Displaying publications 1 - 20 of 33 in total

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  1. Diagnostic Value of the EZH2 Immunomarker in Malignant Effusion Cytology
    Ang PP, Tan GC, Karim N, Wong YP
    Acta Cytol., 2020;64(3):248-255.
    PMID: 31352449 DOI: 10.1159/000501406
    BACKGROUND: Differentiating reactive mesothelial cells from metastatic carcinoma in effusion cytology is a challenging task. The application of at least 4 monoclonal antibodies including 2 epithelial markers (Ber-EP4, MOC-31, CEA, or B72.3) and 2 mesothelial markers (calretinin, WT-1, CK5/6, or HBME-1) are often useful in this distinction; however, it is not readily available in many resource-limited developing countries. Aberrant immunoexpression of enhancer of zeste homolog 2 (EZH2), a transcriptional repressor involved in cancer progression, is observed widely in various malignancy. In this study, we evaluate the diagnostic value of EZH2 as a single reliable immunomarker for malignancy in effusion samples.

    METHODS: A total of 108 pleural, peritoneal, and pericardial effusions/washings diagnosed as unequivocally reactive (n = 41) and metastatic carcinoma (n = 67) by cytomorphology over 18 months were reviewed. Among the metastatic carcinoma cases, 54 were adenocarcinoma and others were squamous cell carcinoma (n = 1), carcinosarcoma (n = 1), and carcinoma of undefined histological subtypes (n = 11). Cell block sections were immunostained by EZH2 (Cell Marque, USA). The percentages of EZH2-immunolabeled cells over the total cells of interest were calculated. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off score to define EZH2 immunopositivity.

    RESULTS: A threshold of 8% EZH2-immunolabeled cells allows distinction between malignant and reactive mesothelial cells, with 95.5% sensitivity, 100% specificity, 100% positive predictive value, and 93.2% negative predictive value (p < 0.0001). The area under the curve was 0.988.

    CONCLUSION: EZH2 is a promising diagnostic biomarker for malignancy in effusion cytology which is inexpensive yet trustworthy and could potentially be used routinely in countries under considerable economic constraints.

    Matched MeSH terms: Cytodiagnosis/methods
  2. Fulltext Comparing CxBladder to Urine Cytology as Adjunct to Cystoscopy in Surveillance of Non-muscle Invasive Bladder Cancer-A Pilot Study
    Chai CA, Yeoh WS, Rajandram R, Aung KP, Ong TA, Kuppusamy S, et al.
    Front Surg, 2021;8:659292.
    PMID: 34055868 DOI: 10.3389/fsurg.2021.659292
    Purpose: Guidelines advocate cystoscopy surveillance (CS) for non-muscle invasive bladder cancer (NMIBC) post-resection. However, cystoscopy is operator dependent and may miss upper tract lesions or carcinoma in-situ (CIS). Urine cytology is a common adjunct but lacks sensitivity and specificity in detecting recurrence. A new mRNA biomarker (CxBladder) was compared with urine cytology as an adjunct to cystoscopy in detecting a positive cystoscopy findings during surveillance cystoscopy in our center. Materials and Methods: Consented patients older than 18, undergoing CS for NMIBC, provide paired urine samples for cytology and CxBladder test. Patients with positive cystoscopy findings would undergo re-Trans Urethral Resection of Bladder Tumor (TURBT). Results: Thirty-five patients were enrolled from April to June 2019. Seven contaminated urine samples were excluded. The remaining cohort of 23 (82%) and 5 (18%) females had a mean age of 66.69 (36-89). Eight (29%) patients with positive cystoscopy finding underwent TURBT. All 8 patients also had positive CxBladder result. This shows that CxBladder has a sensitivity and negative predictive value (NPV) of 100%, specificity of 75% and positive predictive value (PPV) of 62% in predicting a positive cystoscopy finding. TURBT Histo-pathological findings showed Low-grade Ta NMIBC in one patient (4%), and 7 (25%) patients had inflammatory changes. Urine cytology was only positive in one patient with a positive cystoscopy finding. This led to a sensitivity of merely 13% and NPV of 74%, while specificity and PPV was 100% in predicting a positive cystoscopy finding. Conclusion: CxBladder had high NPV and sensitivity which accurately predicted suspicious cystoscopy findings leading to further investigation. It has great potential for use as adjunct to cystoscopy for surveillance of NMIBC.
    Matched MeSH terms: Cytodiagnosis
  3. Fulltext Pleomorphic Adenoma Originating from Submandibular Salivary Gland in an 8-year-old Girl: A Case Report.
    Gani, A.N., Megat Shiraz, M.A.R., Siti Aishah, M.A., Norazizah, M., Mozita, A., Sharifah, N.A.
    Medicine & Health, 2007;2(2):164-168.
    MyJurnal
    Pleomorphic adenoma (PA) typically presents as a benign slow growing, painless neoplasm of the parotid gland. PA arising from the submandibular gland in the paediatric age group is rare. Surgical excision is the treatment of choice. A case of PA in an 8-year-old Malay girl is presented. Clinically she presented with a painless right submandibular mass measuring 2x2cm. A diagnosis of Pleomorphic adenoma was made on Fine Needle Aspiration Cytology (FNAC). She underwent submandibulectomy uneventfully. Postoperatively after two years follow up, she is asymptomatic.
    Matched MeSH terms: Cytodiagnosis
  4. Cytologic evaluation of prognostic markers in breast carcinoma
    Jayaram G, Elsayed EM
    Acta Cytol., 2005 Nov-Dec;49(6):605-10.
    PMID: 16450899
    To type breast carcinomaon on fine needle aspiration cytology (FNAC) material and correlate the results with histologic typing, to grade breast carcinoma on FNAC material and correlate the findings with Bloom-Richardson histologic grading, and to determine the estrogen receptor (ER) status in cases of breast carcinoma by immunocytochemical (ICC) staining of FNA cytologic material and correlate the findings with ER status, as determined by immunohistochemical (IHC) staining of tissue sections.

