CYTOLOGICAL FEATURES OF NON - NEOPLASTIC LESIONS OF THYROID: An overview (original) (raw)
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Cytological study of thyroid lesions by fine-needle aspiration cytology
Journal of Medicine, Radiology, Pathology and Surgery, 2016
Background: Thyroid disorders are the most common endocrine disorders worldwide. Thyroid enlargement has to be investigated to rule out a neoplasm. The main purpose of fine-needle aspiration (FNA) is to provide a rational approach for management and determine the correct surgical procedure when surgery is required. Objectives are: (1) To assess the cytologic and morphological features of thyroid swellings by FNA cytology (FNAC), (2) to study the age of occurrence and sex predilection of various thyroid disorders diagnosed by FNAC, and (3) to classify all the thyroid lesions based on The Bethesda System of Reporting Thyroid Cytopathology (TBSRTC). Methods: In the present study, evaluation of 100 cases of thyroid FNA's was undertaken and interpreted. All thyroid lesions conventionally diagnosed by FNA were classified according to TBSRTC. Results: In the present study, a total of 100 cases of thyroid swellings were analyzed, out of which 84 cases were diagnosed as non-neoplastic lesions, 3 cases as suspicious for malignancy, and 13 cases as neoplastic lesions by FNAC. The results were further classified under TBSRTC. Conclusion: FNAC is a relatively uncomplicated and safe diagnostic method, which is cost-effective. It is a helpful adjunct to pre-operative screening in the diagnosis and management of thyroid diseases.
The Role of Fine Needle Aspiration Cytology (Fnac) In the Evalution of Thyroid Lesions
Abstract: Objective: To determine the sensitivity, specificity and diagnostic accuracy of fine needle aspiration cytology in the management of thyroid lesions. Material and Methods: A prospective study of Fine needle aspiration cytology of the thyroid gland was undertaken to evaluate its diagnostic utility, during the period from June 2011 to December 2013 in the Department of Pathology, S.P. Medical College Bikaner. A total of 52 patients presenting with palpable thyroid nodule was included in the study. All the patients underwent fine needle aspiration of the nodule. Among 52 cases, 37 were biopsied subsequently and subjected to histopathological study. A comparison of FNA cytology and biopsy results was made. Results: Age of the patients ranged from 15-70 yrs with a mean age of 42.44 yrs. The majority of the patients were females in the present study with 45 (86.5%) females and 7 males, with a ratio of 6.41:1. Urban and rural distribution of sample population included 38 (73.1%) cases from rural and 14 (26.9%) cases from the urban population. Of the 52 cases of thyroid lesions, 39 were Non neoplastic lesions and 9 were Neoplastic lesions. Of the Non neoplastic lesions, 34 were Nodular colloid/ Adenomatous goiter, 4 Hashimoto thyroiditis, 1 neoplasm and 1 anaplastic neoplasm. Among 52 cases, 37 were biopsied subsequently and subjected to histopathological study. 28 cases were Non-neoplastic, 9 cases were Neoplastic. Out of 9 cases of Neoplastic lesions, 4 were Papillary carcinoma, 5 were Follicular adenoma. The diagnostic accuracy of non neoplastic and neoplastic lesions is 96.42% and 88.9% respectively. The sensitivity, specificity, positive predictive value and negative predictive value for FNAC of thyroid lesion neoplasm in the present study are 92.86%, 95.65%, 92.86% and 95.65% respectively. Conclusion: It helps to categorize Non-neoplastic from Neoplastic thyroid lesions. Its use has decreased the number of surgeries performed. FNAC of thyroid lesions has been shown to be safe, simple, cost effective and accurate method for the management of palpable thyroid lesions. However, in view of a small number of false negative results, the FNA results should be interpreted in the light of clinical findings. In case of doubt the true nature of the disease should be confirmed by biopsy. Keywords: Palpable thyroid lesions, Fine Needle Aspiration Cytology, Histopathology, Sensitivity, Specificity
Tropical Journal of Pathology and Microbiology, 2019
Background: Thyroid lesions are one of the significant clinical problems encountered in most of patients coming to the tertiary care units. Fine Needle Aspiration Cytology (FNAC) is the present day's worldwide accepted diagnostic tool as it is a cost effective, minimally invasive, low complication, non-operative method and has a high sensitivity and specificity in most of thyroid lesions. Fine Needle Aspiration Cytology can be used in the diagnosis of these lesions and hence categorising them into benign / inflammatory / neoplastic and aiding the clinician in the next step of surgical / medical management and reduces the unwanted surgeries. Aim: To study the clinical and cytological spectrum of thyroid lesions encountered in everyday practice. Materials and Methods: This was a retrospective study conducted over the period of 1 year and 1 month, from January 2018 to January 2019 in department of pathology Gadag Institute Medical Science, Gadag. A total of 101 Patients with thyroid lesions who underwent Fine Needle Aspiration procedure were identified and their clinical details, available biochemical and radiological parameters were collected, and cyto-morphological features were studied. The lesions were categorised into benign, inflammatory, Follicular neoplasm, malignant and inadequate. Results: Out of 101 cases studied, 47 (46.5%) were Benign, 33 (32.6%) were Inflammatory,09 (8.9%) cases were Follicular Neoplasm and 04 (3.9%) cases were Malignant while 09 (8.9%) cases were inadequate. Conclusions: FNAC is one of the simple useful primary diagnostic tool for the identification and categorization of thyroid lesions. It is safe, cost-effective, minimally invasive and sensitive technique for its diagnosis.
