Clinicopathological Correlation of Core-Needle Biopsy in Thyroid Nodule Assessment: Insights from a Tertiary Care Center.
6 affiliations
- 1Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
- 2Department of Pathology, Chirayu Medical College and Hospital, Bhopal, Madhya Pradesh, India.
- 3Department of Radiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
- 4Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
- 5Department of Biostatistics and Health Informatics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
- 6Department of Anaesthesia, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Abstract
Background
Fine-needle aspiration cytology (FNAC) is the mainstay for thyroid nodule assessment, boasting excellent specificity and cost-effectiveness. However, its diagnostic limitations often yield nondiagnostic or indeterminate results, especially in complex thyroid cases. Core-needle biopsy (CNB) has emerged as a complementary technique that preserves tissue architecture, enabling improved morphological and molecular analysis. This study compares the diagnostic performance and clinical utility of FNAC and CNB in a tertiary care setting.Materials and methods
In this retrospective analysis at Sanjay Gandhi Postgraduate Institute of Medical Sciences, 116 patients with thyroid masses underwent both FNAC and CNB between 2014 and 2024. Clinicopathological features, imaging, and cytological/histological data were reviewed. Diagnoses were correlated with final surgical outcomes where available.Results
FNAC adequacy was 96.6%, and CNB adequacy was 99.1%. FNAC's sensitivity, negative predictive value, and diagnostic accuracy were 81.8%, 50%, and 81.5%, respectively, whereas CNB achieved 95.7%, 80%, and 96.2%, respectively. All four nondiagnostic FNAC cases were accurately diagnosed by CNB, with precise subtyping of poorly differentiated, medullary, and anaplastic carcinomas and lymphomas.Conclusion
FNAC is a valuable first-line investigation, but its limitations-especially in indeterminate or high-risk thyroid lesions in tertiary centers-justify early use of CNB. CNB complements FNAC by improving diagnostic yield, subtype accuracy, and suitability for ancillary studies, thus optimizing clinical management and reducing unnecessary surgeries in complex thyroid pathology.
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BibTeX
@article{nigam2026clinicopathological,
title = {{Clinicopathological Correlation of Core-Needle Biopsy in Thyroid Nodule Assessment: Insights from a Tertiary Care Center.}},
author = {Neha Nigam and Rishabh Sahai and Anil Singh and Anjali Mishra and Sabaretnam Mayilvaganan and Ojas Gupta and Prabhakar Mishra and Nirbhay Kumar and Amit Rastogi},
journal = {Journal of cytology},
year = {2026},
month = sep,
doi = {10.4103/joc.joc_145_25},
url = {https://europepmc.org/article/MED/42899036},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Clinicopathological Correlation of Core-Needle Biopsy in Thyroid Nodule Assessment: Insights from a Tertiary Care Center.
AU - Neha Nigam
AU - Rishabh Sahai
AU - Anil Singh
AU - Anjali Mishra
AU - Sabaretnam Mayilvaganan
AU - Ojas Gupta
AU - Prabhakar Mishra
AU - Nirbhay Kumar
AU - Amit Rastogi
PY - 2026
DA - 2026/09/25
JO - Journal of cytology
DO - 10.4103/joc.joc_145_25
UR - https://europepmc.org/article/MED/42899036
AB - Background Fine-needle aspiration cytology (FNAC) is the mainstay for thyroid nodule assessment, boasting excellent specificity and cost-effectiveness. However, its diagnostic limitations often yield nondiagnostic or indeterminate results, especially in complex thyroid cases. Core-needle biopsy (CNB) has emerged as a complementary technique that preserves tissue architecture, enabling improved morphological and molecular analysis. This study compares the diagnostic performance and clinical utility of FNAC and CNB in a tertiary care setting.Materials and methods In this retrospective analysis at Sanjay Gandhi Postgraduate Institute of Medical Sciences, 116 patients with thyroid masses underwent both FNAC and CNB between 2014 and 2024. Clinicopathological features, imaging, and cytological/histological data were reviewed. Diagnoses were correlated with final surgical outcomes where available.Results FNAC adequacy was 96.6%, and CNB adequacy was 99.1%. FNAC's sensitivity, negative predictive value, and diagnostic accuracy were 81.8%, 50%, and 81.5%, respectively, whereas CNB achieved 95.7%, 80%, and 96.2%, respectively. All four nondiagnostic FNAC cases were accurately diagnosed by CNB, with precise subtyping of poorly differentiated, medullary, and anaplastic carcinomas and lymphomas.Conclusion FNAC is a valuable first-line investigation, but its limitations-especially in indeterminate or high-risk thyroid lesions in tertiary centers-justify early use of CNB. CNB complements FNAC by improving diagnostic yield, subtype accuracy, and suitability for ancillary studies, thus optimizing clinical management and reducing unnecessary surgeries in complex thyroid pathology.
SN - 0970-9371
SN - 0974-5165
ER -