Diagnostic Cytopathology Approach along with Malignant Risk Stratification in Thyroid Lesions
Abstract
Objectives: Fine needle aspiration cytology (FNAC) plays a pivotal role
in the initial diagnosis of thyroid swellings. The standardisation of
cytomorphological classification by The Bethesda System for Reporting
Thyroid Cytopathology (TBSRTC) has simplified the treatment and
malignancy risk analysis can help select the follow-up strategies. The
aim of this study was to enumerate the cytomorphological features of
thyroid swellings, classification in TBSRTC and corroboration of their
radiological features along with illustration of diagnostic approaches
in non-diagnostic cases and malignancy risk stratification in thyroid
nodules.
Methods: FNAC were done in 153 cases of thyroid swellings and
cytomorphological diagnoses were made as per TBSRTC. Repeat FNAC
was done in non-diagnostic cases.
Results: Among 153 cases, benign lesions constituted 108 (70.6%) cases,
malignancy constituted 9 (5.9%) cases, and 22 (14.4%) cases were
non-diagnostic. Among benign cases, the majority (62, 57.4%) were
cases of colloid and multinodular goitre. Five out of nine malignant
cases (55.5%) showed a hypoechoic nodule in the ultrasound scan.
Repeat FNAC succeeded in making a diagnosis in three cases (13.6%)
of the non-diagnostic group. With guided FNAC, 10 cases (45.4%) were
diagnosed and 2 cases (11.1%) were found to be malignant. Among
the known risk factors, the number of nodules showed a significant
causal association with malignancy (Odds ratio: 8.9; p value 0.04) and
121 cases (79%) were euthyroid irrespective of malignancy status.
Conclusion: FNAC is a sensitive, accessible, and inexpensive diagnostic
tool and repeat FNAC in non-diagnostic cases is useful in diagnosing
and analysing malignant risk in thyroid lesions.
How to cite this article:
Das S, Gon S, Chakarabarti P R, Mallick D.
Diagnostic Cytopathology Approach along with
Malignant Risk Stratification in Thyroid Lesions
Rec Adv Path Lab Med. 2024;10(3&4):9-15.
DOI: https://doi.org/10.24321/2454.8642.202406
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