Frozen Section as an Aftermath to Fine Needle Aspiration Cytology in Thyroid Lesions

Introduction: Study of thyroid diseases are of significant importance as it has implications on medical and surgical management. The choice of the diagnostic method used is also vital as it may influence the quality of the outcome. Fine Needle Aspiration Cytology (FNAC) has for long been a useful, c...

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Main Authors: Vidyashree Vittal Anchan, Parinitha Sadashivappa Sangam, Dinesh Udipi Shastri, Vandana Udaykumar Grampurohit, Hephzibah S Rani
Format: Article
Language:English
Published: JCDR Research and Publications Pvt. Ltd. 2018-01-01
Series:National Journal of Laboratory Medicine
Subjects:
Online Access:http://www.njlm.net/articles/PDF/2275/34602-CE(VSU)_F(GG)_PF1(VSU_GG)_PFA(GG)_PF2(VSU_GG).pdf
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author Vidyashree Vittal Anchan
Parinitha Sadashivappa Sangam
Dinesh Udipi Shastri
Vandana Udaykumar Grampurohit
Hephzibah S Rani
author_facet Vidyashree Vittal Anchan
Parinitha Sadashivappa Sangam
Dinesh Udipi Shastri
Vandana Udaykumar Grampurohit
Hephzibah S Rani
author_sort Vidyashree Vittal Anchan
collection DOAJ
description Introduction: Study of thyroid diseases are of significant importance as it has implications on medical and surgical management. The choice of the diagnostic method used is also vital as it may influence the quality of the outcome. Fine Needle Aspiration Cytology (FNAC) has for long been a useful, cheap and safe procedure in preoperative evaluation of thyroid lesions. Frozen sections on the other hand can confirm the FNAC diagnosis and it also serves as an intraoperative guide to decide the extent of the thyroid surgeries. Aim: To assess the diagnostic accuracy of FNAC and frozen sections and to determine the utility of frozen sections in thyroid lesions. Materials and Methods: This five year retrospective study was conducted between July 2010 to July 2015. All patients undergoing both FNAC and frozen sections for thyroid lesions were included in the study. Results were then compared with the gold standard which is histopathology. SPSS 20.0 software was used to analyse the data. Descriptive statistics was applied to draw conclusions. Sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and diagnostic accuracy were calculated for both FNAC and frozen sections. Results: Among 70 cases, FNAC was reported as nonneoplastic in 43 cases among which eight cases differed on histopathology. Total 27 cases reported as neoplastic of which eight cases differed on histopathology. On frozen sections, among 43 reported as non neoplastic and 27 as neoplastic, only four cases in each differed on histopathology studies. On the final histopathology sections 43 were non neoplastic and 27 were neoplastic lesions (9 benign, 18 malignant). FNAC sensitivity was 70.37%, specificity was 81.39%. Frozen section sensitivity was 85.18%, specificity was 90.69%. The difference was statistically significant. Conclusion: In the present study, frozen sections had better sensitivity and specificity compared to FNAC in thyroid lesions. Thus, concluding that FNAC can definitely help the clinician to stratify the patients and select them for surgery but frozen section can confirm the FNAC diagnosis and guide the extent of thyroidectomy.
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spelling doaj.art-38c8edc51cbf45059bf710accbba5c802022-12-22T01:01:10ZengJCDR Research and Publications Pvt. Ltd.National Journal of Laboratory Medicine2277-85512455-68822018-01-0171PO12PO1810.7860/NJLM/2018/34602:2275Frozen Section as an Aftermath to Fine Needle Aspiration Cytology in Thyroid LesionsVidyashree Vittal Anchan0Parinitha Sadashivappa Sangam1Dinesh Udipi Shastri2Vandana Udaykumar Grampurohit3Hephzibah S Rani4Assistant Professor, Department of Pathology, East Point College of Medical Sciences and Research Centre, Bengaluru, Karnataka, India.Associate Professor, Department of Pathology, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India.Professor, Department of Pathology, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India.Professor, Department of Pathology, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India.Associate Professor, Department of Pathology, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India.Introduction: Study of thyroid diseases are of significant importance as it has implications on medical and surgical management. The choice of the diagnostic method used is also vital as it may influence the quality of the outcome. Fine Needle Aspiration Cytology (FNAC) has for long been a useful, cheap and safe procedure in preoperative evaluation of thyroid lesions. Frozen sections on the other hand can confirm the FNAC diagnosis and it also serves as an intraoperative guide to decide the extent of the thyroid surgeries. Aim: To assess the diagnostic accuracy of FNAC and frozen sections and to determine the utility of frozen sections in thyroid lesions. Materials and Methods: This five year retrospective study was conducted between July 2010 to July 2015. All patients undergoing both FNAC and frozen sections for thyroid lesions were included in the study. Results were then compared with the gold standard which is histopathology. SPSS 20.0 software was used to analyse the data. Descriptive statistics was applied to draw conclusions. Sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and diagnostic accuracy were calculated for both FNAC and frozen sections. Results: Among 70 cases, FNAC was reported as nonneoplastic in 43 cases among which eight cases differed on histopathology. Total 27 cases reported as neoplastic of which eight cases differed on histopathology. On frozen sections, among 43 reported as non neoplastic and 27 as neoplastic, only four cases in each differed on histopathology studies. On the final histopathology sections 43 were non neoplastic and 27 were neoplastic lesions (9 benign, 18 malignant). FNAC sensitivity was 70.37%, specificity was 81.39%. Frozen section sensitivity was 85.18%, specificity was 90.69%. The difference was statistically significant. Conclusion: In the present study, frozen sections had better sensitivity and specificity compared to FNAC in thyroid lesions. Thus, concluding that FNAC can definitely help the clinician to stratify the patients and select them for surgery but frozen section can confirm the FNAC diagnosis and guide the extent of thyroidectomy.http://www.njlm.net/articles/PDF/2275/34602-CE(VSU)_F(GG)_PF1(VSU_GG)_PFA(GG)_PF2(VSU_GG).pdfDyshormonogenetic goitreHistopathologyThyroidectomy
spellingShingle Vidyashree Vittal Anchan
Parinitha Sadashivappa Sangam
Dinesh Udipi Shastri
Vandana Udaykumar Grampurohit
Hephzibah S Rani
Frozen Section as an Aftermath to Fine Needle Aspiration Cytology in Thyroid Lesions
National Journal of Laboratory Medicine
Dyshormonogenetic goitre
Histopathology
Thyroidectomy
title Frozen Section as an Aftermath to Fine Needle Aspiration Cytology in Thyroid Lesions
title_full Frozen Section as an Aftermath to Fine Needle Aspiration Cytology in Thyroid Lesions
title_fullStr Frozen Section as an Aftermath to Fine Needle Aspiration Cytology in Thyroid Lesions
title_full_unstemmed Frozen Section as an Aftermath to Fine Needle Aspiration Cytology in Thyroid Lesions
title_short Frozen Section as an Aftermath to Fine Needle Aspiration Cytology in Thyroid Lesions
title_sort frozen section as an aftermath to fine needle aspiration cytology in thyroid lesions
topic Dyshormonogenetic goitre
Histopathology
Thyroidectomy
url http://www.njlm.net/articles/PDF/2275/34602-CE(VSU)_F(GG)_PF1(VSU_GG)_PFA(GG)_PF2(VSU_GG).pdf
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