Diagnostic pitfalls in the evaluation of fine needle aspiration cytology of the thyroid: correlation with histopathology in 260 cases

• Published in: Cytopathology (Oxford) Vol. 20; no. 2; pp. 103 - 108
• Main Authors: Haberal, A.N, Toru, S, Özen, Ö, Arat, Z, Bilezikçi, B
• Format: Journal Article
• Language: English
• Published: Oxford, UK Oxford, UK : Blackwell Publishing Ltd 01.04.2009; Blackwell Publishing Ltd
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biopsy, Fine-Needle; Carcinoma, Papillary - diagnosis; Carcinoma, Papillary - pathology; Child; cytodiagnosis; Diagnosis, Differential; Diagnostic Errors; diagnostic pitfalls; Female; fine needle aspiration cytology; Hashimoto Disease - diagnosis; Hashimoto Disease - pathology; Humans; Male; Middle Aged; sensitivity; Sensitivity and Specificity; specificity; thyroid gland; Thyroid Gland - pathology; Thyroid Neoplasms - diagnosis; Thyroid Neoplasms - pathology; Young Adult
• ISSN: 0956-5507; 1365-2303
• DOI: 10.1111/j.1365-2303.2008.00594.x

Fine needle aspiration cytology (FNAC) of the thyroid is a non-invasive, cost-effective screening procedure that is valuable for distinguishing neoplastic lesions from non-neoplastic nodules. The aim of this study was to determine the diagnostic accuracy of FNACs performed at our institution by correlating FNAC results with histopathological diagnoses. Two hundred and seventy-one aspiration cytology specimens followed by thyroidectomy were included in the study, and the results of 260 adequate FNACs were compared with their histological diagnoses. The sensitivity and specificity of thyroid FNAC for detecting neoplasia were 92.6% and 91.6%, respectively. There were 15 (5.7%) false positives and six (2.3%) false negatives. The results showed that follicular cells that exhibit some of the features of papillary carcinoma could be observed in a cytology slide of Hashimoto's thyroiditis, leading to a diagnostic pitfall. In addition, cellularity and overlapping cytological criteria in hyperplasia might lead to a false diagnosis.