Background :

Thyroid swelling is a common problem in Bangladesh. Early and systematic evaluation of a nodular thyroid swelling is necessary as it is a frequent presentation of thyroid neoplasia. USG Guided Fine Needle Aspiration Cytology (FNAC) is one of the diagnostic tools for early evaluation of thyroid nodules.

USG Guided FNAC is considered a cost-effective, simple, minimally invasive and easily repeatable procedure for preoperative screening in the diagnosis of most thyroid lesions. The objective of this study is to determine the sensitivity and specificity of USG Guided Fine Needle Aspiration Cytology (FNAC) and compare its efficacy with histopathology in diagnosis of thyroid swellings.

Objective :

To evaluate the sensitivity and specificity of USG Guided Fine Needle Aspiration Cytology (FNAC) and histopathology for the diagnosis of thyroid swelling.

Method :

This observational prospective study was performed in the Department of Otolaryngology & Head Neck Surgery, Dhaka Medical College Hospital, Dhaka over 6 months duration from January 2019 to June 2019.

A total of 50 patients with thyroid swelling were selected after taking informed written consent and fulfilling the inclusion criteria. Smears were taken by standard procedure and stained with Papanicolaou stain and Haematoxylin and Eosin stain.

The smears were classified into categories like benign, indeterminate, malignant and unsatisfactory. Sensitivity, specificity, positive and negative predictive value and accuracy of USG Guided FNAC were calculated and compared with already available data. Appropriate statistical analysis was done to compare final histopathological findings with initial USG Guided FNAC findings.

Result :

During the study period a total of 73 patients were found eligible for USG Guided FNAC. Most of the patients (52%) were from the 20?39 years age group. Among them 67.12% were female and the rest (32.87%) were male. In this government hospital, 75.34% were from low income group.

According to the findings of USG Guided FNAC, nearly half (43.83%) of the patients had multinodular goiter, followed by colloid goiter (16.43%). Only 18 (24.66%) patients had carcinoma.

From histopathological diagnosis, 55 patients had benign lesions and 18 patients had carcinoma. The efficacy of USG Guided FNAC as a diagnostic tool of solitary thyroid nodule showed sensitivity, specificity, PPV, NPV, PLR and NLR of 94.73%, 100%, 100%, 98.18%, 0 and 0.052 respectively.

Conclusion :

This study revealed that this minimally invasive procedure, USG Guided FNAC, had the highest level of specificity, which was 100%. The hypothesis of the study was that USG Guided FNAC is the most useful preoperative diagnostic tool in thyroid swelling diagnosis.

In this study, sensitivity of USG Guided FNAC was found to be 94.73%. Thus, it can be suggested that in maximum cases the diagnosis is accurate.

Keywords :

Swelling, USG Guided FNAC, Histopathology, Benign, Malignant.