FNAC IN THE MANAGEMENT OF SOLITARY THYROID NODULE

Objective: To determine the significant role of FNAC upon other diagnosticmodalities in pre-operative investigations of patients presenting with solitary thyroid nodules and to compare the postoperative histopathological results with the results of FNAC. Design: A Comparative study. Place and Duration ofStudy: Department of Surgery Combined Military Hospital Quetta and Combined Military Hospital Rawalpindi fromDecember 1999 to December 2001. Patients and Methods: In this study 46 patients with solitary thyroid nodule werestudied. Only 2 patients were toxic while remaining 44 were with euthyroid. In this study only one case was suspectedto be malignant clinically out of 5 malignant cases. All 46 patients under went thyroid scanning, ultrasound examinationand fine needle aspiration biopsy and the diagnostic accuracy was assessed. Results: 36 patients (78.26%) wereoperated while 10(21.73%) were managed conservatively. There were 5(10.86%) malignant nodules while 41(89.13%)were benign. All the 5 cases with malignancy were with ‘cold’ nodules on scan as most of others, while ‘solid’ onultrasound examination and so were most of other benign nodules. All cases diagnosed malignant pre-operatively onFNAC, proved to be malignant on histopathology after surgery and the others diagnosed as benign on FNAC provedto be benign. Conclusion: This study shows that conventional investigations for evaluation of solitary thyroid nodulesare inaccurate in identifying the malignant from the benign nodules and their routine use in such patients should beabandoned, while the use of FNAC should be encouraged more in our hospitals as this technique is with high degreeof sensitivity and specificity, cost effective and safe.