Diagnostic Efficacy of Ultrasonography and Fine-needle Aspiration Cytology in Correlation with Histopathology in Euthyroid Patients Having Solitary Thyroid Nodule
Clinical Medicine Research
Volume 8, Issue 1, January 2019, Pages: 1-5
Received: Apr. 26, 2018; Accepted: May 14, 2018; Published: Feb. 25, 2019
Views 565      Downloads 81
Vijay Kumar Sharma, Department of Otorhinolaryngology and Head and Neck surgery, Sawai Man Singh Medical College, Jaipur, India
Antony Abraham Paulose, Department of Otorhinolaryngology and Head and Neck surgery, Sawai Man Singh Medical College, Jaipur, India
Parvendra Singh, Department of Otorhinolaryngology and Head and Neck surgery, Sawai Man Singh Medical College, Jaipur, India
Nishi Sonkhya, Department of Otorhinolaryngology and Head and Neck surgery, Sawai Man Singh Medical College, Jaipur, India
Article Tools
Follow on us
Objective: In patients with solitary thyroid nodules, first approach is to confirm whether the nodule is benign or malignant. Commonly available investigations used in the evaluation include thyroid hormone assays, fine needle aspiration cytology (FNAC) and ultrasonography (USG) among others. These procedures are not without drawbacks. The present study was undertaken to compare the diagnostic efficacy of USG and FNAC in correlation with histopathology in euthyroid patients having solitary thyroid nodule. Study Design: A prospective study was carried out on 48 euthyroid cases of solitary thyroid nodule attending the Department of ENT, SMS Medical College & Hospital, Jaipur, during the period of March 2016 to November 2017. All patients underwent ultrasonography and fine-needle aspiration cytology. The results of FNAC and USG were correlated with post surgical histopathogical examination (HPE) of the specimens to evaluate their sensitivity and specificity by statistical methods. Results: Ultrasound was 87.5% sensitive & 92.50% specific in the detection of malignancy in solitary thyroid nodules while the fine needle aspiration cytology had a sensitivity of 87.50% & specificity of 100% in the same regard. Conclusion: It was found that FNAC is a safe, reliable and cost effective diagnostic modality with a high sensitivity and specificity and is the single best investigation for preoperative evaluation of solitary thyroid nodule to differentiate between benign and malignancy nodules.
STN, USG, FNAC, Thyroid Malignancy
To cite this article
Vijay Kumar Sharma, Antony Abraham Paulose, Parvendra Singh, Nishi Sonkhya, Diagnostic Efficacy of Ultrasonography and Fine-needle Aspiration Cytology in Correlation with Histopathology in Euthyroid Patients Having Solitary Thyroid Nodule, Clinical Medicine Research. Vol. 8, No. 1, 2019, pp. 1-5. doi: 10.11648/j.cmr.20190801.11
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Ezzat S, Sarti DA, Cain DR. Braunstein GD. Thyroid incidentalomas, prevalence by palpation and ultrasonography. Arch Intern Med 1994; 154: 1838-40.
Hegedus L. Clinical practice. The thyroid nodule. N Engl J Med 2004; 351: 1764-1771.
Vander JB, Gaston EA, Dauber TR. The significance of non-toxic thyroid nodules. Final report of 15 years study of incidence of thyroid malignancy. Ann Intern Med 1968; 537-40.
Mazzaferri EL, de los Santos ET, Rofagha-Keyhani S. Solitary thyroid nodule: diagnosis and management. Med Clin North Am 1988; 72: 1177-1211.
Cooper DS, Doherty GM, Haugen BR, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009; 19:1167-1214.
Cole WH, Majarakis JD. Incidence of carcinoma of the thyroid in nodular goitre. J Clin Endocrinol. 1949;9:1007-11
Layfield LJ, Cibas ES, Gharib H, Mandel SJ. Thyroid aspiration cytology: current status. CA Cancer J Clin 2009;59:99-110.
Thompson NW, Nishiyama RH, Harness JK. Thyroid carcinoma: Current controversies. Curr Probl Surg 1978;15:1.
Rinaldi S, Plummer M, Biessy C, et al, 2014 Thyroid stimulating hormone, thyroglobulin, and thyroid hormones and risk of differentiated thyroid carcinoma: the EPIC study. J Natl Cancer Inst 106: Doi: 10.1093/ jnci/dju097
Hedinger C, Williams ED, Sobin H. Histological typing of thyroid tumours: WHO international classification of tumours, 4th edn. Berlin: Springer-Verlag, 1998.
