Title: Role of High Resolution Ultrasonography and Guided Fine Needle Aspiration Cytology in the Evaluation of Patients with Thyroid Swellings
Authors: Dr Rajmohan J L, Dr Minimol K L, Dr Nizarudeen A
DOI: https://dx.doi.org/10.18535/jmscr/v5i3.118
Abstract
Introduction: Thyroid swellings constitute a major proportion of neck swellings. Approach to the management of solitary and multinodular thyroid differs, and conservative management is considered to be the preferred treatment option. The utilization of high-frequency ultrasound to augment clinical diagnosis would be helpful in avoiding unnecessary thyroidectomy in a patient presented with nodular thyroid disease.
Materials and Method: This study was carried out in the department of surgery, Medical College, Trivandrum during 2009 to 2012. We evaluated the role of high resolution ultrasound and FNAC in thyroid swelling in 50 patients. Sensitivity, specificity, true positive predictive value and negative predictive value and accuracy of sonological findings compared to FNAC findings were calculated.
Results: There was a female predominance with male to female ratio of 1:9. Although clinical evaluation showed most of the cases as solitary nodules, sonological examination and fine needle aspiration cytology proved that the most common type was multinodular goiter followed by adenoma . In the present study sonological diagnosis failed to identify malignancy in all cases but was proven by FNAC.
Discussion: Major challenges faced by a clinician in management of thyroid swelling is, whether the nodule is benign or malignant and whether management need to be conservative or surgical. In our study group, a marked discrepancy was found between palpatory findings of solitary nodule and sonographic findings. There was also a marked discrepancy between palpatory finding of diffuse enlargement and sonographic findings. Multi nodulargoitre was found to be the most common abnormality. Although 24 patients were diagnosed as having solitary nodule on clinical evaluation ultrasonography showed 14 had solitary nodule while 10 patients had multiple nodules. Out of all 7 cases categorized as malignant in FNAC, all were reported as benign in ultrasound.
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