Abstract

Background: One of the major advancement in anatomic pathology is found to be the improvements in aspiration cytology. Cancer is found to be one among the 10 leading causes of mortality in India. The advantages of FNAC are: safety, quick results, sensitivity and specificity for the diagnosis of malignancy, less requirement of equipments, minimal discomfort caused to the patient, an outpatient procedure, nonuse of frozen sections, reduction in the rate of exploratory procedures, definitive diagnosis of inoperable cases, repeatable, and cost-effective. Fine needle aspiration cytology (FNAC) is of particular significance in thyroid lesions, because of easy accessibility; outstanding patient adherence; being a minimally invasive procedure; and aid in avoiding the surgery in nonneoplastic lesions, inflammatory conditions, and some tumors.

Objective: To test the utility of FNAC, establish the diagnostic accuracy of cytology by comparison with histopathology diagnosis, and establish the sensitivity and specificity of this technique in thyroid neoplastic lesion.

Materials and Methods: This study was undertaken in the Department of Pathology, Government Medical College and Hospital, Nashik, between January 2008 and June 2009. All cases were studied with initial clinical evaluation, followed by FNAC, and subsequent histopathology wherever needed.

Result: Of the total 84 cases of neoplastic thyroid lesions, 22 (26.19%) cases were malignant and 62 (73.81%) cases benign. Of the total 84 cases, 16 (19.05%) cases were male and 68 (80.95%) cases female subjects. The most common age group affected was found to be 51–60 years (23.81%). Of the total 84 aspirates, 20 (23.81%) cases were available for follow-up and histopathology examination. Of these 20 follow-up cases, cytological diagnosis and histopathological diagnosis were the same in 16 (80%) cases, whereas they were different in 4 (20%) cases.

Conclusion: Excisional biopsy remains the gold standard for the diagnosis of thyroid neoplastic lesion; cytological study can establish the diagnosis of the majority of thyroid neoplasm and can be recommended as an adjunct to histopathology.

Key words: Fine needle aspiration cytology, histopathological confirmation, thyroid neoplastic lesions