Clinico - Pathological Correlation of Thyroid Swellings
Keywords:
Fine Needle Aspiration Cytology, Thyroid Function Tests, Follicular Neoplasm of thyroid
Abstract
Introduction: Thyroid being an actively functioning gland is subjected to series of disturbances, both physiological and pathological. It may be affected by various disorders like developmental, inflammation, hyperplastic and neoplastic that may present with similar sign and symptoms. Almost any disorder of thyroid can present as a nodule. The thyroid nodule is common problem faced by the clinicians as they cause apprehension due to their unpredictable behaviour.
Method: A total of 110 patients were studied. All patients underwent FNAC after prior consent. FNAC was done with aseptic precautions by using 23 gauze needles, non-aspiration technique. Material obtained was smeared on 2 glass slides, air dried and stained with Leishmann’s stain. Remaining wet slides fixed by using ethanol and were stained with hematoxylin and eosin (H&E) method. Pre-operative FNAC results were then compared with the definitive histological diagnosis.
Result: Incidence of malignancy in thyroid nodules was 8.18%. Sensitivity and specificity in the present study was 85.7% and 96.4%, respectively with PPV, NPV and diagnostic accuracy of 92.3%, 93.1% and 92.9%, respectively. False positive and false negative error rate was 2.4 and 4.8 respectively.
Conclusion: Definitive diagnosis of either benign or malignant can be suggested by FNAC and accordingly line of management can be planned. So we can avoid unnecessary surgeries for benign lesions and reduce the cost of hospitalisation.
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References
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27. Leonard N, Melcher DH. To operate or not to operate? The value of fine needle aspiration cytology in the assessment of thyroid swellings. J Clin Pathol. 1997 Nov;50(11):941–3. [PubMed]
28. Wang CC, Friedman L, Kennedy GC, Wang H, Kebebew E, Steward DL, et al. A large multicenter correlation study of thyroid nodule cytopathology and histopathology. Thyroid. 2011 Mar;21(3):243–51. [PubMed]
29. Holleman F, Hoekstra JB, Ruitenberg HM. Evaluation of fine needle aspiration (FNA) cytology in the diagnosis of thyroid nodules. Cytopathology 1995 Jun;6(3):168-75. [PubMed]
30. Lopez LH, Canto JA, Herrera MF, Gamboa-Dominguez A, Rivera R, Gonzalez O, et al. Efficacy of fine-needle aspiration biopsy of thyroid nodules: Experience of a Mexican institution. World J Surg. 1997 May;21(4):408–11. [PubMed]
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32. Settakorn J, Chaiwun B, Thamprasert K, Wisedmongkol W, Rangdaeng S. Fine needle aspiration of the thyroid gland. J Med Assoc Thai. 2001 Oct;84(10):1401–6. [PubMed]
33. Mahar SA, Husain A, Islam N. Fine needle aspiration cytology of thyroid nodule: Diagnostic accuracy and pitfalls. J Ayub Med Coll Abbottabad. 2006 Oct-Dec;18(4):26–9. [PubMed]
34. Haberal AN, Toru S, Ozen O, Arat Z, Bilezikçi B. Diagnostic pitfalls in the evaluation of fine needle aspiration cytology of the thyroid: Correlation with histopathology in 260 cases.Cytopathology. 2009 Apr;20(2):103–8. [PubMed]
35. Moosa FA, Khan FW, Sultan N, Rao MH. Up to what extent FNAC is accurate in detecting malignancy in solitary thyroid nodule? A comparison with post-operative histopathology findings. Med Chann. 2010;16:280–3.
2. Ezzat S, Sarti DA, Cain DR, Braunstein GD. Thyroid incidentalomas prevalence by palpation and ultrasonography. Arch Intern Med. 1994;154(16):1838–1840. [PubMed]
3. Yeung MJ, Serpell JW. Management of the solitary thyroid nodule. Oncologist 2008;13(2):105-12. [PubMed]
4. Cappelli C, Castellano M, Pirola I, Gandossi E, De Martino E, Cumetti D, et al. Thyroid nodule shape suggests malignancy. Eur J Endocrinol. 2006 Jul;155(1):27–31.
