Thyroid Cytology Research Articles

Cytological accuracy and radiological staging in patients with thyroid cancer in Glasgow

To assess the accuracy of initial combined cytological accuracy and radiological staging of patients suspected of having thyroid malignancy with their final histopathology. Retrospective case series in a tertiary referral centre for head and neck malignancy. All patients with malignant thyroid cytology and cytology suspicious for malignancy, between the dates of June 2010 and July 2014, were included. The pre-operative staging was compared against the final histological staging. Demographics and outcomes for each patient were recorded. Sixty-five patients were recorded in this group. 20 (30.7%) were male. The mean age at presentation was 51years (SD 16.8years). 39 (60%) patients were aged over 45years. Fine needle aspiration cytology (FNAC) was performed in all patients and was Thy 4 in 40 (62%) and Thy 5 in 25 (38%). Following surgery or subsequent biopsy, FNAC was found to be accurate in 38/40 (Thy 4) and 25/25 (Thy 5) cases in diagnosing malignancy, with Thy 4 yielding 95% malignancy and Thy 5% 100%. Fifty-eight patients underwent a surgical procedure for thyroid cancer. Two further patients had a diagnostic hemi-thyroidectomy for later proven benign disease. Five patients due to medical co morbidities, inoperable disease or refusal of surgery were managed non-surgically. In the surgical group 16 patients underwent a diagnostic hemi-thyroidectomy and 11 of these required a completion thyroidectomy. Forty-six patients underwent total thyroidectomy. Forty-six patients underwent a neck dissection: 27 prophylactic central compartment neck dissections and 19 planned therapeutic neck dissections were performed. Radiological staging correctly predicted final pathological TNM staging in 25 (43%) patients. 27 (47%) patients had radiological staging which under staged their final histological staging and 6 (10%) patients had scans that over staged their cancer. Of those that were under staged, 15 (56%) had their nodal disease under staged (following prophylactic central neck dissection). Radiological staging comprised ultrasound (n=58) and CT scanning (n=45/58 pre-operatively). Pre-operative staging in thyroid cancer should include cytology, ultrasound and CT scanning. Unless low-risk papillary thyroid cancer is suspected pre-operatively, patients with Thy 4 cytology can be given the offer of a total thyroidectomy as surgical management.

Riesgo de malignidad de los nódulos tiroideos con atipia de significado incierto

IntroductionPrevalence of malignancy among cytologies with atypia of undetermined significance (Bethesda category iii) is variable, ranging from 5%-37% in the different studies. There is thus no agreement on whether FNA should be repeated or surgery should be performed in these cases. The aim of this paper was to analyze the risk of malignancy in order to establish the most adequate clinical approach. Material and methodsWe analyzed 431 thyroid cytologies performed at our hospital since the introduction of Bethesda System (from January 2011 to September 2014), of which 32 (7.1%) were labeled as categoryiii. The second FNA, when performed, and the histological results after surgery were reviewed. ResultsTwenty-three patients (82.1%) underwent thyroidectomy, while repeat FNA was performed in the remaining 5 patients (17.9%). Cytology was reported as benign (categoryii) in 3 (60%) and as unsatisfactory (categoryi) in 2 (40%), who underwent thyroidectomy. Thirteen of the 25 (52%) surgical thyroid specimens showed no malignancy, while differentiated thyroid carcinomas were found in 12 (48%): papillary cancer in 10 (83.3%), follicular cancer in 1 (8.3%), and papillary cancer with follicular areas in 1 (8.3%). The risk of malignancy of Bethesda categoryiii in our patients was 42.9%-48.0%. ConclusionWe recommend thyroidectomy for all patients with of cytological Bethesda categoryiii.

Outcome of Subclassification of Indeterminate (Thy-3) Thyroid Cytology into Thy-3a and Thy-3f

