Management of solitary thyroid nodule by USG guided FNAC
Journal Title: Medpulse International Journal of ENT - Year 2018, Vol 5, Issue 1
Abstract
Problem Statement: Ultrasonography (USG) is very helpful to detect the size of the tumour, diagnosing multinodular goitres, and more important the nature of the solitary thyroid nodule whether it is solid or cystic. Only rarely is a cystic nodule associated with a malignancy. We have planned to undertake a study on solitary thyroid nodules and shall try to corroborate the pre-operative cytological diagnosis obtained by USG guided FNAC with the postoperative histopathological diagnosis. Methods: We have studied 30 patients. The patients were taken from the indoor and OPD of the Department of ENT and Head-Neck Surgery, M.G.M. Medical College & L.S.K. Hospital. The period of the study was between October2016 and September 2017. We have considered only the patients with solitary thyroid nodule of both sexes and all age groups. The type of operation was according to the report of USG guided FNAC. The postoperative specimen was sent for histopathological examination. The results were compared with the pre-operative USG guided FNAC report. Results: The age of the patients was between 15-75 years. The most of the patients in our study were middle aged females. So, in our study 83 % patients were females where as 17 % patients were males. we can see that, the associated symptoms were hoarseness of voice (4 patients), lymph node involvement (2 cases) and fixity to the deeper structures (1 cases). All these 3 symptoms are in favour of malignancy. There was no pain or obstructive symptoms like dysphagia. Here to mention that we have selected patients with small solitary thyroid nodules. In our series predictive value for clearly benign cases was 93 % and the false negative report was 7 %. We considered 7 cases out of 30 for this investigation and all were cold nodules, 5 cases were reported as malignant lesion on USG guided FNAC. Conclusion: When properly done by an experienced cytopathologist, in can reliably diagnose the clearly benign cases, that can be managed reasonably by conservative approach rather than subjecting all patients to operations
Authors and Affiliations
B K Bhattacharjee, Subhajit Sarkar
Keywords
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