Abstract
Background: Several authors have questioned the accuracy of fine- needle aspiration cytology (FNAC) in large thyroid nodules. It’s the current practice to provide thyroidectomy to patient with thyroid nodules 4 cm or larger regardless of the FNAC results. The aim of the study is to answer two questions: is the size of nodule associated with higher risk of malignancy and is the size indication for surgery. Subjects and Methods: This study included 20 patients who underwent thyroidectomy. We compared all thyroid nodules with benign FNAC and their final histopathology reports. Patients were divided into two groups based on the size of the nodule (< 4cm or >4cm) and indication of surgery. Results: 20 patients with thyroid nodule underwent thyroid surgery. 13 patients had nodule <4cm and 7 patients were 4 cm. For patients with nodules <4 cm, 3 patients had a malignancy, and for those with nodules 4 cm, 1 patients had a malignancy. For benign cases FNAC and histopathology reports are showing same results, (p<0.05). Conclusion: Thyroid nodules 4 cm are not risk factor of malignancy. Thyroid nodules 4 cm with benign FNAC should not undergo thyroidectomy as false negative rate is low. Therefore, the decision for surgery ought not to be taken based on the size of the nodule.
Highlights
Thyroid nodules are common diseases of the endocrine system, with prevalence of 3%–7% by palpation and 19%–67% by high resolution ultrasound. [1,2] Thyroid cancer accounts for approximately 5% to 15 % of thyroid nodules. [3] In recent years; the number of thyroid cancer has been on the rise.Due to early identification of thyroid nodule, diagnosis and management of thyroid cancer have been expanded
Repeat cytology was recommend for patient with abnormal feature in ultrasound and changes in the size of the nodule. [4,11] the purpose of this study was to investigate the relationship between the size of thyroid nodules and malignancy risk
A “p” value of less than 0.05 was considered significant. This prospective study included 20 cases who presented with neck swelling with thyroid nodule and they were subsequently underwent thyroid surgery between January 2019 and June 2019
Summary
Thyroid nodules are common diseases of the endocrine system, with prevalence of 3%–7% by palpation and 19%–67% by high resolution ultrasound. [1,2] Thyroid cancer accounts for approximately 5% to 15 % of thyroid nodules. [3] In recent years; the number of thyroid cancer has been on the rise.Due to early identification of thyroid nodule, diagnosis and management of thyroid cancer have been expanded. Thyroid function test (TFT), ultrasound of the neck and fine-need aspiration cytology (FNAC) are all part of initial evaluation of a thyroid nodule. Fine needle aspiration cytology is gold standard tool to define nature of thyroid nodule. Several authors have questioned the accuracy of fine- needle aspiration cytology (FNAC) in large thyroid nodules. It’s the current practice to provide thyroidectomy to patient with thyroid nodules 4 cm or larger regardless of the FNAC results. We compared all thyroid nodules with benign FNAC and their final histopathology reports. Patients were divided into two groups based on the size of the nodule (< 4cm or >4cm) and indication of surgery. Results: 20 patients with thyroid nodule underwent thyroid surgery. Thyroid nodules ≥4 cm with benign FNAC should not undergo thyroidectomy as false negative rate is low. The decision for surgery ought not to be taken based on the size of the nodule
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