Spectrum of thyroid lesions on fine needle aspiration cytology.

The incidence of thyroid lesions is increasing significantly nowadays. Many a times, differentiation between physiological, inflammatory, autoimmune, hyperfunctioning and hypofunctioning of thyroid gland, benign and malignant tumor poses diagnostic difficulty. Fine needle aspiration cytology (FNAC) with clinical correlation, along with ultrasonography and thyroid function tests are done in relevant cases. Final diagnosis requires morphological examination of the lesions. FNAC is widely accepted and has become the cornerstone in evaluation of the thyroid lesions, as unnecessary surgery can be avoided. We studied a total of 251 cases in the age range of 3 years to 72 years, who presented with thyroid swelling over a period of one year and got a spectrum of thyroid lesions on cytology. Incidence was more in females 230 cases (91.63%) compared to males 21 cases (8.36%). Nodular goiter was the commonest disease constituting 127 cases (50.59%) followed by Hashimoto’s thyroiditis 93 cases (33.05%) and malignancy was reported in 7 cases (2.78%). USG guided FNAC for optimization of results is necessary for the location of target lesion. Careful searching for malignant cells and repeat FNAC are the key to a successful diagnosis and to plan a proper surgical procedure. Follow-up is necessary in case of a benign mass.

Histopathological pattern of thyroid lesions in western region of Saudi Arabia

Partial or complete thyroidectomies are frequently encountered by the practicing pathologist and the possibility of neoplastic disease is of major concern in patients with thyroid nodules. Pathological evaluation of those specimens ranged from non-neoplasticlesion to highly aggressive malignancy. This study aimed to document the frequency of different patterns of thyroid diseases as presented to pathology departments at King Abdul-Aziz University Hospital [KAUH] and King Faisal Specialty Hospital and Research centre [KFSHRC] within the last twelve years. All specimens presented to pathology departments at KAUH [1997-2008] and KFSHRC [2000-2008] as thyroidectomies [partial or complete] were retrospectively reviewed and categorized according to their histological appearance. The total number of the studied cases was 845 cases. The age of the patients ranged between 9 and 93 years. One hundred seventy eight were males and 667 were female [male to female ratio; 1:3.7]. The reviewed cases were classically categorized into two main groups; Non-neoplastic [494; 58.5%] and Neoplastic [351; 41.5%]. The non-neoplastic group includes: Multinodular Goiter [311 cases; 36.8%], hashimoto/chronic lymphocytic thyroiditis [64 cases; 7.6%], single hyperplastic nodule [51 cases; 6%], Grave's disease [8 cases; 0.9%], miscellaneous [58 cases; 6.9%]. The neoplastic group includes benign category represented by "Adenomas" and includes 94 cases [11% of all cases, and 26.8% of neoplastic cases] and the malignant category includes 256 cases, representing 30.3% of all studied cases and 73% of the neoplastic category. Two hundred and nine cases [81.6% of malignant] were papillary carcinoma. Thyroid lesions are more common in Saudi female. The majority of the thyroid nodules in Saudi are non-neoplastic. Papillary carcinoma is the commonest type of thyroid cancer in Saudi society. Thyroid neoplasm is rare in Saudi children

Guia de consenso para el diagnostico y seguimiento de la enfermedad tiroidea Parte 3 de 3 / Guide of consensus for the diagnosis and pursuit of the tiroidea disease Part 3 of 3

Nota del Editor: Medicina & Laboratorio ha recibido autorización de Academia Nacional de Bioquímica Clínca para reproducir, en su totalidad, la ®Guía de Consenso para el Diagnóstico y Seguimiento de la Enfermedad Tiroidea¼, como una excelente herramienta de mejoramiento continuo en el manejo de las pruebas tiroideas, de vital importancia para la región, documento que llegará en tres entregas consecutivas. Demers LM, Spencer CA. Guía de consenso para el diagnóstico y seguimiento de la enfermedad tiroidea. Medicina & Laboratorio 2005; 11: 11-38.

Guía de consenso para el diagnóstico y seguimiento de la enfermedad tiroidea / Guide of consensus for the diagnosis and pursuit of the tiroidea disease Part 1 of 3

Nota del Editor:Medicina & Laboratorio ha recibido autorización de Academia Nacional de Bioquímica Clínca para reproducir, en su totalidad, la ®Guía de Consenso para el Diagnóstico y Seguimiento de la Enfermedad Tiroidea¼, como una excelente herramienta de mejoramiento continuo en el manejo de las pruebas tiroideas, de vital importancia para la región, documento que llegará en tres entregas consecutivas. Demers LM, Spencer CA. Guía de consenso para el diagnóstico y seguimiento de la enfermedad tiroidea. Medicina & Laboratorio 2005; 11: 11-38.

