Cytohistological correlations of thyroid masses findings at the moi teaching and referral hospital, Kenya

Thyroid masses are common clinical manifestations with a worldwide prevalence of 4–7% in the general adult population and 0.2% – 1.2% in children. Thyroid nodules are 4 times more common in females than in males and increase in frequency with age. The vast majority of thyroid nodules are benign; fewer than 5% are malignant. The distinction of benign from malignant nodules is fundamental, as it is preferred to operate only on those patients with suspicion of malignancy, while strict patient follow-up is necessary in dealing with benign cases. Fine Needle Aspiration Cytology (FNAC) of thyroidis simple, minimally invasive, cost effective, readily available, time saving and an easy to perform outpatient procedure. The study was carried out at Moi Teaching and Referral Hospital (MTRH); its objective was to assess the FNAC findings of thyroid masses with those of corresponding histological evaluation findings. FNAC and corresponding histological findings for 118 participants who had a pre-operative FNAC and subsequently a thyroid resection for definitive histological diagnosis between January 2007 and December 2014 were accessed from the archives of MTRH pathology laboratory. Therewere88 (74.60%) females and 30 (24.40%) Males; with a male, female ratio of 1:3.Their ages ranged between 17-88 years with a mean of 40.61 and SD of 14.93. Majority of the participants were in their third decade. Of the 118 FNACs, 17(14.40%) were inadequate to make a diagnosis, 14(11.86%) were suspicious for malignancy, and 78 (66.1%) were benign while 9 (7.62%) were malignant. FNAC diagnoses were compared with the corresponding histological evaluation diagnoses for correlations and discrepancies. However the suspicious and inadequate FNAC diagnoses were excluded from statistical calculations analysis owing to their non-diagnostic importance. The concordance, false positive and false negative rates were 90.80%, 3.44% and 5.74% respectively. There was a significant agreement between the two tests (p= 0.34). FNAC of thyroid is accurate and has a low rate of false-negatives and false-positives diagnoses and can be adopted and relied upon in evaluating thyroid nodules, thus reducing the rate of unnecessary surgeries, the cost of health care and the risks associated with surgeries, resulting in better outcome of patients care.

Kiptanui Chebii, Finson Bargoria and Dominic Alwala
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Int J Inf Res Rev
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David Johnson
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