Fine Needle Aspiration Cytology Research Articles

Unveiling the Malignancy Risk of Surgically Treated Bethesda III Thyroid Nodules: A 10-Year Retrospective Study Comparing Fine-Needle Aspiration Cytology (FNAC) and Histopathology

Unveiling the Malignancy Risk of Surgically Treated Bethesda III Thyroid Nodules: A 10-Year Retrospective Study Comparing Fine-Needle Aspiration Cytology (FNAC) and Histopathology

Evaluation of Benign and Malignant Cervical Lymphadenopathy: A Comparative Study of Shear Wave Elastography and Grayscale Ultrasound

Abstract Objectives The aim of the study was to evaluate role of shear wave elastography (SWE) using a novel methodology for differentiation of benign and malignant cervical lymph nodes. Methods SWE was performed on 38 patients who presented with cervical lymph adenopathy. Color-coded elasticity maps were obtained, from which the stiffest region of interest (ROI) with a diameter of 2 mm was chosen. Maximum and mean Young's modulus values (Kpa) were calculated in selected 2-mm ROI. Finally, the results were correlated with the fine needle aspiration cytology findings in all patients to assess the diagnostic accuracy, sensitivity, and specificity at a defined cutoff value for distinguishing between benign and malignant lymphadenopathies. Results There were 20 malignant cervical lymph nodes and 18 benign cervical lymph nodes. Malignant nodes showed significantly higher mean Young's modulus value (154.2 ± 46.19 kPa) compared with benign nodes (70.39 ± 30.76 kPa), with a p-value of less than 0.0001. Our findings indicate that the mean Young modulus value within a standardized 2-mm ROI outperformed grayscale ultrasound in terms of diagnostic accuracy (92.1 vs. 78.9%), sensitivity (100 vs. 80%), and specificity (83.3 vs. 77.7%), with the established cutoff values for high diagnostic accuracy indicating malignancy as greater than 92 for mean Young's modulus with an area under the curve of 0.964. Conclusion SWE using a standardized 2-mm ROI provides improved sensitivity and diagnostic accuracy for differentiation of benign and malignant lymph node lesions.

Bilateral Cystic Endosalpingiosis in Cervical Lymph Nodes Mimicking Metastatic Papillary Thyroid Carcinoma Morphologically on Cytology: A Case Report and Literature Review of Diagnostic Challenges.

The presence of cystic lymph nodes in the neck can present a challenging differential diagnosis, with considerations often including metastatic papillary thyroid carcinoma (PTC), cystic squamous cell carcinoma, and congenital cysts. The cytologic overlap between benign Müllerian inclusions and PTC features adds complexity, especially in unusual locations. A 45-year-old woman with a history of ovarian serous borderline tumor (SBT) and non-invasive Müllerian implants presented with cystic lymphadenopathy in the neck. Imaging revealed multiple suspicious, partially cystic lymph nodes. Fine-needle aspirations (FNA) from two nodes showed moderate cellularity, monolayered epithelial sheets, and nuclear features suggestive of PTC. FNA cytology, thyroglobulin level, and immunocytochemical profile revealed benign Müllerian cells within lymph nodes. Subsequent histologic evaluation of the excised lymph nodes confirmed cystic endosalpingiosis. This case emphasizes the value of comprehensive clinical-pathologic correlation and appropriate ancillary studies in the evaluation of cystic lymphadenopathy. Awareness of benign Müllerian inclusions and their mimicry of metastatic disease is essential for accurate diagnosis and optimal patient management.

Validation of ACR TI-RADS performance in transition age: results from a multicenter retrospective study by the TALENT study group.

Although thyroid nodules are less common in the pediatric population, the risk of malignancy is higher than in adult patients. The aim of this study was to evaluate the ultrasonographic predictive factors of malignancy in thyroid nodules and to validate American College of Radiologists (ACR) TI-RADS performance in transition age patients. One hundred forty-two patients aged between 14 and 21 years referred to the participating centers for FNA biopsy of a thyroid nodule between 2007 and 2022 were included and ultrasound reports and sonographic images were retrospectively analyzed. Nodule features were defined according to the ACR-TIRADS lexicon. Two reference standards were applied: FNA cytology and surgical histology. The diagnostic performance of single sonographic features was estimated. Significant predictors were then included in a multivariate regression model. Nodules included in ACR-TIRADS categories TR4 or TR5 had 10-fold increased risk of indeterminate or suspicious/malignant cytology [p < 0.001]. In univariate analysis, solid composition [p = 0.016] and presence of hyperechoic foci [p = 0.040] significantly increased the likelihood of malignant histology. In multivariate regression analysis, irregular margins [p = 0.011] and hyperechoic foci [p = 0.019] were independent predictors of indeterminate or suspicious/malignant cytology. Nodules included in ACR-TIRADS categories TR4 or TR5 had 10-fold increased risk of indeterminate or suspicious/malignant cytology in transition age. ACR-TIRADS was not able to rule-out malignancy compared to FNAB alone, suggesting the need to reconsider recommendations in the transition age group.

