Role of Fine Needle Aspiration Versus Non-Aspiration Cytology In Diagnosis of Thyroid Lesions

Abstract

Background: Fine needle aspiration cytology (FNAC) is the first choice for evaluation of thyroid enlargement. Diagnosis is based on the identification of predominant cell pattern, cell morphology and background details. Fine needle non-aspiration cytology (FNNAC) avoids aspiration, uses capillary action of the fine needle. It is more patient friendly with less pain and better perception of lesion. Aim of the study: To evaluate the results ofFine Needle Aspiration Cytology (FNAC) and Fine Needle Non Aspiration Cytology (FNNAC) in diagnosis of thyroid lesions. Materials and Methods: One-year observational, prospective study was conducted on patients with palpable thyroid lesions in the Department of Pathology, Government Medical College, Jammu. Patients were investigated with a thyroid function test and a needle biopsy. Both FNAC and FNNAC techniques were performed simultaneously at the same site by the same investigator. Points were allocated to each specimen according to Mair et al. scoring system and categorized as follows: unsuitable for cytodiagnosis (0-2 points), diagnostically adequate (3-6 points) and diagnostically superior (7-10 points). Results: A total of 140 patients with palpable thyroid lesions were subjected to needle biopsies. Females dominated the study with female to male ratio of 5.36:1. Non-neoplastic lesions were observed in 89.29% and neoplastic in 10.71% cases. . The cumulative score was found significantly more in case of FNNAC than FNAC (946 vs 784; p<0.0001). For diagnostically superior category, results of both FNAC and FNNAC were comparable. Conclusion: FNAC smears produced adequate results in more cases. FNNAC was more diagnostically superior. It causes less damage to tissue, less artefacts and allows better perception of lesion. FNNAC is a good technique that should be used alone or in combination with FNAC for better diagnostic yield.