Fine-needle Non-aspiration Cytology Research Articles

Comparative evaluation of thyroid imaging reporting and data system and cytopathological correlation in thyroid nodules

Background: With the increasing availability of ultrasound (USG) and concern for malignancy, there has been significant increase in the detection of thyroid lesions. However, there is no uniformity in the reporting pattern among radiologists, and hence, such USG reports are mostly inconclusive to exclude thyroid malignancy. Therefore, most of the patients have to undergo fine needle aspiration cytology or fine needle non-aspiration cytology (FNNAC), which is avoidable. The sonographic assessment of thyroid nodule can provide alternative method to this invasive modality of diagnosis. Therefore, the need was felt for establishing uniformity in USG reporting of thyroid nodules and risk stratification for malignancy with aim of reducing unnecessary FNNAC. Thyroid imaging reporting and data system (TIRADS) classification brings uniformity in reporting and reduces ambiguity in management of the patients. Aims and Objectives: The objective of the study was to perform comparative evaluation of TIRADS and cytopathological evaluation of thyroid nodules FNNAC in Indian scenario. Materials and Methods: Multicentric prospective study was conducted in the department of radio diagnosis and department of surgery at defence service hospitals of Jaipur and Chandimandir during the study period of July 01, 2017–October 31, 2022. Results: Out of the 208 nodules, 28 (13.5%) turned out to be malignant. The percentage of malignant thyroid nodules was higher in nodules with TIRADS scores 4 and 5. The percentage of malignant thyroid nodules was 1% and 2%, respectively, for TIRADS 2 and 3 categories. The most common finding of USG evaluation was diffuse thyroiditis. There was a significant correlation between the USG findings and FNNAC findings in TIRADS scoring system. Conclusion: Our study shows high degree of correlation between TIRADS classification and cytopathological evaluation of thyroid nodules. Hence, TIRADS can be used an effective tool for avoiding unnecessary FNNAC procedures.

A COMPARATIVE STUDY OF FINE NEEDLE ASPIRATION CYTOLOGY VS FINE NEEDLE NON ASPIRATION CYTOLOGY VS ULTRASOUND GUIDED FINE NEEDLE ASPIRATION CYTOLOGY IN THE CYTOLOGICAL EVALUATION OF THYROID LESIONS

Introduction: FNAC is mainly used in differentiating malignant thyroid nodules from benign nodules as the later can be followed up clinically. A modified sampling technique called fine needle non-aspiration cytology (FNNAC), has come into clinical use in recent times. To evaluate the efficacy of fine-needle non-aspiration cytology (FNNAC) with that of standard fine-needle aspiration cytology (FNAC) and USG guided FNAC of thyroid lesions as regards to cellular and hemorrhagic yield. Methodology: Patients attending Out patient and In patient Department of General Surgery with clinically palpable thyroid swelling for a period of one year are included in this study. Patients were randomised into 3 groups_ 25 patients in each group. After a thorough clinical examination, all the patients in group 1 were subjected to FNAC. Patients in group 2 were subjected to FNNAC .Patients in group 3 were subjected to USG guided FNAC. The details of the technique of Fine needle cytology were explained to the patient and an appropriate consent was obtained from each case before performing the procedure. After subjecting patients to FNNAC and FNAC using 23 gauge needle,the samples were smeared and air dried and sent to the pathologist. Cytological evaluation and reporting was done by pathologist. Results: Out of 50 patients, 25 patients were subjected to FNNAC & 25 patients were subjected to USG guided FNAC from thyroid lesions. The smears was scored and graded accordingly. Based on the results, it was found that superior quality smears were more in FNNAC technique, but diagnostically adequate samples are more in USG guided FNAC than FNNAC. Conclusion: For highly vascular organs like thyroid , FNNAC is the preferred technique as there is better material with less admixture of blood. The number of superior quality smears without admixture of blood is more from FNNAC. FNAC smears although equally diagnostic, mostly produced diagnostically adequate rather than superior quality smears.