Application of Human Papillomavirus-DNA Test on Salivary Gland Fine Needle Aspiration Cytology Samples Confirms the Absence of the Virus in Primary Neoplasms and Demonstrates for the First Time Its Presence in Salivary Intraglandular Cysts.

The correlation between Human Papillomavirus (HPV) and salivary gland neoplasms is still controversial. Data in the literature are conflicting, reporting the presence of the HPV-DNA in a significant percentage of cases or none. We investigated the presence of HPV in a series of salivary gland neoplasms using fine needle aspiration cytology (FNAC) samples to explore its potential oncogenic role in salivary gland tumor development. The study included 66 salivary gland lesions from 65 patients. For all cases, residual cytological material in the needle hub, once direct smears were obtained, was fixed by rinsing the needle in Cytolyt hemolytic and preservative solution (Hologic Inc. Marlborough, MA 01752 USA). The samples fixed in the Cytolyt hemolytic and preservative solution (Hologic Inc. Marlborough, MA 01752 USA) were centrifuged at 252 g, then the sediment was transferred to the Preservcyt solution and used for the detection of HPV-DNA. We found evidence of the presence of HPV in two salivary intraglandular cysts lined by squamous cell epithelium. Furthermore, we also found HPV in three metastatic oropharyngeal squamous cell carcinomas (SCC) located in the parotid gland. Regarding primary salivary gland tumors, the HPV test produced negative results in all cases. HPV testing produced negative results in all primary salivary gland tumors, failing to confirm the potential involvement of HPV infection in the pathogenesis of salivary gland tumors. Instead, the presence of HPV DNA in samples of salivary intraglandular cysts, never reported before, may be an interesting fact, which however requires further evaluation.

Fine Needle Aspiration Cytology of Palpable Head and Neck Masses: A Descriptive Cross-sectional Study

Introduction: Fine needle aspiration cytology is a quick and safe technique done for the initial diagnosis of head and neck region masses. This study aims to assess the utility of fine needle aspiration cytology in head and neck palpable masses. Materials &amp; Methods: A descriptive cross-sectional study was done in the Pathology Department of Kathmandu Medical College from 1st February 2023 to 31st December 2023. All the patients with palpable head and neck lumps were included in the study. A convenience sampling method was used. The data was entered and analyzed using the Statistical Package for Social Science (SPSS) version 22.0 Results: Among 650 fine needle aspiration cytology done during the study period, 184 were from head and neck lesions (28.30%). The mean age of the patient was 35.4 years with female predominance. The most common site was lymph node 85 (46.19%) followed by thyroid 39 (21.19%). Reactive lymphadenitis was the most common cause of lymphadenopathy seen in 41(22.2%) patients and colloid goitre was the most common cause of thyroid swelling seen in 26(14.13%) patients. Conclusions: Fine needle aspiration cytology is a useful and reliable technique for the diagnosis of head and neck mass. It helps to avoid unnecessary surgeries and is recommended and guides the clinician in general clinical management.

Reporting Bone Cytopathology-A Proposal Based on a Single Tertiary Centre Experience.

Fine-needle aspiration cytology (FNAC) from bone lesions has been proven to be a useful diagnostic tool but lacks standardisation. The aim of the study was to evaluate the diagnostic utility of FNAC as a basis to propose and test a reporting system for bone reporting cytopathology. This retrospective study is based on patients with bone lesions, that were approached by cytology at Skåne University Hospital, Sweden between 2015 and 2023. The diagnostic performance was measured by sensitivity, specificity and accuracy analyses. All diagnoses were then distributed in six categories: (I) Non-diagnostic, (II) Benign, (III) Atypia, (IV) Bone neoplasm of uncertain significance, (V) Suspicious for malignancy and (VI) Malignant. The risk of malignancy (ROM) in each category was calculated. The final cohort consisted of 721 cases. Bone cytology was able to differentiate between benign and malignant lesion with a sensitivity of 89% and a specificity of 99%. The overall diagnostic accuracy was 65% but varied significantly among different types of lesions. Within the tested diagnostic categories, the ROM was (I) 48%, (II) 6.7%, (III) 69%, (IV) 28%, (V) 93% and (VI) 100%. FNAC from bone lesions is a sensitive and specific diagnostic tool with high diagnostic accuracy among various tumour types. This study provides valuable insights for the development of a standardised reporting system for bone cytopathology.

