Fine needle aspiration cytology accuracy in diagnosis of thyroid lesions: a comparative study with histopathological examination of thyroid swellings

Shivani Nautiyal, Alok Jain, Shashwat Tiwari, Kumar Ashutosh


Background: Thyroid enlargement, whether diffuse or in the form of a nodule, leads to a battery of investigations to be done. Fine needle aspiration cytology (FNAC) is usually the first line of investigation but the limitations of cytology are well recognized in the diagnosis of some thyroid malignancies, in particular it is not able to differentiate between follicular adenoma and carcinoma. We conducted a prospective study to assess the role of FNAC in diagnosing the nature of thyroid swelling and comparing its result with histopathology finding.

Methods: This was a prospective study conducted on 100 consecutive patients presented with thyroid swelling in department of otorhinolaryngology.  

Results: The present data show high specificity (96.29%) of FNAC as compared to sensitivity, which came out to be (78.9%). Positive and negative predictive value is 93.75% and 95.23%. This is quite similar to previous studies.

Conclusions: FNAC has high specificity (96.29%), sensitivity (78.9%), positive predictive value (93.75%), negative predictive value (95.23%) and accuracy (95%) therefore it can be reliably used as initial investigation. A benign FNAC diagnosis should be viewed with caution as false negative results do occur and these patients should be followed up clinico-radiologically for any progression that will require repeated FNAC and/or surgery. 


Thyroid swelling, FNAC, Histopathology

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Deary M, Buckey T, Soldin OP. TSH - Clinical Aspects of its Use in Determining Thyroid Disease in the Elderly. How does it Impact the Practice of Medicine in Aging? Adv Pharmaco-Epidemiol Drug Safety. 2012;1(119):9369.

Basharat R, Bukhari MH, Saeed S, Hamid T. Comparison of Fine Needle Aspiration Cytology and Thyroid Scan in Solitary Thyroid Nodule. Pathol Res Int. 2011; 2011.

Handa U, Gaiz S, Mohan HJ. Role of FNAC in Diagnosis and Management of thyroid lesion. Indian J Pediatr. 2008;25(1):13.

Sikder AH, Rahman AM, Khair MA. Accuracy of Fine Needle Aspiration Cytology (FNAC) In the Diagnosis Of Thyroid Swellings. J Dhaka National Med Coll Hos. 2012;18(2):47-513.

Jawaid MF, Rahim DU, Memon MA, Magsi PB. Presentation, Management and Outcome of Surgery PF Thyroid Swellings by ENT & Head and Neck Surgeons at Civil Hospital Karachi. JLUMHS. 2012;11(2):71-5.

Sreeramulu PN, Venkatachalapathy TS, Prathima S, Kumar K. A prospective study of clinical, sonological and pathological evaluation of thyroid nodule. J Biosci Tech. 2012;3(1):474-8.

Patel MM, Patel K, Kaptan KR, Italiya SL, Saini GS. Fine needle aspiration as first line investiga-tion in thyroid lesions. Natl J Med Res. 2013;3(2):106-10.

Porwal S, Vyas CS, Vijayvargiya SC, Gupta R, Swarnkar M. A study of thyroid swelling with clinicopathological parameters. Int J Biol Med Res. 2013;4(2):3250-2.

Sekhri T. Role of different diagnostic modalities in the evaluation of solitary thyroid nodules, experience in a tertiary referral central of north India. IJNM. 2001;16(3):105-8.

Mangshetty SS, Jewargikar R, Andola SK. Fine Needle Aspiration Cytology of 220 Thyroid Lesions with Histopathological Correlation. Int J Res Health Sci. 2014;2(1):243-53.

Mosawi AH, Mohammed AT, Rubaey RA. Fine Needle Aspiration Cytology (F.N.A.C.) of Goi-ter.A Comparative Study between F.N.A.C. and Histopathology. Medical J Babylon. 2010;7:352-8.

Parikh UR, Goswami HM, Shah AM, Mehta NP, Gonsai RN. Fine Needle Aspiration Cytology (FNAC) Study of Thyroid Lesions (Study of 240 Cases) Gujarat Med J. -2012;67(2):25-30.

Islam MS, Siddiquee BH, Akhtar N, Salam KS, Aktaruzzaman M. Comparative study of FNAC and histopathology in the diagnosis of thyroid swelling Bangladesh J Otorhinolaryngol. 2010;16(1):35-43.

Gupta M, Gupta S, Gupta VB. Correlation of Fine Needle Aspiration Cytology with Histopathology in the Diagnosis of Solitary Thyroid Nodule. J Thyroid Res. 2010;(2010):379051.