5. Agrawal S. Diagnostic accuracy and role of fine needle aspiration cytology in management of thyroid nodules. Journal of Surgical Oncology. 1995;58(3):168–172.
6. Baloch MN, Ali S, Ansari MA, Maher M. contribution of fine needle aspiration cytology (FNAC) in the diagnosis of malignant thyroid nodules. Pak J Surg.Mar 2008;24(1):19–21. [PubMed]
7. Bagga P K, Mahajan N C. Fine needle aspiration cytology of thyroid swellings: How useful and accurate is it?. Indian J Cancer 2010 Oct-Dec;47(4):437-42. [PubMed]
8. E.A. Sinna, N. Ezzat, Diagnostic accuracy of fine needle aspiration cytology in thyroid lesions, Journal of the Egyptian National Cancer Institute, Volume 24, Issue 2, June 2012, Pages 63-70.
9. Uma Handa, Sukant Garg, Harshmohan, Nitin Nagarkar: Role of fine needle aspiration cytology in diagnosis and management of thyroid lesions, a study on 434 patients. Journal of Cytololgy: 2008; 25(1) :13-17. [PubMed]
10. Gharib H, Goellner JR. Fine-needle aspiration biopsy of thyroid: an appraisal. Ann Intern Med 1993 Feb 15;118(4):282-9.
11. Gupta M, Gupta S, Gupta VB. Correlation of fine needle aspiration cytology with histopathology in the diagnosis of solitary thyroid nodule. J Thyroid Res. 2010;18:37–40. [PubMed]
12. A. Martinek, J. Dvorackovia, M. Honka, et al. Importance of Guided Fine needle aspiration Cytology (FNAC) for the diagnosis of Thyroid Nodules-Own Experience. Biomed Papers. 2004; 148(1),45-50.
13. Quddus MA, M Alimuzzaman, & MKH Sardar. "Role of FNAC in the Evaluation of Solitary Cold Thyroid Nodule." Journal of Shaheed Suhrawardy Medical College [Online], 2012;4(1): 15-17. Web. 25 Oct. 2014, [PubMed]
14. Wahid FI, Khan SF, Rehman HU, Khan IA. Role of fine needle aspiration cytology in diagnosis of solitary thyroid nodules. Iranian Journal of Otorhinolaryngology.2011;23(4):111–118.
15. Screaton NJ, Berman LH, Grant JW. US-guided core-needle biopsy of the thyroid gland.Radiology. 2003 Mar;226(3):827–32.
16. Alam M, Qureshi H, Jan QA. Accuracy of FNAC as a diagnostic modality in the management of solitary thyroid nodule. J Med Sci. 2010;18:94–61.
17. Morgan JL, Serpell JW, Cheng MSP. Fine-needle aspiration cytology of thyroid nodules: how useful is it? ANZ Journal of Surgery. 2003;73(7):480–483.
18. Sengupta A, Pal R, Kar S, Zaman FA, Sengupta S, Pal S. Fine needle aspiration cytology as the primary diagnostic tool in thyroid enlargement. Journal of Natural Science, Biology and Medicine. 2011;2(1):113–118. [PubMed]
19. V RC, B V, M KK, Durbesula PT, Rao PS. A study on the clinical manifestations and the incidence of benign and malignant tumors in a solitary thyroid nodule. Int J Res Med Sci. (2013), [cited October 25, 2014]; 1(4): 429-434.
20. Russel CFJ. The management of the solitary thyroid nodule. In: Johnson CD, Taylor I, editors. Recent advances in surgery. Vol. 17. London: Churchill-Livingstone; 1994. pp. 4–16.
