International Science Index


10007436

A 3-Year Evaluation Study on Fine Needle Aspiration Cytology and Corresponding Histology

Abstract:

Background and Objectives: Incidence of thyroid carcinoma has been increasing world-wide. In the present study, we evaluated diagnostic accuracy of Fine needle aspiration (FNA) and its efficiency in early detecting neoplastic lesions of thyroid gland over a 3-year period. Methods: Data have been retrieved from pathology files in King Khalid Hospital. For each patient, age, gender, FNA, site & size of nodule and final histopathologic diagnosis were recorded. Results: Study included 490 cases where 419 of them were female and 71 male. Male to female ratio was 1:6. Mean age was 43 years for males and 38 for females. Cases with confirmed histopathology were 131. In 101/131 (77.1%), concordance was found between FNA and histology. In 30/131 (22.9%), there was discrepancy in diagnosis. Total malignant cases were 43, out of which 14 (32.5%) were true positive and 29 (67.44%) were false negative. No false positive cases could be found in our series. Conclusion: FNA could diagnose benign nodules in all cases, however, in malignant cases, ultrasound findings have to be taken into consideration to avoid missing of a microcarcinoma in the contralateral lobe.

References:
[1] Seada LS, Al Rashid F, Negm A: A four-year Study of Thyroid Carcinoma in Hail Region: Increased Incidence. International Journal for Medical, Health, Biochemical, Bioengineering and Pharmaceutical Engineering. Vol:10, No:12, 2016.
[2] Khoo ML, Asa SL, Witterick IJ, Freeman JL: Thyroid calcification and its association with thyroid carcinoma. Head Neck. Jul;24(7):651-5. 2002.
[3] Mundasad B, Mcallister I, Carson J, Pyper P. Accuracy of fine needle aspiration cytology in diagnosis of thyroid swellings. Internet J Endocrinol 2006.
[4] H. Galera-Davidson: Diagnostic problems in thyroid fine needle aspirations. Diagn Cytopathol, 17 (1997), pp. 422–428.
[5] Z.W. Baloch, M.J. Sack, G.H. Yu, V.A. Livolsi, P.K. Gupta: Fine needle aspiration of thyroid an institutional experience. Thyroid, 8 (1998), pp. 565–569.
[6] Lee MJ, Kim EK, Kwak JY, Kim MJ. Partially cystic thyroid nodules on ultrasound: probability of malignancy and sonographic differentiation. Thyroid 2009; 19:341–346.
[7] Lin JD, Hsuen C, Chen JY, Liou MJ, Chao TC. Cystic change in thyroid cancer. ANZ J Surg 2007; 77:450–454.
[8] Choi KU, Kim JY, Park DY, et al. Recommendations for the management of cystic thyroid nodules. ANZ J Surg 2005; 75:537–541.
[9] Bommanahalli B, Bhat R, and R Rupanarayan: A cell pattern approach to interpretation of fine needle aspiration cytology of thyroid lesions: A cyto-histomorphological study. J Cytol. 2010 Oct; 27(4): 127–132.
[10] I. V. Renuka, G. Saila Bala, C. Aparna, Ramana Kumari, and K. Sumalatha: The Bethesda System for Reporting Thyroid Cytopathology: Interpretation and Guidelines in Surgical Treatment. Indian J Otolaryngol Head Neck Surg. 2012 Dec; 64(4): 305–311.
[11] Basharat R, Bukhari MH, Saeed S, Hamid T: Comparison of Fine Needle Aspiration Cytology and Thyroid Scan in Solitary Thyroid Nodule Pathology Research International Volume 2011 Article ID 754041, 9 pages.2011
[12] Meko JB, Norton JA: Large cystic/solid thyroid nodules: a potential false-negative fine-needle aspiration. Surgery. 1995 Dec;118(6):996-1003
[13] Manon Auger: Hürthle cells in fine-needle aspirates of the thyroid: A review of their diagnostic criteria and significance. Cancer Cytopathology. Volume 122, Issue 4, pages 241–249, April 2014
[14] Hürthle K. Beiträge zur Kenntniss des sekretionsvorgangs in der schilddrüse. Arch Gesammte Physiolie Menschen Thiere.1894;56:1-44.
[15] Mete O, Asa SL. Oncocytes, oxyphils, Hürthle, and Askanazy cells: morphological and molecular features of oncocytic thyroid nodules. Endocr Pathol. 2010;21:16-24.
[16] Giorgadze T, Rossi ED, Fadda G, Gupta PK, LiVolis VA, Baloch Z. Does the fine-needle aspiration diagnosis of “Hürthle cell neoplasm/follicular neoplasm with oncocytic features” denote increased risk of malignancy? Diagn Cytopathol. 2004;31:307-312.
[17] Agcaoglu O, Aksakal N, Ozcinar B, Sarici IS et al : Factors That Affect the False-Negative Outcomes of Fine-Needle Aspiration Biopsy in Thyroid Nodules .International Journal of Endocrinology Volume 2013 , 1-5 (2013).
[18] Scott N. Pinchot, Hatem Al-Wagih, Sarah Schaefer, Rebecca Sippel,Herbert C: Accuracy of fine-needle aspiration biopsy for predicting neoplasm or carcinoma in thyroid nodules 4 cm or larger . Arch Surg. 2009 July; 144(7): 649–655.2009.
[19] Michael W. Yeh; Orhan Demircan; Philip Ituarte; Orlo H. Clark: False-Negative Fine-Needle Aspiration Cytology Results Delay Treatment and Adversely Affect Outcome in Patients with Thyroid Carcinoma Thyroid. 2004;14(3)
[20] Dong Gyu Na, Dae Sik Kim, Soo Jin Kim, Jae Wook Ryoo, So Lyung Jung: Thyroid nodules with isolated macrocalcification: malignancy risk and diagnostic efficacy of fine-needle aspiration and core needle biopsy. Ultrasonography 2016; 35(3): 212-219.