Fine Needle Aspiration Cytology of Thyroid Lesions: Diagnostic Accuracy and Limitations
Fine Needle Aspiration cytology (FNAC) of thyroid gland is firmly established as an important test for the evaluation of thyroid disease and an effective test for the preoperative diagnosis of solitary thyroid nodule. This study was undertaken to determine the correlation between the FNAC and histopathologic diagnosis of the thyroid lesions. Total 179 cases were included in this study. All had FNAC thyroid.Out of the total 179 patients studied, 123 were cases of benign thyroid lesions,14 were malignant, 3 were inadequate, and 39 were follicular neoplasm. Histopathology of 48 thyroid specimens showed 17 colloid and nodular goiter,3 colloid cyst,1 thyroglossal duct cyst, 1 Hashimoto's thyroiditis,1 granulomatous thyroiditis, 11 Follicular adenoma,1 hurthle cell adenoma, 7 Papillary carcinoma and 4 Follicular carcinomas and 2 cases turned out to be false negative.By comparing the results of FNAC and histopathology, FNAC has sensitivity of 84.61% and specificity of 100% and an accuracy of 95.83% in the diagnosis of malignant thyroid diseases. FNAC is safe, inexpensive and less invasive diagnostic method with excellent patient compliance. Its existence use can make the management of thyroid swelling cost effective to avoid unnecessary surgery on conditions like thyroiditis.
Indian Journal of Surgical Oncology, 2014
Thyroid swellings are a significant clinical problem in the general population but majority of them are nonneoplastic and do not require surgery. The initial screening procedures include ultrasonography, fine needle aspiration cytology (FNAC) and radionucleotide scan. An initial screening test which will diagnose thyroid lesions accurately will help to avoid surgery in nonneoplastic conditions. The aim of the present study is to correlate the cytology findings with final histopathology. Two hundred and forty-eight cases of thyroid nodules which underwent FNAC followed by surgery were included in this study. The cytology diagnoses were classified into nondiagnostic/unsatisfactory, benign, atypia of undetermined significance/follicular lesion of undetermined significance, follicular neoplasm/suspicious for a follicular neoplasm, suspicious for malignancy and malignant. The fine needle aspiration diagnosis was compared with the histopathology diagnosis. In majority of cases the FNA diagnosis was in concordance with final histopathology. A high incidence of follicular variant of papillary carcinoma thyroid was detected in this study. The awareness of this entity and the search for fine nuclear details of papillary carcinoma can lead to proper identification of this category of tumors and thus help to avoid false negative and equivocal results. Fine needle aspiration cytology is a simple, cost effective, rapid to perform procedure with high degree of accuracy and is recommended as the first line investigation for the diagnosis of thyroid lesions.
Indian Journal of Pathology and Oncology, 2023
Background: Patients with anterior neck swelling constitute common problems encountered in the clinical practice. In all age groups, including children, thyroid cancer is the most prevalent endocrine system cancer. Initial diagnostic testing using fine needle aspiration cytology (FNAC) has been found to be quick and cost effective. Therefore, it is widely accepted and more thyroid cases are diagnosed at an early stage, but it is associated with pitfalls due to difference in correlations between FNAC and Histopathological Examination (HPE). The purpose of the study is to compare the results of FNAC with histopathological findings in order to evaluate the diagnostic efficacy of FNAC. Materials and Methods: The present study was performed over a period of two years in a tertiary care center. Included in the study were 100 cases of thyroid nodule, which underwent FNAC and the post-operative specimens of whom were subjected to histopathological examination. The results obtained by FNAC were compared with histopathological findings. Results: Out of the 100 cases taken for the purpose of the study, 92 were benign whereas 8 were malignant. The cytological and histopathological diagnosis correlated with each-other in 89 cases. A partial correlation between the cytological and histopathological diagnoses was found in 5 cases. In 6 cases the FNAC diagnosis was not correlating with histopathological diagnosis. FNAC revealed a sensitivity of 62.50%, a specificity of 97.83%, an accuracy of 95%, a positive predictive value of 71.43% and a negative predictive value of 96.77%. Conclusions: FNAC of thyroid lesions is thus proved to be a simple, cost effective and accurate method to diagnose and to guide the management of palpable thyroid lesions Thus, we can see that the diagnostic accuracy of FNAC procedure is very high making it a very useful investigation in the work-up of thyroid patients. However final diagnosis and treatment pattern should be based upon histopathology. Keywords: Accuracy, Bethesda system, FNAC, Thyroid swelling.
