DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20195919

A study on fine needle aspiration cytology of thyroid lesions with correlation to histopathological examination with special reference to Bethesda system of reporting at a tertiary care centre

Nandinee Lahkar, Manoj Kumar Deka, Nitu Mani Khakhlari

Abstract


Background: Annual incidence of thyroid nodules ranges from 40,000 to 70,000 per 1 lac population worldwide. Fine Needle Aspiration (FNA) of the thyroid is widely accepted simple, cost effective and quick to perform outpatient procedure with minimal complication. The National Cancer Institute (NCI) Bethesda, Maryland, United States standardized the reporting system for thyroid FNA by using Bethesda system for reporting thyroid cytopathology.

Methods: FNA was performed in total 155 patients presenting with the thyroid swelling with or without Ultrasonography (USG) guidance. All patients were analyzed for age, gender, type of lesions. FNA was done and smears were examined and reported according to Bethesda system of reporting for thyroid cytopathology. Findings were correlated with post-operative histopathological diagnoses in 103 cases who underwent surgery.

Results: Out of total 155 patients, 32 were male and 123 were female. Average age of presentation was 38.4 years. On cytology, according to Bethesda system, most cases were in benign category (76.1%) followed by malignant (8.4%). On histopathological study most common diagnosis was colloid goiter followed by papillary thyroid carcinoma. From the study it was found that sensitivity, specificity and accuracy of fine needle aspiration cytology of thyroid lesions were 81.8%, 97.3% and 95.4% respectively.

Conclusions: Fine needle aspiration cytology is simple, easy to perform, cost effective procedure with high sensitivity, specificity and diagnostic accuracy in case of thyroid lesions.


Keywords


Bethesda, Colloid goiter, Fine needle aspiration, Sensitivity, Specificity, Thyroid lesions

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References


Davies L, Welch HG. Current thyroid cancer trends in the United States. JAMA Otolaryngol Head Neck Surg. 2014 Apr 1;140(4):317-22.

Vaccarella S, Franceschi S, Bray F, Wild CP, Plummer M, Dal Maso L. Worldwide thyroid-cancer epidemic? The increasing impact of overdiagnosis. N Engl J Med. 2016 Aug 18;375(7):614-7.

Basharat R, Bukhari MH, Saeed S, Hamid T. Comparison of fine needle aspiration cytology and thyroid scan in solitary thyroid nodule. Pathol Res Int. 2011;2011.

Martin HE. Ellis EB. Aspiration biopsy. Surg. Gynaecol Obstet. 1934;59:578-89.

Hamberger B, Gharib H, Melton LJ, Goellner JR, Zinsmeister AR. Fine-needle aspiration biopsy of thyroid nodules: impact on thyroid practice and cost of care. Am J Med. 1982 Sep 1;73(3):381-4.

Baloch ZW, LiVolsi VA, Asa SL, Rosai J, Merino MJ, Randolph G, et al. Diagnostic terminology and morphologic criteria for cytologic diagnosis of thyroid lesions: a synopsis of the National Cancer Institute Thyroid Fine‐Needle Aspiration State of the Science Conference. Diag Cytopatho. 2008 Jun;36(6):425-37.

Cibas ES, Ali SZ. The Bethesda system for reporting thyroid cytopathology. Thyroid. 2009 Nov 1;19(11):1159-65.

Bhartiya R, Mallik M, Kumari N, Prasad BN. Evaluation of thyroid lesions by fine-needle aspiration cytology based on Bethesda system for reporting thyroid cytopathology classification among the population of South Bihar. Ind J Med Paediatr Oncol: Offi J Ind Soc Med Paediatr Oncol. 2016 Oct;37(4):265.

Handa U, Garg S, Mohan H, Nagarkar N. Role of fine needle aspiration cytology in diagnosis and management of thyroid lesions: A study on 434 patients. J Cytol. 2008 Jan 1;25(1):13.

Bhatta S, Makaju R, Mohammad A. Role of fine needle aspiration cytology in the diagnosis of thyroid lesions. J Pathol Nepal. 2012;2(3):186-8.

Pandey P, Dixit A, Mahajan NC. Fine-needle aspiration of the thyroid: A cytohistologic correlation with critical evaluation of discordant cases. Thyroid Res Pract. 2012 May 1;9(2):32.

Gupta M, Gupta S, Gupta VB. Correlation of fine needle aspiration cytology with histopathology in the diagnosis of solitary thyroid nodule. J Thyroid Res. 2010;2010.

Rao K, Goyal VP. Comparative Study of FNAC and Excisional Biopsy in Thyroid Swelling. Ind J Otolaryngol Head Neck Surg. 2010 Oct 1;62(4):415-6.

Bouvet M, Feldman JI, Nahum AM, Robbins KT, Gill GN, Dillmann WH, et al. Surgical management of the thyroid nodule: patient selection based on the results of fine‐needle aspiration cytology. Laryngo. 1992 Dec;102(12):1353-6.

Sinna EA, Ezzat N. Diagnostic accuracy of fine needle aspiration cytology in thyroid lesions. J Egy National Cancer Instit. 2012 Jun 1;24(2):63-70.

Goldstein RE, Netterville JL, Burkey B, Johnson JE. Implications of follicular neoplasms, atypia, and lesions suspicious for malignancy diagnosed by fine-needle aspiration of thyroid nodules. Annal Surg. 2002 May;235(5):656.

Muratli A, Erdogan N, Sevim S, Unal I, Akyuz S. Diagnostic efficacy and importance of fine-needle aspiration cytology of thyroid nodules. J Cytol/Ind Acad Cytol. 2014 Apr;31(2):73.