Journal of Practical Medicine and Medical Science

Thyroid cancer is the most common malignant endocrine tumor. Its clinical presentation is usually as a solitary thyroid nodule of increasing goiter size. As for diagnosis, ultrasound-guided thyroid Fine Needle Aspirate (FNA) followed by cytological examination is considered the standard practice due to its cost effective and minimally invasive nature. In this regard, FNA can be considered a screening test, selecting for surgery nodules with a greater probability of malignancy. The aim of the present study is to assess the importance of FNA in diagnosis of different thyroid pathologies in Lebanon. This study was retrospective in which data was collected by reviewing patients’ medical files with thyroid pathology samples collected by FNA at the Institut National de Pathologie for the period of 2015-2017. The specificity and sensitivity of cytological diagnoses were evaluated based on histological diagnosis. The results show that a total of 735 FNA cytology were performed in 735 patients, of whom 165 (22.4%) were males and 570 (77.6%) were females. Mean age of the patients was 48.6±13.4 years. Amongst the 735 cases, 57 cases (7.8%) were classified as unsatisfactory, 526 cases (71.6%) as benign, 32 cases (4.4%) as follicular lesion of undetermined significance, 35 cases (4.8%) as suspicious for malignancy, 41 cases (5.6%) as suspicious for follicular neoplasm, and 44 cases (6.0%) as malignant. The mean size of nodule (19.4±10.2 mm) decreased by year from 22.3 mm in 2015 till 18.4 mm in 2017 (p< 0.001) and malignancy was higher with larger nodules (p< 0.001). Therefore, the sensitivity, specificity, positive predictive value, and negative predictive value were 85.7, 99.6, 75.0, and 99.8%, respectively. In conclusion, this study highlighted the relevance of FNA in diagnosing thyroid pathologies and evaluated malignancy prevalence. More studies are needed to test whether FNA’s role is important in diagnosing thyroid nodules and ruling out malignancy.