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Comparison of radiological and histocytological examination of thyroid lesions in Udaipur area

Nipa Hathila, Dwarkaprasad Agrawal.

Background: The evaluation of the thyroid lesion is much important for both medical and surgical point of view. Ultrasonography (USG) is far more sensitive than palpation, but diagnostic accuracy is always found to be less than fine needle aspiration cytology (FNAC) and histopathological examination. If cost-effectiveness and diagnostic value considered, the repeat FNA can be done when the nodule shows any suspicious feature on the initial USG. However, known ultrasound features associated with malignancy show an extremely variable probability of malignancy.

Objectives: To compare the radiological findings with histo-cytological findings and diagnosis of various thyroid lesions.

Material and Methods: The present prospective study was carried out over one and half years. The patients visiting various departments with thyroid enlargement and referred to radiology department were included in the study. Detailed clinical history like demographic data, history of the present thyroid swelling, change in weight, diplopia, mood, and drug history was taken. Patients’ general examination and local examination of swelling was performed. Radiological examinations like X-ray examination, USG, and if needed CT scan were performed. USG-guided FNAC was performed in all participants while histo-pathological examination was done only in operated lesions. Correlation of radiological examination and cyto-histological examination was done.

Results: Female:male ratio was 8.3:1 with common age group of presentation was 21–40 years of age. Ultrasound findings show that nodule size varied from 8 mm to 3.5 cm. Total 64.29% participants had single nodule, 26.19% had multiple nodules, and 9.52% had diffuse lesion. Briefly, 90.48% lesions had regular shape and 78.57% had well-defined margin. Nearly 55% of lesions had hyperechoic, 24% had isoechoic, and 21% had hypoechoic picture. Microcalcification was seen in 28.57% of lesions. Radiologically 70% of lesions were colloid goiter, 9.52% were thyroiditis, 8.33% were thyroglossal cyst, 10.71% were benign neoplasm, and 2.38% were malignant. Comparison with cyto-histological examination shows that accuracy of diagnosing the thyroid lesions by radiological examination was 92.86%.

Conclusion: Although FNAC and biopsy examination give accurate diagnosis, radiological evaluation of thyroid lesion by ultrasound gives valuable findings that help in further management of the thyroid lesions. Ultrasound also helps in the procurement of sample from the lesion accurately for the FNAC and biopsy.

Key words: Thyroid lesions, ultrasound examination, FNAC, histological examination

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