COMPARATIVE EVALUATION OF CELL BLOCK METHOD AND SMEAR CYTOLOGY IN FINE NEEDLE ASPIRATION CYTOLOGY OF PALPABLE THYROID LESION IN PATIENTS ATTENDING KIST MEDICAL COLLEGE TEACHING HOSPITAL

Abstract

Background: Most patients with thyroid diseases present with palpable neck swelling. Accurate evaluation of thyroid nodules is crucial as they can be neoplastic. The use of fine needle aspiration and smear cytology for the detection of malignant thyroid lesions is the usual practice. However, it has its limitations and diagnostic pitfalls. Cell block analysis can be a useful adjunct to smears for establishing a more definitive cytopathologic diagnosis. This study was aimed to evaluate cytology and cell block findings in the patients of palpable thyroid lesions. Methods: A cross sectional, hospital-based comparative, observational study was conducted in Department of Pathology after receiving ethical approval from Institutional Review Committee. The study was conducted from 1st August 2022 to 1st August 2023. Statistical analysis of the diagnostic utility of cell block was evaluated taking into account sensitivity and specificity. Results: Among the 50 cases diagnosed as non-neoplastic by smear cytology, 2 were found to be neoplastic by cell block and similarly among the 5 cases which were not diagnosed by cytology, 2 cases were confirmed to be non-neoplastic thyroid lesions by cell block. Sensitivity of FNAC to detect neoplastic lesions was 66.6% and specificity was 100%, while cell block had 100% sensitivity and 100% specificity to detect those lesions. Conclusions: As both smear cytology and cell block procedures are done in a single setting, combination of two procedures has beneficial effect not only to support diagnosis but also to establish new diagnosis.