Abstract
ASSOCIATION BETWEEN FINE NEEDLE ASPIRATION AND POSTOPERATIVE HISTOPATHOLOGY IN THYROID LESIONS OF JORDANIAN PATIENTS

Sahel W. Haddadin*, Ahmad M. Mahasna, Ibrahim AK. Abumekhleb, Fares S. Almaaitah, Yasmin M. Alsaidat, Adeeb S. Halasa, Soud K. Rouhaldin, Anas M. Mhasnah, Donyaz N. Ghnaneem and Mohammad M. Buwaitel

ABSTRACT

Background: Thyroid lesions are one of the most common issues that are encountered by a physician. Assessment of these lesions is collectively done with the aid of ultrasound, thyroid function tests, and cytology through FNA, which shows that up to 60% of the general population might be spotted with a thyroid lesion with an incidence of 20% to 25% of indeterminate significance and a malignancy rate of 5%, which is usually confirmed by the final histology report. Fine needle aspiration has false negative and false positive outcomes. Fine needle aspiration is the first-line confirmation investigation to assess thyroid lesions, aiming to diagnose benign lesions and decrease unnecessary operations. Fine needle aspiration is the sole main precise and cost-effective technique. Goal: To associate fine needle aspiration before surgery and histopathology after surgery in thyroid lesions. Methods: Our retrospective investigation included 247 patients with thyroid lesions, single or multiple, aged 20–80 yrs. and of both sexes, at King Hussein hospital, King Hussein medical city, Amman, Jordan, during the period Feb 2018–Feb 2022. Fine needle aspiration was used before surgery and was followed by histopathology after surgery. Confirmation classification of 247 thyroid lesions was done according to fine needle aspiration and histopathology. A correlation was done between fine needle aspiration before surgery and surgical specimen results after surgery, including confirmation of FNA results and malignancy rates. Fine needle aspiration results were based on the Bethesda System of the Royal College of Pathologists (RCPath) classification. In general, classification is divided into six categories: Bethesda category I (non-diagnostic), Bethesda category II (benign), Bethesda category III (Atypia of undetermined significance/Follicular lesion of undetermined significance; AUS/FLUS), Bethesda category IV (follicular neoplasm), Bethesda category V (suspicious for malignancy) and Bethesda category VI (malignant). The examined specimens were classified into Bethesda categories (III–VI). The examined FNA specimens included a minimum of an air-dried slide and an alcohol-fixed slide and were prepared using Papanicolaou and Romanowsky-type stains. Following fine needle aspiration, all patients were scheduled for surgery. The thyroidectomy specimen was assessed by histopathological examination. Surgical specimens were fixed in formalin, processed by automated tissue processors and stained using hematoxylin and eosin. Results: Fine needle aspiration showed that 80.97% (200/247) lesions were benign, and 19.03% (47/247) were malignant. In benign lesions, 31.6% (78/247) of patients were follicular. In malignant lesions, 19.03% (47/247) of patients had papillary carcinoma. Histopathology demonstrated that 64.8% (160/247) of lesions were benign, and 35.2% (87/247) were malignant. In benign lesions; 38.1% (94/247) of patients had a multinodular goiter. In malignant lesions, 25.9% (64/247) of patients had papillary carcinoma. Regarding men, there was a complete match of multinodular goiter (4) between fine needle aspiration and histopathology. Regarding women, there was complete matching of multinodular goiter (6) and papillary carcinoma (34) between fine needle aspiration and histopathology. Conclusions: Fine needle aspiration is a safe and cost-effective investigation for thyroid lesions, but histopathology is diagnostic.

Keywords: Thyroid lesions; Fine needle aspiration; Histopathology.


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