Ultrasound-guided fine needle aspiration versus non-aspiration techniques in the evaluation of solid thyroid nodules

BackgroundComparison between the Fine Needle Non-Aspiration Cytology (FNNAC) and Fine Needle Aspiration Cytology (FNAC) in acquiring ultrasound-guided fine needle cytology (FNC) samples from solid thyroid nodules to determine the better technique, hence improving the sample quality aiming to decrease the number of unnecessary thyroidectomy operations.ResultsProspective study showed statistically significant increase in cellular yield, preservation of cellular architecture and decrease in cellular trauma along with statistically significant increase in total sample quality with FNNAC (P value = 0.32, 0.004, 0.011, 0.21 respectively), and statistically insignificant difference in background blood in the sample (P value = 0.8).Regarding sample convenience, FNNAC was found to be more convenient for both the patient (syringe is not seen by the patient reducing discomfort) and for the operator (better handling of the needle and fewer maneuvres).ConclusionsFNC is an approved sensitive and cost-effective method to evaluate thyroid nodules, FNNAC technique was found to be more convenient for both the patient and the operator with statistically significant improvement in total sample quality compared to FNAC.

Evaluation of the contribution of fine-needle non-aspiration cytology to diagnosis in cases with pulmonary malignant lesions.

Fine-needle non-aspiration cytology (FNNAC) is an easy-to-apply, minimally invasive diagnostic method that contributes to the diagnosis and staging of lung cancer. FNNAC can be performed from peripheral lymph nodes as well as in peripheral lung lesions. This study aimed to evaluate the contribution of FNNAC performed from peripheral lesions or lymph nodes to diagnosis in patients with pulmonary malignant lesions. FNNAC was applied from a peripherally located mass in the lung, chest wall lesion, or peripheral lymph node using a needle without an injector or active suction. The collected material was evaluated using the cytoblock method. The FNNAC accuracy was obtained by dividing the true positivity value by a number of needle biopsies performed. The 95% confidence interval of the obtained rate was also calculated. The mean age of 56 patients, two female (3.6%) and 54 male (96.4%), was 63.9 ± 9.1 (38-80) years. FNNAC was performed from the peripheral lymph node in 48 patients, the peripheral pulmonary lesion in four, and the accompanying chest wall lesion in four. While true positivity was present in 42 patients, two patients had true negativity, and 12 had false negativity. In five of the 12 cases reported as false negative, the collected material was evaluated as insufficient, while the malignant diagnoses of the remaining seven cases were confirmed by other diagnostic methods. The diagnostic success of FNNAC was determined as 78.57% (95% CI: 65.56-88.41). FNNAC was more successful in diagnosis when performed from the peripheral lymph node compared to the peripheral pulmonary lesion (p=0.033).

A Comparative Study of Fine-Needle Aspiration and Nonaspiration Cytology Diagnosis in Thyroid Lesions.

Background:Aspiration cytology is one of the first-line diagnostic tests in thyroid malignancies. Fine-needle aspiration cytology (FNAC) in thyroid lesions causes hemorrhagic smear and cell trauma, often leading to the repetition of smear and delay in diagnosis. This study was conducted to identify the diagnostically superior technique with regard to thyroid swelling and to assess the quality of smears obtained from FNAC and fine-needle nonaspiration cytology (FNNAC).Methodology:This was a prospective diagnostic study carried out for 2 years in a tertiary care center from South India. All patients with complaints of thyroid swellings, after examination, underwent FNNAC, followed by FNAC of the lesion. They underwent thyroidectomy when indicated. The final postoperative biopsy reports were compared with the preoperative reports of these two techniques (FNNAC and FNAC). The quality of smears was compared using Mair's score.Results:The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in diagnosing malignancy were 93.4%, 100%, 100%, 98.78%, and 98.96% for FNNAC and 94.12%, 100%, 100%, 98.82%, and 99% for FNAC, respectively, which were comparable. Regarding the quality of smears, FNNAC had more smears with less blood in the background. FNAC had more smears with adequate cellularity. The difference in overall Mair's score between the two techniques was not significant (P = 0.28).Conclusion:No difference was found in the accuracy of FNAC and FNNAC in diagnosing thyroid lesions. Furthermore, the smear quality of both techniques was comparable. Hence, either can be used based on the operator's preference and experience.

