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Prospective Observational Study: Congruence of Fine-needle Aspiration Cytology and Histopathological Report in
Ninad Waghmare1, Ekta Desai, Amit Girme
1Department of General Surgery, Dr. D. Y. Patil Medical College Hospital and Research Centre, Pune, Maharashtra, India.
Background:
Fine-needle aspiration cytology (FNAC) is a key preoperative investigation for thyroid swellings, but final clinical decision-making requires correlation with ultrasonography, operative findings, and the histopathological report (HPR).
Materials And Methods:
This prospective observational study included 50 operated thyroid swelling cases over 18 months. FNAC findings were compared with final HPR findings, and diagnostic performance for detection of malignancy was calculated using HPR as the reference standard.
Results:
Women constituted 84.0% of the cohort, and most patients were euthyroid at presentation (86.0%). FNAC reported malignancy in 2 of 50 cases (4.0%); 7 of 50 aspirates (14.0%) were nondiagnostic. Final HPR confirmed 44 benign lesions (88.0%) and 6 malignant lesions (12.0%), including papillary carcinoma in 4 cases and follicular carcinoma in 2 cases. FNAC showed 33.3% sensitivity, 100.0% specificity, 100.0% positive predictive value, 91.7% negative predictive value, and 92.0% overall diagnostic accuracy for malignancy in this operated cohort.
Conclusion:
FNAC remains a highly specific and clinically useful preoperative triage tool in thyroid swellings. However, its limited sensitivity in this surgically selected cohort emphasizes that benign or nondiagnostic cytology should be interpreted along with the broader clinicoradiological profile and final HPR.
