Fine needle aspiration cytology in diagnosis and management of thyroid disease

The objective of this study was to determine the efficacy of fine needle aspiration cytology in diagnosis and management of thyroid nodules. The study also evaluated the predictive value of pre-operative fine needle aspiration cytology (FNAC) in surgical decision making, by comparing the final pathological diagnosis with the initial FNAC result. All patients who underwent thyroidectomy between 1999 and 2003 were analysed. One hundred and sixty patients who underwent pre-operative FNAC were included in this study. Fine needle aspiration was accurate in 119 (74.3 per cent) patients. Fine needle aspiration cytology and histology did not correlate in 32 (20 per cent) patients and FNAC was inadequate in nine (5.6 per cent) cases. Failures were mainly noted in cases of follicular neoplasm. Our results indicate that FNAC is helpful in the diagnosis of thyroid pathology. However, complete histopathological analysis is essential to distinguish follicular adenoma from follicular carcinoma. From this study, it can be concluded that FNAC is a cost-effective method of evaluating thyroid pathology pre-operatively and plays a useful role in planning the surgical management of thyroid nodules. However, results must be interpreted with the clinical picture in mind.