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. 2020 Oct;41(10):1098-1103.
doi: 10.15537/smj.2020.10.25417.

Role of fine-needle aspiration cytology in evaluating thyroid nodules. A retrospective study from a tertiary care center of Western region, Saudi Arabia

Ahmed S Bahaj  1 , Haddad H Alkaff, Bashair N Melebari, Anwar N Melebari, Suhail I Sayed, Syeddah S Mujtaba, Sherif K Abdelmonim, Saeed A Alghamdi, Fares E Alghamdi, Omar A Abu Suliman, Mohammad A Alessa, Firas R Abi Sheffah, Anas H Al-Tammas, Rajab A Al-Zahrani, Osama A Marglani, John C Heaphy, Osama A Bawazir, Ameen Z Alherabi
Affiliations

Role of fine-needle aspiration cytology in evaluating thyroid nodules. A retrospective study from a tertiary care center of Western region, Saudi Arabia

Ahmed S Bahaj et al. Saudi Med J. 2020 Oct.

Abstract

Objectives: To evaluate the accuracy and e cacy of ne-needle aspiration cytology (FNAC) in diagnosing thyroid nodules, correlating it with the histopathological findings.

Methods: A retrospective evaluation of 314 patients was undertaken at a tertiary referral center of King Abdullah Medical City (KAMC), Makkah, Kingdom of Saudi Arabia, between 2010-2019. Patients who presented with thyroid swellings underwent ultrasonography and FNAC. If indicated, surgery was performed. The FNAC findings were compared to the final histopathological reports.

Results: The findings for FNAC from our data set of 314 patients showed a sensitivity value of 79.8%, specificity of 82.1%, accuracy of 74.8%, positive predictive value of 74.8%, and negative predictive value of 85.9%. Conclusion: Our study showed that FNAC has high sensitivity and speci city in the initial evaluation of patients with thyroid nodules. When guided by ultrasonography, the accuracy can be markedly improved. Molecular markers once widely available can improve the diagnostic power of FNAC to be no less than the histopathologic evaluation of thyroid tissue.

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Figures

Figure 1
Figure 1
Papanicolaou stain of direct smear showing follicular cells in macrofollicular arrangement, A) 20X (Bethesda II). Papanicolaou stain showing follicular cells with mild overlapping and nuclear enlargement, B) 20X (Bethesda III). Nuclear enlargement and occasional nuclear grooving, C) 40X (Bethesda III). Diff-quick staining (DQ) showing follicular cells in microfollicular pattern, follicular neoplasm, D) 20X (Bethesda IV). Follicular cells showing nuclear grooving, psammoma bodies and overlapping, E) 40X (Bethesda VI). Tumor cells with positive staining for calcitonin, F) 20X (Medullary thyroid carcinoma).
Figure 2
Figure 2
Schematic representation of the histopathology reporting of thyroid nodules in the patient population.
Figure 3
Figure 3
Fine-needle aspiration cytology reporting of the 314 thyroid nodules according to the Bethesda System for reporting thyroid cytopathology.
See this image and copyright information in PMC

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