Efficacy of Fine Needle Aspiration Cytology in the Diagnosis of Thyroid Swellings in Red Sea State, Sudan

Abstract

Background: Fine needle aspiration cytology (FNAC) is a safe, easy to perform, cost effective and an accurate procedure used in the diagnosis of thyroid lesions.
Objective: In this study we aimed to demonstrate the effectiveness of FNAC in the diagnosis of thyroid swellings in Red Sea State, Sudan.
Methods: FNAC from one hundred and fifty six patients presented with thyroid swelling were examined in the period from February 2009 to August 2011 in a histopathology laboratory in the Red Sea Medical center, Port Sudan, Sudan. This is the only regional laboratory, to which FNAC
and histopathological samples were sent. The cytological results were classified as inadequate when the aspirate was not enough to reach a diagnosis; benign which included different goiters, cysts and thyroiditis; follicular which included cases showing features of follicular or Hurthle cell
neoplasms; and malignant that included non-follicular malignant tumors of the thyroid. The histopathology diagnosis was classified as benign and malignant.
Results:The results of the FNA cytological diagnosis showed that three (1.9%) of the patients had inadequate samples for cytological  assessment, 138 (88.5%) patients had benign lesions, 6 (3.8%)
had follicular pattern, and nine (5.8%) had malignant neoplasms. The sensitivity, specificity and accuracy of FNAC for the diagnosis of thyroid swellings were 89.7%, 96.7% and 93.2% respectively. Commonest malignancy detected was papillary carcinoma in seven patients.
Conclusions: The findings of this study are consistent with the current published data and demonstrate that FNA cytology is a sensitive, specific and accurate initial diagnostic test for evaluation of patients with thyroid swellings. Clinicians should be encouraged to embrace this procedure as a first line investigation for the diagnosis of thyroid swellings.

Keywords: papillary carcinoma, Hurthle, FNAC, follicular pattern.