Objectives: The British Thy system is a widely used classification system for reporting thyroid fine-needle aspiration (FNA) cytology. The Royal College of Pathologists in 2009 recommended the subdivision of the Thy-3 (indeterminate) category into Thy-3a (atypia) and Thy-3f (follicular neoplasm). Our objective was to examine the malignancy rates of Thy-3a and Thy-3f cases at our institution and to investigate whether the risk of malignancy in Thy-3a cases is reduced by FNA on a different occasion showing benign cytology. Methods: This is a retrospective study of 748 thyroid nodules undergoing 1,032 FNAs, with indeterminate (Thy-3) cytology subdivided into Thy-3a and Thy-3f. Cases were correlated with final histology in surgical cases. Incidental carcinomas occurring outside the biopsied nodule were discounted. Results: A total of 109 nodules had a final cytological diagnosis of Thy-3a, of which 67 underwent surgery, with an incidence of malignancy of 13.4% (9/67); 90 nodules had a final cytological diagnosis of Thy-3f, of which 84 underwent surgery, with an incidence of malignancy of 17.9% (15/84). The difference in malignancy rates was not significant (p = 0.51). The incidence of malignancy in nodules with benign and Thy-3a cytology on separate occasions was not significantly different from cases with a single Thy-3a cytology. Conclusions: Thyroid nodules with Thy-3a cytology have a slightly lower risk of malignancy than Thy-3f cases. However, the difference is not significant and does not appear to be reduced by FNA on a separate occasion showing benign cytology. Management decisions for patients with Thy-3a cytology should be taken carefully to avoid missing cancers.

Diagnostic accuracy of circulating thyrotropin receptor messenger RNA combined with neck ultrasonography in patients with Bethesda III–V thyroid cytology

The aim of this study was to analyze the usefulness of thyrotropin receptor messenger RNA (TSHR-mRNA) combined with neck ultrasonography (US) in the management of thyroid nodules with Bethesda III-V cytology. Cytology slides of patients with a preoperative fine needle aspiration (FNA) and TSHR-mRNA who underwent thyroidectomy between 2002 and 2011 were recategorized based on the Bethesda classification. Results of thyroid FNA, TSHR-mRNA, and US were compared with the final pathology. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. There were 12 patients with Bethesda III, 112 with Bethesda IV, and 58 with Bethesda V cytology. The sensitivity of TSHR-mRNA in predicting cancer was 33%, 65%, and 79 %, and specificity was 67%, 66%, and 71%, for Bethesda III, IV, and V categories, respectively. For the same categories, the PPV of TSHR-mRNA was 25%, 33%, and 79%, respectively; whereas the NPV was 75%, 88%, and 71%, respectively. The addition of neck US to TSHR-mRNA increased the NPV to 100% for Bethesda III, and 86%, for Bethesda IV, and 82% for Bethesda V disease. This study documents the potential usefulness of TSHR-mRNA for thyroid nodules with Bethesda III-V FNA categories. TSHR-mRNA may be used to exclude Bethesda IV disease. A large sample analysis is needed to determine its accuracy for Bethesda category III nodules.

13. Neck hematoma after thyroidectomy. Do antiplatelet/anticoagulant drugs use or coagulopathies affect it? A case control study from a single center on 3150 patients

13. Neck hematoma after thyroidectomy. Do antiplatelet/anticoagulant drugs use or coagulopathies affect it? A case control study from a single center on 3150 patients

12. Forgotten goiter (FG). Lession learned from a multicentric experience

12. Forgotten goiter (FG). Lession learned from a multicentric experience

24. Central review of thyroid cytology for the MDTM – Does it improve accuracy?

24. Central review of thyroid cytology for the MDTM – Does it improve accuracy?

A Thyroid Cytology Experience: The Comparision of Cytological and Histopathological Findings

Aim: Thyroid fine needle aspiration cytology (FNAC) is a common technique used for the follow-up and diagnosis of nodules. FNAC is used for differentiating between benign and malignant lesions preoperatively, and therefore, is helpful to determine the type of surgery. The aim of this study is to screen cases that have been evaluated for thyroid cytology and thyroid surgery specimens in our department, and to investigate the experience of the diagnosis using thyroid fine needle aspiration cytology. Materials and Methods: In the present study, thyroid fine needle aspiration cytology and surgery specimens obtained from 213 cases that were diagnosed in our pathology department in 2012 were screened retrospectively. Results: One hundred seventy-seven patients out of 213 were female. Seventy-seven cases were diagnosed with benign cytology on fine needle aspiration cytology. In the histopathological examination of surgical specimens, benign lesions were identified in 63 cases and malignant lesions were identified in 8 cases. According to the histopathological examination of 42 cases that had malignant cytology, 22 cases were diagnosed with papillary carcinoma, and 6 cases were diagnosed with well-differentiated tumor of uncertain malignant potential. When the findings of FNAC and histopathology were compared, the specificity was 75.9%, sensitivity was 73.3%, and the test validity was 75.2%. Conclusions: The present study supports the notion that fine needle aspiration cytology is a reliable tool for the evaluation of thyroid lesions and the management of patients who are considered for surgery due to complaints of mass lesions. Key Words: Fine Needle Aspiration Cytology; Histopathology; Thyroid.