Williams ED. Histogenesis of medullary carcinoma of the thyroid. Journal of Clinical Pathology 1966;19: 114-18.
Pacini F, Castagna MG, Cipri C, Schlumberger M. Medullary thyroid carcinoma. Clinical Oncology 2010; 22:475-85.
Schneider DF, Chen H. New developments in the diagnosis and treatment of thyroid cancer. CA: a cancer journal for clinicians. 2013;63(6):373-394.
Gharib H, Papini E. Thyroid nodules: clinical importance, assessment, and treatment. Endocrinol Metab Clin North Am. 2007;36(3):707–35.
Czerwonka L, Freeman J, McIver B, et al. Summary of proceedings of the second World Congress on Thyroid Cancer. Head Neck 2014;36:917-920.
Koike E, Noguchi S, Yamashita H, et al. Ultrasonographic characteristics of thyroid nodules: prediction of malignancy. Arch Surg 2001;136:334-337.
Shrestha M, Crothers BA, Burch HB. The impact of thyroid nodule size on the risk of malignancy and accuracy of fine-needle aspiration: a 10-year study from a single institution. Thyroid 2012;22:1251-1256.
NCCN Clinical Practice Guidelines in Oncology- Thyroid Carcinoma. Version 2.2017-May17, 2017. NCCN.org
Can AS, Peker K. Comparison of palpation-versus ultrasound-guided fine-needle aspiration biopsies in the evaluation of thyroid nodules. BMC Res Notes. 2008 May 15. 1:12.
Goldfarb M, Gondek S, Solorzano C, Lew JI. Surgeon-performed ultrasound can predict benignity in thyroid nodules. Surgery. 2011 Sep. 150(3):436-41.
Hegde A, Gopinathan A, Abu Bakar R, Ooi CC, Koh YY, Lo RH. A method in the madness in ultrasound evaluation of thyroid nodules. Singapore Med J. 2012 Nov. 53(11):766-72.
Katz J. F, Kane R. A. Thyroid nodules: sonographic pathologic correlation. Radiology.1984: Vol.151; 741-745.
Watters DA, Ahuja AT, Evans RM, Chick W, King WW, Metreweli C, Li AK. Role of ultrasound in the management of thyroid nodules. Am J Surg. 1992 Dec; 164(6):654-7..
Jones AJ, Altman TJ. Comparison of FNAC, RNS & USG in the management of thyroid nodules. Post Grad Med J 1990: 66; 914-17.
Moon WJ, Jung SL, Lee JH, Na DG, Baek JH, Lee YH, et al. Benign and malignant thyroid nodules: US differentiation - multicenter retrospective study. Radiology. 2008; 247:762–70.
ArunKumar, Ahuja MMS et al FNAC, USG & RNS in STN. J Assoc Physicians India 1992:40; 302 -306
Cox MR Marshall SG STN A prospective scanning & USG Br. J Surg 1991 78, 90-93.
Basharat R, Bukhari MH, Saeed S, Hamid T. Comparison of fine needle aspiration cytology and thyroid scan in solitary thyroid nodule. Patholog Res Int. 2011. 2011:754041.
Yip L, Farris C, Kabaker AS, Hodak SP, Nikiforova MN, McCoy KL, et al. Cost impact of molecular testing for indeterminate thyroid nodule fine-needle aspiration biopsies. J Clin Endocrinol Metab. 2012 Jun. 97(6):1905-12.
Arul P, Masilamani S. A correlative study of solitary thyroid nodules using the Bethesda System for Reporting Thyroid Cytopathology. J Cancer Res Ther. 2015 Jul-Sep. 11 (3):617-22.
Bakkar S, Poma AM, Corsini C, Miccoli M, Ambrosini CE, Miccoli P. Underestimated risk of cancer in solitary thyroid nodules ≥3 cm reported as benign. Langenbecks Arch Surg. 2017 Jul 8.
Goellner JR, Gharib H. FNAC Of the thyroid. ActaCytologica. 1987: 31; 587-591.
Kaliszewski K, Diakowska D, Wojtczak B, et al. Fine-Needle Aspiration Biopsy as a Preoperative Procedure in Patients with Malignancy in Solitary and Multiple Thyroid Nodules. PLoS One. 2016. 11 (1):e0146883.
Altavilla G, Pascale M. FNAC of thyroid gland diseases. ActaCytologica 1990 34, 251-256.
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
Tel: (001)347-983-5186