English

Abstract

BACKGROUND: Study aims to determine correlation of the cytological pattern of thyroid lesions in addition to the utility and accuracy of FNAC as initial diagnostic method along with thyroid hormone profile (T3, T4 and TSH) which provides information at physiological and pathological levels and thus can enhance the likelihood of early detection of ambiguous thyroid dysfunction with minimal clinical findings. OBJECTIVES: To obtain role of thyroid hormone profile (T3, T4 and TSH) aimed at defining prognostic parameters and correlating it with cytology results, diagnosis of diffuse nontoxic goiter, diagnosis of solitary/dominant thyroid nodule, confirmation of clinically obvious thyroid malignancy. MATERIALS AND METHODS: 150 patients with thyroid swellings underwent FNAC along with complete thyroid hormone profile in Central Diagnostic Lab of AJIMS Mangalore. Procedure was performed without L.A with the help of aspirating technique using 23G needle attached to 10 ml disposable syringe. An average of one attempt per nodule was performed usually resulting in 4 direct smears. Both air dried and wet fixed smears fixed in 95% alcohol for about 30 minutes and stained with Leishman’s stain and Pap stain examined under light microscope. Thyroid profile is also performed in all the above patients. RESULTS: One hundred and fifty aspirations of patients (both females and males) were analysed.T3, T4 and TSH was analyzed for all 150 patients. The mean age of patients in this study was 39.66 years and age range was 1-76 years. There were 142 females (94.66%) and 8 males (5.33%). Maximum number of patients was in the age range 21-40 years (49.3%). Most common lesion was colloid goitre accounting for 98 number of cases. There were 141 non-neoplastic lesions, 9 cases were found to be neoplastic. Maximum number of patients, 92 cases was euthyroid while minimum numbers of patients, 4 cases were found to be hypothyroid. 17 cases were hyperthyroid, 23 cases were subclinical hyperthyroidism while 14 cases were subclinical hypothyroidism respectively. CONCLUSION: It renders unnecessary the need for excisional biopsy in advanced disease, elderly patients or in case where treatment is non-surgical. All the fine needle aspiration diagnosis must be viewed in the light of the clinical picture and thyroid hormone profile to minimize the risks of a false-negative report. The widespread application of this method should be fully encouraged as it fulfills a genuine medical need. FNAC is gold standard for preoperative assessment of thyroid nodule. Early and accurate diagnosis reduces surgical intervention, morbidity and mortality.