Cytomorphological characterization of lymphadenopathies in guinea pigs: study of 31 clinical cases

ABSTRACT Lymphadenopathy is a commonly found condition in guinea pigs that suffer diseases caused by bacterial organisms as Streptococcus zooepidemicus, Yersinia pseudotuberculosis, Bordetella, and Salmonellae (S. linate) which access cervical lymph nodes via an abraded oral mucosa. In this study, we investigate all possible alterations present in cytological smears obtained from cervical lymph nodes of guinea pigs with lymphadenopathy. Thirty-one clinical cases of guinea pigs with different grades of lymphadenomegaly and 10 clinically healthy guinea pigs were considered. The fine-needle nonaspiration cytology (FNNAC) provided an adequate quantity and quality of samples for cytological analysis. Air-dried FNNAC smears yielded excellent results with Wright stain. From 31 evaluated clinical cases, 64.5% were compatible with pseudoeosinophilic lymphadenitis, 22.6% compatible with reactive lymphatic node, 6.45% compatible with lymphoma, and 6.45% with Hodgkin's-like lymphoma. The findings revealed the usefulness of the FNNAC technique and Romanowsky stains as fast and easy methods for lymph node sampling and analysis, and also, the importance of recognizing various causes of lymphadenopathies associated with morbidity and mortality in guinea pigs which would influence treatment protocols and prognosis for patients.

Comparative study of USG guided aspiration and non-aspiration cytology for evaluation of specimen quality and diagnostic accuracy in abdominal and pelvic lumps

Introduction: The aim of this study was to compare the efficacy of USG guided fine needle aspiration cytology (FNAC) with that of fine needle non aspiration cytology (FNNAC) in abdominal, pelvic masses. Objectives: Although a large volume of data is available to compare FNAC and FNNAC sampling in superficial lesions, very less literature is available regarding FNNAC for abdominal and pelvic masses. Therefore we have directly compared the diagnostic accuracy and specimen quality of both techniques FNAC and FNNAC under guidance of ultrasound in intra abdominal and pelvic mass lesions. Method: Samples were obtained by applying both FNAC and FNNAC techniques for abdominal, pelvic lumps of 71 patients who attended the pathology department of BRD Medical College Gorakhpur, Uttar Pradesh. The sampling procedure were done by single operator, smears made from FNAC and FNNAC techniques were studied using a objective scoring system based on the background blood or clot, amount of cellular material, degree of cellular degeneration, degree of cellular trauma and retention of appropriate architecture and then comparison of diagnosed case was done with histopathology. Results: The overall diagnostic accuracy was 85.9% in FNAC and 83.0% in FNNAC(p=0.80).Diagnostic accuracy by FNAC are 83.3%,92.8%,91.6% in cases of liver,gallbladder and ovary respectively. In cases of G.I.T masses it is 81.9% by FNAC.Diagnostic accuracy by FNNAC it is maximum 93.4% in cases of liver masses and lower in ovarian masses (66.6%) when compared with the histopathology. A statistically insignificant difference was recorded in sampling technique score for quality of smears in all cases except in the liver where the FNNAC score was statistically significant. Conclusion: Although both techniques have their own advantages and disadvantages but diagnostic accuracy was much better by FNAC than FNNAC but quality of smears for cytodiagnosis was superior by FNNAC technique than FNAC in all abdominal, pelvic masses.

