Fine needle aspiration cytology in isolated thyroid swellings: a prospective two year evaluation.

ABSTRACT

During 1 September 1981 to August 1982 aspiration cytology was carried out in all isolated thyroid swellings referred to the Aberdeen Thyroid Clinic cytological findings were not disclosed, did not influence management, and were compared retrospectively with the histological diagnosis. In a total of 70 swellings sensitivity for the detection of neoplasia was 86% and overall accuracy 92%; the positive predictive value was 80% and negative predictive value 96%. During the second year (1 September 1982 to 31 August 1983), when cytological findings were used to influence management, the frequency of operation for isolated thyroid swellings decreased by 25% and the proportion of operations for neoplasia increased from 31% to 50%. In terms of bed occupancy the potentially avoidable surgical workload for benign disease was reduced by 34%. Aspiration cytology, carried out at the first clinic attendance, makes a sound basis for selective surgery and leads to economy in the management of isolated thyroid swellings.