COLD THYROID NODULE

A COMPARISON OF FINE NEEDLE ASPIRATION CYTOLOGY WITH HISTOPATHOLOGY

Abstract

Objectives: To determine the diagnostic potential of FNAC. Study Design:
Comparative diagnostic procedure study. Place and Duration: Surgical outdoor and surgical unit-I Nishtar Hospital
Multan during December 2003 to November 2004. Patients and Methods: Study was carried out on 50 patients of
either sex, above the age of 15 years and who had cold thyroid nodule. These patients were subjected to FNAC. The
findings of FNAC were adopted as a guide for their further management. Results: 50 patients, on FNAC 8 patients
(16%) had cystic nodules, 30 patients (60%) had benign solid nodules, 4 patients (8%) had malignant disease while
8 patients (16%) had cytology indeterminate or suspicious for malignancy. Out of 8 patients with cystic nodules, which
were aspirated. Three patients had no recurrence while 5 patients who had blood stained aspirate had lobectomy
followed by histopathology showing benign lesions. Out of 30 patients with benign solid nodule, 26 (88.88%) had
surgery. Seventeen patients (65.4%) had lobectomy while 9 patients had STT. 12 patients having malignant and
indeterminate or suspicious cytology had near-total thyroidectomy. Four patients proved to have papillary carcinoma
and 2 patients folicular carcinoma, 3 patients had follicular adenoma and 3 had colloid nodular goiter. The diagnostic
specificity of FNAC in cold thyroid nodule in this study was 90%. There were 8% false positive and 0% false negative
results. Conclusion: The fine needle aspiration cytology proved to be a reliable method for the preoperative diagnosis
of cold thyroid nodule and better planning of their management.