Fine needle non-aspiration cytology for the diagnosis of cervical lymph node tuberculosis: a single center experience

IntroductionThe fine-needle cytology is being used as a first line of investigation in the diagnosis of head and neck swellings, as it is simple, cost effective and less invasive as compared to biopsy. ObjectiveThe aims of this study were to evaluate the results of the fine-needle non-aspiration cytology of cervical lymphadenopathy and to study the factors influencing the rate of non-diagnosis results. MethodsThis retrospective study was conducted on selected patients with cervical lymphadenopathy that had undergone a fine-needle non-aspiration cytology followed by a histological biopsy. The sensitivity, specificity, positive predictive value and negative predictive value of fine-needle non-aspiration cytology for diagnosing tuberculosis were estimated. The risk factors of non-diagnosis results were evaluated. ResultsThe sensitivity, specificity, positive predictive value rates of fine-needle non-aspiration cytology for tuberculosis were 83.3%, 83.3%, 78.9% and 86.9% respectively. In total, 47 out of the 131 samples (35.8%) were considered non-diagnosis. Of the non-diagnosis samples, 84.2% (38 out of 47) were benign mostly due to tuberculosis (30 cases). Among the studied factors, only tuberculosis (confirmed by histopathological examination) was significantly associated with non-diagnosis cytology (p=0.02, Odds-Ratio=2.35). ConclusionTuberculosis is currently the commonest cause of cervical lymphadenopathy in North Africa. Fine-needle non-aspiration cytology is safe and accurate in the diagnosis of cervical tuberculous lymph node that is associated with the risk of non-diagnosis cytology.

A comparison of fine needle nonaspiration cytology versus fine needle aspiration for thyroid nodules: a Meta-analysis

Objective:To evaluate the differences of smear quality and diagnostic accuracy between thyroid nodules and fine needle nonaspiration cytology (FNNAC) and fine needle aspiration cytology (FNAC).Method:Databases were used to search the literature on FNNAC and FNAC. All statistical analyses were performed using Review Manager 5.3 Software.Result:A total of 10 studies were included in the study. Meta-analysis showed no significant difference in FNNAC and FNAC between low, middle and high quality smears. There was no significant difference in diagnostic accuracy.Conclusion:There were no difference in obtaining the smear quality and diagnostic accuracy, the person doing the piercing can freely choose which way according to the habit.

Comparative study of aspiration versus non-aspiration fine needle technique in thyroid nodule and its correlation with post-operative histopathological examination

Background: Thyroid gland is unique of all endocrine glands because it is the largest, superficial and the only one amendable to direct physical examination. A discrete swelling in one lobe and with no palpable abnormality elsewhere is termed as solitary swelling. Fine needle aspiration cytology (FNAC) is the investigation of choice in solitary thyroid swellings. There is another technique fine needle non aspiration cytology (FNNAC) which avoids aspiration but still permits cytologic review of the swellings which can also be done in thyroid swellings. The objective of the study was to compare and analyze the preoperative efficiency of FNAC vs FNNAC in solitary thyroid nodules and its correlation with post-operative histopathological examination findings.Methods: A total of 72 patients presenting with thyroid nodule in this hospital in BMCRI, Bengaluru during period of January2017 to December2017 underwent both FNAC and techniques. 23 G needles was used for both FNAC and FNNAC. FNAC was performed using needle and a syringe using aspiration. In FNNAC technique the needle held between thumb and fore finger of one hand was gently inserted into the nodule and was moved in different directions. Material entering the needle hub by capillary action was then expressed onto clean glass slides after attaching syringe filled with air to it and smears were prepared. Cases which underwent total/hemi thyroidectomy, the specimen was sent to pathology department in 10% formalin solution.Results: FNNAC produced diagnostically superior samples and less diagnostically inadequate samples than FNAC.Conclusions: As thyroid is a vascular and a colloid organ, in FNAC aspiration gives blood/colloid with less cellular architecture in most of the cases. In FNNAC cellular architecture was preserved with less blood/colloid background which aids in easier cytological diagnosis. Hence FNNAC is a better technique than FNAC in cytological diagnosis of solitary thyroid nodule.