Institution-specific risk of papillary thyroid carcinoma in atypia/follicular lesion of undetermined significance.

The Bethesda System for Reporting Thyroid Cytopathology (BSRTC) is used in surgical decision-making according to malignancy risk in each category. Malignancy risk in atypia/follicular lesion of undetermined significance (AUS/FLUS) is estimated in BSRTC to be 5% to 15%, but institutional data have varied widely. We conducted a post-BSRTC 4-year retrospective analysis of index thyroid nodule cytology and histopathology in an academic head and neck endocrine surgery setting. Of 2939 thyroid cytology reports from 1944 patients, the most advanced BSRTC category was AUS/FLUS in 233 patients (12.0%) of which 187 went to thyroidectomy. In AUS/FLUS, the upper and lower boundary estimates of the malignancy rate were 46% and 37%, accordingly. The malignancy rate did not vary significantly by cytopathologist or cytopathologic features. Malignancy rates in AUS/FLUS vary by institution from 6% to 46%. Given the subjective nature of thyroid cytopathology and interpretation of the BSRTC categories, guidelines should encourage the use of institution-specific data on malignancy risk in treatment decisions. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1210-E1215, 2016.

A Pilot Study of Galectin-3, HBME-1, and p27 Triple Immunostaining Pattern for Diagnosis of Indeterminate Thyroid Nodules in Cytology With Correlation to Histology.

Indeterminate thyroid nodules form a heterogenous group of lesions that constitute 5% to 30% of thyroid cytology diagnoses. We introduce a triple immunostaining protocol for subtyping. Galectin-3, HBME-1, and p27 triple immunostaining, performed on destained cytology slides and formalin-fixed paraffin-embedded tissue, was developed and applied to 51 patients retrospectively with preoperative cytologic diagnoses of follicular lesion of undetermined significance (n=40), atypia of undetermined significance (n=6), and suspicious for follicular neoplasm (n=5). The malignant rate in this series was 43.1% (22/51). A hierarchal evaluation algorithm was generated based on digital image quantitation of triple-stained histologic sections, and applied to both cytology and histology specimens. Fifty of 51 cytology cases have triple staining validated by internal controls. In cytology specimens, the individual sensitivities and specificities of p27, Galectin3, and HBME1 for cancer with 95% confidence interval are: 86.2% (0.674, 0.955)/66.7% (0.431, 0.845); 77.3% (0.542, 0.913)/72.4% (0.525, 0.866); and 72.7% (0.496, 0.884)/93.1% (0.758, 0.988), respectively. Sensitivity is increased to 95.5% (0.751, 0.998), but specificity is decreased to 69.0% (0.490, 0.840), if Galectin3 and HBME1 are both used in combination as markers for malignancy. However, the level of specificity is increased to 86.2% (0.674, 0.955) and sensitivity remains high 100% (0.808, 1) if in addition, using the Galectin3/HBME1:p27 ratio (ratio ≥2 indicating malignancy) for 2 or 3 markers positive cases. Thus, the triple staining method on cytology slides and histology sections shows a similar sensitivity/specificity/positive predictive value/negative predictive value of 100.0%/86.2%/84.0%/100.0% and 95.5%/86.2%/84.0%/96.2%, respectively (P=0.92). Overall, p27 is the most frequent single positive marker (19/50, 38% in cytology), consistent with benign nature of most indeterminate thyroid nodules. Galectin-3 and HBME-1 colocalization (positive in the same cell) was demonstrated in thyroid cancer in 45.5% (10/22) of histology sections, but in none of the normal thyroid tissues and benign thyroid lesions. This supports the notion that synchronous activation of Galectin-3 and HBME-1 occurs in thyroid malignancy and is highly specific for malignancy. We have demonstrated the performance and pattern of triple immunostaining for subtyping indeterminate thyroid nodules. Further studies and validation in different larger populations are warranted.

