value of fine needle aspiration cytology in the assessment of thyroid swellings at Queen Alia military hospital

ABSTRACT

To assess the accuracy of cytological examination of thyroid swellings and to evaluate the relationship between cytology and histopathology of fine needle aspiration at Queen Alia Military Hospital between 2002-2003. This study was carried out at Queen Alia Military Hospital between Jan.2002- Dec.2003. There were 251 FNAs of which 207 had subsequent excisional histopathological examination. All the records of histology and cytology were carefully reviewed and cases were identified and classified into six subsets benign follicular lesions, thyroiditis, follicular neoplasm, suspicious of papillary carcinoma, malignant and non-diagnostic aspirate. Cases with no subsequent histopathological examination [n = 36] were excluded, also non-diagnostic aspirate [n = 8] were excluded. Only the medical records and histology of 207 cases were reviewed and correlated with the cytology results. There were 162 [75.3%] cases of benign aspirate, 31[12.3%] cases of follicular neoplasm, 8 [3.2%] cases of suspecious papillary carcinoma, 8 [3.2%] cases of non- diagnostic aspirate, 6 [2.4%] cases of papillary carcinoma. These 215 cases that underwent cytological and histopathological examinations, were classified as non-neoplastic and neoplastic [including follicular neoplasm and malignancy]. According to the postoperative histopathology and correlation that was carried out with preoperative cytology there were 145 true negative, 49 true positive, 11 false negative and 10 false positive. This gives a sensitivity of [81.7%], specificity of [93.5%], positive predictive value of [83%], negative predictive value of [93%] and accuracy of [90%]. The sensitivity and specificity of FNAs cytology in this study are similar comparatively with other published results, so FNA in experienced hands is a good screening test in the assessment of thyroid swellings, but one must be aware that a negative FNAs, doesnit exclude malignant lesions