scholarly journals Correlation between Ultrasonography and Fine Needle Aspiration Cytology (FNAC) Findings in Patients with Thyroid Lesions

Author(s):  
Asraf Hussain ◽  
Kalim Akhtar

Background:Thyroid nodules are common presentation in patients having thyroid disorders. There is approximately 4-5% incidence of clinically apparent thyroid lesions in general populations.Thyroid nodules are about four times more common in females than in males. The present study aims to diagnose the thyroid lesions and evaluate to relation and diagnostic test of ultrasonography (USG) and Fine Needle Aspiration Cytology (FNAC) report. To determine the sensitivity of ultrasonography in detecting thyroid lesions.Method:This was hospital based prospective study carried in 94 patients who came to radiology department for USG neck, after clinical examination frommedicine, surgery and ENT department.Those patients with thyroid lesions were followed and advised for USG guided FNAC of thyroid swelling. The patients who were advised for FNAC, and gave consent for procedure were included in the study. The USG guided FNAC was done and wasfurther evaluated by pathologist. Results:Out of 94 cases, 85 were benign nodules and 9 were malignant nodules by USG which were further confirmed by FNAC with results of 87 benign and 7 malignant.The USG diagnosed the benign thyroid nodule with sensitivity of 96.55% and specificity of 85.71%, positive predictive value 98.82%, negative predictive value 66.67%, accuracy 95.74%. The result revealed that there is a strong relation between diagnoses of benign thyroid lesions by USG and final diagnosis by FNAC (P=0.001).Conclusion:High resolution grey scale imaging features can differentiate benign and malignant lesions. USG is very helpful for FNAC, characterization of nodules and provides differential diagnosis in those patients affecting with thyroid disorders.

2018 ◽  
Vol 90 (5) ◽  
pp. 1-5 ◽  
Author(s):  
Ewa Machała ◽  
Jan Sopiński ◽  
Iulia Iavorska ◽  
Krzysztof Kołomecki

ABSTRACT Fine needle aspiration cytology (FNAC) is considered as the gold standard diagnostic test for the diagnosis of thyroid nodules. It is a cost-effective procedure that provides specific diagnosis rapidly with minimal complications. It plays an important role in the determination of treatment- patients with suspected malignancy diagnosis can be subjected to surgery. On the other hand it can decrease the rate of unnecessary surgeries. Aims: The aim of this study was to evaluate and compare the correlation, accuracy of fine needle aspirational cytology (FNAC) in the diagnosis of thyroid lesions with the final histopathologic diagnosis in the surgical specimens. Materials and Methods: In our study we have performed a retrospective analysis of a case series of patients who were admitted to the Department of Endocrine, General and Oncological Surgery of Hospital of M. Kopernik in Łodź (Poland) between May 2016 and December 2017 and underwent FNAC with subsequent surgery. Cytological diagnosis was classified into six Bethesda categories. Results: On cytological examination 1070/1262 were reported as benign, 49 malignant and 143 suspicious. On histopathological examination, 956/1070 cases were confirmed as benign but there were 114 discordant cases. Among the other cases histopathology diagnosis of malignancy matched in 45/49 and 128/143 cases.The sensitivity and specificity were 60,28% and 98,05% respectively. False positive rate was 1.95% and false negative rate was 39.72%. The positive predictive value was 90.1% and negative predictive value was 89.35%. Accuracy of FNA in differentiating benign from malignant thyroid lesions was 89,46%. Conclusions: Fine needle aspiration cytology is a simple, cost-effective and popular procedure for the diagnosis of thyroid cancer. It is recommended as the first line investigation for the diagnosis of thyroid lessions.


Author(s):  
Farzana Manzoor ◽  
Arif R. Sheikh ◽  
Bilal A. Sheikh

Background: Thyroid fine needle aspiration cytology (FNAC) is an important screening tool and thereby dictates clinical management. The exclusion of non-invasive follicular variant of papillary carcinoma (NIFVPTC) from thyroid malignancies and its reclassification as non-malignant entity i.e., non-invasive follicular thyroid neoplasm with papillary like nuclear features (NIFTP) has added a new dimension. Aim of this study was to study the role of fine needle aspiration cytology in screening thyroid lesions by correlation with histopathological examination and to calculate diagnostic accuracy of FNAC considering NIFTP as non-malignant and compare it with pre NIFTP era.Methods: It was an observational study done over a period of 2 years (2017-2018). It included the cases where FNAC was followed subsequently by histopathology. FNAC results were correlated with histopathological diagnosis established thereof.Results: A total of 107 patients were included in this study. Considering NIFTP as non-malignant, sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were 92.97%, 100%, 100%, 92.73% and 96.23% respectively, that is significantly higher if authors considered NIFTP as malignant.Conclusions: FNAC plays an indispensable role in making preliminary diagnosis in thyroid lesions. There is a notable increase in diagnostic accuracy of FNAC in thyroid lesions and significant decrease in risk of malignancy by considering NIFTP as non-malignant.


