- Visibility 83 Views
- Downloads 64 Downloads
- Permissions
- DOI 10.18231/j.ijoas.81551.1760002507
-
CrossMark
Study on manifestations in benign versus malignant tumours in thyroid at a tertiary care centre: comparing USG, FNAC and HPE
- Author Details:
-
Santosh UP
-
Sahil Arora
-
Arfan Nasser
Arfan Nasser
Introduction: Thyroid swelling is commonly encountered by an Otorhinolaryngologist in OPD. With varying combination of manifestation clinically and varying manifestations requiring a thorough understanding of the gland and its pathophysiology and investigations. So a broad overview and clinical understanding regarding incidence of benign and malignant thyroid swellings and correlation of pre-operative Ultrasonography (USG) neck, Fine Needle Aspiration Cytology (FNAC) and post-operative histopathological examination (HPE) is imperative in a clinical setting.
Aim: To study clinical manifestations of Thyroid swellings. To study incidence of benign and malignant tumours in thyroid swellings. To co-relate findings of USG, FNAC & HPE
Materials and Methods: Patients attending ENT OPD with thyroid swelling of either sex in age group 18-75 were considered for study. History and complete physical examination of patients were done and patients in euthyroid state with Ultrasound and FNAC proven thyroid lesion willing to undergo thyroidectomy and participate in the study were included.
Patients were evaluated for the clinical manifestations of the thyroid swelling, incidence of benign and malignant swelling was calculated. Pre-operative USG and FNAC were correlated with Post-operative HPE to study accuracy of USG & FNAC compared to HPE
Result: Difficulty Swallowing was the most common among clinical features with 6 cases followed by difficulty breathing in supine position in 5 cases. 11 out of 70 cases turned out to be malignant, with papillary thyroid carcinoma being most common malignancy in 8 cases followed by Follicular Thyroid Carcinoma amongst 3 cases. Keeping HPE as the gold standard, USG showing 45% sensitivity and 86% specificity to HPE and FNAC showing 64% sensitivity and 93% specificity to HPE.
Conclusion: Clinically difficulty in swallowing was the most common complaint in patients with Papillary Thyroid Carcinoma is the most common malignancy. USG and FNAC proves to be easy and highly specific investigation for diagnosis with HPE being the gold standard of thyroid swelling evaluation though having relatively low sensitivities.
References
- Kaur K, Sonkhya N, Bapna AS, Mital P. A Comparative study of Fine needle Aspiration cytology, Ultrasonography and Radionuclide scan in the management of solitary thyroid nodule: A prospective analysis of fifty cases. Indian J otolaryngol Head Neck Surg. 2002;54(2):96-101. DOI: 10.1007/BF02968725
[Google Scholar] - Manoj G, Savita G, Bhushan VG. Correlation of Fine needle aspiration cytology with histopathology in diagnosis of solitary thyroid nodule. J Thyroid Res. 2010: 379051. DOI: 10.4061/2010/379051
[Google Scholar] - Santhraya MG, Bhandary R, Valsamma RG, Deepalakshmi T, Devan PP, Pai VK. et al. A Comparative Study of Ultrasound (USG), fine needle aspiration cytology (FNAC) and Histopathological Examination (HPE) of thyroid Swellings. J Evol Med Dental Sci. 2015;4:15543-5. DOI:10.14260/jemds/2015/2227
[Google Scholar] - Bagga P K, Mahajan N C. Fine needle aspiration cytology of thyroid swellings: How useful and accurate is it? Indian J Cancer. 2010;47(4):437-42.
- Layfield LJ, Reichman A, Bottles K. Clinical determinants for the management of thyroid nodules by fine needle aspiration cytology. Arch Otol Head Neck Surg. 1992;182:(7)717-21. DOI: 10.1001/archotol.1992.01880070047009
[Google Scholar] - Panato C, Vaccarella S, Dal Maso L. Thyroid Cancer Incidence in India Between 2006 and 2014 and Impact of Overdiagnosis. J Clin Endocrinol Metab. 2020;105(8):2507 -14. doi:10.1210/clinem/dgaa192
[Google Scholar] - Kumar A, Bhadouriya SKS, Narain P, Chauhan JPS, Bharti B, Singh J. Comparative study of FNAC and histopathology of thyroid swellings,diagnostic accuracy and role in its management. Int J Otorhinolaryngol Head Neck Surg 2017;3:885-92. DOI:10.18203/issn.2454-5929.ijohns20174183
[Google Scholar] - Sreeramulu PN, Venkatachalapathy TS, Prathima S, Kumar K. A Prospective Study of clinical, Sonological and Pathological evaluation of thyroid nodule. J Biosci Tech. 2012;3(1):474-8. DOI:10.4172/2167-7948.1000109
[Google Scholar] - De D, Dutta S, Tarafdar S, Kar SS, Das U, Basu K. et al. Comparison between Sonographic Features and Fine Needle Aspiration Cytology with Histopathology in the Diagnosis of Solitary Thyroid Nodule. Indian J Endocrinol Metab. 2020;24(4):349-54. DOI: 10.4103/ijem.IJEM_349_20
[Google Scholar] - Alshahrani AS, Algazlan AG, Junaid M, Aldosari AA, Amer KA, Mubarki MH. Et al. Association of Fine-Needle Aspiration of Thyroid Nodules With Final Histopathology in Diagnosing Thyroid Malignancy: A Single Institute Retrospective Study. Cureus. 2022;14(11):e31733. DOI: 10.7759/cureus.31733
[Google Scholar] - Chaudhary M, Baisakhiya N, Singh G. Clinicopathological and Radiological Study of Thyroid Swelling. Indian J Otolaryngol Head Neck Surg. 2019;71(1):893-904. DOI: 10.1007/s12070-019-01616-
[Google Scholar] y - Rao K, Goyal VP. Comparative Study of FNAC and Excisional biopsy in thyroid swellings. Indian J otolaryngol Head Neck Surg 2010;62(4):415-6. DOI: 10.1007/s12070-010-0109-2
[Google Scholar] - Singaporewalla RM, Hwee J, Lang TU, Desai V. Clinico- pathological Correlation of Thyroid Nodule Ultrasound and Cytology Using the TIRADS and Bethesda Classifications. World J Surg. 2017 ;41(7):1807-11. doi: 10.1007/s00268-017-3919-5
[Google Scholar] - Nguyen HVV, Nguyen BV, Nguyen XT, Pham LNT, Nguyen TTN, Vo TT. Et al. Ultrasound-Guided Fine-Needle Aspiration Biopsy Of Thyroid Nodules Smaller Than 10 mm in the Maximum Diameter: The Efficacy and Its Correlation with TIRADS Classification. Asian Pac J Cancer Prev. 2025;26(5):1563-9. Doi:10.31557/APJCP.2025.26.5.1563
[Google Scholar]