Endocrine Abstracts

Introduction: FNA cytology are done for solitary nodule or a dominant nodule in MNG.FNA classified in 5 groups (THY1 to THY5). FNA labelled as THY1 and THY2 should have repeat FNA. We have studied the FNA cytology over the period of 5 years. They are done in clinical settings by physician, surgeon or radiologist. Aim: To assess the trust practice of FNA cytology in Thyroid swelling and compare them with standards.

Methods: Data were collected from pathology laboratory and medical records. There were 456 FNA of which 195 had subsequent histologies and 261 has normal follow up. FNA were classified into benign, inadequate, suspicious and malignant.

Results: There were 271 benign FNA 41/271(15%) has repeat FNA 83/271(30%) has histologies 188/271 has normal follow up, 74/271(27%) has benign and 9/271(3.3%) has malignant histologies. 142 has inadequate FNA 33/142(23%) has repeat FNA 69/142(48%) has histologies 73 had normal follow up, 57/142(40%) has benign and 12/142(8%) has malignant histologies.38 suspicious FNA 26 were benign and 12 were malignant. 5 were malignant FNA 4 were malignant and 1 benign. 262 were true negative, 28 true positive, 9 false positive and 27 false positive. This gives sensitivity of 75%, specificity of 90%, positive predictive value of 50% negative predictive value of 96%and a accuracy of 88%.

Conclusion: Our study has shown that repeat FNA (benign 15% malignant 23%) were far below the standard. Significant amount of patient (31%) has benign histologies. The FNA cytology has high negative predictive value, if guide lines were followed large number of patients will be spared from unnecessary surgery. However a negative FNA should never exclude malignancy if there is a clinical suspicion.

Declaration of interest: There is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Funding: No specific grant from any funding agency in the public, commercial or not-for-profit sector.