Primary Thyroid Diffuse Large B-Cell Lymphoma: A Case Report.

Primary thyroid lymphoma is rare. Hashimoto's disease is usually found as a risk factor. Among thyroid lymphoma, diffuse large B-cell lymphoma (DLBCL) is the most aggressive and frequent one. A 56-year-old man with a medical history of Hashimoto's disease presented with a neck mass and dysphonia. A computed tomography scan revealed a large thyroid mass. Fine-needle aspiration cytology (FNAC) was consistent with lymphoma, confirmed by a core needle as a DLBCL. The patient was transferred to the Department of Hematology and Oncology for chemotherapy with good results. Primary thyroid lymphoma accounts for less than 5% of all thyroid gland malignancies and less than 2% of extranodal lymphomas. It frequently affects women in the sixth or seventh decade. Hashimoto's disease is a major risk factor. DLBCL is the most common histological subtype with aggressive evolution. Radiology and FNAC are not usually very precise and a biopsy is needed. Treatment includes surgery, radiotherapy, chemotherapy, and targeted therapy.

A Prospective Clinical Study to Evaluate the Accuracy of Axillary Lymph Node Staging Using Ultrasound Guided Fine Needle Aspiration Cytology in Breast Cancer Patients

A Prospective Clinical Study to Evaluate the Accuracy of Axillary Lymph Node Staging Using Ultrasound Guided Fine Needle Aspiration Cytology in Breast Cancer Patients

Fine Needle Aspiration Cytological Diagnosis of Primary Breast Large-Cell Neuroendocrine Carcinoma/Squamous Cell Carcinoma.

Primary breast large-cell neuroendocrine carcinoma (LCNEC)/squamous cell carcinoma (SCC), also referred to as mixed neuroendocrine/non-neuroendocrine neoplasms of the breast (Br-MiNENs), represents an exceedingly rare malignancy. We report the first case of primary breast LCNEC/SCC diagnosed via ultrasound-guided fine-needle aspiration (FNA) biopsy of the left supraclavicular and left internal mammary lymph nodes. The patient, a 40-year-old female, underwent a lumpectomy followed by breast-conserving surgery and was diagnosed with primary breast LCNEC. Notably, within merely four months following the breast-conserving surgery, PET-CT revealed lymph node enlargement, prompting the performance of FNA. FNA cytology of metastatic lymph nodes revealed two distinct tumor components, allowing for clear differentiation between LCNEC and SCC in the smear. The diagnosis was further corroborated by immunocytochemical (ICC) staining of the cell blocks. Subsequently, histopathological re-examination of the breast mass revealed occult SCC components comprising less than 1% of the tumor cells. Additionally, the case exhibited triple-negative breast cancer, with PIK3CA, TP53, RB1, and BCL2L11 mutations identified through next-generation sequencing (NGS). Br-MiNEN is exceedingly rare, and its cytological diagnosis poses significant challenges. It is recommended that a detailed and objective description of each tumor component and its proportion be provided. This report provides the first detailed description of the FNA cytology of LCNEC/SCC, thereby enhancing cytopathologists' comprehension of this tumor. Auxiliary studies, including ICC staining and molecular biology assays, are crucial for accurate diagnosis, therapy, and prognosis.

Enhancing Diagnostic Precision and Clinical Outcomes With FNAC in Parotid Gland Masses.

