Noha Ezzat

Citation:

E.A.Sinna, and N. Ezzat, "Diagnostic accuracy of fine needle aspiration cytology in thyroid lesions", Journal of Egyptian National Cancer Institute, vol. 24, issue 2, pp. 63-70, 2012.

Abstract:

Purpose: Evaluation of the accuracy of FNAC in the preoperative diagnosis of different thyroid lesions.
Patients and methods: This is a retrospective study of 296 diagnosed cases of thyroid nodules referred to cytology unit, pathology department, NCI, who underwent preoperative cytologic diagnosis. The results were categorized into: insufficient for diagnosis, benign, atypical follicular lesion of undetermined significance, follicular neoplasm, suspicious for malignancy, and malignant sampling according to the recent Bethesda classification. The final histologic diagnosis and/ or follow up ultrasonography assessment for non-neoplastic lesions were considered the gold standard.
Results: The study included 296 cases presented with thyroid nodules who underwent preoperative diagnostic thyroid FNAC. Male to female ratio was 5.2:1, and the median age was 44 years. 98 cases (33.1%) were diagnosed as benign, 40 cases (13.5%) as follicular lesion of undetermined significance, 49 cases (16.5%) as follicular neoplasm, 30 cases (10.1%) as suspicious for malignancy, 58 cases (19.5%) as malignant, and 21 cases (7.1%) as unsatisfactory. Nodular hyperplasia represented the majority of benign cases (89.8%), while papillary carcinoma was the most frequent malignant lesion (72.4%). Cytologic diagnoses were compared with their corresponding final histologic ones. FNAC achieved a sensitivity of 92.8, specificity of 94.2%, positive predictive value of 94.9%, negative predictive value of 91.8%, false positive rate of 7.2%, false negative rate of 5.8%, and a total accuracy of 93.6%.
Conclusion: FNA cytology is a sensitive, specific, and accurate initial diagnostic test for the preoperative evaluation of patients with thyroid swellings.