Role of fine needle aspiration and frozen section in determining the extent of thyroidectomy |
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Authors: | Shabbir Akhtar Mohammad Sohail Awan |
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Institution: | (1) Department of Otolaryngology Head and Neck Surgery, Aga Khan University Hospital, Stadium Road, PO Box 3500, Karachi, 74800, Pakistan |
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Abstract: | The routine use of fine needle aspiration (FNA) and frozen section (FS) in the management of a thyroid nodule is controversial
and needs to be evaluated on an institution to institution basis. Our aim was to determine the role of FNA and FS in determining
the extent of thyroidectomy. We performed a comparative study of FNA and FS examination of all patients presenting with nodular
thyroid disease between September 2002 and December 2005. Data were collected on a proforma by reviewing FNA, FS and histopathological
reports. Data were analyzed on SPSS 11. Sensitivity, specificity, accuracy, positive predictive value and negative predictive
values were calculated. We included 44 patients with preoperative FNA, intraoperative FS examination and final histopathology
reports available. We excluded patients with local invasion and distant metastases. Final histopathological report was taken
as gold standard. FNA reported 8 benign, 7 papillary carcinoma, 22 follicular neoplasm, 1 medullary and 6 suspicious lesions.
On final pathology there were 16 benign and 28 malignant cases. Thus a total of 20 carcinomas were missed by FNA. When routine
FS was done, a total of ten patients who had malignancy were missed. Both FNA and FS have high specificity for diagnosis of
thyroid cancer but lacked sensitivity at our instituition. This is mainly because of high false negative results. |
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Keywords: | Fine needle aspiration Frozen section Thyroid nodules |
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