• Mohammed Ayub Musani
  • Faheem A. Khan
  • Shoukat Malik
  • Yousuf Khambaty


Background: Thyroid enlargement is one of the common problems in patients presenting at outpatientsdepartment of ENT particularly in females. Thyroid nodules are common, thyroid cancer is uncommonand the most common way for it to present is as a solitary thyroid nodule. This study was conducted toevaluate the sensitivity and specificity of Fine Needle Aspiration Cytology (FNAC) in thyroid diseases.Method: This prospective analytic study was conducted at ENT Department of Karachi Medical andDental College/Abbasi Shaheed Hospital during year 2004–8. One hundred and five cases wereenrolled who underwent thyroid surgery after complete evaluation by history, clinical examination,Thyroid profile, Thyroid Scintigraphy, Ultrasound neck and FNAC. In cases which were revealedmalignant by FNAC, CT scan were done to see the extent of disease and neck node status. Surgery wasdone in all cases and specimens sent for histopathology. Results: Male to female ratio of the patientswas 1:8.5. Most common lesion was benign nodule (96). Malignant lesions were 9 in FNAC. Inhistopathology, the benign nodules were 92, and malignant cases were 13. Sensitivity of FNAC was61.53% and specificity was 98.9%. Conclusion: FNAC in Thyroid has high sensitivity and specificity.Keywords: FNAC, Thyroid, nodule, malignant, cytology


Wienke JR, Chong WK, Fielding JR, Zou KH, Mittelsteadt CA.

Sonographic features of benign thyroid nodules. J Ultrasound

Med 2003;22:1027–31.

Howard RJ. Tumors of the Thyroid and Parathyroid glands. Stell

and Maran’s, Head and Neck Surgery. Butterworth and

Heinemann, 4th edition, 2000;459–85.

Grace A Lee, Masharani U. Disorder of the Thyroid Gland.

Current Diagnosis and Treatment, Otolaryngology Head and

Neck Surgery, Mc Graw Hill, 2nd edition, 2008:548–66.

Patel N, Gill J, Shammari AL, Khalil HMB, Chowdhary CR.

Fine needle aspiration cytology–Are we getting it right? Int

Congress Series (1240) 2003;1399–1402.

Martin HE, Ellis EB. Biopsy by needle puncture and aspiration.

Ann Surg 1930;92:169–81.

Derrick T Lin, Daniel G Deschler. Neck Masses. Current

Diagnosis and Treatment, Otolaryngology Head and Neck

Surgery, Mc Graw Hill, 2nd edition, 2008:397–407.

Tilak V, Dhaded AV, Jain Ragini. Fine needle aspiration of head

and neck masses. Indian J Pathol Microbiol 2003;45(1):23–30.

Russ EJ, Scanlon FE, Christ AM. Aspiration cytology of head

and neck masses. Am J Surg 1978;36(1):342–7.

Lampe BH, Crammer MH. Advances in the use of fine needle

aspiration cytology in the diagnosis of palpable lesions of head

and neck. J Otolaryngol 1991;120(2):108–16.

Bajaj Y, Thompson A. Fine needle aspiration cytology in

diagnosis and management of thyroid disease. J Layrngol Oto


Mahar SA, Husain A, Islam N. Fine needle aspiration cytology of

thyroid nodule: diagnostic accuracy and pitfalls. J Ayub Med

Coll Abbottabad 2006;18(4):26–9.

J Ayub Med Coll Abbottabad 2011;23(1)

Gharib H. Diffuse nontoxic and multinodular goiter. Curr Ther

Endocrinal Metab 1994;5:99–101.

Bugis SP, Young JKE, Archibald SD, Chen VS. Diagnostic

accuracy of fine needle aspiration cytology verses frozen section

in solitary thyroid nodules. Am J Surg 1986;152(4):411–6.

Boyd LA, Earnardt RC, Dunn JT, Frierson HF, Hanks JB.

Preoperative evaluation and predictive value of fine needle

aspiration and frozen section of thyroid nodules. J Am Coll Surg


Baloch MN, Ali S, Ansari MA, Maher M. Contribution of Fine

needle aspiration cytology in the diagnosis of malignant Thyroid

nodules. Pak J Surg 2008;24(1):19–21.

Naggada HA, Musa AB, Gali BM, Khalil MIA. Fine needle

aspiration cytology of thyroid nodules. A Nigerian tertiary

hospital experience. Internet J Cardiovasc Res 2006:5.

Humburger JI. Diagnosis of thyroid nodules by fine needle

aspiration biopsy: use and abuse. J Clin Endocrinol Metab


Tabaqchali MA, Hanson JM, Johnson SJ, Wadehra V, Lennard

TW, Proud G. Thyroid aspiration cytology in Newcastel: s sox

year cytology/histology correlation study. Ann R Coll Surg Engl


Safirullah, Mumtaz N, Khan A. Role of Fine Needle Aspiration

Cytology (FNAC) in the diagnosis of thyroid. J Postgrad Med

Inst 2004;18(2):196–201.

Ramsden J, Watkinson JC. Thyroid cancers. Scott-Brown’s

Otorhinolaryngology, Head and Neck Sugery. 7th edition, vol 2,

Hodder Arnold, 2008:2663–701.

Handa U, Garg S, Mohan H, Nagarkar N. Role of fine needle

aspiration cytology in diagnosis and management of thyroid

lesions: A study on 434 patients. J Cytol [serial online] 2008

[cited 2009];25:13–7.

Caruso D, Mazzaferri EL. Fine needle aspiration biopsy in the

management of thyroid nodules. Endocrinologist 1991;1:194–202.

Gharib H, Goellner JR. Fine needle aspiration biopsy of the

thyroid: An appraisal. Ann Intern Med 1993;118:282–9.

Guidelines of the Papnicoloau Society of Cytopathology for the

examination of fine needle aspiration specimens from thyroid

nodules. Mod Pathol 1996;9(6):710–5.

Ashcraft MW, Van Herle AJ. Management of thyroid nodules II:

scanning techniques, thyroid suppressive therapy and fine needle

aspiration. Head Neck Surg 1981;3:297–322.

Cambell JP, Pillsbury HC 3rd. Management of the Thyroid

nodule. Head Neck 1989;11(5):414–25.

Grant CS, Hay ID, Gough IR, Mc Carthy PM, Goellner JR. Long

term follow-up of patients with benign thyroid FNA Cytologic

diagnosis. Surgery 1998;106:980–6.