Diagnostic accuracy of fine needle aspiration cytology in patients undergoing thyroidectomy in mulago hospital: A cross sectional study

Abstract

Background. Thyroid disease affects about 5% of the general population worldwide. About 82% of patients attending Mulago hospital who present with thyroid disease have nodular thyroid disease. Emerging studies especially in tropical Africa with a high prevalence of nodular thyroid disease show slightly low sensitivity and specificity with FNAC compared to other studies. The objectives of this study were to estimate the sensitivity and specificity of FNAC for thyroid disease using histopathology of excised specimen as the gold standard and to describe the histopathological diagnoses in patients with thyroid disease that have undergone thyroidectomy. Methods. A cross sectional study with both prospective and retrospective arms. Patients with goitres underwent clinical evaluation, investigations and surgery. The study was conducted from January 2014 to April 2014. Data were entered into EPIDATA 3.1 and exported to STATA version 10 for statistical analysis. Results. In total 99 patients were recruited, F: M ratio was 15.5:1 and median age was 42 years (IQR 34-50). The median duration of symptoms was 364 weeks (IQR 104-986). The overall incidence of malignancy was 13.3% with papillary thyroid carcinoma being the most predominant type and colloid goiter was the most predominant benign thyroid disease. The sensitivity was 61.54% and specificity 89.53%. Conclusions and recommendations. There was a high incidence of malignancy. There was a low sensitivity and high specificity for detecting malignancy by FNAC in our setting. FNAC should be used as part of initial evaluation of thyroid nodules for malignancy before surgery.