ABSTRACT
Background Fine needle aspiration cytology (FNAC) is the gold standard for detecting thyroid nodules. It is a cost-efficient approach that affords prompt and accurate evaluation. It is crucial in deciding to treat patients with suspected malignancy of thyroid nodules that might have thyroid surgery. According to findings in cytology, patients may be observed when the cytology is benign, and surgery can be performed if the cytology is malignant, which leads to a reduction in the incidence of unneeded surgery. Aim The current study aims to assess the concordance between FNAC of thyroid nodules with final histopathology and identify the different types of detected thyroid lesions. Methodology A retrospective record-based study reviewed the medical files of all patients presenting to the Armed Forces Hospital, Southern region, with suspected thyroid nodules from April 2018 to January 2020. Data were extracted using pre-structured data extraction sheet to avoid inconsistency. Data extracted included patients' demographic data, swelling laterality, size, ultrasound, and histopathological findings. Results The baseline characteristics of studied samples in the present study: Forty-seven samples had a mean age of 44.27 (SD=±13.5) years, and 85.1% were female gender. The study showed that 12.5% of benign samples were lymphocytic in histopathology, 25% suspicious for follicular neoplasm samples were benign multi-nodular goiter in histopathology, and all 100% of samples suspicious for malignancy were malignant in final histopathology. Conclusions The current study showed that the malignancy rate of the examined nodules was not uncommon in FNAC and histopathology. Where papillary carcinoma was the most detected malignancy, the diagnosis of malignancy using FNAC is a cost-efficient approach that affords prompt and accurate evaluation. Once diagnosed, these cases should be subjected to surgery.
ABSTRACT
INTRODUCTION: Foreign body inhalation (FBI) is a serious and common emergency in children. Such children present in the emergency room (ER) with cough, shortness of breath, choking, or wheezing but rarely present with pneumomediastinum. PATIENT CONCERNS: Three children aged 2 to 5 years (2 girls and 1 boy) were seen in our ER complaining of FBI. Emergency bronchoscopy removal of the inhaled foreign body was performed; however, all 3 patients developed pneumomediastinum. DIAGNOSIS: A foreign body inhalation complicated by Pneumomediastinum/pneumothorax. INTERVENTION AND OUTCOMES: All the patients underwent emergency bronchoscopy and foreign body removal. After the ER intervention, 2 children were placed in the pediatric intensive care unit, and the pneumomediastinum resolved without intervention. The third patient required an operation for chest tube placement, which was then observed in the pediatric intensive care unit, and had several chest radiography follow-ups. After 5 days, the patient exhibited clinical improvement, and the chest tube was removed. CONCLUSION: In this case series, we present 3 cases of children aged 2 to 5 years seen in our ER with a history of different types of organic FBI complicated by pneumomediastinum/pneumothorax. Pneumomediastinum/pneumothorax is a rare complication of FBI in pediatric patients. However, such complications require multidisciplinary collaboration for early diagnosis and intervention.
