Concordance between fine needle aspiration cytology and post operative histopathology in thyroid nodules

Abstract

Objective: To analyze the concordance between fine needle aspiration cytopathology (FNAC) and post-operative histopathological (POH) reports including characteristics of local invasions and cervical lymph node metastasis (LNM) in thyroid carcinoma at the 108 Military Central Hospital. Subject and method: Retrospective study was designed to analyze 1384 thyroid nodules from 1322 patients who underwent surgery comparing preoperative fine needle aspiration cytology with post-operative histology results at the 108 Military Central Hospital from January 2020 to December 2020, these patients met eligible criteria to have simultaneously FNAC and POH reports. Result: There were (1259/1384) 90.97% cases of thyroid carcinoma in all thyroid nodules with ratio of male/female was 1/4.7, ages from 11 to 85 years old, the peak of malignancy at the group over fifth decade of life and papillary thyroid carcinoma (PTC) generally accounted for (1243/1259) 98.73% of all thyroid carcinomas. There were 6 categories of Bethesda System for Reporting Thyroid Cytopathology (BTS) including categories I, II, III, IV, V and VI; thyroid carcinomas in each category as following 89.09%, 45.10%, 76.09%, 71.05%, 98.93% and 100.00%, respectively. Local and vascular invasions also occurred at the rate of 12.44% in papillary thyroid microcarcinoma (PTMC) and 41.85% in PTC. LNM reached to 7.39% in PTMC, 25.23% in PTC. Conclusion: Most patients with thyroid nodules had FNAC and operated at The 108 Military Central Hospital (from January 2020 to December 2020) were thyroid carcinoma (90.97%) in which PTC accounted for 98.73%, the rate of PTC is very high in any BTS categories, and most of them come from BTS categories V plus VI (72.25%). Surprisingly, PTC occurs in BTS category I unusually reached to 89.09%. Local invasion was generally over 50% (682/1259) and LNM was nearly 30% (319/1259) in the all malignant nodules.