Introduction : The main role of fine needle aspiration cytology (FNAC) lies in the
differentiating between a malignant and benign thyroid nodule. It greatly influences the
treatment decision.
Aim : This study aimed to evaluate the accuracy of fine
needle aspiration cytology
(FNAC) in the diagnosis of thyroid nodules by evaluating the cytology–histopathology
correlation .
Materials and Methods : This is a prospective study of 49 diagnosed cases of thyroid
nodules who underwent FNAC and histological study of surgical biopsies for diagnosis at
Tishreen University Hospital , during the period between march 2017 – march 2018 .The
results were categorized according to Betheseda classification into:
insufficient for diagnosis, benign, follicular lesion of undetermined significance, follicular
neoplasm, suspicious for malignancy, and malignant sampling. The final histologic
diagnosis was considered the gold standard.
Results : The study included 49 cases presented with thyroid nodules who underwent
diagnostic thyroid FNAC. Female to male ratio was 7.2:1, and the mean age was 43.6
years.
Thirty –nine cases (79.6%) were diagnosed as benign, 3 cases (6.1%) as unsatisfactory , 2
cases (4.1%) as follicular neoplasm, 2 cases (4.1%) as suspicious for malignancy, 2 cases
(4.1%) as malignant, and 1 case (2%) as follicular lesion of undetermined significance.
Nodular goitre represented the majority of benign cases (62.8%), while papillary
carcinoma was the most frequent malignant lesion (83.3%).
Cytologic diagnoses were compared with their corresponding final histologic ones. FNAC
achieved a sensitivity of 83.3%, a specificity of 97.4%, a positive predictive value of
83.3%, a negative predictive value of 97.4%, a false positive rate of 2.5% , a false negative
rate of 16.6% , and a total accuracy of 95.5%.
Conclusion : FNA cytology is a sensitive, specific, and accurate initial diagnostic test for
the evaluation of patients with thyroid nodules.
This research is designed to study the diagnostic yield of brush cytology for biliary
strictures. Brush cytology technique is of a great value to provide cytological samples
during ERCP for patients with biliary strictures .
The study included 34
patients with biliary stricture, ERCP was performed to all
patients and cellular samples were taken using a brush for cytology . During the study
period (one year) , the final diagnosis was made using a systematic approach based on
clinical, radiological, laboratory or histopathological diagnosis . Sensitivity and specificity
of brush cytology were studied .
The sensitivity of biliary brushing was 57.1% , specificity was 100%, positive
predictive value was 100% , negative predictive value was 76.9% and accuracy was 82% .
Conclusions: Brush cytology has a very high specificity but an intermediate
sensitivity for the diagnosis of malignant biliary strictures . Despite that , brush cytology
is of a high diagnostic utility to distinguish between malignant and benign causes of biliary
strictures .