To Study the Role of FNAC in the Preoperative Diagnosis of Thyroid Lesions.

Background Thyroid nodules are the most common endocrine disorders particularly in countries where dietary iodine intake is Low. Thyroid enlargement requires a battery of investigations in which fine needle aspiration cytology (FNAC) has surpassed most of the other test, to study cytomorphological smear patterns, so that depending on it further management of the disease can be done either medically or surgically. Objectives: a)       To study cytomorphological smear patterns in various non-neoplastic and neoplastic thyroid disorders on FNAC. b)       To compare the diagnostic efficacy of smears in fine needle aspiration. Materials & Methods: A prospective study was done study the role of FNAC in the preoperative diagnosis of thyroid lesions in the department of Pathology in MM Institute of Medical Sciences & Research, Mullana, Ambala. Over a period of one year and included 80 Patients, A semi structured Performa was used USG Guided FNAC was done where it was required. Fine needle Sampling without Aspiration and Fine Needle Aspiration technique was used. Two Types of staining used were Papanicolaou & May Grunewald Giemsa. Results: For Cystic lesions FNAC is the procedure of choice, FNAC lead to spillage of contents. FNAC is cheap, easy to learn and well tolerated by children as well as adults. To increase the probability of a diagnostic sample both FNAC & FNCS should be used where one technique supplements the other. Among the solitary nodules, nodular goiter was most common benign thyroid lesion (22.5%), thyroiditis (11.25%), Multinodular goiter with cystic degeneration (10%), follicular neoplastic (8.75%), undifferentiated Carcinoma (2.25%) and (1.25%), Medullary Carcinoma (7.5%), Hurthle Cell Tumor (1.25%). Conclusion: FNAC of the thyroid is a useful tool for making a correct diagnosis in majority of cases based on clinic-cytological correlation. Nature of organ and lesions has important bearing on the efficacy of sampling techniques. For cystic lesions, FNAC is the procedure of choice. FNCS would lead to spillage of contents. The choice of technique need to be selected, depending on anatomic site and clinical situation. FNCS is cheap, simple, easy to learn and leads to better perception of lesion. It is well tolerated by children as well as adults. For solid thyroid lesions, FNCS often yields specimen of text book quality.