scholarly journals Ultrasound and guided fine needle aspiration cytology in the submandibular triangle

1997 ◽  
Vol 2 (3) ◽  
pp. 8-13
Author(s):  
A. T. Ahuja ◽  
W. T. Yang ◽  
W. King ◽  
C. Metreweli

Objective: The aim of this study was to evaluate whether High Resolution Ultrasound (US) along with Fine Needle Aspiration Cytology (FNAC) can provide the surgeon with adequate preoperative information for masses in the submandibular triangle.Subjects and methods: Eighty-two consecutive patients with suspected masses of the submandibular triangle had US with guided FNAC (49 patients) and final histological correlation (47 patients).Results: Compared to final histology, US had a sensitivity of 97%, specificity 83%, positive predictive value 91% and a negative predictive value of 95% while FNAC had sensitivity of 100%, specificity 90%, positive predictive value 94% and negative predictive value of 100%.Conclusion: US combined with a FNAC is an ideal initial investigation for evaluating masses in submandibular area.  It is quick, inexpensive, easily available, and provides the surgeon with relevant information preoperatively obviating the need for further expensive imaging.

2013 ◽  
Vol 98 (12) ◽  
pp. 4790-4797 ◽  
Author(s):  
Flavia Magri ◽  
Spyridon Chytiris ◽  
Valentina Capelli ◽  
Margherita Gaiti ◽  
Francesca Zerbini ◽  
...  

Context: Ultrasound (US) elastography (USE) was recently been reported as a sensitive, noninvasive tool for identifying thyroid cancer. However, the accuracy of this technique is hampered by the intra- and interoperator variability, some US features of the nodule, and the coexistence of autoimmune thyroid disease (ATD). Objectives: The purpose of this article was to assess the accuracy of USE findings in the differential diagnosis of thyroid nodules compared with other US features to evaluate its feasibility in the presence of ATDs and identify the strain index (SI) cutoff with the highest diagnostic performance. Design: We evaluated 528 consecutive patients for a total of 661 thyroid nodules. All nodules underwent fine-needle aspiration cytology (FNAC) and USE evaluation. The SI was calculated as a ratio of the nodule strain divided by the strain of the softest part of the surrounding normal tissue. Results: The median SI value was significantly higher in THY4 and THY5 than in THY2 nodules in ATD-positive, ATD-negative, and ATD-unknown patients. The cutoff of SI for malignancy was estimated to be 2.905 by receiver operating characteristic curve analysis in a screening set (379 FNAC results), and then tested in a replication set (252 FNAC results). In all cases, a SI value of ≥2.905 conferred to the nodule a significantly greater probability of being malignant. This SI cutoff had the greatest area under the curve, sensitivity, and negative predictive value, compared with the conventional US features of malignancy. Conclusion: The elastographic SI has a high sensitivity, specificity, and negative predictive value for the diagnosis of thyroid malignancy both in the presence and in the absence of ATD. If our data on USE are also confirmed in THY3 nodules, FNAC could be avoided in a number of thyroid nodules with certain features.


2017 ◽  
Vol 4 (10) ◽  
pp. 3409
Author(s):  
Jawahar Krishnaswamy ◽  
Khalilur Rahaman ◽  
Reshma S.

Background: Cervical lymphadenopathy is one of the commonest presentations in inflammatory and neoplastic disorders. Fine needle aspiration cytology (FNAC) is a well-established diagnostic method used to sample swellings at various sites in the body. It is a simple, quick, inexpensive and minimally invasive OPD technique used for establishing the etiology of cervical lymphadenopathy. Aim of this study was to evaluate the diagnostic accuracy of Fine needle aspiration cytology (FNAC) in cervical lymphadenopathy.Methods: This study included 50 patients presenting to the surgery outpatient department with cervical lymphadenopathy. Detailed history and physical examination was done followed by FNAC in all the patients. The diagnosis was then compared with the gold standard excisional biopsy and histopathological examination by standard statistical methods.Results: Among the 50 patients studied 31 were male and 19 were female. According to histopathologic diagnoses in 50 cases, the patients were diagnosed to have benign lesion in 28 cases (56%), and malignant lesion in 22 cases (44%). Among the benign etiologies, tuberculosis was the most frequent (40%) followed by reactive nonspecific inflammation (16%). Among the malignant etiologies, metastatic deposits constituted 30 % followed by lymphoma constituting 14%. FNAC results supported a benign lesion in 27 cases and were compatible with a malignant lesion in 19 cases. Comparing FNAC results with histopathological diagnoses revealed that, in 46 cases the FNAC results were compatible with histopathology, a total accuracy of 92%. In one case, benign lesion was over diagnosed as malignant and in 3 cases malignant lesions were underdiagnosed as benign lesions. It was found that, in diagnosing benign and malignant lesions, FNAC had a sensitivity of 96.42% and a specificity of 86.36%. Positive predictive value was 90% and negative predictive value was 95%. Out of the 50 patients studied, 20 patients (40%) were confirmed to have tuberculous lymphadenitis by histopathological examination. FNAC supported a tuberculous etiology in 14 cases and 6 cases were underdiagnosed by FNAC. The sensitivity of FNAC in diagnosing tuberculous etiology was found to be 70%, specificity was 100%, positive predictive value was 100%, negative predictive value was 85.71%. Overall the sensitivity of FNAC in diagnosing a pathological cervical lymph node was found to be 92.85%, specificity was 87.5%, positive predictive value was 97.5%, negative predictive value of 70%.Conclusions: The utility of fine needle aspiration cytology in the evaluation of cervical lymphadenopathy has been well established by this study. It is a reliable and convenient method with minimal complications in the management of patients presenting with cervical lymphadenopathy. The various causes of cervical lymphadenopathy were found to be tuberculosis, secondary metastasis, primary malignancy of the lymph nodes and nonspecific reactive lymphadenitis. This study also supports the fact that tuberculosis is still a common cause of cervical lymphadenopathy in India.


