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Indian Journal of Pathology and Oncology


Thyroid FNAC: Practice and Pitfalls


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Author Details: Sujatha R., Gayathri J., H.T. Jayaprakash

Volume : 4

Issue : 2

Online ISSN : 2394-6792

Print ISSN : 2394-6784

Article First Page : 203

Article End Page : 206


Abstract

Introduction: Thyroid swellings are a common clinical problem, with an estimated prevalence ranging from 4-8%.Most of the thyroid nodules are benign with small fraction of them harbour malignancy. Fine needle aspiration cytology (FNAC) is a widely employed and gold standard tool in the investigative work-up of patients with thyroid nodules with its diagnostic accuracy approaching 95%. Although its advantages are well documented, there are limitations and problems in interpretation of this technique.
Aims and Objectives: The aim of this study is to document the diagnostic difficulties and to determine the accuracy of FNAC in evaluation of thyroid nodules, highlighting the pitfalls of this technique.
Materials and Method: A total of 110 patients were studied between August2014 to November2015 in the Dept. of pathology Dr. B.R. Ambedkar medical college Bangalore. All patients underwent FNAC of thyroid nodule after prior consent. Material obtained analysed and interpreted
Results and Conclusions: The procedure has two major limitations: non-diagnostic yield and indeterminate results. Inadequate specimen rate of 22.7% which declined with increasing experience. Overall accuracy was 85%, with sensitivity of 98% and specificity of 82%. Markedly haemodiluted smears & combination lesions are often problems in cases of MNG. Follicular carcinomas could not be differentiated from follicular adenomas by cytology. Difficulties may arise in the detection of papillary carcinomas in cystic lesions, mixed papillary and follicular carcinomas. In view of these cytologic limitations, care must be exercised in interpreting cytological results.

Keywords:
Thyroid Nodule, Papillary Carcinoma, Nodular Goitre, WHAFFT Lesions