Clinico-Pathological Study of Solitary Thyroid Nodule Cases in Rural Setup

Aims: To study the role of Fine Needle Aspiration Cytology (FNAC) in investigation of Solitary Thyroid Nodule (STN) and incidence of Malignancy in STN in a rural setup.

Material and Method: Setting: The Present Prospective Study carried out in Department of Surgery at Rural Government Medical College and Hospital, Ambajogai (Maharashtra State) between June 2007 to October 2009. Sample Size: 80 cases presenting with Solitary Thyroid nodule. Method: FNAC done as per method described by Lowhagen Torsten et al and findings were compared with histopathology obtained at surgery. The efficacy of FNAC was evaluated by calculating sensitivity, specificity, positive predictive value and negative predictive value.

Results: Out of 80 cases, FNAC showed 70 cases as benign and 6 as malignant lesions, opinion was not possible in 4 cases which have been excluded from sensitivity and specificity analysis. Histopathological examination revealed 74 benign and 6 malignant lesions. FNAC was able to correctly pick 68 benign cases while 2 cases thought to be benign turned out to be malignant on histopathology (False negative). Out of total 6 cases which turned out to be malignant on histopathology, FNAC was able to pick 4 cases, while 2 benign lesions were misdiagnosed as malignant (false positive).

Conclusions: This study concluded that FNAC is highly effective in detecting thyroid malignancy in solitary thyroid nodule with a sensitivity of 66.66% and specificity of 97.14%.