A comparative study of fine needle aspiration cytology versus non aspiration technique in thyroid lesions

Background: Fine needle aspiration cytology (FNAC) is regarded as the gold standard investigation in the diagnosis of thyroid swellings. But often unsatisfactory specimen, especially mixed with blood, poses an obstacle in proper cytological interpretation. To overcome this problem, an alternative method of fine needle non aspiration cytology (FNNAC) technique was developed which, relies on the capillary pressure only to suck the cells inside the needle bore.Methods: Patients presenting with thyroid swellings from July 2008 to January 2009 were included in the study. 91 patients treated for thyroid lesions entered a prospective comparative evaluation of fine needle cytology with aspiration and non-aspiration techniques in thyroid. The thyroid swelling in every patient was sampled by both the aspiration as well as the non-aspiration technique by a single operator. Both procedures were done using 23G needles. Aspiration was done using a 10ml syringe. Both dry and wet smears were made and stained. All smears were interpreted by a cytologist without knowledge of the technique employed. Apart from the diagnosis, comments were made on the quality of the slides and three qualitative categories are created as unsuitable specimens, diagnostically adequate and diagnostically superior.Results: Non-neoplastic lesions accounted for 92.3%. They comprised mainly of nodular colloid goiter 53.84%, colloid nodules 29.6%, thyroiditis 8.79%, and one case of suppurative lesion. Out of the 7 neoplasms, 2 were follicular neoplasms, 1 was papillary carcinoma, 2 cases of Hurthle cell neoplasm and 1 cellular nodule in an MNG. Diagnostically superior material was obtained in 42 cases (46.15%) of the non-aspiration samples, as compared with 18 cases (19.78%) of aspiration samples which was statistically significant.Conclusions: The FNNAC produces better results in the form of a better quality of the cellularity and less field obscurity by blood. This technique should be used alone or in tandem with FNAC for better diagnostic yield.

Accuracy of diagnosis by Fine Needle Non Aspiration Cytology technique in head and neck swellings.Its advantages and disadvantages in comparison with Fine Needle Aspiration Cytology.

Background & Objectives: Fine needle aspiration cytology (FNAC) is a first line investigation in the diagnosis of head and neck swellings. The negative pressure applied during aspiration leads to bloody smears, especially in vascular organs like thyroid. In 1981 fine needle non-aspiration cytology (FNNAC) was introduced. The present study was undertaken to compare FNAC and FNNAC techniques in head and neck swellings. Methods: One hundred and ninety seven head and neck swellings were sampled using both FNAC and FNNAC techniques. They were compared for the five objective parameters, amount of background blood or clots, amount of cellular material present, retention of appropriate architecture, degree of cellular degeneration and degree of cellular trauma, using Mairs point scoring system. Statistical analysis was done using Mann Whitneys test. The differences were considered significant at P0.05. Results: Blood contamination was less in FNNAC as compared to FNAC in all the cases. The difference was statistically significant in thyroid, lymphnode and salivary gland lesions. Cellular yield was more in FNNAC in thyroid and lymphnode lesions, with a significant difference being noted only in lymphnode lesions. Better retention of architecture with a statistically significant difference was seen in FNNAC smears from lymphnode and thyroid lesions. There was no significant difference between the two techniques in degree of cellular degeneration and cellular trauma. More number of FNNAC smears were diagnostically superior. The diagnostic yield in FNAC was 93.43% and in FNNAC 94.28%. Conclusion: The FNNAC technique provides adequate cellular yield in all head and neck swellings, except in cystic and fibrotic swellings where FNAC is a better technique.

Comparison of fine needle aspiration and non-aspiration cytology for diagnosis of thyroid nodules: A prospective, randomized, and controlled trial.