    STUDY DESIGN: Seventy-seven cases of breast carcinoma diagnosed on FNAC formed the basis of this study. Typing was done in all cases on the basis of cytologic features and grading in 62. (Fifteen cases were special types of breast carcinoma). In all cases, ER status was determined by immunostaining of cytologic smears. Results of tumor typing, grading and ER status on cytologic material were compared with the results of histologic typing, grading and immunostaining of histologic material obtained from mastectomy or wide excision specimens.

    RESULTS: Tumor typing was accurate in 73 of 77 cases (94.8%). Fifteen of 18 cases that were cytologically grade 3 were confirmed on histology, while 3 proved to be grade 2. Of 40 cytologic grade 2 cases, 26 were confirmed on histology, while 14 cases were grade 3. Three of 4 cytologically grade 1 cases were confirmed on histology while 1 was grade 2. The overall accuracy for cytologic grading was 71% (44 of 62 cases). Thirty-seven of 40 ER-positive cases (92.5%) were labeled ER positive on ICC. One case was ER negative on cytology, while in 2 cases the cellularity of the cytologic smear was insufficient to assess ER expression. Thirty-seven cases were negativefor ER on IHC. Nine of these showed ER positivity on ICC, 26 were negative, and 2 had cellularity that was inadequate for assessment of ER. Sensitivity and specificity rates for ER detection on ICC were 97.4% and 74.3%, respectively.

    CONCLUSION: Tumor typing, grading and evaluation of ER status on FNA C material in breast carcinomas are simple, quick and moderately reliable techniques that compare and correlate favorably with histologic typing, grading and ER status on IHC.
    Matched MeSH terms: Cytodiagnosis/methods
  5. Cytologic appearances in invasive lobular carcinoma of the breast. A study of 21 cases
    Jayaram G, Swain M, Chew MT, Yip CH
    Acta Cytol., 2000 Mar-Apr;44(2):169-74.
    PMID: 10740602
    OBJECTIVE: To examine the fine needle aspiration cytologic features of invasive lobular carcinoma of breast and to discuss problems that may occur in cytodiagnosis.

    STUDY DESIGN: Fine needle aspiration cytologic smears from 21 cases of invasive lobular carcinoma (ILC) of breast were subjected to detailed cytomorphologic analysis. Features studied included pattern of cells, size of cells, nuclear placement, pleomorphism, presence of intracytoplasmic lumina (ICL) and signet ring cells.

    RESULTS: Cellularity was generally moderate or high, and the pattern was predominantly or partly dissociated in 86% of cases. Rosettelike pattern was discerned in alveolar-type ILC. Cell size was usually small or intermediate, with nuclei placed eccentrically in most cases. ICLs with or without signet ring cells were present in 12 cases (57%).