Application of the Bethesda System for Reporting Thyroid Cytopathology in the Eastern Province of Saudi Arabia: A Follow-Up Study

This is a follow-up study to our previous analysis of thyroid aspirates utilizing the Bethesda System for Reporting Thyroid Cytology (BSRTC). The same study design was utilized for 2 years comparing 2 periods. A total of 251 thyroid aspirates from 218 patients were reviewed and deemed comparable to the previous cohort. The variance and consequently the number of interpretations dropped from 26 to 11 with a statistically significant 58% reduction and more consistency. Our unsatisfactory rate dropped from 22 to 10% (reduction of 55%). The risk of malignancy in this follow-up study showed a similar trend: an increase in risk with each step up in the BSRTC categories starting from the ‘nondiagnostic' and up to ‘malignant'. Few of our benign cases ended up with resection. We noticed sensitivity to the word ‘follicular' in this benign category; therefore we propose a modification of the current BSRTC system by omitting the word ‘follicular' from the benign category. We strongly believe that this modification harbors no serious damage to the intentions of BSRTC. This follow-up study has shown that the previous awareness campaign about the implementation has worked and can be considered a valid performance improvement program.

Sensitivity and specificity of thyroid cytology in the diagnosis of malignancy: results of a series of 1567 thyroidectomies

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Variations in single/two stage thyroidectomies for cancer may be due to differences in thyroid fine needle cytology provision

Background & aimsRecommended treatment for thyroid cancers >10 mm is single stage total thyroidectomy (SST). Cancers diagnosed by diagnostic lobectomy may need completion surgery resulting in two stage thyroidectomies (TST). We noticed significant variation in numbers of SST and TST between hospitals within our cancer network and explored reasons for this using a prospective database containing all cases from 2004 to 2011 (n = 1030). We therefore conducted a survey of thyroid cytology provision across the network during 2010–2011. MethodsA central university hospital with the largest caseload (21.5% of total) was chosen as “benchmark”. Of 14 remaining hospitals 3 were excluded from analysis due to low thyroid operation numbers and the remaining compared with benchmark. We used individual chi-squared tests with Bonferroni correction to explore variation in expected and observed numbers of SST/TST. Analysis of variance (ANOVA) was used to examine reasons for observed differences. ResultsSignificant variance in SST/TST was seen between hospitals (p < 0.00001). Three hospitals had frequencies of SST statistically similar to reference hospital; each reported 201–300 thyroid cytology cases during the survey period. The remaining 8 had lower rates of SST, the 2 lowest performing hospitals having SST rates of 11% (p = 0.0004) and 9% (p < 0.0001). These eight hospitals reported fewer than 200 cytology cases each, shared amongst 4–7 pathologists per site. Differences were unrelated to patient age, gender, tumour histology or stage (ANOVA). Only the reference hospital had specialist cytopathologists. ConclusionVariation in thyroid cytology provision may increase TST rates. Thyroid cytology should be concentrated in high volume centres with specialist thyroid cytopathologists.

Thyroid cytopathology reporting by the bethesda system: a two-year prospective study in an academic institution.

Background. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has attempted to standardize reporting and cytological criteria in aspiration smears. Aims. The objective of this study was to analyze the thyroid cytology smears by TBSRTC, to determine the distribution of diagnostic categories and subcategories, to analyze cytological features, and to correlate the cytopathology with histopathology, wherever surgery was done. Materials and Methods. This was a prospective study of 225 fine needle aspirations (FNA) of thyroid nodules. All fine needle aspiration cytology (FNAC) diagnoses were classified according to the features given in the monograph of TBSRTC into nondiagnostic/unsatisfactory (ND/UNS), benign, atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), follicular neoplasm/suspicious of a follicular neoplasm (FN/SFN), suspicious for malignancy (SFM), and malignant. Cytohistological correlation was done, when surgical material was available. Results. The distribution of various categories from 225 evaluated thyroid nodules was as follows: 7.2% ND/UNS, 80.0% benign, 4.9% AUS/FLUS, 2.2% FN, 3.5% SFM, and 2.2% malignant. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated. Conclusions. TBSRTC is an excellent reporting system for thyroid FNA. It also provides clear management guidelines to clinicians to go for follow-up FNA or surgery and also the extent of surgery.

