Malignancy risk and false-negative rate of fine needle aspiration cytology in thyroid nodules ≥4.0 cm

Introduction: Fine needle aspiration cytology is considered as the gold standard for the diagnosis of thyroid nodules. This study aimed to evaluate and compare the accuracy of fine-needle aspiration cytology in the diagnosis of thyroid lesion by comparing it with the corresponding histopathologic diagnosis after thyroidectomy. Methods: This is a retrospective study conducted over five years at a teaching hospital in Kathmandu. Eighty-nine cases of FNAC of thyroid nodule with subsequent histopathological reports were reviewed. The corresponding reports were compared and the accuracy of FNAC diagnosis was evaluated. Results: 87% of the cases were females and the majority of cases were in the age group 41 to 50 years. Among 89 cases, 55 were reported as benign on cytology and 34 were reported as malignant. On histopathological examination, out of 55 cases diagnosed as benign on cytology, 47 cases were diagnosed as benign whereas eight cases were diagnosed as malignant. HPE of 34 cases diagnosed as malignant on cytology showed that 29 were malignant and five were benign. The false-positive rate was 9.6% and the false-negative rate was 21.6%. The sensitivity was 78.3% and specificity was 90.3%. The positive predictive value and negative predictive value were 85.2% and 85.4% respectively. The accuracy of FNAC in differentiating benign from malignant thyroid lesions was 85.3%. Conclusions: The findings of this study showed that FNAC is a sensitive method for the diagnosis of a solid thyroid lesion

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Exploring the Diagnostic Efficacy of Fine-Needle Aspiration Cytology in Thyroid Nodules ≥ 4 cm: Results from a Tertiary Health Care Center in Jharkhand

International Journal of Recent Surgical and Medical Sciences ◽

10.1055/s-0038-1676561 ◽

2018 ◽

Vol 4 (02) ◽

pp. 054-056

Author(s):

Rajeev Bhardwaj ◽

Rishabh Kumar Rana

Keyword(s):

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

Thyroid Nodules ◽

False Negative ◽

Needle Aspiration ◽

Histopathologic Examination ◽

Aspiration Cytology ◽

Fine Needle ◽

Malignancy Rate ◽

Needle Aspiration Cytology

Abstract Background Any nodules of the thyroid, ≥ 4 cm, are generally associated with false-negative results for malignancy on fine-needle aspiration cytology (FNAC), which generally are confirmed cases of malignancy after histopathologic examinations. Methods A retrospective hospital-based study was done in which data of patients having thyroid lesions ≥ 4 cm were reviewed. We checked the FNAC and histopathologic examination done on these lesions. Ultrasonography (USG)–guided aspiration records were also assessed. Sensitivity and specificity of FNAC for the detection of neoplastic or malignant lesions was determined. Results A total of 192 patients (57 female) were included in study. Preoperative fine-needle aspiration (FNA) biopsies were categorized as negative for malignancy (n = 183, 63%), suspicious (n = 6, 4%), and malignant (n = 4, 2%). Final pathology of nodule was found to be benign in 157 (81.35%) patients, whereas in 36 (18.65%) patients, nodules were found to be malignant. Conclusion In this study, we found the malignancy rate of thyroid nodules ≥ 4 cm to be similar to the accepted malignancy rate of smaller thyroid nodules. We missed 32 cases of malignancy on FNAC. Because of high incidence of thyroid malignancy, all nodules ≥ 4 cm must undergo histopathologic examination.

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Does Tumor Size Influence the Diagnostic Accuracy of Ultrasound-Guided Fine-Needle Aspiration Cytology for Thyroid Nodules?

International Journal of Endocrinology ◽

10.1155/2016/3803647 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 11

Author(s):

Do Hoon Koo ◽

KwangSeop Song ◽

Hyungju Kwon ◽

Dong Sik Bae ◽

Ji-hoon Kim ◽

...

Keyword(s):

Fine Needle Aspiration ◽

Predictive Value ◽

Fine Needle Aspiration Cytology ◽

Thyroid Nodules ◽

False Negative ◽

Needle Aspiration ◽

Aspiration Cytology ◽

Fine Needle ◽

Needle Aspiration Cytology ◽

Accuracy Rates

Background. Fine-needle aspiration cytology (FNAC) is diagnostic standard for thyroid nodules. However, the influence of size on FNAC accuracy remains unclear especially in too small or too large thyroid nodules. The objective of this retrospective cohort study was to investigate the effect of nodule size on FNAC accuracy. Methods. All consecutive patients who underwent thyroidectomy for nodules in 2010 were enrolled. FNAC results (according to the Bethesda system) were compared to pathological diagnosis. The nodules were categorized into groups A–E on the basis of maximal diameter on ultrasound (≤0.5, >0.5–1, >1-2, >2–4, and >4 cm, resp.). Results. There were 502 cases with 690 nodules. Overall FNAC sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 95.4%, 98.2%, 99.4%, 86.4%, and 96.0%, respectively. False-negative rates (FNRs) of groups A–E were 3.2%, 5.1%, 1.3%, 13.3%, and 50%, respectively. Accuracy rates of groups A–E were 96.8%, 94.8%, 99%, 94.7%, and 87.5%, respectively. Conclusion. Although accuracy rates of FNAC in thyroid nodules smaller than 0.5 cm are comparable to the other group, thyroid nodules larger than 4 cm with benign cytology carry a higher risk of malignancy, which suggest that those should be considered for intensive follow-up or repeated biopsy.

