TITLE:
Evaluation of non-palpable thyroid nodules by ultra sound guided fine needle aspiration cytology
AUTHORS:
Khalid Ahmad Al-Sindi, Mulazim Hussain Bukhari, Kanwal Saba, Wajid Ali, Madiha Arshad, Nasir Raza Zaidi
KEYWORDS:
FNAC; USG; The Bethesda Classification; Follicular Adenoma; Follicular Carcinoma; Papillary Carcinoma; Medullary Carcinoma
JOURNAL NAME:
Natural Science,
Vol.5 No.2,
February
18,
2013
ABSTRACT: The aim of this study
was to see the usefulness of fine needle aspiration by “theBethesdasystem for reporting Thyroid
Cytopathology” (TBS- RTC) for non palpable thyroid nodules through ultrasound-guidance for the evaluation and treatment
planning of nonpalpable thyroid lesions. This study was conducted on 200 patients
with non palpable thyroid nodules which are very low lying or felt on
swallowing; in Department of Pathology and Radiology since January 2011 to June
2012. The patients were scanned and USG- FNAC was performed and reporting was
done by “TBSRTC”. Of the 200 specimens 17 samples were nondiagnostic or unsatisfactory (Class I), 145 samples were benign
(Class II), 20 samples were showing Atypical
of Undetermined Significance (AUS) or Follicular Lesion of Undetermined
Significance (FLUS); (Class III), 6 were showing follicular neoplasm or suspicious for a follicular neoplasm (Class IV), 7
samples were suspicious for malignancy (Class V) and 5 samples were positive for malignancy (Class VI). On comparison
of ultrasound guided FNAC with histopathology the sensitivity for correct diagnosis
was 93%, specificity was 86%, positive predictive value was 37%, negative
predictive value was 99% and accuracy was 86%. USG-FNAC is a useful modality
for the evaluation and treatment planning of nonpalpable thyroid lesions
smaller than5 mmin
the maximum diameter. TBSRTC is the best method of reporting but class III and
IV are the main pitfall of this system for reporting Thyroid Cytopathology and
show high sensitivity, specificity and accuracy.