Comparative study of fine needle aspiration cytology and histopathology in thyroid nodules at a tertiary care hospital: First report from Somalia

Abstract

BackgroundFNAC is a minimally invasive procedure and cost-effective, especially in developing countries where patients are mostly poor and surgery is not affordable. The present is the first study that examines the correlation between FNAC and histopathology in diagnosing thyroid cancers at a tertiary hospital in Somalia. MethodThis study included 231 patients with thyroid lesions who underwent pre-operative FNACs and histopathologic examination over five years. Investigated clinical parameters include sociodemographic and clinical features and cyto-histopathological findings. ResultsThe mean patient age was 39.3 ± 15.5 years, and there was a significant female predominance (n = 194; 84%), with a female to male ratio of 5.2:1. The overall sensitivity, specificity, and accuracy rate of cyto-histopathology correlation was 91.1%, 96.6%, and 94.9%, respectively. According to the Bethesda classification system of thyroid FNACs, (n = 141, 61%) of cases were Bethesda II (Benign), of which 95.7% of patients had a benign final histological diagnosis, while 4.3% had malignancy (6 false-negative results). Twenty-two patients (9.5%) were Bethesda III, (n = 3,1.3%) were Bethesda IV (suspicious for neoplasm), and all cases had a follicular adenoma on their final histological diagnosis. Forty-four of the patients were Bethesda V, found in 88.6% of its final histological diagnosis, while 11.4% were benign. Bethesda IV accounted for 9.1%, and all patients in this group were papillary thyroid carcinoma on its final histological confirmation. ConclusionOur study findings revealed that FNAC of thyroid lesions has a high accuracy rate, sensitivity, and specificity, allowing appropriate initial diagnostic management. It should be applied as the first investigative tool for thyroid lesions.