    CONCLUSION: A cytologic picture consisting of predominantly dissociated small or intermediate-sized tumor cells with eccentric nuclei, with some of the cells showing ICLs, is highly suggestive of ILC. Indian file pattern, another characteristic feature of ILC, is, however, focal and inconsistent. Variant patterns of ILC may show other cytologic features, such as rosettelike pattern (alveolar variant of ILC) or large cell pattern (pleomorphic variant of ILC) and may consequently be difficult to categorize on cytologic smears.
    Matched MeSH terms: Cytodiagnosis
  6. The laboratory diagnosis of veneral diseases--II--the laboratory diagnosis of gonorrhoea
    Jegathesan M
    Med J Malaysia, 1974 Sep;29(1):66-9.
    PMID: 4282635
    Matched MeSH terms: Cytodiagnosis
  7. Rapid diagnosis of Helicobacter pylori infection in gastric imprint smears
    Kaur G, Madhavan M, Basri AH, Sain AH, Hussain MS, Yatiban MK, et al.
    Southeast Asian J. Trop. Med. Public Health, 2004 Sep;35(3):676-80.
    PMID: 15689086
    The objective of this study was to determine the sensitivity, specificity, positive (PPV), and negative predictive values (NPV) of Diff-Quik-stained gastric imprint cytology smears in the detection of H. pylori compared with histology. Air-dried imprint smears of gastric biopsies from 150 patients were stained by the Diff-Quik method in the endoscopy suite and examined for H. pylori, providing results within minutes. The presence of inflammation and intestinal metaplasia were documented. The same biopsy was processed and stained with H&E and Warthin-Starry stains, and reviewed by a different pathologist blind to the imprint cytology results. Ninety-four of the 150 patients were male with a mean age of 50 years. Based on histology, the H. pylori prevalence was very low at 8%. The sensitivity and specificity of imprint cytology in the detection of H. pylori were 83.3% and 100%, respectively. The PPV and NPV were 100% and 98.6%, respectively. There were two false negatives and no false positives. A combination of imprint cytology and histology achieved 100% sensitivity. Imprint smears did not provide added value over histology with regards to inflammation and metaplasia. Gastric imprint smears stained with Diff-Quik method is a rapid, cheap, and reliable method for the detection of H. pylori and have their best results when complemented with histology.
    Matched MeSH terms: Cytodiagnosis/methods*
  8. Comparative Assessment of a Self-sampling Device and Gynecologist Sampling for Cytology and HPV DNA Detection in a Rural and Low Resource Setting: Malaysian Experience
    Latiff LA, Ibrahim Z, Pei CP, Rahman SA, Akhtari-Zavare M
    Asian Pac J Cancer Prev, 2015;16(18):8495-501.
    PMID: 26745108
    PURPOSE: This study was conducted to assess the agreement and differences between cervical self-sampling with a Kato device (KSSD) and gynecologist sampling for Pap cytology and human papillomavirus DNA (HPV DNA) detection.

    MATERIALS AND METHODS: Women underwent self-sampling followed by gynecologist sampling during screening at two primary health clinics. Pap cytology of cervical specimens was evaluated for specimen adequacy, presence of endocervical cells or transformation zone cells and cytological interpretation for cells abnormalities. Cervical specimens were also extracted and tested for HPV DNA detection. Positive HPV smears underwent gene sequencing and HPV genotyping by referring to the online NCBI gene bank. Results were compared between samplings by Kappa agreement and McNemar test.

    RESULTS: For Pap specimen adequacy, KSSD showed 100% agreement with gynecologist sampling but had only 32.3% agreement for presence of endocervical cells. Both sampling showed 100% agreement with only 1 case detected HSIL favouring CIN2 for cytology result. HPV DNA detection showed 86.2%agreement (K=0.64, 95% CI 0.524-0.756, p=0.001) between samplings. KSSD and gynaecologist sampling identified high risk HPV in 17.3% and 23.9% respectively (p= 0.014).

    CONCLUSION: The self-sampling using Kato device can serve as a tool in Pap cytology and HPV DNA detection in low resource settings in Malaysia. Self-sampling devices such as KSSD can be used as an alternative technique to gynaecologist sampling for cervical cancer screening among rural populations in Malaysia.