To compare the sampling efficiency and diagnostic performance of ultrasound (US)-guided fine-needle aspiration cytology (FNAC) and fine-needle non-aspiration cytology (FNNAC) for thyroid nodules. 629 thyroid nodules in 629 cases (477 females, 152 males) were randomly subjected to FNAC or FNNAC from Jun 2014 to Feb 2015. Diagnostic performance was calculated in reference to the histological findings or follow-up results. 629 patients (152 men, 477 women) with 629 thyroid nodules were enrolled in the study. Pathological results were obtained in 173 nodules and benign nodules at FNA with more than six months' follow-up were found in 65 nodules. Tumor size for FNAC ranges from 3.0 to 51.0 mm (mean±SD; 10.2±6.9 mm); whereas FNNAC (2.0-43.0 mm; 11.9±7.7 mm). Non-diagnostic results were found in 7.59% (24/316) of FNNAC procedures and 7.59% (25/313) of FNAC (P > 0.05). Determinate and indeterminate results were found in 50.63% (160/316) and 41.77% (132/316) of FNNAC procedures, whereas 58.15% (182/313) and 33.87% (106/313) of FNAC (P < 0.05). In order to obtain determinate cytological results, FNAC might be more suitable than FNNAC for diagnosis of nodules with hypovascularity (51.38% vs. 41.78%, P < 0.05) and macrocalcifications (9.72% vs. 6.50%, P < 0.05). No US and Color-Doppler US characteristics, such as the presence of hypervascularity (P > 0.05), microcalcifications (P > 0.05), internal component (P > 0.05), or size(P > 0.05), were significantly different to obtain determinate cytological results between the FNAC and FNNAC groups. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy of FNAC and FNNAC were as follows: 96.67% vs. 100%, 89.74% vs. 96.5%, 87.88% vs. 96.97%, 97.22% vs. 100%, 92.75% vs.98.36%, respectively (all P > 0.05). Both FNAC and FNNAC are effective for diagnosis of thyroid nodules. However, FNAC is more effective than FNNAC to acquire determinate cytological results for nodules which US present hypovascularity and macrocalcifications.

Examination of Selective Low-pressure Fine Needle Aspiration Cytology Under Ultrasound Guidance

Cytology by fine-needle cytology is indispensable for diagnosing head and neck tumor, especially for thyroid nodule. There are two methods of fine needle cytology; one of fine-needle aspiration cytology (FNAC and another of fine-needle non-aspiration cytology (FNNAC). These previous procedures has each disadvantage such as the mixing of blood or low yield of cells. We proposed a new technique: selective low-pressure fine needle aspiration cytology (SLOP-FNAC) to overcome the backwards of previous procedures. We used the scoring system by Mair et al.to evaluate smear quality of specimens obtained with FNNAC and SLOP-FNAC. SLOP-FNAC smears exhibited higher scores in amount of cellular material, degree of cellular degeneration and cell yield, and retention of appropriate architecture compared to FNNAC smears. The SLOP-FNAC smears scored significantly higher for amount of cellular material and retention of appropriate architecture evaluated (P = 0.0261 and P = 0.0024, Student's t-test). SLOP-FNAC may be a useful cell sampling technique that reduces blood contamination while securing a high cell yield with maintaining tissue structure.

Comparison of aspiration VS non- aspiration techniques in fineneedle cytology of thyroid lesions

AIM: To compare the efficacy of fine – needle non – aspiration cytology (FNNAC) with that of fine – needle aspiration cytology (FNAC) of thyroid lesions. Materials and Methods: FNAC and FNNAC techniques were studied in 88 cases of thyroid lesions. All the needle – sampling procedures were done by a single operator. The samples were assessed cytologically and evaluated using five parameters, that is, background blood or clot, amount of cellular material, degree of cellular degeneration, and degree of cellular trauma and retention of appropriate architecture. Statistical Analysis: Wilcoxon signed rank test was performed using SPSS 14 software. Differences between all the individual parameters as observed in FNAC and FNNAC smears were insignificant. Results and Conclusion: After evaluation of FNAC and FNNAC on the basis of these scores, greater numbers of diagnostically superior samples were obtained by FNNAC; however, by FNAC more number of diagnostically adequate smears were observed. The numbers of unsuitable smears were also more by FNNAC technique.

