A Comprehensive Approach to Thyroid Swellings: Clinical, Sonological, Cytological and Histopathological Correlation

Abstract

Objectives: This study was conducted with the aim of clinicopathological evaluation of thyroid swellings.Setting: Tertiary referral centre, Davangere, Karnataka, India.Design: Retrospective study. Materials and methods:Clinical details, sonological reports, laboratory reports were retrieved from the records for the 110 patients with thyroid swellings who were included in our study, between May 2009 and April 2013 and the data was analyzed. Cytological smears in all patients and histopathology slides in operated patients were retrieved and studied. Results:The highest incidence (37.4%) of thyroid swellings were found in age group of 21 to 30 years. The youngest patient being 10 years. Females (90%) predominated in this study, male to female ratio being 1:9. Majority of patients (35%) came with complaints of swelling of duration less than 6 months. Among 110 patients, 36.36% of them were treated conservatively, out of which 7 cases (17.5%) were hyperthyroid, 10 cases (25%) were hypothyroid and 23 cases (57.5%) were euthyroid and the remaining 63.63% of them underwent surgery. Of the 110 patients subjected to FNAC, 16 patients (14.54%) were neoplastic and 94 patients (85.45%) were non-neoplastic. Upon correlation with the histopathology report, the sensitivity of FNAC was 78.57%, specificity was 91.07%, with a positive pre dictive value of 68.75% and negative predictive value of 94.44%. Diagnostic accuracy of FNAC is 88.50%.Conclusion: FNAC and USG are valuable tools in assessing the need for surgical intervention in thyroid swellings. USG guided aspiration will further enhance the cytological yield and diagnostic accuracy.