Clinical, pathological and radiological correlation of thyroid swellings

Hetal H. Chauhan, R. G. Aiyer, Purva C. Shah


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.



Thyroid swelling, Malignancy, Fine needle aspiration cytology, Ultrasonography

Full Text:



Vinci DL. Leonardo on the human body. New York: Dover Publications; 1925.

Graves RJ. Clinical lectures - part II. London Medical and Surg J. 1838;7:516-7.

Basedow VCA. Exophthalmus durch Hypertrophie des Zellgewebes in der Augenhöhle. Wochenschr. Ges Heilk. 1840;6:197-220.

Garrison, Fielding H. An introduction to the history of medicine with medical chronology, bibliographic data and test questions. 4th ed, Philadelphia: WB Saunders Company; 1929.

Venkatachalapathy TS, Sreeramulu PN, Maddineni RK. A prospective study of clinical, sonological and pathological evaluation of thyroid nodule. J Thyroid Dis Therapy. 2012;1:2.

Kapur MM, Sarin R, Karmakar MG, Sarda AK. Solitary thyroid nodule. Indian J Surg. 1982;44:174-79.

Bhansali SK. Solitary nodule in the thyroid gland; experience with 600 cases. Indian J Surg. 1982;44:547-61.

Gharib H. Fine needle aspiration biopsy of thyroid nodules: advantages, limitations and effect. Mayo Clinic Proceedings. 1994;69(1):44-9.

Solbiati L, Charboneau JW, Osti V, James EM, Hay ID, Rumack CM, et al. The thyroid gland. Diagnostic Ultrasound. St Louis, Missouri: Elsevier Mosby; 2005;3(1):735-70.

Brkljacic B, Cuk V, Brzac TH, Zigman BZ, Brkljacic DD, Drinkovic I. Ultrasonic evaluation of benign and malignant nodules in echographically multinodular thyroids. J Clinical Ultraso. 1994;22:71-6.

Gardner HA, Ducatman BS, Wang HH. Predictive value of fine needle aspiration of the thyroid in classification of follicular lesions. Cancer. 1993;71(8):2598-603.

Hawkins F, Bellido D, Bernal C, Rigopoulou D, Valdepenas RMP, Lazaro E, et al. Fine needle aspiration biopsy in the diagnosis of thyroid cancer and thyroid disease. Cancer. 1987;59(6):1206-9.

Khafagi F, Wright G, Castles H. Screening for thyroid malignancy: the role of fine needle aspiration biopsy. Medi J Austra. 1988;149(6):302-3.

Caplan RH, Strutt PJ, Kisken A. FNAB of thyroid nodules. Wisconsin Medi J. 1991;90(6):285-8.

Gharib H, Goellner JR. Fine-needle aspiration biopsy of the thyroid: an appraisal. Annals Int Medi. 1993;118(4):282-9.