Utilization of Molecular Testing in Thyroid Cytology

Thyroid nodules are a common finding in the general population. The differential diagnoses of these lesions encompass numerous entities, both nonneoplastic and neoplastic. Fine-needle aspiration cytology is the most important diagnostic tool for evaluating thyroid lesions. It has found worldwide application because of its simplicity, safety, and cost-effectiveness, and its essential role is mainly focused on the discrimination between benign and malignant neoplasms. Increasing knowledge of molecular mechanisms of thyroid cancer, combined with an inability to definitively characterize a proportion of cases cytologically, has encouraged research into and clinical utilization of molecular techniques on fine-needle aspiration cytology samples. In particular, BRAF, RET/PTC, or RAS alterations are found in more than 70% of papillary thyroid carcinomas, and some of them are associated with more aggressive tumor behavior. Furthermore, there is evidence of correlation of BRAF mutations with extrathyroidal extension, advanced tumor stage, and nodal or, less frequently, distant metastases. We believe that molecular testing can contribute to patient management, as an ancillary tool, in selected thyroid cases. However, molecular studies should not be ordered indiscriminately as a reflex test, and their results must not replace cytologic interpretation and clinical judgment.

Pattern and frequency of thyroid pathologies among thyroid cytology specimen in rural part of central India: A retrospective secondary data analysis

Background: Thyroid nodules are very frequent, with an annual incidence rate of 4-8%. Thyroid fine needle aspiration cytology (FNAC) is more than 50 years old and is the principal method of preoperative diagnosis in both children and adults. Aims: (1) To assess the pattern and frequency of thyroid lesions in cytology, (2) To study the correlation of thyroid lesions with different age groups (3) To identify the frequency benign and malignant thyroid lesions in cytology, (4) To report the thyroid lesions in Bethesda system of reporting pattern on cytology. Settings and Design: Rural Institute of Medical Science and research is a 750 bedded tertiary care institute. This is a retrospective study. Materials and Methods: 300 thyroid lesion (from December 2012 to May 2014) who attended the pathology department of Rural Institute of Medical Science and research was taken and association between variables and thyroid lesions were observed. Thyroid lesions were also classified according to Bethesda system of reporting. Statistical Analysis Used: SPSS. Results: Male to female ratio was 1:9. Frequency of benign thyroid lesions is 78% with the most common diagnosis being colloid nodule and colloid cyst. Thyroid malignancies were diagnosed in 5% cases. Bethesda category I included 11%, category II 78%, category III (AUS/FLUS) 2%, category IV (Follicular Neoplasm) 3%, category V (Suspicious of malignancy) 1%, category VI (malignant) 5%. Conclusions: Thyroid lesions can be efficiently classified on cytology.The Bethesda system has proved useful and helped improving communication between cytopathologists and clinicians leading to consistent management.

The diagnostic utility of combination of HMGA2 and IMP3 qRT-PCR testing in thyroid neoplasms.

The diagnosis of malignant thyroid tumors in some cytologic and histologic specimens remains challenging. High-mobility group A2 (HMGA2) expression and insulin-like growth factor II mRNA-binding protein-3 (IMP3) expression were evaluated by relative quantitative reverse transcription-polymerase chain reaction (qRT-PCR). The aim of this study was to evaluate whether the combination of HMGA2 and IMP3 qRT-PCR was diagnostically useful in differentiating benign from malignant thyroid neoplasms. Fine-needle aspiration (FNA) specimens from 120 patients including 56 benign lesions and 64 carcinomas were used. The available 80 corresponding formalin-fixed paraffin-embedded (FFPE) thyroid tissues from 66 patients were also included in this study. HMGA2 and IMP3 expression levels were detected by qRT-PCR and reported as relative fold change after normalizing with a calibrator. The diagnostic utilities of HMGA2 and IMP3 qRT-PCR tests were evaluated individually and in combination. In FNA specimens, HMGA2 and IMP3 expression was consistently higher in thyroid malignancies compared with benign lesions in all subgroups except in Hürthle cell tumors. After exclusion of Hürthle cell tumors, the sensitivity was 90.2% for HMGA2, 88.2% for IMP3, and 98% for HMGA2+IMP3; the specificity was 97.1% for HMGA2, 79.4% for IMP3, and 79.4% for HMGA+IMP3. qRT-PCR data showed similar results in FFPE tissues: the sensitivity was 84.2% for HMGA2, 85.7% for IMP3, and 94.7% for HMGA2+IMP3; the specificity was 96.9% for HMGA2, 91.2% for IMP3, and 90.6% for HMGA2+IMP3. qRT-PCR data were concordant between FNA and FFPE samples for HMGA2 (97.4%) and IMP3 (96.9%). The results indicate that HMGA2 qRT-PCR with high specificity may be a useful ancillary technique to assist in the classification of difficult thyroid specimens, excluding Hürthle cell tumors. The HMGA2 and IMP3 qRT-PCR combination model with increased sensitivity and negative predictive value (96.4%) may be useful in screening thyroid cytology specimens.