A Comparative Study of Fine Needle Aspiration Cytology (FNAC) and Fine Needle Non-aspiration Cytology (FNNAC) Technique in Lesions of Thyroid Gland.

The present study was done to compare diagnostic yield by fine needle non aspiration technique (FNNAC) with Fine Needle Aspiration cytology (FNAC) of lesions in thyroid gland. FNNAC and FNAC both were performed on 69 patients presenting with thyroid lesions, except those suffering from thyrotoxicosis. Smears were then cytologically interpreted by a single pathologist as unsuitable, diagnostically adequate or diagnostically superior for opinion, without the knowledge of sampling method employed. Slides were evaluated for following aspects namely cellularity, presence of colloid, inflammatory cell, hemosiderin laden macrophages, papillary clusters nuclear overlapping, nuclear grooving, hurthle cells. FNNAC gave better results in form of better quality of cellularity and less field obscurity by blood in lesions of thyroid. Diagnostically superior specimens were obtained more frequently by FNNAC, so this technique should be used alone or in tandem with FNAC for better diagnostic yield.

Comparison of aspiration vs non-aspiration techniques in fine-needle cytology of thyroid lesions

Aim:To compare the efficacy of fine-needle non-aspiration cytology (FNNAC) with that of fine-needle aspiration cytology (FNAC) of thyroid lesions.Materials and Methods:FNAC and FNNAC techniques were studied in 50 cases of thyroid lesions. All the needle-sampling procedures were done by a single operator. The samples were assessed cytologically and evaluated using five parameters, that is, background blood or clot, amount of cellular material, degree of cellular degeneration, and degree of cellular trauma and retention of appropriate architecture.Statistical Analysis:Wilcoxon signed rank test was performed using SPSS14 software. Differences between all the individual parameters as observed in FNAC and FNNAC smears were insignificant.Results and Conclusion:After evaluation of FNAC and FNNAC on the basis of these scores, greater numbers of diagnostically superior samples were obtained by FNNAC; however, by FNAC more number of diagnostically adequate smears were observed. The numbers of unsuitable smears were also more by FNNAC technique.

A Comparative Study of Fine Needle Aspiration and Fine Needle Non-Aspiration Biopsy on Suspected Thyroid Nodules

Ultrasonography-guided fine needle aspiration (FNA) and fine needle non-aspiration (FNNA) biopsy were performed consecutively on 104 patients (mean age 50 +/- 15 years) affected by multinodular and uninodular goiter. Both techniques were executed on the same patients in the same clinical session beginning with the first (FNA) on half of the patients (randomly selected) and vice versa. The cytological findings on cell samples were divided into four groups: colloidal (benign), follicular (suspicious), malignant, and inadequate. The overall cytologic findings obtained with the two techniques were as follows (FNA % vs FNNA %): inadequate, 16.3% vs 5.8%; colloidal, 69.2% vs 76.9%; follicular, 9.6% vs 10.5%; and malignant, 4.8% vs 6.7%. A statistically significant difference between FNA and FNNA cytology was found only on the number of inadequate results (p = 0.015). Interestingly, the frequency of inadequate specimens for FNNA showed a significantly different distribution depending on the sequence (first or second) in which the technique was executed. In conclusion, FNA and FNNA are useful and cost-effective techniques for the pre-operative assessment of patients with thyroid nodules. However, due probably to its minimally invasive procedure, FNNA produces specimens of better quality and reduces inadequate results. For these reasons FNNA should be preferable to FNA for the cytological evaluation of thyroid nodules.