A Clinicopathological audit of thyroid malignancies A 2 year study

Abstract

Thyroid cancer is the commonest of all endocrine malignancies with annual incidence of 0.5-10 cases /100000 population constituting 1 % of all malignancies .Most present as solitary thyroid nodules clinically indistinguishable from benign lesions posing great diagnostic trial . Histopathology plays a major role in diagnosis. Aim : The objective of this study is to determine the overall incidence ,frequency of variants and analyse with clinical presentation. Material /Methods : All specimens of thyroid were grossed and processed methodically. Diagnosed cases of primary malignant neoplasms were analysed clinicopathologically. Results - Papillary carcinoma formed the majority (83%) with 63% classical type . Solid and tall cell variants (4%) behaved in aggressive manner. Medullary and follicular carcinomas were rare (12%). 66% cases presented with solitary nodule. 71% comprised of less than 2cm in size. 22% of cases presented with metastases in lymphnode, liver, lung .Three cases of Non-Hodgkins lymphoma and mesenchymal sarcoma ,confirmed by immunohistochemistry marker study ,were the least common(6%). Fourteen cases of papillary carcinoma and three medullary carcinomas were discerned in the background of multinodular goitre (28%). Likewise,three papillary carcinomas and a lymphoma occured in Hashimotos thyroiditis (7%). Conclusion - 1. Papillary carcinoma is most common type with predominantly classical variant having presentation at any age also with secondaries. 2. Papillary carcinoma can be aggressive in solid and tall cell variant. 3. Size is not a criterion for malignancy. 4. Majority show female preponderance. 5. Lymphomas and sarcomas are not uncommon.