Parotid gland masses encompassing both neoplastic and non-neoplastic conditions present diagnostic challenges. Fine-needle aspiration cytology (FNAC) is commonly used to differentiate between benign and malignant lesions but has limitations such as variable sensitivity and potential sampling errors. This study assesses FNAC's accuracy for parotid gland lesions, evaluates the Milan Salivary Gland Cytopathology Reporting System (MSRSGC), and compares FNAC results with histopathological findings. This retrospective study at our medical center analyzed data from 2321 patients who underwent parotid gland FNAC followed by surgical resection over 20 years. Patients were included if they had both cytological analysis and surgery between January 2004 and July 2024. Surgical procedures varied based on mass characteristics and FNAC results, and all samples were assessed using MSRSGC. Statistical analysis compared FNAC results with histopathology findings, calculating sensitivity, specificity, and accuracy. This study included 352 patients who underwent both FNAC and surgical resection. FNAC had an overall accuracy of 93.9%, with a sensitivity of 78.3% and specificity of 91.5%. The risk of malignancy was 30% for Milan Category I (nondiagnostic), 6.3% for Category II (non-neoplastic), 0% for Category III (Atypia of Undetermined Significance), 2.3% for Category IVa (benign neoplasm), 5.8% for Category IVb (neoplasm of uncertain malignant potential), 58.8% for Category V (suspicious for malignancy), and 95% for Category VI (malignant). The false negative rate was 2.4%, while the false positive rate was 3.4%. The malignancy risk increased with age, and malignant masses were larger and more likely to cause facial paralysis. FNAC is a key diagnostic tool for parotid gland masses, offering high specificity and accuracy despite some limitations. Patients with young ages and inappropriate histories should be assessed more carefully. MSRSGC is a useful system to show appropriate risk of malignancy.

Pitfalls in the Cytological Diagnosis of Nodal Hodgkin Lymphoma.

Hodgkin lymphoma (HL) is a hematopoietic neoplasm characterized by malignant Reed-Sternberg (RS) cells in an inflammatory background. Although the cytological features of HL are well elucidated in literature, yet many postulated factors cause its misdiagnosis. This study aims to assess the diagnostic reliability of fine needle aspiration cytology (FNAC) in HL and evaluate the factors contributing to a false-negative and false-positive diagnosis, taking histopathology as the gold standard. This was a retrospective study in which 47 cases of HL diagnosed on histopathology were compared with their prior cytological diagnosis. The patient's age ranged from 3 to 80 years (median: 36 years) with a M:F ratio of 2.9:1. Lymph node aspirations were performed from multiple anatomical sites, out of which the cervical was the most common (57.8%). FNAC was inconclusive in two cases due to unsatisfactory smears. The false-negative diagnosis of reactive lymphadenitis was given in four cases, and false-positive in four cases, which included three cases of non-HL, and one case of malignant small round blue cell tumor. The overall diagnostic accuracy of FNAC in the diagnosis of HL was 82.2%. The cytological diagnosis of HL can be challenging when classic RS cells are absent. Contributing factors for a false-negative diagnosis include obscuring reactive inflammatory cells, fibrosis of the involved lymph nodes, partial involvement of the lymph node, and misinterpretation. A thorough clinical examination with evaluation of FNAC smears from multiple areas, and ancillary tests help improve the diagnostic accuracy of cytological diagnosis.

Extra-Adrenal Paraganglioma on Fine-Needle Aspiration Cytology: A Case Series.

Paragangliomas (PGs) are rare tumors that most commonly occur in the head and neck region and along the sympathetic chain. Fine-needle aspiration cytology is not commonly used for the diagnosis of PG due to the potential risk of hemorrhage and hypertensive crisis. As a result, limited studies describe the cytological features of PGs. In this case series, we will discuss the fine-needle aspiration features of three cases of extra-adrenal PGs. The cellular arrangement in smears was either singly scattered or loosely cohesive clusters. The cells were polygonal with pleomorphic nuclei, abundant granular cytoplasm, and bland chromatin. Cellblock showed two types of cells with focal acinar formation. Immunohistochemistry also confirmed the diagnosis. These results were also in keeping with radiological findings. Fine-needle aspiration cytology, along with clinicoradiological findings, can help in making an accurate preoperative diagnosis of PG.

Expression of the Hopeful Therapeutic Target CD15 in Women with Breast Cancer

Background: CD15 is emerging as a recent prognostic marker with potential as a future therapeutic target in human malignancies. Its biological role in human cancer involves facilitating tumor cell adhesion through interaction with E-, L-, and P-selectins. This interaction allows adhesion to endothelial cells, enhancing metastatic potential. Objective: to study CD15 expression and its relationship to some pathologic parameters to provide the first Iraqi data-driven analysis of this growing concept in women with breast cancer. Subjects and Methods: A retrospective study was carried out utilizing tissue samples obtained from 85 patients with invasive breast cancer. Materials included one formalin-fixed paraffin-embedded tissue block, one hematoxylin and eosin-stained histological section, and two immunohistochemical-stained ER and HER2/NEU sections for each patient. The samples were obtained through core needle biopsy under ultrasound guidance. Data review and immunohistochemical staining with CD15 were conducted, followed by statistical analysis using the chi-square test to explore correlations. Results: CD15 expression was observed in 55% of breast cancer samples. There was a highly significant statistical relationship between CD15 expression and the presence of axillary lymph node metastasis (proven by fine needle aspiration cytology). However, there was no significant statistical relationship between CD15 expression and the histological grade, ER receptor, HER2-NEU status, and tissue calcification. Conclusion: CD15 expression was detected in breast cancer cells, with a highly significant association observed between CD15 expression and axillary lymph node metastasis at presentation. CD15 could serve as a prognostic marker as association with axillary lymph nodes reflects negative impact on prognosis and at the same time a promising therapeutic target for patients with breast cancer as blockage of CD15 antigen’s function will result in reduction of the metastatic potential and it could be an immunotherapeutic target.

