A comparative study of fine needle aspiration cytology versus non aspiration technique in thyroid lesions

Authors

  • Sasikumar M. N. Department of General Surgery, Government Medical College, Kottayam, Kerala, India
  • Sam Christy Mammen Department of General Surgery, Government Medical College, Kottayam, Kerala, India
  • Jacob P. Thomas Department of General Surgery, Government Medical College, Kottayam, Kerala, India

DOI:

https://doi.org/10.18203/2349-2902.isj20180336

Keywords:

Diagnostically superior, Fine needle aspiration cytology, Fine needle non aspiration technique

Abstract

Background: Fine needle aspiration cytology (FNAC) is regarded as the gold standard investigation in the diagnosis of thyroid swellings. But often unsatisfactory specimen, especially mixed with blood, poses an obstacle in proper cytological interpretation. To overcome this problem, an alternative method of fine needle non aspiration cytology (FNNAC) technique was developed which, relies on the capillary pressure only to suck the cells inside the needle bore.

Methods: Patients presenting with thyroid swellings from July 2008 to January 2009 were included in the study. 91 patients treated for thyroid lesions entered a prospective comparative evaluation of fine needle cytology with aspiration and non-aspiration techniques in thyroid. The thyroid swelling in every patient was sampled by both the aspiration as well as the non-aspiration technique by a single operator. Both procedures were done using 23G needles. Aspiration was done using a 10ml syringe. Both dry and wet smears were made and stained. All smears were interpreted by a cytologist without knowledge of the technique employed. Apart from the diagnosis, comments were made on the quality of the slides and three qualitative categories are created as unsuitable specimens, diagnostically adequate and diagnostically superior.

Results: Non-neoplastic lesions accounted for 92.3%. They comprised mainly of nodular colloid goiter 53.84%, colloid nodules 29.6%, thyroiditis 8.79%, and one case of suppurative lesion. Out of the 7 neoplasms, 2 were follicular neoplasms, 1 was papillary carcinoma, 2 cases of Hurthle cell neoplasm and 1 cellular nodule in an MNG. Diagnostically superior material was obtained in 42 cases (46.15%) of the non-aspiration samples, as compared with 18 cases (19.78%) of aspiration samples which was statistically significant.

Conclusions: The FNNAC produces better results in the form of a better quality of the cellularity and less field obscurity by blood. This technique should be used alone or in tandem with FNAC for better diagnostic yield.

References

Franzen S, Zajicek J. Aspiration biopsy in the diagnosis of palpable lesions of the breast: Critical review of 3479 consecutive biopsies. Acta Radiol Ther Phys Biol. 1968;7:241-62.

Kocjan G. The Fine Needle Aspiration Cytology. Introduction and Historical Perspective. London: Springer, Berlin, Heidelberg; 2006:1-5.

Dey P, Ray R. Comparison of fine needle sampling by capillary action and fine needle aspiration. Cytopathol. 1993;4(5):299-303.

Rizvi SA, Husain M, Khan S, Mohsin M. A comparative study of fine needle aspiration cytology versus non aspiration technique in thyroid lesions. Surgeon. 2005;3(4):273-6.

Santos JEC, Leiman G. Non aspiration fine needle cytology. Application of a new technique to nodular thyroid disease. Acta Cytol. 1988;32(3):353-6.

DeMay RM. Thyroid. In: The art and science of cytopathology. Chicago, IL: ASCP Press; 1996:704-778.

Briffod M, Gentile A, Hébert H. Cytopuncture in the follow-up of breast carcinoma. Acta Cytol 1982;26(2):195-200.

Tauro LF, Lobo GJ, Fernandes H, George C, Aithala PS, Shenoy D, Shetty P. A Comparative Study on Fine Needle Aspiration Cytology versus Fine Needle Capillary Cytology in Thyroid Nodules. Oman Med J. 2012;27(2):151-6.

Ramachandra L, Kudva R, Rao BH, Agrawal S. A Comparative Study of Fine Needle Aspiration Cytology (FNAC) and Fine Needle Non-aspiration Cytology (FNNAC) Technique in Lesions of Thyroid Gland. Indian J Surg. 2011;73(4):287-90.

Sajeev S, Siddaraju N. A comparative analysis of fine-needle capillary cytology vs. fine-needle aspiration cytology in superficial lymph node lesions. Diagn Cytopathol. 2009;37(11):787-91.

Dey P, Ray R. Comparison of fine needle sampling by capillary action and Fine needle aspiration cytology. Cytopathology. 1993;4:299-303.

Rizvi SA, Husain M, Khan S, Mohsin M. A comparative study of fine needle aspiration cytology versus non-aspiration technique in thyroid lesions. Surgeon. 2005;3(4):273-6.

de Carvalho GA, Paz-Filho G, Cavalcanti TC, Graf H. Adequacy and diagnostic accuracy of aspiration vs. capillary fine needle thyroid biopsies. Endocr Pathol. 2009;20(4):204-8.

Mahajan P, Sharma PR. Fine-Needle Aspiration Versus Non Aspiration Technique of Cytodiagnosis in Thyroid Lesions. JK Sci. 2012;12(3):120-2.

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Published

2018-01-25

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Original Research Articles