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  3. Fine Needle Aspiration Cytology of Thyroid Lesions: A Cytohistological…
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Fine Needle Aspiration Cytology of Thyroid Lesions: A Cytohistological Correlation Study on Diagnostic Accuracy and Pitfalls

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Annals of Medicine and Medical Sciences Volume 04 (2025), Version 4 April 26, 2025 pp. 256 - 261
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Abstract

Background: Given the low malignancy rate in palpable thyroid nodules (~5%), accurate pre-operative differentiation of benign from malignant lesions is critical to avoid unnecessary surgery. However, thyroid cytology has a diagnostic "grey zone" with reduced classification precision, leading to ambiguity. Aims: This study aimed to: (1) determine the age and sex distribution of thyroid lesions; (2) evaluate the diagnostic performance (sensitivity, specificity) of fine needle aspiration cytology (FNACC); and (3) identify reasons for cytological-histological discrepancies. Methods: A retrospective analysis of 64 thyroid lesion cases from a five-year cohort involved cytohistological correlation. FNAC diagnoses were categorized based on agreement or disagreement with histology. Cytological smears and histological sections underwent independent re-evaluation. Results: Cytopathological diagnoses agreed with histopathology in 58/63 cases (92.06% concordance; 7.93% discordance, 5 cases). No false positive cytological diagnoses occurred. False negative diagnoses were attributed to sampling error and challenges in recognizing concurrent distinct pathologies. Conclusion: FNAC is an efficient and accurate tool for evaluating palpable thyroid nodules and guiding clinical management. The high malignancy detection rate in resected nodules suggests a reduction in overall thyroid surgeries. Integrating stringent FNAC adequacy criteria with clinical and radiological correlation is crucial to minimize false negative and false positive diagnoses.

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