Fine needle aspiration cytology of thyroid nodules--evaluation of its role in diagnosis and management.

Thyroid swelling is a common problem in India. Early and systematic evaluation of a nodular thyroid swelling is necessary as it is a frequent presentation of thyroid neoplasia. The objective of this study was to evaluate the efficacy of fine needle aspiration cytology (FNAC) in diagnosis and management of thyroid nodules. With the help of statistical parameters, the significance of FNAC in surgical decision making protocol has been evaluated. A comparison between final histopathological findings with initial FNAC findings is done and sensitivity, specificity, positive and negative predictive value and accuracy of FNAC is calculated and compared to already existing studies. A total of 120 cases of nodular thyroid were included, among which 12 cases were excluded from statistical analysis as they were managed conservatively. Total operated cases were 108 and study period was from November 2006 to October 2009. Analysis revealed sensitivity, specificity and accuracy of FNAC as 90%, 84.6% and 86.1% respectively. There were 12 FNAC false positive cases among which 9 were follicular neoplasm and 3 were Hurthle cell neoplasm which ultimately came as benign in histopathology. Only 3 cases of adenomatous nodule as per FNAC report proved to be papillary carcinoma on histology (ie, false negative). This study concludes that FNAC is an important diagnostic tool in early and cost effective evaluation of thyroid nodules. It helps in decision making for appropriate surgical/non-surgical management.