FNAC IN THE MANAGEMENT OF SOLITARY THYROID NODULE

Abstract

Objective: To determine the significant role of FNAC upon other diagnostic
modalities in pre-operative investigations of patients presenting with solitary thyroid nodules and to compare the post
operative histopathological results with the results of FNAC. Design: A Comparative study. Place and Duration of
Study: Department of Surgery Combined Military Hospital Quetta and Combined Military Hospital Rawalpindi from
December 1999 to December 2001. Patients and Methods: In this study 46 patients with solitary thyroid nodule were
studied. Only 2 patients were toxic while remaining 44 were with euthyroid. In this study only one case was suspected
to be malignant clinically out of 5 malignant cases. All 46 patients under went thyroid scanning, ultrasound examination
and fine needle aspiration biopsy and the diagnostic accuracy was assessed. Results: 36 patients (78.26%) were
operated while 10(21.73%) were managed conservatively. There were 5(10.86%) malignant nodules while 41(89.13%)
were benign. All the 5 cases with malignancy were with ‘cold’ nodules on scan as most of others, while ‘solid’ on
ultrasound examination and so were most of other benign nodules. All cases diagnosed malignant pre-operatively on
FNAC, proved to be malignant on histopathology after surgery and the others diagnosed as benign on FNAC proved
to be benign. Conclusion: This study shows that conventional investigations for evaluation of solitary thyroid nodules
are inaccurate in identifying the malignant from the benign nodules and their routine use in such patients should be
abandoned, while the use of FNAC should be encouraged more in our hospitals as this technique is with high degree
of sensitivity and specificity, cost effective and safe.