Study of Cyto-Histopathological Correlation of Thyroid Lesions at Jhalawar Medical College - A Five Year Study

Background: Thyroid diseases are fairly frequent among endocrine disorders. In clinical practice, a majority are benign but a substantial number of them are malignant. It is difficult to overall diagnose simply on clinical assessment. Fine needle aspiration cytology (FNAC) has been accepted as the first line investigation, especially for palpable thyroid swellings. But FNAC has its own limitations, therefore for final diagnosis histopathological examination is necessary. Aim: This study mainly aims to correlate the preoperative FNAC results as per The Bethesda system for Reporting Thyroid Cytopathology with subsequent Histopathological findings as the gold standard. Objectives: To evaluate the discordant cases, find out causes of discordance and to find out the sensitivity, specificity, positive and negative predictive values of thyroid FNAC. Methods: This was a five year observational study (3 years retrospective and 2 years prospective) conducted from august 2019 to august 2024 at Department of Pathology, Jhalawar Medical College, Jhalawar, Rajasthan. Total 146 cases were included in this study for which cytopathological and histopathological diagnosis were made. Results: Out of total 146 cases, 35 cases (23.97%) were neoplastic and 111 cases (76.03%) were non neoplastic lesions. Cytological diagnosis achieved sensitivity of 62.9%, specificity 98.2%, positive predictive value 91.7% and negative predictive value 89.3%. The diagnostic accuracy of cytological diagnosis was 89.72%. Conclusion: FNAC of thyroid lesions has been shown to be simple, reliable and accurate method for the management of palpable thyroid lesions. It bridges the gap between clinical evaluation and final surgical pathological diagnosis in majority of cases. It enables the clinician to obtain a diagnosis in high percentage of cases with minimal expenditure of time and money and often to prevent unnecessary surgery. As a screening method, it has high sensitivity and specificity, thus helps in planning the future management of patients. The Bethesda system for reporting thyroid cytopathology has standardized the diagnostic approach for reporting of thyroid lesions providing a uniform and clinically pertinent nomenclature.