Fine needle aspiration cytology of thyroid lesions with histopathological correlation
Introduction: FNAC of thyroid lesions is a simple, rapid, patient friendly and inexpensive procedure, which can be repeated in cases of inadequate samples. It has the best predictive value of all currently available diagnostic procedures. Along with FNAC, other diagnostic modalities such as thyroid scanning, ultrasonography, thyroid hormone and antibody level measurements enhance the diagnostic accuracy of the technique. Material and Methods: The present study was a prospective and interventional type of study done from January 2013 to December 2013. The study was undertaken in 50 patients to evaluate the cytology of the palpable thyroid lesions and compared them with histopathology to determine its diagnostic accuracy at Department of Pathology, Dhiraj general hospital, Piparia. Result: Among the non-neoplastic lesions, benign follicular lesion (51.16%) and colloid and nodular goitre was commonly encountered (41.86%). Hashimoto's thyroiditis was diagnosed in 3 cases (6.98%). Among the neoplastic lesions (14%), papillary carcinoma was the commonly encountered lesion (56.14%). Histopathological examination was confirmatory in all cases. Conclusion: The diagnostic accuracy of FNAC on palpable thyroid lesions with histopathologic correlation is 100%.
FINE NEEDLE ASPIRATION CYTOLOGY AS A FIRST LINE INVESTIGATION IN THYROID LESIONS
National Journal of Medical Research, 2013
Introduction: Fine needle aspiration cytology (FNAC) is regarded as the gold standard investigation in diagnosis of thyroid swellings especially to rule out need of surgery. Aims: To study role of FNAC in thyroid lesions. Materials and Methods : During period of 1 year from 1st January to 31st December 2011 aspiration cytology is been carried out in 194 thyroid swellings reffered to cytology department of our institute which is a tertiary care hospital in Surat to study the role of FNA cytology in various thyroid lesions. Fine needle aspiration cytology was performed using mainly non-aspiration and aspiration techniques. Results: The cytological samples were assessed by qualified consultant pathologist and were classified as inadequate, non-neoplastic, neoplastic, and indeterminate. Fine needle aspiration cytology analysis revealed 180 (92.78%) non-neoplastic, 10 (5.16%) neoplastic and 4 (2.06%) indeterminate aspirates. 15 (7.73%) samples were inadequate from total of 194 samples. Conclusion:The results are comparable with the current published data and demonstrate that FNA cytology in our hands is accurate investigation for further management of thyroid lesions. Also The Bethesda System of Reporting thyroid cytology is vital guide and should be followed to maintain uniformity as a guide to further management.
Fine needle aspiration cytology of thyroid lesions and classification as per the bethesda system
IP Innovative Publication Pvt. Ltd., 2018
Aims: The objective of this study was to analyse the thyroid cytology smears by The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), to determine the distribution of diagnostic categories and subcategories, to analyse cytological feature, and to correlate cytopathology with histopathology wherever surgery was done. Materials and Methods: This is a prospective study was undertaken in the Department of Pathology, Sharda hospital, Greater Noida for a period of one year and 6 months starting from January 2016 to June 2017. Observation and Results: The distribution of various categories from 100 evaluated thyroid nodules were as follows: TBSRTC, 3% non-diagnostic, 92% benign, 0% AUS/FLUS, 1% Follicular neoplasm, 0% suspicious for malignancy and 4% malignant. Medullary carcinoma thyroid was misdiagnosed as adenomatoid nodule and thus not included in malignant category (category-6), but included in benign category (adenomatoid nodule). Conclusions: TBSRTC is an excellent reporting system for thyroid FNA. It also provides clear management guidelines to clinicians to go for follow up FNA or surgery and also the extent of surgery. Keywords: TBSRTC- The Bethesda system of reporting thyroid cytopathology, FNAC.
Interest of fine-needle aspiration cytology in thyroid nodule
European Annals of Otorhinolaryngology, Head and Neck Diseases, 2011
The aim of the present study was to evaluate our technique of thyroid fine-needle aspiration cytology (FNAC), its limitations and means of improvement by comparing our results with those of literature. Material and methods: Thyroid FNAC results from 117 consecutive patients (May 2006 to July 2007) were categorized into four groups: benign, with suspected malignancy, malignant and unrepresentative. The FNAC results were compared with histopathologic analysis after thyroidectomy. Results: All ''benign'' and ''malignant'' FNAC findings were confirmed on final histology. All ''suspect'' FNAC findings were benign on histology. Cytological diagnosis of malignancy was consistent with histological examination in all cases. Sensitivity was 100% (no false negatives), specificity 67% (28% false positives), positive predictive value 72% and negative predictive value 100%. There was a significant difference in the proportion of ''unrepresentative'' results between two of the operators performing aspiration (51% versus 29.2%). Conclusions: The main pitfall of FNAC in thyroid pathology is the ''suspect'' category, for which positive diagnosis is founded on histological criteria alone. The second limitation identified in this study was the high number of ''unrepresentative'' aspirates. However, the technique remains useful.