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Reporting Fine Needle Aspiration Cytopathology (FNAC) of Thyroid Lesion Per Guidelines of Recent Bethesda System For Reporting Thyroid Cytopathology Markedly Reduces Number of Un Necessary Thyroidectomies

Authors: Hussain Abady Aljebori --- Basim Shehab Ahmed --- Hiba Ahmed Gaidan
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2017 Volume: 14 Issue: 2 Pages: 309 -316
Publisher: Babylon University جامعة بابل

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Abstract

Estimation of accuracy of fine needle aspiration cytopathology (FNAC) of thyroid in diagnosis of different thyroid lesions, and evaluation of the value of reporting FNAC per guidelines of Bethesda system in reducing the number of un necessary thyroidectomies. This is a case control prospective study conducted on 221 patients with thyroid nodule[s]. Patient were recruited to Cytopathology Department, Al-Yarmouk Teaching Hospital in the period from January 2014 to March 2017. Results of FNAC were reported per recent Bethesda System for Reporting of Thyroid Cytopathology (TBSRTC). Final diagnoses were determined by histopathology of surgically removed thyroid tissues. Females were more than males with a ratio of 5.31/1, median age was 45.67±3.1 years. Twelve of cases (5.43%) categorized as nondiagnostic/ unsatisfactory samples, 128 (57.92%) as benign, and 29 (13.13%) as atypia of undetermined significance/atypical follicular lesion of undetermined significance (AUS/AFLUS), 34 (15.38%) as follicular neoplasm/suspected follicular neoplasm (FN/SFN), 5 (2.26%) as suspicious for malignancy, and 13 cases (5.88%) as malignant. Histopathology found 2 cases from cytopathological benign category, 7 from AUS/AFLUS, 11 from FN/SFN, 3 from SFM, and twelve from malignantcategory to be malignant. FNAC achieved a sensitivity of 85.71%, specificity of 99.21%, positive predictive value of 92.31%, negative predictive value of 98.44%, and total accuracy of 97.87%. Reporting thyroid cytopathology per Bethesda system increases sensitivity, specificity, accuracy of thyroid cytopathology, increases understanding of reporting system by clinician, improves management plans, and reducing number of un necessary thyroidectomies.


Article
Accuracy of Perineal Percutaneous Fine Needle Aspiration Cytology (FNAC) of Prostate under Ultra- Sound in Comparism with Transrectal Aspiration in Diagnosis of Prostatic Cancer

Authors: Hussain Abady Aljebori --- Hiba Ahmed Gaidan --- Suhaila Sleem Kareem
Journal: Iraqi Journal of Cancer and Medical Genetics المجلة العراقية للسرطان والوراثة الطبية ISSN: 20786123 Year: 2017 Volume: 10 Issue: 2 Pages: 196-203
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Prostatic carcinoma is the commonest internal malignancy of adult males. Patients usually presenting withvoiding symptoms. Clinical suspicion of prostatic carcinoma depends on finding of one or more of the followings; hard prostaticnodule(s) on digital rectal examination (DRE), hypoechoic lesion on transrectal ultrasonography (TRUS), and/or highserum level of prostatic specific antigen (PSA). Final diagnosis depends on FNAC and/or histopathology. Objective: This is acase control prospective study designed to evaluate the usefulness of FNAC of prostate through perineal skin under ultrasoundinstead of transrectal aspiration in diagnosis of suspicious prostatic conditions.Patients and Methods: One hundred and ten males with voiding symptoms and clinical suspicion of prostatic carcinoma wereparticipated in the study. Their ages were between 45 and 92 years. The aspiration was carried out as outpatient procedure.Results: Cytopathological results were; 64 (58.18%) positive, 4 (3.64%) suspicious, and 40 (36.36%) negative for prostaticcancer. Two specimens (1.82%) were inadequate for proper cytopathology. Results of histopathological examination of resectedspecimens from the same patients was very close to that of cytopathology with only two false positive and one falsenegative results. There was no any mentioned complication following aspiration, and sensitivity, specificity, and accuracywere 98%, 95%, and 91.81% respectively, and all results were statistically significant with p-values <0.05.Conclusion: Percutaneous perineal FNAC of prostate under ultrasound is a safe, reliable, cost effective, and as accurate astransrectal FNAC in diagnosis of prostatic cancer.

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