Clinicopathological and Radiological Profile of Multinodular Goitre – A Prospective Study

Abstract

Introduction Multinodular goitre (MNG) is defined as multiple palpable distinct nodules in the enlarged thyroid gland. MNG can harbour malignancy in 1-10% cases. We undertook the present study to correlate the clinical, radiological and cytological features of MNG with that of final histopathological diagnosis. Materials and Methods A prospective cohort study was done in a tertiary care hospital in northern part of West Bengal from January 2018 to December 2019. Patients aged between 12 years and 75 years, presenting with MNG on clinical examination, were included in the study. We compared the pre-operative ultrasonography (USG) of neck and fine needle aspiration cytology (FNAC) reports with post-operative histopathological examination (HPE) report. Results Among 100 patients 80 were female and 20 were male. Most patients were in 41-50 years age group. For detection of malignancy in MNG, USG had 40% sensitivity, 97.78% specificity, 66.67% positive predictive value (PPV), 93.62% negative predictive value (NPV), and 92% diagnostic accuracy. Sensitivity, specificity, PPV, NPV and diagnostic accuracy of FNAC for detection of malignancy in MNG were 20%, 93.33%, 25%, 91.3% and 86% respectively. When USG features were combined with FNAC features non-diagnostic result decreased from 6% to 2% and diagnostic accuracy for detecting malignancy in MNG increased from 86% to 90%. Conclusion USG and FNAC are complementary to each other in the diagnostic workup of MNG. USG guided FNAC is still better for reaching final diagnosis and exclusion of malignancy.