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Category: Volume 05 Issue 07 July 2017
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Title: Spectrum of Thyroid Lesions and its Clinicopathological Correlation – A Two Year Study from A Tertiary Care Centre

Authors: Dr Priya P Kartha, Dr Santha Sadasivan

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i7.214

Abstract

Introduction: Thyroid diseases are one of the common endocrine abnormality both in India and worldwide. Clinically apparent thyroid nodules are seen in 4-5 % of population.  Majority of thyroid swellings are non-neoplastic, only <5 % are malignant. Non-neoplastic diseases of thyroid gland manifests as enlargement of thyroid, altered hormone secretion and its consequences or as both. Papillary carcinoma thyroid is the most common primary malignancy of thyroid. Our attempt was to study the spectrum of thyroid lesions and to correlate histopathological findings with biochemical, radiological & cytological features.

Materials & Method: Descriptive study over 2 years where all thyroidectomies received in our department satisfying the inclusion and exclusion criteria were studied and statistically analysed.

Results: Thyroid diseases were most commonly seen in 40-50 years of age with females being more affected than males. Multinodular goitre was the most common lesion cytologically, radiologically and histo pathologically. Papillary carcinoma was the most common malignancy detected, most common variant being classic papillary type. Most common associated lesion with papillary carcinoma thyroid was multinodular goitre.  Fine needle aspiration cytology and ultrasound showed moderate agreement with histopathology as far as the diagnosis of papillary carcinoma was concerned.

Conclusion: Thyroid diseases showed definite female predominance, with most of them occurring in an age group of 30-50 years.  Multi nodular goitre remains the most common disease clinically, radiologically and cytologically even after vigorous iodisation programmes. Fine needle aspiration findings and ultrasonogram findings showed moderate agreement with histopathology as far as papillary carcinoma was concerned. Papillary carcinoma was the most common neoplastic disease, with classic papillary variant being most common. Most common associated lesion with Papillary Carcinoma was Multi nodular goitre. This study emphasises the need of periodic evaluation in middle aged female patients with multi nodular goitre for early detection of papillary carcinoma. It also highlights the significance of FNAC as an indispensable tool for early diagnosis of papillary carcinoma. A combined cytological and radiological approach is expected to yield better results.

Keywords: goitre, thyroid nodule/ swelling, thyroiditis, papillary carcinoma, FNAC, Thyroid function tests.

References

  1. Spectrum of goitrous lesions in patients at a tertiary care center of Sikkim [Internet]. [cited 2017 Jul 19]. Ava. from: http://www.smjonline.org/article.asp?issn=1118-8561;year=2014;volume=17;issue=3;spage=112;epage=116;aulast=Sengupta
  2. Antony J, Celine TM, Chacko M. Spectrum of thyroid disorders: A retrospective study at a medical college hospital. Thyroid Res Pract. 2014 May 1;11(2):55.
  3. Clinical Cancer Investigation Journal [Internet]. [cited 2017 Jun 30]. Available from: http://www.ccij-online.org/article.asp?issn=2278-0513;year=2014;volume=3;issue=3;spage=208;epage=212;aulast=Bamanikar
  4. Sukumaran R, Kattoor J, Pillai KR, Ramadas PT, Nayak N, Somanathan T, et al. Fine Needle Aspiration Cytology of Thyroid Lesions and its Correlation with Histopathology in a Series of 248 Patients. Indian J Surg Oncol. 2014 Sep;5(3):237–41.
  5. Klee GG, Hay ID. Biochemical testing of thyroid function. Endocrinol Metab Clin North Am. 1997 Dec;26(4):763–75.
  6. Dean DS, Gharib H. Epidemiology of thyroid nodules. Best Pract Res Clin Endocrinol Metab. 2008 Dec;22(6):901–11.
  7. Bomeli SR, LeBeau SO, Ferris RL. Evaluation of a thyroid nodule. Otolaryngol Clin North Am. 2010 Apr;43(2):229–38.
  8. Tsegaye B, Ergete W. Histopathologic pattern of thyroid disease. East Afr Med J. 2003 Oct;80(10):525–8.
  9. Nggada HA, Ojo OS, Adelusola KO. A histopathological analysis of thyroid diseases in Ile-ife, Nigeria. a review of 274 cases. Niger Postgrad Med J. 2008 Mar;15(1):47–51.
  10. Sushel C, Khanzada TW, Zulfikar I, Samad A. Histopathological Pattern of Diagnoses in Patients Undergoing Thyroid Operations -. Rawal Med J. 2009;34(1):14–6.
  11. Thomas T, Sreedharan S, Khadilkar UN, Deviprasad D, Kamath MP, Bhojwani KM, et al. Clinical, biochemical & cytomorphologic study on Hashimoto’s thyroiditis. Indian J Med Res. 2014 Dec;140(6):729–35.
  12. Sanyal D. Spectrum of Hashimoto’s thyroiditis: Clinical, biochemical & cytomorphologic profile. Indian J Med Res. 2014 Dec;140(6):710–2.
  13. Unnikrishnan AG, Menon UV. Thyroid disorders in India: An epidemiological perspective. Indian J Endocrinol Metab. 2011 Jul 1;15(6):78.
  14. Jain S, Nayak R, Totade S, Shukla N. Clinico - Pathological Correlation of Thyroid Swellings. Int J Med Res Rev [Internet]. 2014 Dec 30 [cited 2017 Jul 18];2(06). Available from: http://medresearch.in/index.php/IJMRR/article/view/180
  15. Basharat R, Bukhari MH, Saeed S, Hamid T. Comparison of Fine Needle Aspiration Cytology and Thyroid Scan in Solitary Thyroid Nodule. Pathol Res Int [Internet]. 2011 May 4;2011. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108561/
  16. Tauro LF, Lobo GJ, Fernandes H, George C, Aithala PS, Shenoy D, et al. A Comparative Study on Fine Needle Aspiration Cytology versus Fine Needle Capillary Cytology in Thyroid Nodules. Oman Med J. 2012 Mar;27(2):151–6.
  17. Moon HJ, Yoon JH, Kwak JY, Chung WY, Nam K-H, Jeong JJ, et al. Positive Predictive Value and Interobserver Variability of Preoperative Staging Sonography for Thyroid Carcinoma. Am J Roentgenol. 2011 Aug 1;197(2):W324–30.
  18. Adeniran AJ, Zhu Z, Gandhi M, Steward DL, Fidler JP, Giordano TJ, et al. Correlation between genetic alterations and microscopic features, clinical manifestations, and prognostic characteristics of thyroid papillary carcinomas. Am J Surg Pathol. 2006 Feb;30(2):216–22.
  19. Lam AK-Y, Lo C-Y, Lam KS-L. Papillary carcinoma of thyroid: A 30-yr clinicopathological review of the histological variants. Endocr Pathol. 2005;16(4):323–30.
  20. Pang H-N, Chen C-M. Incidence of cancer in nodular goitres. Ann Acad Med Singapore. 2007 Apr;36(4):241–3.

Corresponding Author

Dr Priya P Kartha

Assistant Professor, Department of Pathology,

Integrated Institute of Medical Sciences, Palakkad Kerala

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