ABSTRACT

Background: solitary thyroid nodule (any palpable discrete swelling within normal thyroid gland); is usually benign lesion. However; physician, pathologist and patient alike are typically concerned about the possibility of thyroid cancer. FNAC is considered the gold standard diagnostic test for the diagnosis of thyroid nodule.

Aim: The major goals in the evaluation of the “solitary thyroid nodule” is the differentiation of “benign” and “hyperplastic” from “true neoplasm”.

Study setting: A prospective analysis carried out in Al-Ramadi Teaching Hospital “surgical department and histopathology department”.

Methods: A total of 150 patients were diagnosed as a monnodular thyroid disease between February 2017 and December 2019. For all patient's clinical examination and specific investigations were done. Patients with specific inclusion criteria were selected. “FNAC” was done using a 23-gauge needle; fixed in ethanol-95% alcohol solution, and stained with Papanicolaou's staining. All patients selected were under gone thyroidectomy; and the specimens were evaluated by histopathological examination. Specimens were processed; staining was performed with routine, hematoxylin and eosin, stain.

Results: “Age of the patient range between 10-59 years; median age 38 years; female predominance “90%” and the site of swelling was more in Rt. lobe “56.7%” compared to Lt. lobe and isthmus. Different types of benign and malignant thyroid lesion were diagnosed. The values of sensitivity; specificity; false positive%; false negative %; positive predictive value; negative predictive value and accuracy rate were “91.5%”, “61.2%”, “8.5%”, “38.8%”, “51.8”, “94.0%” and “70.7%”, respectively. Benign lesions were “103” cases and malignant lesions were “47 cases. The final diagnosis were colloid goiter “62”, follicular adenoma “26”, follicular carcinoma “6”, papillary carcinoma “38”, Hurthel cell adenoma “3”, Hurthel cell carcinoma “3”, Hashimoto thyroiditis “9” and Lymphocytic thyroiditis “3”.

Conclusion: we conclude that “FNAC” is highly significant for malignant lesions and they should be subjected to surgery. False negative results for benign lesions should be considered and those patients required regular follow up. Patients with results of “suspicious of malignancy” require surgery.

Keywords: Thyroid nodule, FNAC, thyroidectomy