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Fine-needle aspiration of thyroid and diagnostic accuracy

BACKGROUND: Fine-needle aspiration cytology (FNAC) is widely considered as the gold standard in the assessment of thyroid lesions. The aim of this study is to determine the diagnostic accuracy of FNAC of thyroid lesions performed at our institution and correlate it with histopathological findings and also to compare our findings with that of studies from other regions of the world. MATERIALS AND METHODS: The present study is a 1-year prospective study of FNAC of thyroid lesions performed in the pathology department of our institution during January 2014–December 2014. The FNAC findings were correlated with the histopathological diagnosis, wherever available. The records of 236 patients who had undergone FNAC during the study period were followed by histopathological evaluation wherever possible. The cytological results were classified as inadequate, benign, suspicious, and malignant. The histopathology diagnosis was classified as nonneoplastic (benign) and neoplastic (malignant). RESULTS: The results of the FNA histological diagnosis showed that 6 (2.5%) of the patients had FNA, which were inadequate for cytological assessment, 222 (93.6%) patients had benign lesions, 4 (2.2%) had lesions that were suspicious for malignancy, and 4 (2.2%) had malignant neoplasm. CONCLUSIONS: The correlation of FNAC findings with the histopathological diagnosis showed that our FNAC diagnostic accuracy rate was 97.55% with a sensitivity of 85.75% and specificity of 100%. The results of our study are comparable with the previous studies done and showed that FNAC is a sensitive, specific, and accurate initial diagnostic test for preoperative evaluation of patients with thyroid swelling. It is recommended as the first-line investigation.