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Research Articles

Role of fine-needle aspiration cytology & ultrasound in the management of solitary thyroid nodule

Authors:

D. U. Dantanarayana ,

Colombo-North Teaching Hospital, Ragama, LK
About D. U.
Registrar in ENT
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M. Sheriff,

Colombo-North Teaching Hospital, Ragama, LK
About M.
Consultant ENT Surgeon
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G. R. Gallage,

Colombo-North Teaching Hospital, Ragama, LK
About G. R.
Medical officer ENT
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S. N. U. Jayawardana,

Colombo-North Teaching Hospital, Ragama, LK
About S. N. U.
Medical officer ENT
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E. M. C. D. Wickramanayake,

Colombo-North Teaching Hospital, Ragama, LK
About E. M. C. D.
Medical officer ENT
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W. M. Wijeyananda

Colombo-North Teaching Hospital, Ragama, LK
About W. M.
Medical officer ENT
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Abstract

Objectives

To evaluate the effectiveness of fine-needle aspiration cytology (FNAC) & ultrasound scanning (US) in the diagnosis and management of solitary thyroid nodules.

 

Materials & Methods

A retrospective study was carried out on 63 patients who were euthyroid and had a clinically palpable solitary thyroid nodule, who underwent either total or hemi-thyroidectomy, during a period of two years (January 2018 to December 2019) in the ENT unit of a tertiary care hospital in Sri Lanka. All patients with FNAC of Bethesda ≥5 underwent total thyroidectomy. Diagnostic hemi-thyroidectomy was performed only in patients with a FNAC of Bethesda ≤4, irrespective of US suspicious features.

 

Results

Mean age was 46.9 years (±13.2). 53(84.1%) patients were females and 10 (15.9%) of them were male. 28(44.4%) patients had histologically proven malignancy while the other 35(55.6%) had benign histology. Sensitivity, specificity, positive predictive values and negative predictive values for FNAC and ultrasound were calculated. Out of 34 patients who underwent diagnostic hemi-thyroidectomy, 12(35%) had to undergo completion surgery due to malignant histology. 58% who underwent completion surgery had suspicious features of malignancy in their pre-op US.

 

Conclusion

Both ultrasonography and FNAC are cost-effective, minimally invasive investigations in the diagnosis of malignancy in patients with solitary thyroid nodules. However, there is a notable false negative rate in FNAC; hence it is best to incorporate US findings with FNAC in the decision making process in management of solitary thyroid nodules.
How to Cite: Dantanarayana, D.U., Sheriff, M., Gallage, G.R., Jayawardana, S.N.U., Wickramanayake, E.M.C.D. and Wijeyananda, W.M., 2019. Role of fine-needle aspiration cytology & ultrasound in the management of solitary thyroid nodule. Ceylon Journal of Otolaryngology, 8(1), pp.27–35. DOI: http://doi.org/10.4038/cjo.v8i1.5289
Published on 28 Dec 2019.
Peer Reviewed

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