21.Mandreker SR, Nadkarni NS, Pinto RG, Menezes S. Role of FNAC as the initial modality in the investigation of thyroid lesions. Acta Cytol 1995 Sep-Oct;39(5):898-904. [PubMed]
22. Burch HB, Burman KD, Reed HL, Buckner L, Raber T, Ownbey JL: Fine needle aspiration of thyroid nodules. Determinants of insufficiency rate and malignancy yield at thyroidectomy. Acta Cytol 1996, 40 (6):1176-1183. [PubMed]
23. Kumar H, Daykin J, Holder R, et al. Gender, clinical findings, and serum thyrotropin measurements in the prediction of thyroid neoplasia in 1005 patients presenting with thyroid enlargement and investigated by fine-needle aspiration cytology. Thyroid.1999 Nov;9(11):1105–9. [PubMed]
24. Muratli A, Erdogan N, Sevim S, Unal I, Akyuz S. Diagnostic efficacy and importance of fine-needle aspiration cytology of thyroid nodules. J Cytol 2014 Apr;31(2):73-8.
25. Raab SS, Vrbin CM, Grzybicki DM, Sudilovsky D, Balassanian R, Zarbo RJ, et al. Errors in thyroid gland fine-needle aspiration. Am J Clin Pathol 2006 Jun;125(6):873-82. [PubMed]
26. Pandey P, Dixit A, Mahajan NC. Fine-needle aspiration of the thyroid: A cytohistologic correlation with critical evaluation of discordant cases. Thyroid Res Pract. 2012;9(2):32–9. [PubMed]
27. Leonard N, Melcher DH. To operate or not to operate? The value of fine needle aspiration cytology in the assessment of thyroid swellings. J Clin Pathol. 1997 Nov;50(11):941–3. [PubMed]
28. Wang CC, Friedman L, Kennedy GC, Wang H, Kebebew E, Steward DL, et al. A large multicenter correlation study of thyroid nodule cytopathology and histopathology. Thyroid. 2011 Mar;21(3):243–51. [PubMed]
29. Holleman F, Hoekstra JB, Ruitenberg HM. Evaluation of fine needle aspiration (FNA) cytology in the diagnosis of thyroid nodules. Cytopathology 1995 Jun;6(3):168-75. [PubMed]
30. Lopez LH, Canto JA, Herrera MF, Gamboa-Dominguez A, Rivera R, Gonzalez O, et al. Efficacy of fine-needle aspiration biopsy of thyroid nodules: Experience of a Mexican institution. World J Surg. 1997 May;21(4):408–11. [PubMed]
31. Cáp J, RyŠka A, Rehorková P, Hovorková E, Kerekes Z, Pohnetalová D. Sensitivity and specificity of the needle aspiration biopsy of the thyroid: clinical point of view. Clin Endocrinol (Oxf) 1999 Oct;51(4):509-15. [PubMed]
32. Settakorn J, Chaiwun B, Thamprasert K, Wisedmongkol W, Rangdaeng S. Fine needle aspiration of the thyroid gland. J Med Assoc Thai. 2001 Oct;84(10):1401–6. [PubMed]
33. Mahar SA, Husain A, Islam N. Fine needle aspiration cytology of thyroid nodule: Diagnostic accuracy and pitfalls. J Ayub Med Coll Abbottabad. 2006 Oct-Dec;18(4):26–9. [PubMed]
34. Haberal AN, Toru S, Ozen O, Arat Z, Bilezikçi B. Diagnostic pitfalls in the evaluation of fine needle aspiration cytology of the thyroid: Correlation with histopathology in 260 cases.Cytopathology. 2009 Apr;20(2):103–8. [PubMed]
35. Moosa FA, Khan FW, Sultan N, Rao MH. Up to what extent FNAC is accurate in detecting malignancy in solitary thyroid nodule? A comparison with post-operative histopathology findings. Med Chann. 2010;16:280–3.
CITATION
DOI: 10.17511/ijmrr.2014.i06.08
Published: 2014-12-31
How to Cite
1.
Jain S, Nayak R, Totade S, Shukla N. Clinico - Pathological Correlation of Thyroid Swellings. Int J Med Res Rev [Internet]. 2014Dec.31 [cited 2024Nov.8];2(6):553-60. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/157
Section
Original Article
OAI - Open Archives Initiative
