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NJBMS - Volume 4, Issue 2, October - December 2013

Pages: 132-138
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ROLE OF CYTOLOGY,HISTOPATHOLOGY,HORMONAL ASSESSMENT AND IMAGING IN DIAGNOSING THYROID LESIONS-A PROSPECTIVE STUDY

Author: A. BHAGYA LAKSHMI, A. KASIBABU, S.V. KUMAR VENKAT , P. UMA, K. SATYASRI, S. HIMAJA

Category: Pathology

Abstract:

Introduction:Thyroid enlargement is a common problem in the coastal districts of Andhra Pradesh.For accurate diagnosis and early management of these lesions, combination of investigations are necessary. In our institute 20% of cases attending the surgical out patient department are with thyroid enlargement.

Objectives : 1. To evaluate the overall accuracy of FNAC and Imaging in diagnosing non-neoplastic and neoplastic lesions of thyroid taking histopathology as gold standard.

2. To evaluate the role of thyroid function tests (T3,T4 and TSH) in diagnosing various non-neoplastic and neoplastic lesions of thyroid.

Material and Methods : This is a prospective study for a period of 2 years from August 2008 to July 2010 at tertiary care hospital. In 215 patients the data was available for correlation between cytology, ultrasonography and histopathology. Hormonal status was available for analysis in 910 cases with thyroid lesions.

Results: The sensitivity, specificity and overall accuracy in diagnosing non-neoplastic and neoplastic lesions of thyroid on cytology in comparision with histopathology was 71.8%, 94.95% and 84.65% respectively. Overall accuracy in diagnosing non-neoplastic and neoplastic lesions of thyroid on ultrasonography in comparison with histopathology was 100%.

Conclusions:FNAC even though it is simple and cost effective procedure, it has limitations. Ultrasonography was superior to cytology in picking up malignancies associated with multinodular goiter and differentiating follicular adenoma from hyperplastic nodule in a goiter hence ultrasound guided FNAC is more useful. In elderly females with chronic lymphocytic thyroiditis and high levels of TSH, ultrasonography and histopathological examination aids in ruling out lymphoma.

Keywords: Thyroid lesions, Cytology, Hormonal levels, Ultrasonography