Comparison of Fine Needle Aspiration Cytology andHistopathology in diagnosing malignant thyroid swellings: Experience from a Tertiary Care Centre of Tripura, India

Background Thyroid nodular disease, including thyroid cancer, is increasingly prevalent worldwide, with significant incidence in India. This study compares FNAC and histopathological examination (HPE) findings in diagnosing malignant thyroid lesions in a tertiary care center in Tripura, India. Methods This retrospective study analyzed data from patients who underwent both FNAC and HPE between September 2019 and August 2020 at Agartala Government Medical College and GBP Hospital. Out of 98 records, 30 cases with malignant HPE results were included. Data were abstracted using Epi Info software and analyzed with IBM SPSS software. Qualitative variables were summarized using percentages, while quantitative variables were summarized using mean (SD). Results The majority of the cases were female (86.67%), Bengali (76.67%), and aged 21-40 years (73.33%). FNAC accurately detected malignant thyroid lesions in 73.3% of cases. Discrepancies between FNAC and HPE were found in eight cases, primarily involving papillary carcinoma of the thyroid (PCT), which FNAC misdiagnosed as other conditions. PCT was the most common HPE diagnosis, representing 76.66% of cases, predominantly in females. Most patients (86.67%) underwent total thyroidectomy, with a few requiring additional surgical interventions. Conclusion FNAC is a minimally invasive, cost-effective procedure with high accuracy in diagnosing malignant thyroid swellings. However, the definitive diagnosis relies on HPE, which remains the gold standard due to FNAC's limitations. The study emphasizes the need for precise diagnostic techniques and vigilant monitoring, especially among females with thyroid malignancies. Further research with larger sample sizes is recommended to enhance the generalizability of these findings.