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Background: Solitary thyroid lesions are a common presentation in the surgical OPD. The signi?cance of solitary nodule is its malignant potential. Thyroid nodule is an elusive clinical problem. Surgeons and Physicians are often required to make a diagnostic or management decision in its treatment. To study the Aim and Objectives: correlation between Clinical, Radiological, Cytological and Histopathological ?nding in patients who presented with “solitary thyroid nodule”. A prospective observational study, Ramakrishna Mission Materials and Methods:Study design: Study area: Seva Pratishthan Hospital, Kolkata, July 2019 to June 2022(3 years), 40 patients, Inclusion criteria: Study period: Sample size: Patients presenting with solitary thyroid nodule, Patients with multinodular goitre, patients with carcinoma Exclusion criteria: thyroid with distant metastasis, paediatric patients and those unwilling. Thorough history, clinical examination, Methodology: investigation (FNAC/USG/Isotope Scan, TSH), appropriate surgical intervention and HPE of excised specimen was done. Results: In our study of 40 cases, 28(70.0%) were colloid goiter, 7(17.5%) were papillary carcinoma, 2(5%) were follicular adenoma, 1(2.5%) was follicular carcinoma, 1(2.5%) was adenomatoid hyperplasia and 1(2.5%) was Hashimoto thyroiditis. 28(70%) cases underwent hemithyroidectomy, 11(27.5%) underwent total thyroidectomy and 1(2.5%) underwent hemithyroidectomy followed by revision total thyroidectomy. 2 cases of papillary carcinoma with enlarged neck nodes underwent total thyroidectomy with neck node dissection. Solitary nodule is most common in woman and in third Conclusion: and fourth decade of life, more common in the right lobe. USG and FNAC are common modalities of investigations with high speci?city and sensitivity. Isotope scan is only indicated to con?rm the toxic nodule. Malignancy reported in my study was 20%. Early diagnosis and prompt treatment will cure the disease since carcinoma thyroid is more curable amongst all cancers.
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FNAC (Fine Needle Aspiration Cytology) is an essential tool in the preoperative diagnosis and preoperative planning for surgery of solitary thyroid nodules. It is a cost effective procedure that provides specific diagnosis rapidly with minimal complication. The purpose of the study was to evaluate the accuracy of Fine Needle Aspiration Cytology as a diagnostic tool in detecting malignancy in case of solitary thyroid nodule by correlating the preoperative fine needle aspiration cytology (USG Guided) findings with post-operative histopathology findings of the excised specimen in a sub Himalayan tertiary medical college & hospital.METHODSIt was a cross sectional hospital based study conducted on 30 patients in the period from April 2015 to March 2016 after acceptance from West Bengal University of Health Sciences and approval from ethical committee. All admitted patients having solitary thyroid nodule (confirmed clinically & ultrasonographically), biochemically euthyroid and giving consent for surgery were included in this study. Patients who are medically unfit for surgery, biochemically hypo- or hyper-thyroid and not giving consent for surgery were excluded from the study.RESULTSThe sensitivity, specificity, accuracy, positive predictive value and negative predictive value of FNAC for diagnosis of neoplastic solitary thyroid nodule were 75%, 94.44%, 86.67%, 90% and 85%. Commonest malignancy detected was papillary carcinoma in 9 patients.CONCLUSIONSIt is evident from our study that USG guided FNAC should be regarded as the investigation of choice and first line investigation in evaluation of cases with solitary thyroid nodule due to its simplicity, high diagnostic accuracy, easy to perform procedure and absence of significant complications.
