Objective: Fine-needle aspiration (FNA) is currently the primary diagnostic procedure in diagnosing thyroid malignancy and guides surgeons on patient selection for thyroidectomy for thyroid nodules. Based on the cytology findings, patients can be followed in cases of benign diagnosis or subjected to surgery in cases of malignant diagnosis thereby decreasing the rate of unnecessary surgery. Purpose of the present study was to correlate the fine needle aspiration cytology (FNAC) findings with histopathology of excised specimens.

Materials and Methods: A comprehensive view of hospitalization records was performed that have assessed the sensitivity of FNA for detecting thyroid malignancy in hypoactive solitary thyroid nodules. This was a prospective study conducted on 62 consecutive patients between December 2001 and June 2008. All patients with clinically diagnosed solitary thyroid nodule who were clinically, radyologically and biochemically hypothyroid were included for study. Patients with multinodular goitre, euthyroid and hyperthyroid were excluded from the study.

Results: The sensitivity, specificity, accuracy, false positive rate, false negative rate, positive predictive value, and negative predictive value of FNAC for the diagnosis of neoplastic hypoactive solitary thyroid nodules were 80,7 %, 88,8 %, 85,4 %, 11,1%, 19,2 %, 80,7 %, and 88,8 %, respectively. The most common malignancy detected was papillary carcinoma of thyroid in 8 patients.

Conclusion: Fine needle aspiration cytology is a simple, easy to perform, cost effective, and easily repeated procedure for the diagnosis of thyroid cancer. It is recommended as the first line investigation for the diagnosis of hypoactive solitary thyroid nodule.