Introduction: Thyroid nodules are common in surgical practice, most of which are benign, while a subset may be malignant. Fine-needle aspiration cytology (FNAC) is widely used as a minimally invasive and cost-effective first-line diagnostic test. Histopathology, however, remains the gold standard. This study aimed to evaluate the diagnostic accuracy of FNAC compared with histopathology in patients undergoing thyroidectomy. Materials and Methods: A cross-sectional diagnostic test evaluation was conducted in the Department of General Surgery in a Government Tertiary Care Center, over 1 year. A total of 141 consecutive patients who underwent thyroidectomy and had both FNAC and histopathology reports were included. FNAC results were compared with histopathology to calculate sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Data were analysed using SPSS version 27. Results: Histopathology confirmed malignancy in a significant proportion of thyroidectomy specimens, with papillary carcinoma being the most frequent malignant lesion. FNAC demonstrated a sensitivity of 83.8% and specificity of 100%. The PPV and NPV further supported FNAC’s strong diagnostic performance. FNAC showed high concordance with histopathology, though a small proportion of cases were misclassified due to indeterminate cytology. Conclusion: FNAC is a highly accurate, safe and inexpensive diagnostic tool for the pre-operative evaluation of thyroid nodules. Its use reduces unnecessary thyroidectomies, thereby minimising surgical morbidity and healthcare costs. Integration with ultrasound guidance and molecular techniques may further improve diagnostic precision and clinical decision-making.
Kashyap et al. (Thu,) studied this question.