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 19 (2) ◽  
pp. 84-89
Author(s):  
Shova Kunwar ◽  
Barsha Bajracharya ◽  
Kavita Karmacharya ◽  
Amar Narayan Shrestha

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


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.


Author(s):  
Arpita Singhvi ◽  
SR Negi ◽  
Hemant Jain ◽  
Meeta Dewal ◽  
Rajnee Joshi ◽  
...  

Introduction: Fine Needle Aspiration Cytology (FNAC) is increasingly being recognised for its diagnostic utility in evaluation of bone tumours. Though open surgical biopsy is the procedure of choice for diagnosis of bony tumours. Aim: To evaluate the efficacy and reliability of FNAC in diagnosis of bony tumours. Materials and Methods: This cross-sectional study included 40 patients with bony lesions from July 2018 to December 2019 in tertiary level centre of Rajasthan. The FNAC was performed after clinical and radiological assessment. The smears were stained using standard techniques. Also, open biopsy was performed in the patients who presented with bony lesions of patients and slides prepared for histopathological examination using standard techniques. The data was entered in Excel sheets and the results were evaluated using Statistical Package for Social Sciences (SPSS) software version 20.0. Results: Adequate material was obtained in FNAC in 29 (72.5%) cases. Out of 29 cases, FNAC results were accurate in 96.5% cases. False Negative report was obtained in one case with no false positives. Sensitivity of FNAC in diagnosing bony lesions comes to be 90% and Specificity was 100%. The Positive Predictive Value (PPV) was 100% and the Negative Predictive Value (NPV) 95.4%. Conclusion: The FNAC is invaluable tool in primary diagnosis of bony lesions. The technique of obtaining sufficient material though needs to be mastered and will definitely improve with more experience and radiologic correlation.


2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Jessica Aline Tomelin de Cursi ◽  
Mariângela Esther Alencar Marques ◽  
Cristina Andrea Campos de Assis Cunha Castro ◽  
Fernando Carlos Schmitt ◽  
Cleverson Teixeira Soares

Abstract Background Breast cancer is a major public health problem worldwide. It is recommended that small breast lesions or those suspicious for malignancy be evaluated via histopathological examination (“core biopsy” or surgical specimens), and lesions that are probably benign and palpable should be examined via fine-needle aspiration cytology (FNAC). This study aimed to assess the accuracy of FNAC for the diagnosis of small breast lesions. Methods We reviewed all anatomopathological reports of FNACs collected between January 1, 2000 and December 31, 2019 (n = 24,721) in a private community pathology service. Lesions up to 1.0 cm (≤1.0 cm) (n = 8334) were included for evaluation and classified according to the recommendation of the International Academy of Cytology Yokohama System for Reporting Breast Fine Needle Aspiration Biopsy Cytopathology in the following categories: (1) insufficient/inadequate; (2) benign; (3) atypical, probably benign; (4) suspicious of malignancy; and (5) malignant. Subsequently, the results of the FNACs were compared to those of the respective histopathological examinations (n = 785). Results FNAC had a specificity of 99.6%; sensitivity, 97.4%; positive predictive value, 99.6%; negative predictive value, 97.6%; and accuracy, 98.5%. Conclusions FNAC is a reliable method for diagnosing small breast lesions (≤1.0 cm).


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