    Matched MeSH terms: Cytodiagnosis/methods
  9. Fulltext Diagnostic yield of flexible bronchoscopic procedures in lung cancer patients according to tumour location
    Liam CK, Pang YK, Poosparajah S
    Singapore Med J, 2007 Jul;48(7):625-31.
    PMID: 17609823
    This study aims to determine whether the diagnostic yield of flexible bronchoscopy sampling procedures in patients with lung cancer was dependent on tumour location.
    Matched MeSH terms: Cytodiagnosis/methods
  10. Fulltext Primary Thyroid Lymphoma: Surgical experience in HUKM
    Marjmin, O., Rohaizak, M., Naqiyah, I., Imtiaz, H., Hartinie, S.M.
    International Medical Journal Malaysia, 2007;6(2):1-3.
    MyJurnal
    Primary thyroid lymphoma is a rare tumour of the thyroid gland, accounting for 1-2 % of all thyroid malignancies. Diagnosis by fine needle aspiration cytology occasionally inconclusive, needing bigger biopsy or even thyroidectomy. This study reviews our experience with primary thyroid lymphoma.
    Matched MeSH terms: Cytodiagnosis
  11. Fulltext Carcinoma Ex Pleomorphic Adenoma Presented as a Gigantic Tumor: Treatment and Diagnostic Challenges
    Maruthamuthu T, Saniasiaya J, Mohamad I, Nadarajah S, Lazim NM, Wan Abdul Rahman WF
    Oman Med J, 2018 Jul;33(4):342-345.
    PMID: 30038735 DOI: 10.5001/omj.2018.62
    Parotid gland surgery can be challenging due to intricate relationship between the gland and facial nerve. Besides complete removal of the lesion, the main focus of surgery is centered on the facial nerve. Surgery can be technically demanding especially when the tumor is large or involves the deep lobe. We report a patient with a 30-year history of gigantic parotid mass, which initial fine-needle aspiration cytology reported as pleomorphic adenoma. The tumor, weighing 1.3 kg, was successfully resected with facial nerve preservation. Histopathological examination of the excised mass confirmed as carcinoma ex pleomorphic adenoma (CaExPA) of adenocarcinoma, not otherwise specified type. We describe the specific surgical and reconstruction techniques for successful removal of large parotid tumors with facial nerve preservation. To our knowledge, this is the heaviest CaExPA of the parotid gland in South-East Asian region.
    Matched MeSH terms: Cytodiagnosis
  12. Signet-ring Cell Lymphoma-a Case Report
    Masir N, Cheong SK, Noordin K
    Hematology, 2001;6(3):187-92.
    PMID: 27420125 DOI: 10.1080/10245332.2001.11746571
    A case of signet-ring cell lymphoma diagnosed initially by fine needle aspiration cytology is reported. This rare tumor is a variant of follicular lymphoma, which closely resembles metastatic adenocarcinoma and other tumors which exhibit signet-ring cell appearance. Correct diagnosis can be achieved by careful morphologic analysis together with positive reactivity with lymphoid markers. The cytohistologic, immunohistochemical and electron microscopic features are described, and the differ ential diagnostic considerations are discussed in the report.
    Matched MeSH terms: Cytodiagnosis
  13. Diagnostic Accuracy of Cytology Smear and Frozen Section in Glioma
    Mat Zin AA, Zulkarnain S
    Asian Pac J Cancer Prev, 2019 Feb 26;20(2):321-325.
    PMID: 30803189
    Glioma is the commonest primary intracranial tumour and it has been the most predominant tumour in many studies.
    It accounts for 24.7% of all primary brain tumour and 74.6% of malignant brain tumour. Intraoperative diagnosis
    plays a crucial role in determining the patient management. Frozen section has been the established technique in
    providing rapid and accurate intraoperative diagnosis. However due to some disadvantages like ice crystal artefact,
    high expenditure and requirement of skilled technician, there is increase usage of cytology smear either replacing or
    supplementing frozen section technique. The aim of this review is to determine the diagnostic accuracy of cytology
    smear and frozen section in glioma and to see whether there is significant difference between those techniques. The
    overall diagnostic accuracy for frozen section in glioma ranging from 78.4% to 95% while for cytology smear, the
    diagnostic accuracy ranging from 50% to 100%. Based on certain literatures, no statistically difference was observed
    in diagnostic accuracy of cytology smear and frozen section. Thus, cytology smear provides an alternative method in
    establishing intraoperative diagnosis. Both cytology smear and frozen section are complimentary to each other. It is