Subclassification of follicular neoplasms recommended by the Japan thyroid association reporting system of thyroid cytology.

Background. The Japan Thyroid Association recently published guidelines for clinical practice for the management of thyroid nodules, which include a diagnostic system for reporting thyroid fine needle aspiration cytology. It is characterized by the subclassification of follicular neoplasms, which is different from other internationally accepted reporting systems. Materials and Methods. This study examined observer variability in the subclassification of follicular neoplasms among 4 reviewers using Papanicolaou-stained smear samples from 20 surgically treated patients with indeterminate cytology. Results. The favor malignant subcategory had high predictive value of malignancy (risk of malignancy: 60–75%) and good agreement among the 4 reviewers (κ = 0.7714). Conclusion. These results clearly confirmed that the risk stratification of follicular neoplasms, which was adapted from cytology practice of high-volume thyroid centers in Japan, can provide clinically helpful information to estimate the risk of malignancy and to triage patients for surgery.

The Bethesda system for reporting thyroid cytopathology in Colombia: Correlation with histopathological diagnoses in oncology and non-oncology institutions.

Aim:To determine the correlation between the results of thyroid fine-needle aspirations interpreted using the Bethesda system and final histopathological reports for patients at an oncology hospital (OH) and non-oncology hospitals (NOHs).Materials and Methods:A retrospective, cross-sectional, descriptive study was performed to compare the cytology and histopathology results for patients with thyroid nodules in three Colombian hospitals. The final correlation of diagnoses between the two methods is reported. In Colombia, the health system provides the existence of general care hospitals and hospitals specializing in care of patients with cancer.Results:A total of 196 reports were reviewed, of which 53% were from OH and 47% were from NOHs. A greater proportion of category V (37.5%) was diagnosed at the OH, whereas NOHs diagnosed a greater proportion of category II (42.3%). The global correlation between diagnoses made using cytology and histopathology was 93.3% for categories V and VI (based on the final malignant diagnosis) and 86.9% for benign category II. Significant differences between institution types were observed when category IV and V and malignant histopathology were compared (56.3% OH vs. 23.5% NOH; P = 0.05 for category IV, 97.4% OH vs. 82.3% NOH; P = 0.03 for category V), while no significant difference between institution types was observed when category II and final benign diagnosis were compared (P = 0.6).Conclusions:The Bethesda system for thyroid cytology correlates adequately with final histopathological diagnosis in Colombia. Significant differences were identified in the diagnostic correlation for malignant lesions between the OH and NOHs in categories IV and V caused by selection bias of the population.

Cytological patterns of thyroid lesions at Gondar University Hospital, Northwest Ethiopia: A retrospective study

Background: Thyroid lesion is a common disorder of endocrine system worldwide. Characterizing varies type of the lesions in a given setup has paramount importance to design effective strategy. As a result, the purpose of this study was to find out the frequency of various cytological thyroid lesions in Gondar University Hospital. Method: A retrospective data of 1010 thyroid lesions, which were registered from 2009-2013 on fine needle aspirate cytology log book, were included in the study. Descriptive statistics were done to determine the proportion of the thyroid lesions. Results: Of the total patients underwent thyroid cytological examination, 768(76%) were females. More than half of thyroid lesions were observed in patients who were under 30 years old. Benign thyroid lesions (916(90.7%)) were the commonest followed by malignant and neoplastic lesions which account 41(4.1%) and 38(3.76%) respectively. Colloid goiter (862/919(93.8%)), follicular neoplasm (30/38(78.9%)) and papillary carcinoma (25/41(61%)) were the major subtype of benign, neoplasm and malignant lesions respectively. Thyroid tuberculosis was also found in 3 (0.29%) cases of benign lesions. Conclusion: Benign lesions were the predominant thyroid lesion; of which the proportion of colloid goiter was higher compared to other subtype of benign thyroid lesions. Unusual benign lesions like thyroid tuberculosis were also observed. Malignant thyroid lesions had also contributed significant amount. Future research with histological technique, detail socio-demographic information and clinical feature is crucial to determine the patterns of thyroid lesions and associated factors.