Analysis of pattern of thyroid disorders in a tertiary care hospital and evaluating the accuracy of preoperative fine needle aspiration with postoperative histopathological examination

Abstract

Background: Thyroid swelling is a common disease in India. It is very important to differentiate malignant thyroid swellings from benign swellings for definitive planning of appropriate surgery and relevant patient counselling. The present study is undertaken to analyse the pattern of thyroid disease in patients coming to Department of General Surgery and to evaluate the accuracy of thyroid FNA and its correlation with histopathological examination following thyroid surgery, thereby its role in the preoperative diagnosis of thyroid swellings.Methods: A total of 114 thyroid patients were evaluated for a period of one year. The demographic data, clinical features were documented. FNAC was done in 77 patients and results were correlated with 47post operative histopathology reports and diagnostic accuracy of preoperative Fine needle aspiration cytology (FNAC) was evaluated.Results: Age of the patients ranged from 14-70 years. Females were higher than males. Most patients presented with Multinodular goitre and most were in euthyroid state. Sensitivity of FNA was found to be 67% and Specificity was found to be 100%: Accuracy was found to be 93.6% in present study. Positive predictive value was found to be 100%. Negative predictive value (NPV) was found to be 92.7%.Conclusions: Fine needle aspiration cytology has essential role in the evaluation of thyroid patients. We wish to stress the importance of doing multiple aspirations at different sites and usage of USG guidance for representative areas of suspected pathology. The diagnostic accuracy can be improved when combined with advanced imaging techniques.