cytohistopathological correlation was carried out for these cases. The study showed a diagnostic
accuracy of 93% with sensitivity and specificity rates of 75% and 96% respectively. Positive
predictive value is 81% and negative predictive value is 95%. Conclusion: Fine needle aspiration
(FNA) has evolved as an accurate and sensitive diagnostic tool for the initial screening of patients
with thyroid nodules, and has reduced the need for unnecessary surgery.
Keywords: Thyroid nodule, TSH, fine needle aspiration (FNA)
References
Welker MJ, Orliv D. Thyroid nodules. Am Fam Physician
;67:559-66.
Mazzaferri EL. Management of a solitary thyroid nodule. N Engl
J Med 1993;328:553-9.
Amrikachi M, Ramzy I, Rubenfeld S, Wheeler TM. Accuracy of
fine-needle aspiration of thyroid. Arch Pathol Lab Med
;125:484-8.
DeLellis RA, Lloyd RV, Heitz PU, Eng C, World Hralth
Organization Classification of Tumors: Tumors of Endocrine
Organs. Lyon: IARC Press, 2004.p. 26-7
Abdul-Jaber HB, Lynn J. The surgical management of thyroid
cancer. Nucl Med Commun 2004;25:869-72.
Mishra A, Mishra SK. Total thyroidectomy for differentiated
thyroid cancer:primary compared with completion
thyroidectomy. Eur J Surg 2002;168:283-7.
Yang J, Schnadig V, Logrono R, Wasserman PG. Fine-needle
aspiration of thyroid nodules: a study of 4703 patients with
histologic and clinical correlations. Cancer Cytopathol
;111:306-15.
Neven M, Irena T, Nina D, Vlado P, Zvonko K. Diagnostic
relevance of fine-needle aspiration cytology for follicular lesions
of the thyroid: retrospective study. CMJ 2002;43:606-9.
Gharib H, Goellner JR. Fine-needle aspiration biopsy of the
thyroid. Ann Intern Med 1993;118:282-9.
Orell SR, Sterrett GF, Walters MN, Whitaker D (Editors). Head
and neck. In: Manual and Atlas of fine needle aspiration
cytology. 3rd Ed. London: Elsevier Science Limited; 1999. p.
-44.
Ramzy I. (Editor). Clinical cytopathology and aspiration biopsy.
In: Fundamental principles and practice. Second edition. Hong
Kong: The McGraw-Hill; 2001.P361-87.
Cibas E, Ducatman BS. Cytology: Diagnostic principles and
clinical correlates. Second edition. UK: Elsevier limited; 2003. p.
-72.
Nurismah MI, Sharifah NA, Usama AE, Rohaizak M, Naqiyah I,
Jasmi A. Fine needle aspiration cytology of thyroid: a cytohistopathological study of 361 cases in hospital university
Kebangsaan Malaysia. Med Health 2007;2:58-65.
Tunbridge WM, Evered DC, Hall R. The spectrum of thyroid
disease in a community. The Wickham Survey. Clin Endocrinol
;7:481-93.
Orel SR, Sterrett GF, Walters MN, Whitaker D. (Editors). The
thyroid gland. In: Manual and atlas of fine needle aspiration
cytology. Edinburgh: Churchil Livingstone; 1992:96.
Kendall CH. Fine needle aspiration of thyroid nodules: three
years experience. J Clin Pathol 1989;42:23-7.
El Hag IA, Kollur SM, Chiedozi CL. The role of FNA in initial
management of thyroid lesions:7 year experience in a district
general hospital. Cytopathology 2003;14:126-30.
Sanggali G, Serio C, Zampatti M, Lomuscio BG. Fine needle
aspiration cytology of thyroid: a comparison of 5469 cytological
and final histological diagnosis. Cytopathology. 2006;17:245-50.
Vojvodich SM, Ballagh RH, Howard HC. Accuracy of fine
needle aspiration in the preoperative diagnosis of thyroid
neoplasia. J Otolaryngol 1994;23:360-5.
Yeoh GPS, Chan KW. The diagnostic value of fine needle
aspiration cytology in the assessment of thyroid nodules: a
retrospective 5 year analysis. Hong Kong Med J 1999;5:140-4.
Suresh R, Shenovi M, Nisha SN, Roque GWP, Suzette M. Role of
fine needle aspiration cytology as the initial modality in the
investigation of thyroid lesions. Acta Cytologica 1995;39:898-904.
Downloads
Published
How to Cite
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
