Clinical, pathological and radiological correlation of thyroid swellings
Keywords:Thyroid swelling, Malignancy, Fine needle aspiration cytology, Ultrasonography
Background: The cause and type of thyroid swellings vary across geographical areas, lifestyles, and socioeconomic status of people. The incidence of palpable thyroid swellings is 4-7% out of which only 1% are malignant. Out of all thyroidectomy cases, histologically confirmed thyroid malignancy constitutes only 20%. Hence, we attempt to evaluate thyroid swellings based on clinical examination, ultrasonography (USG), Fine needle aspiration cytology (FNAC), and histopathological evidence to aide in arriving at proper diagnosis and treatment at an early stage.
Methods: This was a prospective observational study conducted at the SSG Hospital, Vadodara from December, 2016 to September 2017 and included 30 patients. Following preliminary examination, we performed thyroid function tests, FNAC, and USG pre-operatively. Histopathological examination of excised tissue was performed within 4-5 hours after thyroid surgery, and later, post-op complications were noted. Results were derived after appropriate statistical tests.
Results: 65% patients belonged to 2nd and 3rd decade with male to female ratio of 1:5 and all patients presented with an anterior neck swelling. Clinical examination was found to be 50% sensitive and 100% specific. The sensitivity and specificity of FNAC was 50% and 96% respectively while that of USG was 67% and 100% respectively. Out of 16% malignant cases, all were of papillary type. Most common post-op complication was related to wound care (3-5%).
Conclusions: Correlation between clinical findings, ultrasonography findings, cytology, serum investigations and histopathological examinations are to be carried out for appropriate management of thyroid swelling.
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