Background:
Fine needle aspiration (FNA) cytology allows the stratification of thyroid lesions to direct further management. It is essential that departmental audits are carried out to assess concordance with histology, the ‘gold standard’. This audit reviewed the cytology and subsequent histology for ≥Thy3a grades and assessed concordance with standardised risk of malignancy (ROM).
Method:
A retrospective assessment, using Telepath and the Electronic Patient Record, was completed of all thyroid FNAs received by the Cytopathology Laboratory in St. James’s Hospital over the course of 1 year, between 1st July 2022 and 30th June 2023.
Results:
Of n = 370 thyroid FNAs;
The majority (201) were benign (Thy2) 54.3% while 17.8% were ≥Thy3a (66).
Of n = 66 (≥Thy3a);
(29) were (Thy 3a) 7.8%,
(18) (Thy 3f) 4.9%,
(3) (Thy 4) 0.8% and
(16) (Thy 5) 4.3%.
Twenty-one cases (31.8%) of ≥Thy3a categories had follow up histology; where concordance was seen in
2/3 (Thy3a),
2/4 (Thy3f),
1/1 (Thy4) and
13/13 (Thy5) cases.
Translating to ROM values:
66.7% (Thy3a),
50% (Thy3f),
100% (Thy4) and
100% (Thy5).
Conclusion:
This study shows good thyroid cytology and histology concordance, and higher predictive ROM values when compared to other studies. This is largely attributed to small sample size.
Aoife Cunningham1, Siobhan Nicholson1, Bijal Shah1
1 Department of Histopathology, St. James’s Hospital, Dublin