Adiposity is associated with a higher number of thyroid nodules and worse FNA outcomes.

Adiposity may be associated with thyroid nodularity. However, its impact on the number of nodules and the risk of malignancy is unclear. To evaluate the impact of adiposity on thyroid nodules using Body Mass Index (BMI), ultrasonographic (US) and cytological data. A retrospective cohort study of 310 patients with thyroid nodules was performed. Patients were categorized based on their BMI, and grayscale US data and fine-needle aspiration (FNA) cytology results were evaluated. Patients with BMI ≥25 Kg/ m² were found to have a higher number of thyroid nodules compared to those with BMI <25 Kg/ m² (4.25 ±2.42 vs. 3.66 ± 1.93) (P value=0.05). Patients with BMI ≥25 Kg/ m² had more suspicious and malignant cytology than those with BMI <25 Kg/ m² (P value = 0.029). Patients with BMI ≥25 Kg/m² had more nodules with intermediate and high suspicion sonographic patterns. However, this did not reach statistical significance. Overweight and obese patients have a trend for more thyroid nodules and have a higher risk of being diagnosed with thyroid malignancy.

Fine-needle aspiration cytology of palisading adenocarcinoma: The first cytology report of a newly described salivary gland neoplasm.

Here, we report the first cytology findings of the newly characterized entity, palisading adenocarcinoma of the salivary gland, diagnosed in the sublingual gland of a 61-year-old female. The liquid-based cytology showed a moderately cellular aspirate containing three-dimensional clusters and trabeculae of tumor cells of various sizes. The cells had dark ovoid nuclei, finely granular chromatin, inconspicuous to punctate nucleoli, and ample cyanophilic cytoplasm with indistinct cell borders. In conventional smears, the cells displayed frequent crush artifacts and anisonucleosis resembling endocrine-type atypia. The background was clean, devoid of secretions, and contained singly dispersed tumor cells with stripped nuclei. Interestingly, concentrically laminated globules of extracellular matrix surrounded by the tumor cells were identified. Mitotic figures and tumor necrotic debris were absent. The cytologic findings correlated with the histologic findings of the excision specimen. The cytologic differential diagnosis and tumor grading of palisading adenocarcinoma were briefly discussed.

The role of hormone dosages in the assessment of cervical lesions by FNA: A descriptive analysis of 762 cases

IntroductionThe use of Hormone Dosage (HD) in Fine Needle Aspiration Biopsy (FNA) needle washout fluid, introduced in the 1990s, initially aimed at measuring Thyroglobulin (TG). Elevated TG concentration in an extrathyroidal cervical lesion suggests metastases of Well-Differentiated Thyroid Carcinomas (WDTC). Over the years, HD has evolved to incorporate Calcitonin (CT) and Parathormone (PTH), improving sensitivity and specificity in diverse clinical scenarios. Despite varying cutoffs in the literature, existing data underscore significant advancements in diagnostic accuracy. MethodsThis paper presents a case series of 762 cervical lesions with FNA cytology and HD in different cervical regions. ResultsIt was possible to establish the histogenesis of the lesion based on a combination of the FNA cytology and PTH HD findings, so PTH was useful to determine parathyroid origin in all regions, Thyroglobulin (TG) and PTH together provide insights on cell origin in difficult cases. Thyroglobulin (TG) dosage enhances the accuracy of detecting well-differentiated thyroid carcinomas. In post-thyroidectomy by bed lesions, dosages help to determine non-thyroid/parathyroid lesions. DiscussionThe case series and review underscore the valuable contribution of HD in fine-needle aspiration for the evaluation of cervical lesions. By integrating HD with cytological, ultrasound, and clinical data, clinicians can enhance the accuracy and specificity of FNA in diagnosing various cervical lesions, ultimately improving patient care and management.