2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Sultan Abdulwadoud Alshoabi ◽  
Abdulkhaleq Ayedh Binnuhaid

Background and Objective: Thyroid nodules (TNs) are abnormal growths of thyroid cells that form masses within the thyroid gland. TNs are common, and the importance lies in need to exclude thyroid cancer. This study was intended to evaluate the diagnostic accuracy of ultrasonography for differentiating benign from malignant thyroid lesions in comparison with fine-needle aspiration cytology (FNA cytology). Methods: This study involved 133 patients with thyroid lesions. All patients underwent thyroid ultrasonography and ultrasound (US)-guided-FNA cytology and results were compared. Results: Out of 133 patients included in this study, the mean age was 41.2±15 years, and 113 (85%) were female. Thyroid lesions were benign in 126 cases (94.7%) and malignant in nine cases (5.3%). Among 124 patients with thyroid lesions diagnosed as benign with US, 122 (98.38%) were confirmed to be benign with FNA cytology, and only 2 (1.6%) were proved to be malignant. Among nine patients with thyroid lesions diagnosed as malignant by US, 5 (55.6%) were confirmed to be malignant by FNA cytology, and 4 (44.4%) were proved to be benign. The US diagnosed benign thyroid lesions with a sensitivity, specificity, positive predictive value, and negative predictive value of 98.38%, 71.42%, 98.38%, and 55.55%, respectively. The results revealed strong compatibility between diagnosis of benign thyroid lesions by the US and proved diagnosis by FNA cytology (p<0.001). Conclusion: B-mode ultrasonography is a valuable tool in differentiating benign from malignant thyroid lesions. It can almost always predict the benign nature of thyroid lesions with excellent diagnostic accuracy. doi: https://doi.org/10.12669/pjms.35.3.292 How to cite this:Alshoabi SA, Binnuhaid AA. Diagnostic accuracy of ultrasonography versus fine-needle-aspiration cytology for predicting benign thyroid lesions. Pak J Med Sci. 2019;35(3):---------. doi: https://doi.org/10.12669/pjms.35.3.292 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Author(s):  
Usha Kiran Raina ◽  
Jyotsna Suri ◽  
Subash Bhardwaj ◽  
Bhavna Sahni

Introduction: Fine Needle Aspiration Cytology (FNAC) and Cell Block are very commonly used initial tests for triaging thyroid lesions and play a pivotal role in deciding subsequent clinical management of thyroid nodules. In most cases, after excision, the diagnosis remains unchanged, but at times discordance does occur when benign lesions are reported on FNAC and cell blocks are found to be malignant on final histopathology and vice-versa. Aim: To assess the diagnostic efficacy of both FNAC and Cell Block technique in the evaluation of thyroid lesions by comparing their respective results with final histopathological diagnosis (after excision) in case of malignancies and clinico- radiological follow-up in benign cases. Materials and Methods: An observational hospital-based study was conducted in the Department of Pathology in a Tertiary Care Teaching Institute from 1st November, 2016 to 31st October, 2017. A total of 100 cases of thyroid masses were subjected to both FNAC and Cell Block and the diagnostic efficacy of both the techniques was assessed using MedCalc Statistical Software. Results: Mean age of the patients was 42.75±15.75 years with a range of 12-75 years. Females constituted 88% of the sample with male to female ratio of 1:7.3. 88% lesions were benign, 8% were malignant and 4% suspicious of malignancy on conventional smears in comparison to cell block which showed 90% benign, 8% malignant and 2% suspicious lesions. The validity of FNAC in terms of sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and accuracy was found to be 100%, 95.65%, 66.67%, 100.00% and 96.00% respectively, whereas for cell blocks these statistics were 100%, 97.83%, 80%, 100% and 98% respectively. Conclusion: Cell block improved the overall diagnostic accuracy of FNAC when used as an adjunct leading to 100% diagnostic yield. The results of this study also establish that FNAC and Cell blocks are sensitive, specific, and accurate as preliminary diagnostic tests for evaluation of patients with thyroid swellings. Moreover, their combined use can reduce the diagnostic errors and to improve the overall reporting efficacy. It is thus advised to perform cell block for each case of FNAC in thyroid lesions.