    recommended to use both techniques to improve the diagnostic accuracy in addition with adequate knowledge, clinical
    history, neuroimaging and intraoperative findings.
    Matched MeSH terms: Cytodiagnosis/methods*
  14. Fulltext Obstructive jaundice in small cell lung carcinoma
    Mokhtar Pour A, Masir N, Isa MR
    Malays J Pathol, 2015 Aug;37(2):149-52.
    PMID: 26277673 MyJurnal
    Small cell lung carcinoma (SCLC) commonly metastasizes to distant organs. However, metastasis to the pancreas is not a common event. Moreover, obstructive jaundice as a first clinical presentation of SCLC is extremely unusual. This case reports a 51-year-old male with SCLC, manifesting with obstructive jaundice as the initial clinical presentation. Endoscopic retrograde cholangiopancreatograghy (ERCP) and abdominal computed tomography (CT) scan showed a mass at the head of the pancreas. The patient underwent pancreatoduodenectomy (Whipple procedure). Histopathology revealed a chromogranin- A-positive poorly-differentiated neuroendocrine carcinoma of the pancreas. No imaging study of the lung was performed before surgery. A few months later, a follow-up CT revealed unilateral lung nodules with ipsilateral hilar nodes. A lung biopsy was done and histopathology reported a TTF- 1-positive, chromogranin A-positive, small cell carcinoma of the lung. On review, the pancreatic tumour was also TTF-1-positive. He was then treated with combination chemotherapy (cisplatin, etoposide). These findings highlight that presentation of a mass at the head of pancreas could be a manifestation of a metastatic tumour from elsewhere such as the lung, and thorough investigations should be performed before metastases can be ruled out.
    Matched MeSH terms: Cytodiagnosis
  15. Southeast asian ovalocytosis: the need for a carefull observation of red cell indices and blood smear
    Moulin PA, Nivaggioni V, Saut N, Grosdidier C, Bernot D, Baccini V
    Ann. Biol. Clin. (Paris), 2017 Dec 01;75(6):699-702.
    PMID: 29043981 DOI: 10.1684/abc.2017.1291
    Southeast asian ovalocytosis (SAO) is characterized by macro-ovalocytes and ovalo-stomatocytes on blood smear. SAO is common in Malaisia and Papua-New-Guinea where upwards to 40 per cent of the population is affected in some coastal region. Inherited in an autosomal dominant way, illness results from deletion of codons 400-408 in SLC4A1 gene which encodes for band 3 erythrocyte membrane protein. This deletion is responsible for an unusual erythrocyte stiffness and oval shape of the cells on blood smear. Heterozygous carriers are usually asymptomatic whereas homozygous are not viable without an intensive antenatal care. Here, we describe 4 patients diagnosed incidentally by cytogram appearance of the Advia® 2120i (Siemens) representing hemoglobin concentration according to red blood mean cellular volume (GR/VCH).
    Matched MeSH terms: Cytodiagnosis/methods; Cytodiagnosis/standards
  16. Fulltext Multifaceted usage of HPV related tests and products in the management of cervical cancer--a review
    Nalliah S, Karikalan B, Kademane K
    Asian Pac J Cancer Prev, 2015;16(6):2145-50.
    PMID: 25824730
    HPV viruses are integral to the development of cervical cancer. The pathogenesis has been extensively studied. To date, numerous HPV tests and products have been developed and successfully utilized in diagnosis, treatment and prevention of cervical cancer. The HPV DNA test, when combined with other routine cervical cancer screening and diagnostic tests namely exfoliative cytology, visual inspection with acetic acid (VIA) and colposcopy has increased the detection rate of cervical cancer. HPV DNA products could also be measured in other body fluids like urine, lymph node tissue, and serum. HPV association could also be quantified by measuring other parameters like HPV mRNA, viral load, viral integration and methylation status. Vaccination against HPV has been found to decrease the incidence of cervical cancer. Further, therapeutic vaccines for cervical cancer against HPV continue to evolve. All these findings pertaining to HPV could possibly decrease the incidence of cervical cancer in the near future. This review aims to give an overview of the HPV tests and products in use and those under trial currently.
    Matched MeSH terms: Cytodiagnosis
  17. Fulltext 405 cases of bronchial brushing cytology: an evaluation
    Ngen RMY, Cheong I, Yahaya O
    Med J Malaysia, 1985 Jun;40(2):98-100.
    PMID: 3834293