Challenges in the Cytodiagnosis of Intraparotid Schwannoma.

Clear cell tumors of parotid gland encompass a wide spectrum of neoplasms, including benign and malignant epithelial neoplasms. Additionally, tumors from adjacent structures such as paraganglioma, and metastatic neoplasms may also show clear cells. Overlapping cytological features may cause difficulty in diagnosis. This 50-year-old female presented with inability to close the right eye for 4 years, and with an infra-auricular swelling. Fine-needle aspiration cytology (FNAC) done outside was submitted for review with a diagnosis of neuroendocrine tumor. Smears showed clusters of tumor cells with abundant vacuolated cytoplasm and uniform round to ovoid nuclei. Features were those of salivary gland neoplasm of uncertain malignant potential, that is Milan category IVB: cellular neoplasm with clear cell features, with differential diagnoses of myoepithelial cell neoplasms, acinic cell carcinoma and paraganglioma. FNAC repeated for better characterization showed similar polygonal cells, accompanied by few spindle-shaped cells with ovoid nuclei, suggestive of paraganglioma. However, DOTANOC uptake was absent. Patient underwent radical parotidectomy; intraoperative frozen section showed a spindle cell tumor. Final histopathology revealed an intraparotid facial nerve schwannoma. The tumor was multi-nodular, with some nodules being composed almost entirely of polygonal cells with clear cytoplasm, that is, Antoni B areas, and others showing typical Antoni A areas admixed with Antoni B areas. Parotid FNAC has high accuracy for diagnosis of epithelial lesions; however, mesenchymal tumors often pose a diagnostic difficulty. Intraparotid schwannoma is not uncommon and may be diagnosed easily on FNAC when morphology is classical. However, intra-tumoral heterogeneity and less common histological subtypes may present a pitfall in cytodiagnosis.

Cervical cystic lymphangioma in an adult: a rare entity

Lymphangiomas are benign malformations of the lymphatic system, commonly arising from sequestered lymphatic vessels. While typically found in infancy or childhood, their occurrence in adults is rare. This case details a 44-year-old female with a progressively enlarging, painless neck mass. Imaging revealed a cystic lesion near major neck vessels. Fine-needle aspiration cytology initially suggested lymphocele, while ultrasonography and computed tomography angiography provided differential diagnoses, including lymphangioma. Surgical excision of the mass and histopathological examination confirmed the diagnosis of cavernous lymphangioma. Although benign, lymphangiomas can cause complications through invasion of surrounding structures, leading to mass effects or secondary infections. Definitive management is surgical excision, but thorough imaging and differential diagnosis are critical to ruling out other potential conditions, especially given the rarity of lymphangiomas in adulthood.

Retrospective Study of Fine Needle Aspiration Cytology of Patients with Thyroid Nodule in Benghazi in the Period of (2021-2023)

Background: Thyroid nodules constitute a common endocrine disorder, these nodules could be solitary, multiple, cystic, or solid. Increasing age, female gender, iodine deficiency, and history of thyroid radiation all are high risk for thyroid nodules. FNAC representing the most cost-effective diagnostic tool used in the assessment of nodules of the thyroid. Objective of the study: The aim of this study is to evaluate the result of fine needle aspiration cytology (FNAC) and assess thyroid status using of thyroid hormone obtained from patients with thyroid nodules. Materials and methods: this is a retrospective study, includes collection of data from available cases of thyroid nodules underwent fine needle aspiration between 2021 to 2023, data regarding age, sex, TFT, USS, FNAC was collected from the archive of endocrine out patients clinic of Benghazi Medical Center and from endocrine clinic of Benghazi diabetic center. The analysis was done using the SPSS program. Result: A total of 60 cases were studied, Data was collected from 60 patient’s files for years between 2021 and 2023. The mean age of the patients with FNAC selected for this study was 49.65, and ranged from 21-80 years. The gender distribution shows female predominance in which female cases were 53 (98.33%) while only one case (1.67%) was reported among men. The size of nodules in our cases range from 1cm to 4.5 cm. The mean size of nodules is 1.89cm. In this study the largest group of nodules located in right lobe (21) cases then left lobe (20) cases then both (17) cases and in isthmus only 2 cases. Most of the cases thyroid function test result shows an euthyroid status (38) cases. FNAC of thyroid nodule showed that most of patient’s result diagnosed as benign nodules (47) cases. Conclusion: FNAC is a key tool in diagnosis of thyroid nodule as it has safe, minimally invasive and cost effective diagnostic role.