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Background:Diseases of the thyroid gland can be due to inflammatory and neoplastic causes. Many diagnostic tests like ultrasound, thyroid nuclear scan and fine needle aspiration cytology (FNAC) are available for their evaluation. Histopathologically, they can be adenomas, colloid nodules, cysts, infectious nodules, lymphocytic or granulomatous nodules, congenital abnormalities or hyperplasia, or various types of malignancy. It is therefore crucial to have a clear diagnostic approach to ensure patients are managed appropriately and are not over or under-treated. Present study was done to evaluate FNAC and ultrasonography (USG) as a diagnostic method in thyroid swellings and to plan surgery accordingly.Methods: A prospective observational study was conducted among 60 adult patients undergoing thyroid surgery at Victoria and Bowring and Lady Curzon Hospital. They were investigated with FNAC and USG of thyroid, and were subjected to surgery and subsequent histopathological examination. The histopathological examination reports were correlated with the findings of FNAC and USG in order to evaluate their findings by statistical methods.Results:The sensitivity and specificity of FNAC was 87.5% and 98% respectively. All malignant lesions on FNAC were confirmed by histopathology indicating its excellence. Therefore FNAC helps in planning the correct management and avoids second surgery. And the sensitivity and specificity of USG was 75% and 86% respectively. Therefore combination of both FNAC and ultrasonography will improve the diagnostic accuracy to higher level and helps in better management. Conclusions:FNAC has high sensitivity and specificity, so it is closest to ideal test. However, a combination of both FNAC and ultrasound will give desirable results and so that we can avoid mismanagement.
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Background: Thyroid nodules are a common entity encountered in clinical practice and the prevalence by palpation is only 3-7%, but on ultrasonographic evaluation it is 20-76% with wide variability. Accurate prediction of malignancy with minimal diagnostic modalities and assessing the risk factors in malignancy may help in reducing extensive procedures. The objective of the study is to assess the risk factors associated with development of malignancy in solitary thyroid nodules and to find out the percentage of malignancy among the cases of solitary nodules.Methods: A three year prospective study was conducted at ACSR medical college and all cases diagnosed as solitary thyroid nodules were enrolled and institutional ethical approval was obtained. Socio demographic data, clinical history and ultrasonogram findings were collected and entered in a separate data sheet for analysis. Fine needle aspiration cytology, histopathological examination was done and reported findings were noted. Statistical analysis was done in SPPS version 20 and ‘p’ value <0.05 was considered significant.Results: 128 cases of solitary thyroid nodules (STN) with 41 male and 87 female cases and F:M ratio of 2.13:1 with mean age of 46.6±10.8 years was enrolled. 43.75% were euthyroid, 47.66% were hypothyroid and 8.59% were hyperthyroid on hormonal evaluation. Micro calcification was observed in 50.78%, increased vascularity in 38.28% and irregular margins in 34.38% of cases. Colloid goitre was predominant observation on fine needle aspiration cytology (40.6%) and follicular adenoma (32%) on histopathology.Conclusions: Features of micro calcification, solid echogenicity, and associated lymphadenopathy are associated features with increased risk of malignancy among STN.
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Introduction: Solitary thyroid nodule (STN) presents a challenge in their diagnosis, evaluations, and management. Often,these abnormal growths/lumps are large in size and develop at the edge of the thyroid gland so that they are felt or seen as alump in front of the neck.Materials and Methods: The study is carried out in upgraded Department of General Surgery, Kakatiya Medical College andMahatma Gandhi Memorial Hospital, during the period of February 2017–October 2018.Results: Among the 62 patients studied in this research, 52 were female and there were 10 males. Females accounted for83.9% of the cases while males accounted for 16.1%. The male-to-female ratio was 5.2:1.Conclusions: Incidence of STN is common in the age group of 18–30 years. Hemithyroidectomy was commonly performedon maximum cases.
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Background and objectives: Solitary thyroid nodule(STN} is a common clinical entity encountered in routine clinical practice.STN is defined as a single swelling involving either lobe of thyroid or isthmus of thyroid gland. Present study was undertaken to know distribution of lesion according to age and sex, and also to evaluate efficacy of FNAC in diagnosis of clinically obvious and palpable solitary thyroid nodule. Method: This study was done on 75cases operated in our hospital from May 2012 to May 2016. All patients included in the study were submitted to FNAC and ultrasonography. All patients were subjected to surgery and histopathology examination was obtained. Results: Out of 75 cases of thyroid lesions, 63 cases were benign (84%), 6 cases were malignant (8%) and 6 cases were suspicious(8%) on FNAC. On Histopathological examination, 60 cases were benign(80%) and 15 cases were malignant(20%). Conclusion: FNAC is a single best investigation for preoperative evaluation for STN to differentiate between benign and malignant nodules with 88% accuracy rate.[Doshi H NJIRM2016; 7(5):53-55]
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Tumors are either benign or malignant. The thyroid nodule, which is usually a clinical manifestation of most of the thyroid disorders, is one among them which has been the subject of controversies with divergent opinions and views. Clinical presentation of thyroid nodules varies widely ranging from solitary nodules to benign and malignant tumors. Thyroid nodules accounts up to 8% of the adult population having palpable nodules. However studies on its incidence in the population residing near seacoast are limited. Hence, the present study is carried in an aim to evaluate the clinico-pathological correlation of solitary thyroid nodule and the incidence of malignancy in the population residing at sea coast. The study is conducted in the Narayana Medical College & Hospital (NMCH), which is situated within 10-15 km radius of the seacoast in Nellore district of Andhra Pradesh, India. In this study, 73 subjects were selected who presented with thyroid swelling which was clinically confirmed as solitary thyroid nodule. Out of 73 cases, 12 cases (16.5%) were found to have malignant lesions with remaining 61 cases (83.5%) being benign lesions. The incidence of malignancy among solitary thyroid nodule subjects is up to 16.5% in the population residing near seacoast. Thus the present study warrants people to consult surgeons for early diagnosis and adequate treatment without being passive as most of these swellings are asymptomatic for long duration.
