Correlation of Preoperative Fine Needle Aspiration Cytology with Histopathological Examination Of Thyroid Swellings

Abstract

Background: Swelling of thyroid are frequently encountered in surgical practice. Clinical evaluation is of utmost importance and hepls in early diagnosis but it is difficult to differentiate between early malignant lesions and the most prevalent benign goiters. Objective: To correlating the cytological diagnosis (FNAC) with the histopathological diagnosis to calculate the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FNAC smears.Methods: A proforma was drafted for the studies2 of all patients presenting with history of palpable thyroid swelling and undergo surgery in our hospital. Clinical presentations, FNAC and histopathology of all cases were documented. Results: 50 cases who presented with thyroid swellings were studied and their histopathological diagnosis was compared with the FNAC. Out of the 50 cases, 42 were females and 08 were males, being 5.65 : 1. Of the 42 cases which were seen benign by FNAC, 39 were confirmed by histopathology. Of the 11 cases which were proved to be malignant by histopathology 08 were only seen as malignant by FNAC. The sensitivity of FNAC in the diagnosis of benign lesions was found to be 72.72%, specificity was 100%, positive predictive value 100% and accuracy is 94%.
Conclusion: The majority of cases were benign of which multinodular goiter was the most dominant pathology (34 %). Among the malignancies, papillary carcinoma (72.72 %) was common .The sensitivity, specificity and predictive value of positive smears being 72.72%, 100 %, and 100% respectively. FNAC is simpler, safer, quicker and more informative, when compared with other well known methods in the diagnosis of thyroid lesions.