IMPORTANCE AND RELIABILITY OF FINE NEEDLE ASPIRATION CYTOLOGY (FNAC) FOR THE DIAGNOSIS OF MULTINODULAR GOITER AND SOLITARY THYROID NODULE

Objective: To evaluate the role of FNAC in the early management and treatment of multinodular goitre with solitary thyroid nodules and dominant nodules. Study Design: A Case Series. Configuration and duration: In the Surgical Unit II of Services Hospital Lahore for one year duration from June 2017 to June 2018. Methodology: 90 patients were selected for the analysis, but in 10 patients FNAC aspirate was not adequate and these patients were not included in the study and 20 patients underwent surgery. Previously, we examined routine investigations and physical examination, Thyroid profile and radioisotopes (Tc-99) thalium scan. Patients with multinodular or solitary cold nodules were selected for the analysis. In all multinodular dominant nodules or solitary nodules performed with FNAC. The preoperative diagnosis of FNAC was compared with the histopathological findings of the surgical specimens. Results: 60 operated patients had histological findings for comparison with FNAC results statistically. Fnac was benign 51 (84.23%) and in 11 (17.06%) malignant. 30 patients (51%) were of Hashimoto thyroiditis and subacute thyroiditis and 3 (5%) follicular adenoma, 8 (13.33%) as nodular goiter, 9 (15%). In the 10 patients in the malignant patient group, 2 (3.33%), undifferentiated carcinoma, lymphoma and 2 (3.33%) papillary thyroid carcinoma 1 (1.66%), follicle carcinoma, five (8 was 33%). There were malignant lesions in 11 (17.93%) and 50 (82.06%) benign lesions. Comparison of FNAC histopathological findings shows 3 false negative results and 2 false positive results. For the detection of malignant and malignant thyroid nodules, fnac showed 96.6% accuracy in dominant thyroid, 75%, specificity and 95.83% sensitivity, negative predictive value 81.81% and 93% positive predictive value. Conclusion: Due to high sensitivity and specificity, in the diagnosis FNAC may play an important role in the treatment planning of dominant nodules and solitary thyroid nodules in multinodular goiter. Key Words: FNAC, Multinodular Goitre, Thyroid Nodule