Introduction:
The Fine Needle Aspiration Cytology (FNAC) is a simple, safe, cost-effective minimally invasive procedure for diagnosing thyroid nodules/swelling. Clinicians usually evaluate thyroid function by estimating T3, T4 and TSH level for therapeutic planning. In this study the importance of FNAC in the diagnosis of thyroid diseases was evaluated and FNAC findings were correlated with clinical features and thyroid profile.
Materials and Methods:
The study was designed as prospective cross-sectional hospital based (laboratory investigation) study for 2 months duration (from 17th July, 2017 to 16th September, 2017). Fifty cases of thyroid swelling attending Pathology Department for FNAC were included in the study. For Each case thyroid profile was done.
Result:
Total 50 patients of thyroid swelling were included in the study, out of which 46 were female (92%) and 4 were male (8%). Male to female ratio was 1:12.5. Mean age was 45.44 ±16.02 years. Out of 50 patients 35 (70%) had diffuse thyroid swelling, 9 (18%) had left lobe and 6 (12%) had right lobe involvement. All the 50 patients with thyroid lesion had a common complaint of neck swelling. Some had associated dysphagia (12 cases, 24%) and/ or dyspnoea (6 cases, 12%), and only 2 had hoarseness of voice. Among 38 cases of non-neoplastic lesions colloid goitre was the commonest comprising 20 cases (52.63%), followed by 11 cases ( 28.95%) lymphocytic thyroiditis, 4 cases (10.53%) of granulomatous thyroiditis and 3 cases (7.89%) of follicular hyperplasia. Among 12 cases of neoplastic lesions papillary carcinoma was the commonest consisting of 7 cases (58.33%), followed by follicular neoplasm (4 cases, 33.33%) and 1 case of Hurthle cell neoplasm. Most of the colloid goitre cases were euthyroid (60%), lymphocytic thyroiditis was commonly associated with hypothyroidism (45.5% cases), and most cases of granulomatous thyroiditis were euthyroid (50%). All the patients with follicular hyperplasia had hyperthyroidism.
Most of the cases with papillary carcinoma were in euthyroid (3 of 7, 42.86%) and followed by subclinical hypothyroid state (2cases, 28.57%) and one case of each hypothyroidism and subclinical hyperthyroidism. Follicular neoplasm was commonly associated with euthyroid state (75% cases). One case of Hurthle cell neoplasm had hyperthyroidism.
Conclusion:
Thyroid gland being superficial, it is easy to perform fine needle aspiration. Similar thyroid disease shows variable hormone profile in different patient and different stages of the disease. Hence, FNAC of thyroid lesions in conjunction thyroid hormonal analysis helps in proper assessment and management of patients with thyroid lesion.
Key words: Thyroid lesion, thyroid hormone profile, fine needle aspiration cytology
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