Correlação entre os achados cintigráficos e histológicos em lesões nodulares isoladas da tiróide / Correlation among the discoveries cintigraphycal and histological in lesions isolated nodulares of the thyroid

As doenças da tiróide são de grande significado, porquanto, a grande maioria é passível de tratamento clínico ou cirúrgico. Os nódulos frios da tiróide merecem especial atenção porque sempre levantam a suspeita de neoplasia. Um dos métodos empregados para diagnóstico de nódulos da tiróide é a cintilografia, dado que o aspecto funcional da lesão pode conduzir a investigação no sentido de benignidade e atualmente tal diagnóstico é feito através deste e da análise citológica e histológica da lesão. O estudo constituiu-se da análise do levantamento estatístico sobre a caracterização de nódulos tiroideanos hipocaptantes e o processo patológico subjacente. Os autores correlacionaram os achados cintigráficos obtidos no Laboratório de Medicina Nuclear da Universidade Federal da Paraíba com os achados histológicos e citológicos obtidos no arquivo geral do Hospital Lauro Wanderley. Foram analisados 354 cintilografias da tiróide com lesões nodulares frias isoladas, sendo 156 com diagnóstico citológico e(ou) histopatológico por biópsia aspirativa e(ou) cirúrgica, obtendo-se os resultados: bócio colóide 84/156 (53,84 por cento); adenoma 15/156 (9,61 por cento); carcinoma 14/156 (8,97 por cento); tiroidite 8/156 (5,12 por cento); blastoma 1/156 (0,64 por cento); insatisfatório 34/156(21,79 por cento). Os resultados mostraram incidência semelhante dos processos patológicos em nódulos hipocaptantes aos constatados na literatura.

The diseases of the thyroid gland are clinically important, then, the great majority of then are able of having clinical or surgical treatment. The thyroid cold nodules diserve special attention because they can be a site of cancer. The cintigraphy is one of the utilized methods in diagnosing thyroid cold nodules, and the functional aspect over benignity. Nowadays, this diagnosis is based on the cintigraphy and on the cytohistological analysis of the lesion. This study was based on the statistic data about cold thyroid nodules and the pathologic process found. The authors correlated cintigraphic findings obtained of the Nuclear Medicine Laboratory, with the cytological and histological ones obtained of the general file of Lauro Wanderley University Hospital of the Federal University of Paraíba. It was analysed 354 thyroid cintigraphy with cold thyroid nodules, in which 156 had cytological or histological diagnosis, through aspiration or surgical biopsy, obtaining the following results: colloied goiter 84/156 (53.84); adenoma 15/156 (9.61); carcinoma 14/156 (8.97); thyroiditis 8/156 (9.61); blastoma 1/156 (0.64); insatisfactory 34/156 (21.79). The results showed a similar incidente of the pathologic process in cold thyroid nodules to those foung in the literature.

Patología tiroidea operada: 12 años de experiencia en el Hospital Cayetano Heredia / Thyroid pathology operated: 12 years of experience at the Hospital Cayetano Heredia

Se presenta las características clínicas, técnica operatoria, estudio histopatológico y evolución de 173 pacientes con patología tiroidea operada en el Hospital Nacional Cayetano Heredia entre 1976 y 1987. 52.6 por ciento presentaron bocio nodular, 63.5 por ciento presentaron nódulos fríos y 21.1 por ciento nódulos calientes. Las técnicas operatorias empleadas fueron: lobectomía total más istmectomía (65.8 por ciento), tiroidectomía subtotal bilateral (19 por ciento), lobectomía total más istmectomía más lobectomía parcial contralateral (8 por ciento) y tiroidectomía total (4 por ciento). La biopsia por congelación se realizó en 95 por ciento de los pacientes. Bocio coloide fue el resultaado histopatológico más frecuente (67.6 por ciento). La patología benigna se encontró en 84.6 por ciento y la maligna en 15.4 por ciento. Las complicaciones fueron: lesión unilateral del nervio recurrente (4 por ciento), hematomas sofocantes (2.3 por ciento) e hipoparatiroidismo transitorio (1.7 por ciento). La mortalidad fué de 0.5 por ciento

Bocio en ninos y adolescentes: estudio de tiroiditis de Hashimoto mediante biopsia tiroidea por aspiracion / Goiter in children and adolescents: study of thyroiditis of Hashimoto with thyriod aspiration biopsy

Se estudiaron 103 pacientes con edades entre 4 y 16 anos, portadores de bocio difuso mediante biopsia tiroidea por aspiracion, con el fin de tratar de establecer la incidencia de tiroiditis de Hashimoto en estos grupos etarios en Medellin. Se emplearon para el diagnostico citologico de esta entidad los criterios de clasificacion del Manual for Nutritional Survey del Interdepartamental Comitee of Nutritin for national Defense (ICNND). El 69.9% fueron portadores de bocio grado I, el 28.1% presentaron gradoII y unicamente el 1.9% grado III. Ninguno fue portador de bocio grado IV. En 4 pacientes (3.8%) se hizo el diagnostico de tiroiditis de Hashimoto, en dos de neoplasia folicular y en los restantes de bocio coloide o nodular. Unicamente en un nino se encontro hipotiroidismo en las pruebas de laboratorio y en el el diagnostico histopatologico fue tiroiditis de Hashimoto. De los cuatro pacientes que presentaron tiroiditis de Hashimito tres eran mujeres y tres tenian bocio grado II y el otro grado I. De los 73 en quienes se habia anotado en el protocolo esta informacion, 58 (56.3%) presentaron historia familiar de enfermedad tiroidea. En 13 (12.6%) de los 103 pacientes no se obtuvo material de biopsia suficiente para diagnostico en el primer intento por lo cual se repitio el procedimiento. No se presento ninguna complicacion. Como en trabajos anteriores se encontro en esta investigacion que la biopsia tiroidea por aspiracion puede ser de gran valor en el diagnostico de tiroiditis de Hashimoto y para estudiar la incidencia de esta enfermedad en ciertas poblaciones...