Endocrine Abstracts

Aim: To audit if fine needle aspiration of thyroid nodules are done as per the Royal College of Physicians Guidelines.

Methods: We selected a list of 25 patients who had FNA of throid nodule over a 6 months period between July 2008 and December 2008 and analysed if the procedure had been done in accordance with current Royal College of Physicians guidelines for FNA Thyroid.

Results:

1. None of the cytopathology reporting were done by histopathologist interested in thyroid disease.

2. 96% of procedures were done by physician interested in thyroid disease.

3. Only 24% of cytopathology requests had clinical details; 12% had details of aspiration; and 12% had details about site of aspiration. None conveyed if there was any resolution of mass.

4. 100% of all reports from Histopathology Department included description and numerical coding.

5. 56% of first attempts of FNAs were non-diagnostic. Still among them only 35% had repeat FNA with ultrasound guidance.

6. 12% were found to have follicular cells in FNAC. One among them did not have lobectomy. Rest were non malignant.

7. None of them had clear evidence of malignancy.

Conclusion:

1. It is clear from the analysis that majority of flaws are in the area of entering clinical details, and details of aspiration.

2. Histopathology reports are done by any histopathologist and it is not always possible to get histopathologist interested in thyroid disease.

3. All reports have description of cellular picture and numerical coding.

4. Although initial procedure is non-diagnostic in 56%, there was still reluctance in using ultrasound guidance.

5. Care need to be taken when dealing with FNAs showing follicular cells as one patient in our audit was not referred to surgeons immediately. These patients need to be referred urgently.