Efficacy of AGNOR staining on FNAC smears in non-neoplastic and neoplastic thyroid lesions with special emphasis on distinguishing benign from the malignant

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Original Article

Author Details : Avinash Singh*, V B Prakash, Amita K, Abhishek MG, Vijay Shankar S

Volume : 5, Issue : 3, Year : 2020

Article Page : 267-272

https://doi.org/10.18231/j.jdpo.2020.052

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Abstract

Background: Eventhough FNAC is the most routinely performed, safe and cost effective diagnostic procedure for an initial diagnosis of thyroid lesions, we often come across difficulties in diagnosis, especially the grey zone lesions of the thyroid. In such cases AgNOR staining can be used as an adjunct to FNAC for establishing a more definitive cytopathological diagnosis. Hence this study was conducted to evaluate the role of AgNOR staining in diagnosis of benign and malignant thyroid lesions. 
Materials and Methods: This prospective study included 150 cases of Fine needle aspirates of thyroid lesions done at the Department of Pathology, Adichunchanagiri Institute of Medical sciences, B.G Nagara during November 2016 to April 2018. AgNOR stained smears were evaluated. Silver stained NORs appeared as black dots were counted two different times by a single observer at a magnification of 100X oil immersion lens. 100 representative nuclei of thyroid follicular cells were selected. A mean was calculated which represented mean AgNOR count.
Results: In this study maximum number of cases were seen in 31-40yrs of life (35.3%). Male: female ratio in our study was 1:15.6 The mean values of AgNOR count are significantly higher in malignant group (4.921.71) comparing benign group(2.201.06). In the present study mean AgNOR count was highest in metastatic deposits of squamous cell carcinoma (10.2) and lowest in Hashimoto’s thyroiditis, Hyperplastic goiter, and colloid goiter (1.8). Mean AgNOR count of follicular thyroid carcinoma (4.64) was higher than follicular adenoma (3.050.49). Interpretation and Conclusion: AgNOR staining can be used as an objective tool for correct diagnosis. It can also be used as an adjunct to FNAC for diagnosis of benign and malignant thyroid lesions.

Keywords: FNAC- Fine Needle Aspiration, Cytology, AgNOR, Thyroid, Cytodiagnosis, Adenoma, Thyroid epithelial cells.

How to cite : Singh A, Prakash V B, Amita K, Abhishek Mg, Vijay Shankar S, Efficacy of AGNOR staining on FNAC smears in non-neoplastic and neoplastic thyroid lesions with special emphasis on distinguishing benign from the malignant. IP J Diagn Pathol Oncol 2020;5(3):267-272

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