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Abstract     Introduction: The use of FNA in the investigation of thyroid nodules has been used since the 1950s. It was started by Cardozo from Holland1, by Soderstrom in Sweden2, and the Karolinska Hospital group3. It is a versatile and easy to perform test, and is being widely used as a primary modality in the investigation of thyroid nodules, in order to select cases for surgery or clinical follow up. Various studies have attempted to describe its sensitivity, specificity and accuracy, and its diagnostic pitfalls3. In the present study, we have attempted to find a correlation between cytological and histopathological findings in 100 cases presenting to the Government Medical College and Hospital, Patiala, from August 2006 to November 2008, and have also compared our findings with other studies. Material and Methods: Fine needle aspiration cytology was performed using a Franzen Handle and a 24 gauge 10 cc syringes, in 415 cases with thyroid enlargement referred to the Department of Pathology, Government Medical College and Hospital, Patiala. The slides were stained using May Grunwald stain or Papanicolau stain. Out of these 415 cases, biopsies were available in 100 cases. The biopsy material was received in 10% formalin. It was made to undergo routine histological processing, and slides were stained using Hematoxylin and Eosin. Conclusion: The average patient age in the present study was 38.4 years.Out of the 415 patients, 350 were females, and the rest males; with a male: female ratio of 1: 5.3,with a male: female ratio of 1: 5.3.320 (77.2%) were categorized as benign, 9 cases (2.2%) were categorized as malignant, 57 cases (13.7%) were categorized as suspicious, and 29 cases (6.9%) were categorized as inadequate. On cytology, among the benign lesions, maximum number of cases were of colloid goiter (45.3%), followed by cystic degeneration in adenomatous goiter (19.6 %), follicular neoplasia- probably benign (13.7%), autoimmune thyroiditis (9.9%), primary hyperplasia (2.69%), thyroglossal cysts (1.8%) and granulomatous thyroiditis in 1.07 cases. Out of the 15 cases diagnosed as malignant on cytology, 46.6% were of papillary carcinoma, followed by follicular neoplasia- probably malignant (40.2%), and both medullary carcinoma and lymphoma (6.6% each). Out of the 67 cases labeled as ‘benign’ on cytology, the diagnosis was confirmed in 66 cases. The remaining one case, which had been diagnosed as adenomatous goiter on cytology, turned out to be a Papillary carcinoma on histology.A diagnosis of ‘suspicious – probably malignant’ was made in 6 cases on FNAC. On histopathology, malignancy was confirmed in 3 cases, while the remaining two turned out to be follicular adenomas. In the present study, the values of sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were 88.9%, 97.8%, 80% 98.9% and 97% respectively. The high statistical values prove the utility of FNAC as a very useful tool in differentiating benign from malignant thyroid swellings, except in certain situations like adenomatous goiters which may be misdiagnosed as both papillary and follicular tumors.

Keywords: Cyto-histopathology.


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