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Pathology Research International
Volume 2012 (2012), Article ID 908106, 7 pages
Clinical Study

Role of Multiparameter Analysis of AgNORs in FNA Smears of Thyroid Swellings in Differentiating Benign and Malignant Lesions

1Department of Pathology, Chittagong Medical College, Chittagong 4203, Bangladesh
2Department of Pathology, Cox's Bazar Medical College, Cox's Bazar 4700, Bangladesh

Received 14 February 2012; Revised 18 April 2012; Accepted 2 May 2012

Academic Editor: Luigi Terracciano

Copyright © 2012 Mohammad Ismail Hossain et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. The aim of this study is to assess the role of multiparameter analysis of silver (Ag)-stained nucleolar organizer regions (AgNORs) technique on aspiration smears of thyroid swellings to distinguish between benign and malignant lesions. Materials and Methods. Aspiration smears from 166 cases of thyroid swellings were examined. Diagnosis was confirmed by histology in 61 cases. AgNOR staining was done on FNA smears according to silver-staining protocol proposed by the International Committee for AgNOR quantification. Multiparameter analysis of AgNORs such as mAgNOR, pAgNOR, and AgNOR size grade was done on 50–100 cells under oil immersion lens. Results. AgNOR parameter of benign and malignant thyroid lesions was compared and was found to be statistically significant. Out of 157 satisfactory AgNOR stained cases, 148 (94.3%) were benign lesions and 9 (5.7%) cases were malignant lesions. In AgNOR analysis, sensitivity was found to be 83.33%, specificity 100%, PPV 100%, NPV 98.21%, and accuracy was 98.36%. Conclusions. AgNOR analysis in the FNA smears is a simple, sensitive, and cost-effective method for differentiating benign from malignant thyroid swellings.