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Role of fine needle aspiration cytology in the diagnosis of thyroid lesions

Journal of Pathology of Nepal ◽

10.3126/jpn.v2i3.6018 ◽

1970 ◽

Vol 2 (3) ◽

pp. 186-188 ◽

Cited By ~ 1

Author(s):

S Bhatta ◽

R Makaju ◽

A Mohammad

Keyword(s):

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

False Negative ◽

False Negative Rate ◽

Needle Aspiration ◽

Aspiration Cytology ◽

Fine Needle ◽

Needle Aspiration Cytology ◽

Thyroid Lesions

Background: Fine needle aspiration cytology is regarded as a gold standard investigation in diagnosis of thyroid swellings. This study was carried out to evaluate the role of fine needle aspiration cytology as a diagnostic tool in investigation of thyroid swelling and to correlate the cytological findings with histopathology. Materials and Methods: A total of 90 patients with thyroid lesions submitted for fine needle aspiration cytology at Dhulikhel hospital Kathmandu Univeristy hospital over a four year period (May 2004 to May 2008) were studied. Results: Majority of cases were non neoplastic (77 cases, 85.55 %), whereas 13 cases (14.45 %) were neoplastic. Tissue examination was available for subsequent histocytological correlation in 20 cases (22.22 %). The accuracy of cytodiagnosis was 90 % with a sensitivity of 85.7 %, specificity of 92.3 %, false negative rate of 14.28% and false positive rate of 7.69%. Conclusion: Fine needle aspiration cytology of thyroid lesions provides a reliable diagnosis and is an excellent first line method for investigating the nature of lesion. DOI: http://dx.doi.org/10.3126/jpn.v2i3.6018 JPN 2012; 2(3): 186-188

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Fine Needle Aspiration Cytology of Prostatic Lesions with Histologic Correlation

Ibrahim Medical College Journal ◽

10.3329/imcj.v1i1.2888 ◽

2008 ◽

Vol 1 (1) ◽

pp. 7-10

Author(s):

Tariqul Islam ◽

Tamanna Chowdhury ◽

KH Khan ◽

AR Barua ◽

Mohammed Kamal ◽

...

Keyword(s):

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

False Negative ◽

False Negative Rate ◽

Needle Aspiration ◽

Histological Diagnosis ◽

Aspiration Cytology ◽

Fine Needle ◽

Needle Aspiration Cytology ◽

Transurethral Prostatic Resection

Cytologic diagnosis by fine needle aspiration of the prostate was compared to histological diagnosis by either core biopsy or transurethral prostatic resection in 58 patients suspected to have prostatic lesion by rectal examination.The diagnostic accuracy between cytological and histological diagnosis was 93% and the false negative rate was 3.03% for fine needle aspiration. Inadequate cytological samples occurred only in two cases. This study was conducted during the period of April 2003 to February 2004. Fine needle aspiration cytology of prostatic lesions is a recently introduced procedure in Bangladesh. Our results indicate that fine needle aspiration is an easily performed, diagnostically reliable outpatient procedure with minimal complication. Ibrahim Med. Coll. J. 2007; 1(1): 7-10 Key words : FNAC, Franzen, Papaniculaou doi: 10.3329/imcj.v1i1.2888

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Role of fine needle aspiration cytology in the preoperative diagnosis of malignancy in parotid and submandibular gland neoplasm

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v19i2.17634 ◽

2014 ◽

Vol 19 (2) ◽

pp. 110-118

Author(s):

Mohammad Amzad Hossain ◽

Md Zahedul Alam ◽

Md Rojibul Haque ◽

Md Nazmul Haque ◽

KM Nurul Alam ◽

...

Keyword(s):

Submandibular Gland ◽

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

False Negative ◽

Needle Aspiration ◽

Aspiration Cytology ◽

Fine Needle ◽

Medical College ◽

Preoperative Diagnostic ◽

Needle Aspiration Cytology

Objective: To evaluate the role of Fine Needle Aspiration Cytology in the preoperative diagnosis of malignancy in parotid and submandibular gland neoplasm. Methods: This cross sectional study on 50 cases was conducted in the Department of Otolaryngology and Head-Neck Surgery of Sir Salimullah Medical College Mitford Hospital and Dhaka Medical College Hospital from January2009 to June 2010. Results: Fine needle aspiration cytology findings of our all 50 cases were compared with postoperative histopathological reports. Out of the 50 cases, in 36(72%) cases of benign neoplasm and 7(14%) cases of malignant neoplasm, pre-operative FNAC findings and post operative histopathological findings were same. In 7 cases, FNAC and post operative histopathological findings did not matched. These were 2 (4%) false positive and 5 (10%) false negative result.In our study sensitivity of FNAC for reporting malignancy was 58.33%, specificity to rule out malignancy was 94.73% and overall accuracy in detecting malignant tumour was 86%. Positive predictive value and negative value were 77.77% and 87.80% respectively. It can be concluded that fine needle aspiration cytology is a safe, cheap and useful preoperative diagnostic tool in the diagnosis of malignancy in parotid and submandibular gland, but as fine needle aspiration cytology partly depends on operator skill, it may give false negative and false positive result. Conclusion: FNAC is a useful preoperative diagnostic tool for malignant parotid and submandibular glands with high specificity and sensitivity. DOI: http://dx.doi.org/10.3329/bjo.v19i2.17634 Bangladesh J Otorhinolaryngol 2013; 19(2): 110-118

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