The Yield of Fnac in Thyroid Nodule

Objectives: To assess the diagnostic yield of FNAC in patients presenting with cold thyroid nodules and to identify features that might be useful for making practical decisions about their management. Study Design: Retrospective, descriptive. Place and Duration of Study: Department of Ear, Nose, Throat, Head & Neck Surgery, Dow University of Health Sciences and Civil Hospital Karachi during 2008 to 2010. Subjects and Methods: Total of 90 cases who presented with thyroid nodule in out patient department was included in this study. Out of 90 cases, 30 were excluded from the study either because histopathological confirmation could not be obtained or the aspirate sent for cytopathological study was unsatisfactory for diagnosis. Remaining 60 cases were included in this study. These cases were subjected to radioisotope scanning and FNAC was performed on those showing cold nodules. The yield of FNAC was later correlated with the histopathological reports of the excised thyroid specimens. Results: Out of 60 cases included in the study 08(13.3%) were males and 52(86.6%) were females. The cases were divided into 6 groups according to age with peak incidence in Group II comprising 33.3% and least incidence in Group VI comprising 3% of the subjects. The accuracy of FNAC was determined as a percentage of correct diagnosis made by this technique compared to the final diagnosis established on histopathology report. In this study accuracy of FNAC was found to be 96.6%. Sensitivity was 91.6% and specificity was 81.6%. Conclusion: FNAC of thyroid nodule is sensitive, specific, accurate, rapid, minimally invasive and cost effective. It is the first line procedure in the evaluation of thyroid nodules. FNAC sample results accurately predict the diagnosis and are suggestive of appropriate treatment in most cases. However, atypical FNAC results need to be considered in combination with clinical presentation, imaging data and individual patient risk factor.