2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Rajneesh Madhok ◽  
Ashish Gupta ◽  
Lalit Singh ◽  
Tanu Agarwal

INTRODUCTION: The study is an attempt to evaluate the sensitivity, specificity, positive predictive value, negative predictive value, p Value and complications of CT guided thoracic interventions fine needle aspiration cytology and core biopsy which are used for diagnosing benign and malignant thoracic lesions. MATERIAL AND METHODS: Study included 102 Patients (87 males and 15 females) with age group ranged from 15 to 87 years.A total of 143 CT guided interventions (84 FNAC’s and 59 core biopsies) were performed in 102 patients. The tissue obtained was sent to the laboratory for histopathological and cytological analysis for a final diagnosis which would contribute to patient management. RESULTS: All( 59) core biopsies were successful in procuring adequate tissue for histopathological analysis and the yield of core biopsies was 100% .However out of 84 FNAC’s only 4 were unsuccessful in procuring adequate tissue with a failure rate of 4.8%. Post procedural biopsy complications were only three (2.1%) which were small pneumothorax. There were 75 malignant lesions and 23 benign lesions based on cytology and histopathology (4 were excluded due to inadequate sample). There was good agreement between benign and malignant lesions diagnosed on CT and that diagnosed by pathology. The most common benign and malignant lesions were granulomatous lesion and squamous cell carcinoma. CONCLUSION: Percutaneous CT guided interventions like core biopsy and fine needle aspirations cytology are simple minimal invasive procedures with good patient acceptance and low morbidity and almost negligible mortality. CT guided interventions should be performed early for diagnosis of thoracic lesions.


2009 ◽  
Vol 27 (30) ◽  
pp. 4994-5000 ◽  
Author(s):  
Christiane A. Voit ◽  
Alexander C.J. van Akkooi ◽  
Gregor Schäfer-Hesterberg ◽  
Alfred Schoengen ◽  
Paul I.M. Schmitz ◽  
...  

Purpose Sentinel node (SN) status is the most important prognostic factor for overall survival (OS) for patients with stage I/II melanoma, and the role of the SN procedure as a staging procedure has long been established. However, a less invasive procedure, such as ultrasound (US) -guided fine-needle aspiration cytology (FNAC), would be preferred. The aim of this study was to evaluate the accuracy of US-guided FNAC and compare the results with histology after SN surgery was performed in all patients. Patients and Methods Four hundred consecutive patients who underwent lymphoscintigraphy subsequently underwent a US examination before the SN procedure. When the US examination showed a suspicious or malignant pattern, patients underwent an FNAC. Median Breslow thickness was 1.8 mm; mean follow-up was 42 months (range, 4 to 82 months). We considered the US-guided FNAC positive if either US and/or FNAC were positive. If US was suggestive of abnormality, but FNAC was negative, the US-guided FNAC was considered negative. Results US-guided FNAC identified 51 (65%) of 79 SN metastases. Specificity was 99% (317 of 321), with a positive predictive value of 93% and negative predictive value of 92%. SN-positive identification rate by US-guided FNAC increased from 40% in stage pT1a/b disease to 79% in stage pT4a/b disease. US-guided FNAC detected SN tumors more than 1.0 mm in 86% of cases, SN tumors of 0.1 to 1.0 mm in 46% of cases, and SN tumors less than 0.1 mm in 23% of cases. Estimated 5-year OS rates were 92% for patients with negative US-guided FNAC results and 51% for patients with positive results. Conclusion US-guided FNAC of SNs is highly accurate. Up to 65% of the patients with SN-positive results in our institution could have been spared an SN procedure.


2020 ◽  
Vol 22 (4) ◽  
pp. 260-265
Author(s):  
Neeta Kafle ◽  
B Koirala ◽  
SU Kafle ◽  
M Singh ◽  
A Sinha

More than 50% of the world’s population has at least a thyroid nodule. Detail clinical examination and radiology may help in diagnosing thyroid lesions but the management depends upon the cytopathological diagnosis. Optimum use of fine needle aspiration cytology (FNAC) and better understanding of cytomorphological characteristic of thyroid lesions by using Bethesda system, triaging of patients who are to be treated medically or surgically is more accurate. The objective of this present study is cytopathological evaluation of thyroid lesions based on Bethesda System in patients attending Birat Medical College and Teaching Hospital. The objective was also to correlate the cytological findings with histopathological findings where ever possible. A total of 104 patients with thyroid lesions underwent fine needle aspiration cytology in a period of a year (September 1, 2019 to August 31, 2020). Cytological features were evaluated and classified according to the Bethesda system. Histopathological features were evaluated and correlated wherever available. Among 104 patients with thyroid lesions 93 were female and 11 were male. Four cases turned out to be non diagnostic, 85 benign, three Atypia of undetermined significance, three Suspicious for follicular neoplasm and eight Suspicious of malignancy and one Malignant according to Bethesda system. Histopathology specimen was received in 31 patients out of whom 20 (64.5%) patients were reported as colloid nodule, two follicular adenoma, one Hurthle cell adenoma, six papillary carcinoma and two follicular carcinoma. Medullary carcinoma and anaplastic carcinoma were not seen in the patients evaluated. Specificity and sensitivity of fine needle aspiration cytology was 94.7% and 88.9% respectively. Thus reporting thyroid lesions FNAC with Bethesda system allow a more specific cytological diagnosis.


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