    405 cases of bronchial brushing cytology were evaluated for its effectiveness in detecting pulmonary carcinoma. Cytohistologic findings were correlated whenever endoscopic biopsies were performed. Sputum cytological investigations were also included in this paper to examine the total diagnostic sensitivity of all the three methods combined.
    Matched MeSH terms: Cytodiagnosis
  18. Fulltext Fine Needle Aspiration (FNA) Cytology of the Thyroid: A Cyto-Histopathological Study of 361 Cases in Hospital Universiti Kebangsaan Malaysia
    Nurismah, M.I., Sharifah, N.A., Usama, A.E., Rohaizak, M., Naqiyah, I., Jasmi, A.
    Medicine & Health, 2007;2(1):58-65.
    MyJurnal
    Thyroid nodules are common but thyroid malignancies are not. Fine needle aspiration (FNA) cytology is a diagnostic tool used to screen patients with thyroid nodules who require surgery. We study the diagnostic accuracy of FNA as the initial diagnostic modality in the clinical assessment of thyroid nodules. Between January 1995 until December 2000, 2131 FNA of thyroid nodules were performed. Four hundred and forty-one (20.7%) of these were unsatisfactory and 1690 (79.3%) cases were satisfactory for cytological evaluation. Histopathological diagnosis were available for 361 cases. Cyto-histopathological correlation was carried out  for these cases. Our results showed a diagnostic accuracy of 96.2% with sensitivity and specificity rates of 87.7% and 98.4% res- pectively. Our positive predictive value is  93.4% and our negative  predictive value is 96.8%.  From this study, we conclude that fine needle aspiration is an important initial screening diagnostic tool for the investigation of thyroid nodules.           
    Matched MeSH terms: Cytodiagnosis
  19. Fulltext Electrocautery resection as a treatment option for canine transmissible venereal tumour (CTVT)
    Rajendren, S. K., Krishnan, K., Ganesh, T. N., Roslan, N. S., Hashim, N. A., Mohamad, M. A.
    Jurnal Veterinar Malaysia, 2019;31(2):19-22.
    MyJurnal
    A 5-year-old Mongrel was brought presented with the complaint of having serosanguineous discharge from penis for a month since adoption. Physical examination revealed cauliflower-like mass at the bulbus glandis. Presence of numerous anisokaryotic and anisocytotic round to oval histiocytes with multivacuolated cytoplasm from cytology, an evidence of canine transmissibale venereal tumour (CTVT). The mass was successfully surgically resected using electrocautery and was in remission for 12 months (since January 2019).
    Matched MeSH terms: Cytodiagnosis
  20. Fulltext Accuracy of fine needle aspiration cytology in solitary or dominant nodular goitre: a single centre study
    Rohaizak, M., Aman Fuad, Y., Naqiyah, I., Saladina, J.J., Shahrun Niza, A.S.
    International Medical Journal Malaysia, 2017;16(2):85-88.
    MyJurnal
    Background: Thyroid swelling or goitre is a common condition, either asymptomatic or symptomatic. The
    diagnosis is usually established by ultrasound or fine needle aspiration cytology (FNAC) as a gold standard.
    The sensitivity of the test is inversely related to increasing size of the nodule. The objective of this study is
    to evaluate the accuracy of FNAC especially in cases of large goitre.

    Material and methods: This is a
    retrospective study on patients who underwent thyroidectomy between January 2000 to December 2007 for
    solitary or dominant nodular goitre. The analysis was made only on those patients with complete data on
    FNAC and histology.

    Result: There were 235 patients, but only 161 patients were analysed after excluding
    the suspicious and inadequate sample. The patients’ mean age was 42.1 year old (21 to 60). The size of the
    thyroid nodule ranged from 2.1 to 5.0 cm (mean = 3.9 cm). The overall sensitivity was 67.4% and the overall
    accuracy was 86.3%. The accuracy of FNAC according to the sizes above and below the value were as
    follows; 2 cm (72.2% vs. 88.1%); 3 cm (88.0% vs. 87.4%) ; 4 cm (86.6% vs. 84.4%) ; 5 cm (87.3% vs. 78.8%).
    This was most obvious in the sensitivity of the FNA which also showed reducing trend as the nodules
    increased in size.

    Conclusion: FNAC is an essential diagnostic tool in the management of nodular goitre.
    Our study showed that the accuracy of FNAC decreased as the size of the nodule getting bigger. Cautious
    approach should be taken in the management of large goitre and decision should not be based only on the
    result of FNAC.
    Matched MeSH terms: Cytodiagnosis
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