The accuracy of ultrasonography and fine needle aspiration cytology in the diagnosis of nodular goitre: A prospective analysis of fourty two cases

Abstract

Aims: -The aim of the present study is to evaluate the accuracy of ultrasonography and fine needle aspiration cytology (FNAC) in diagnosis of thyroid nodules in comparison with other diagnostic modalities and to make early and accurate differentiation of benign and malignant thyroid nodules with incidence of malignancy in thyroid nodules. There is 4-5 % incidence of clinically apparent thyroid nodules in the general population. The majority (90%) of thyroid nodules are benign as malignancy occurs in only 1 in 10 thyroid nodules. The overall incidence of malignancy in solitary thyroid nodule ranges between 10% and 30%. Material and Methods: -A prospective study was carried out on 42 cases with nodular goitre attending the surgery OPD, NKP Salve Institute of Medical Science and Research Centre and Lata Mangeshkar Hospital, Digdoh Hills, Hingna Road, Nagpur from October 2010 to October 2012. All patients were subjected to USG and FNAC. Results: -In this prospective study of 42 cases with nodular goitre, clinically 29 patients had solitary thyroid nodule and 13 patients had multinodular goitre. Out of these 42 patients 35 (83.33%) were female and 7 (16.67%) were male with ratio of 5:1, the age of the patients ranged from 18 years to 65 years. Out of these 29 patients of solitary thyroid nodule, 5 patients had malignancy on histopathological examination. So the incidence of malignancy in clinically solitary thyroid nodule was found to be 17.24%.It was observed that USG was 71.43% sensitive and 90.62% specific in detection of malignancy in nodular goitre whereas FNAC was 75% sensitive and 100% specific in the same regard. Conclusion: -The sensitivity and specificity of these diagnostic modalities were evaluated and it was found that USG and FNAC have a high specificity.No investigation was found to be 100% accurate in diagnosing malignancy in nodular goitre but a combination of various diagnostic modalities (ultrasonography and FNAC) rather than any single modality will give optimal results and avoid unnecessary surgery in a great number of patients without missing any malignancy.