ABSTRACT
Objectives: The objective of this study was to determine the diagnostic accuracy of clinical examination ,computed tomography [CT], neck ultrasound [US], thyroid scintigraphy [SC], and fine needle aspiration cytology [FNAC] as a different diagnostic tools for diagnosis of cancer thyroid gland in correlation to the final histopathological examination
Patients and Methods: From a series of 60 patients with different thyroid diseases, this study was conducted on 18 patients [15 females and 3 males with age range from 41 to 63 years] diagnosed clinically and proved histopathologically as cancer thyroid gland. All patients were subjected to full history taking, complete clinical examination, computed tomography [CT], neck ultrasound [US], thyroid scintigraphy [SC] and fine needle aspiration cytology [FNAC]. All the patients with malignant cytological evaluation underwent total thyroidectomy, with selective lateral neck lymph node dissection, for patients with palpable cervical lymphadenopahty, postoperatively histopathological examination of the operative specimens were done. The accuracy, of clinical examination, computed tomography, neck ultrasound, thyroid scintigraphy, and fine needle aspiration cytology, in diagnosis of cancer thyroid was estimated in correlation to the final histopathological examination
Results: The results showed that, the diagnostic accuracy of fine needle aspiration cytology [FNAC] in diagnosis of cancer thyroid gland was 88.9%, while the diagnostic accuracy of computed tomography [CT] was 76% where the diagnostic accuracy of neck ultrasound and clinical examination were 72%, and finally the diagnostic accuracy of scintgraphy was 55.6%
Conclusion: Fine needle aspiration cytology is a safe, cost-effective, sensitive and still the most accurate diagnostic tool in diagnosis of malignant thyroid lesions in clinically suspected cases [cases with regional lymphadenopathy, hoarseness of voice, history of rapid tumour growth, hard and fixed tumour and cases with tumour size >4cm], while CT and sonography, had a nearly similar results in detection of the thyroid malignancy. It is suggested that sonography, is a useful adjunctive test after detection of thyroid lesions on CT