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Purpose:To study the malignant probability of a solitary thyroid nodule,probable risk factor,the status of B-mode ultrasonography,computed tomography,fine needle aspiration and frozen section in the operation and other adjuvant examination in the diagnosis.Methods:In the retrospective analysis of 902 cases of solitary thyroid nodule treated by surger- y and diagnosed by pathology in the Cancer Hospital of Fudan University from March 1998 to May 2001,we analyzed the value of B-mode ultrasonography,computed tomography,fine needle aspiration and frozen section in the operation and com- pared them with the final pathological conclusion.Results:This disease occurred mostly in 20～50 years old women,while the malignant nodules occurred more frequently in men(P50 years) (P50 years) is a risk factor.B-mode ultrasonography can be used as routine preoperative examination.CT is valuable in the cases with metastasis to neck lymph nodules.With FNA the pathological diagnosis of the nodule suspected to be malignant can be made preoperatively.
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BACKGROUND: Percutaneous ethanol injection(PEI) performed in guidance of ultrasonography has been used in cases of thyroid cyst and autonomous functiong thyroid nodule(AFTN). We performed this study to determine the feasibility of PEI on the various type of benign cold nodules(solid, pure cyst, complex cyst) and AFTN. METHOD: Ninety patients(age 41+12 years; 83 women and 7 men) with hot and cold nodule were included in this study. All cases were subjected to FNAB, and sono-guided in cases of complex cyst, at least twice with results of colloid nodule. T4 suppression treatment was done for cold solid nodules for at least 6 months and cases which had partial response(50% or more volume reduction but no further volume decrease on T4 suppression) were included in this study. After PEI, we classified AFTN into three different response groups; complete response (normali- zation of TFT and thyroid scan finding), partial response(normalized freeT4 but suppressed TSH or persistently suppressed scan), or failure group. Each subtypes(solid, pure cyst, complex cyst) of cold nodules were also classified into three groups in accordance with volume reduction; complete response(above 90% of volume reduction), partial response(50-90%), and failure(below 50% or increase in size) group. RESULTS: Overall responses rate of PEI for benign thyroid nodule were complete; 70(78%), partial; 18(20%), and failure; 2(2%). In 27 cold solid nodules, complete response was observed in 23(85%) and partial response in 4(15%). In 11 pure cysts, complete response was observed in 7(64%), partial response in 3(27%), and 1 case(9%) of failure was lost after 1 trial of PEI. In 45 cases of complex cyst, complete response was observed in 36(80%), partial response in 8 (18%), and 1 case(2%) of failure was subjected to operation with pathology report of Hiirthle cell adenoma. In 7 cases of AFTN, complete response was observed in 4(57%) and partial response in 3(43%). We observed complications during PEI therapy such as transient neck pain(n=10), transient unilateral vocal cord palsy(n=l), and intracavitary hemorrhage(n=2), transient hypotension during ethanol injection(n 1). CONCLUSION: Our data suggest that efficacy of PEI(57%) in AFTN is inferior to conventional therapies like surgery and radioiodine, but still can be an alternative therapeutic modality in selected cases. In cold nodules, especially of solid type and complex cyst, PEI may have feasibility as a therapeutic modality in restricted cases. Further studies of prolonged follow-up for the possibility of neglecting occult malignancy are warranted.