Date of Award
2020
Document Type
Dissertation
Degree Name
Master of Medicine (MMed)
First Supervisor/Advisor
Dr. Abdulkarim Abdallah
Second Supervisor/Advisor
Dr. Shahin Sayed
Third Supervisor/Advisor
Dr. Eric Njenga
Department
General Surgery (East Africa)
Abstract
Background: Solitary thyroid nodules are commonly encountered endocrine disorders in surgical practice. Fine Needle Aspiration Cytology (FNAC) is a minimally invasive, accurate and cost-effective diagnostic tool that provides basis for surgical decisions-making in thyroid lesions management. Thus, it’s imperative that such a test should have high diagnostic accuracy in order to avoid under or over-treatment arising from false negative or positive results respectively. Studies from the African region, compared to the developed world have reported higher thyroid cyto-histologic discrepancy.
Objective: To determine the diagnostic accuracy and adverse surgical outcome of discrepant thyroid cytology.
Methods: Retrospective cross-sectional analytical study conducted at the Aga Khan University Hospital Nairobi (AKUHN) between January 2013 and December 2017.
Results: Overall, 176 patients were sampled, the female: male ratio was 5:1 and majority of patients in 30 to 40 years age bracket. Sensitivity and specificity of thyroid cytology obtained in the study was 83.2% and 95.2% respectively with a diagnostic accuracy of 84.7%. The majority of the discordant cases were false positive follicular neoplasm, followed by false negative papillary carcinoma, thyroiditis and Hurthle cell carcinoma. No difference in adverse surgical outcomes was noted between concordant and discrepant cytology cases.
Conclusion: The study showed diagnostic accuracy and false positive rate comparable to those reported from the developed world. No difference in adverse surgical outcomes was noted between concordant and discrepant cytology cases.
Recommended Citation
Barasa, M. (2020). Cyto-histological correlation of thyroid cytology and associated adverse surgical outcomes at aga khan university hospital, Nairobi. (Unpublished master's dissertation). Aga Khan University, East Africa.