Study of FNAC in diagnosis of thyroid lesions: A prospective study

Introduction: Fine needle aspiration cytology ((FNAC) is the most sensitive, accurate and cost effective initial method for the clinical management of patient with thyroid nodules. Majority of the thyroid nodules are benign, with cancer accounting for only 1% of all the lesions. Hence it is imperative for the treating surgeon to know the biologic nature, as to benign versus malignant lesions and thus plan appropriate treatment. This would in turn avoid unnecessary surgeries. Follicular patterned lesions is a grey zone area in cytology. Aims and Objectives: To study the various morphological features of thyroid lesions by fine needle aspiration cytology and classify them according to Bethesda system for thyroid cytopathology-2007 and to evaluate the utility of FNAC in planning the management of thyroid lesions. Materials and Methods: The study was conducted in Department of Pathology, Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Sangli, on patients meeting the mentioned inclusion and exclusion criteria. Results : Out of 90 cases, 3 cases (3.34%) were unsatisfactory for reporting, 69 cases (76.67%) were benign, 7 cases (7.77%) were categorized under AUS/FLUS. 9 cases (10%) were reported as Follicular Neoplasm (FN) or Suspicious for FN, 1 case (1.11%) was reported as suspicious of malignancy and 1 case (1.11%) were reported as malignant. Conclusion: FNAC of the thyroid is simpler and accurate preoperative diagnostic test compared with other diagnostic modalities. The results of thyroid cytology must be assessed in conjunction with the clinical findings and other investigations like TFT and USG findings, in view of the possibility of false negative or false positive cytological diagnosis.