Abstract
Eventhough FNAC is the most routinely performed, safe and cost effective diagnostic procedure for an initial diagnosis of thyroid lesions, we often come across difficulties in diagnosis, especially the grey zone lesions of the thyroid. In such cases AgNOR staining can be used as an adjunct to FNAC for establishing a more definitive cytopathological diagnosis. Hence this study was conducted to evaluate the role of AgNOR staining in diagnosis of benign and malignant thyroid lesions. This prospective study included 150 cases of Fine needle aspirates of thyroid lesions done at the Department of Pathology, Adichunchanagiri Institute of Medical sciences, B.G Nagara during November 2016 to April 2018. AgNOR stained smears were evaluated. Silver stained NORs appeared as black dots were counted two different times by a single observer at a magnification of 100X oil immersion lens. 100 representative nuclei of thyroid follicular cells were selected. A mean was calculated which represented mean AgNOR count. In this study maximum number of cases were seen in 31-40yrs of life (35.3%). Male: female ratio in our study was 1:15.6 The mean values of AgNOR count are significantly higher in malignant group (4.92±1.71) comparing benign group(2.20±1.06). In the present study mean AgNOR count was highest in metastatic deposits of squamous cell carcinoma (10.2) and lowest in Hashimoto’s thyroiditis, Hyperplastic goiter, and colloid goiter (1.8). Mean AgNOR count of follicular thyroid carcinoma (4.64) was higher than follicular adenoma (3.05±0.49).: AgNOR staining can be used as an objective tool for correct diagnosis. It can also be used as an adjunct to FNAC for diagnosis of benign and malignant thyroid lesions.
Highlights
Thyroid gland is affected by a vast array of developmental, inflammatory, hyperplastic and neoplastic disorders
Patients from whom inadequate material was aspirated from the thyroid lesion and noncooperative cases in whom fine needle aspiration cytology (FNAC) was not performed were excluded from the study
A total of 150 cases were who underwent thyroid gland FNAC were included in the study group
Summary
Thyroid gland is affected by a vast array of developmental, inflammatory, hyperplastic and neoplastic disorders. 6 In this study, AgNOR staining is used along with cytomorphological features in FNAC of the thyroid lesion to differentiate benign from malignant neoplasm and improving its diagnostic accuracy. Eventhough FNAC is the most routinely performed, safe and cost effective diagnostic procedure for an initial diagnosis of thyroid lesions, we often come across difficulties in diagnosis, especially the grey zone lesions of the thyroid In such cases AgNOR staining can be used as an adjunct to FNAC for establishing a more definitive cytopathological diagnosis. This study was conducted to evaluate the role of AgNOR staining in diagnosis of benign and malignant thyroid lesions. Interpretation and Conclusion: AgNOR staining can be used as an objective tool for correct diagnosis It can be used as an adjunct to FNAC for diagnosis of benign and malignant thyroid lesions
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