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Abstract
Fine needle aspiration biopsy has been documented as a reliable, cost effective test, diagnosing different thyroid lesions. However, its sensitivity declines much in some
settings.
Objectives: to investigate the value of computerized morphometry and DNA ploidy in differential diagnosis of different thyroid epithelial follicular lesions diagnosed on FNA smears.
Study design: 34 cases of thyroid FNA were cytologically examined, and classified according to their postthyroidectomy histopathological diagnosis as follow: 5 cases of nodular goitre 7 cases of adenomas 5 cases of
follicular carcinoma, 10 cases of papillary carcinoma, 5 cases of anaplastic carcinoma and 2 cases of poorly differentiated carcinoma. Using Leica Qwin 500 image analysis system, nuclear area as a morphological variable, as well as the DNA ploidy, DNA index and proliferation indices were measured for each case.
Results:sensitivity of FNA in the studied cases was optimum (100%) in papillary carcinomas and anaplastic
carcinomas. However, the sensitivity declined sharply in discriminating nodular goiter and follicular adenoma from well differentiated follicular carcinoma, most of these cases were diagnosed as follicular lesions.
A significant difference in mean values of nuclear area was found between benign
and malignant lesions, with no statistical differences within
the benign group. Aneuploidy and DNA index (DI) were significantly associated with malignancy. Proliferation index (PI) was significantly higher in the malignant lesions with no statistically significant difference between the
diagnostic groups. Conclusion: image analysis may become an important ancillary test in the initial evaluation
of patients with thyroid epithelial lesions.