Published: 2021-03-26

Clinicopathological study of thyroid swellings and it’s correlation with ultrasonography

Snehil Shukla, Badri Prasad Patel, Samir Shukla, Vinod Kumar Patel, Kunal Vaidya, Deepak Rathore, Fahaduddin Ansari, Jitendra Kumar Chaurasia, Divya Chaurasia


Background: Thyroid diseases are common and comprise a spectrum of entities. After diabetes mellitus, the thyroid gland is the most common gland to cause endocrine disorder. Lesions of thyroid are predominantly confined to female in the ratio 5:1 to male. Thyroid enlargement is the most common sign, it may be diffuse or generalized or localized. Both benign and malignant lesions of thyroid commonly present with a nodule. Prevalence of thyroid nodule ranges from 0.2% to 1.2% in children and from 4-10% in general adult population. Presently due to common use of ultra-sonography in the clinical practice the incidence of thyroid nodule has risen to 14-50%.

Methods: A prospective, observational, single hospital base study done during the period from 2018 to 2020 in the Department of Surgery, Gandhi medical college Bhopal. Sample size was taken 60 patients.

Results: In this study as patients present with thyroid enlargement and ulrasonography scoring according to TIRAD score, as TIRAD score is increased possibility of malignancy increased. On the basis of ultrasonography of thyroid to detect the malignancy sensitivity is 88.9% and specificity is 98%.

Conclusions: Commonest clinical presentation is multinodular goitre is about 53% and ultrasonography scoring is TIRAD-2 and TIRAD-3 which was consistent with nodular hyperplasia. Second commonest clinical presentation is colloid goitre (31%) and ultrasonography score is TIRAD-2 and TIRAD-3. On the basis of ultrasonography TIRAD-4 and TIRAD-5 are about 13.4% and these findings consistent with Neoplastic thyroid swelling in histopathology.


Goitre, Iodine deficiency, TIRAD score, Thyroid malignancy

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Gharib H. Fine-needle aspiration biopsy of thyroid nodules: advantages, limitations, and effect. Mayo Clin Proc. 1994;69(1):44-49.

Ezzat S, Sarti DA, Cain DR, Braunstein GD. Thyroid incidentalomas prevalence by palpation and ultrasonography. Arch Intern Med. 1994;154(16):1838-1840.

Yeung MJ, Serpell JW. Management of the solitary thyroid nodule. Oncologist. 2008;13(2):105-12.

Cappelli C, Castellano M, Pirola I, Gandossi E, De Martino E, Cumetti D, et al. Thyroid nodule shape suggests malignancy. Eur J Endocrinol. 2006;155(1):27-31.

Agrawal S. Diagnostic accuracy and role of fine needle aspiration cytology in management of thyroid nodules. Journal of Surgical Oncology. 1995;58(3):168-172.

American Association of Clinical Endocrinologists medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract. 2006;12(No. 1)

Horvath E, Majlis S, Rossi R, Franco C, Niedmann JP, Castro A, et al. An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management. J Clin Endocrinol Metab. 2009;94:1748-51.

Kwak JY, Han KH, Yoon JH, Moon HJ, Son EJ, Park SH, et al. Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk. Radiology. 2011;260:892-9.

Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2006;16(2):109-42.

Monika Chaudhary, Nitish Baisakhiya, Gurchand Singh Clinicopathological and Radiological Study of Thyroid Swelling. 2019 Indian J Otolaryngol Head Neck Surg. 2019;71(Suppl 1):S893-S904.

Basharat R, Bukhari MH, Saeed S, Hamid T. Comparison of fine needle aspiration cytology and thyroid scan in solitary thyroid nodule. Patholog Res Int. 2011;754041.

Takashima S, Fukuda H, Nomura N, Kishimoto H, Kim T, Kobayashi T. Thyroid nodules: re-evaluation with ultrasound. J Clin Ultrasound. 1995;23(3):179-184.

Hong Y, Liu X, Li Z, Zhang X, Chen M, Luo Z. Real-time ultrasound elastography in the differential diagnosis of benign and malignant thyroid nodules. J Ultrasound Med. 2009;28:861-7.

Asteria C, Giovanardi A, Pizzocaro A, Cozzaglio L, Morabito A, Somalvico F, et al. US-elastography in the differential diagnosis of benign and malignant thyroid nodules. Thyroid. 2008;18:523-31.

Rago T, Santini F, Scutari M, Pinchera A, Vitti P. Elastography: New developments in ultrasound for predicting malignancy in thyroid nodules. J Clin Endocrinol Metab. 2007;92:2917-22.

Martinek A, Dvorackovia J, Honka M. Importance of Guided Fine needle aspiration Cytology (FNAC) for the diagnosis of Thyroid Nodules-Own Experience. Biomed Papers. 2004;148(1):45-50.

Wahid FI, Khan SF, Rehman HU, Khan IA. Role of fine needle aspiration cytology in diagnosis of solitary thyroid nodules. Iranian Journal of Otorhinolaryngology. 2011;23(4):111-8.

Morgan JL, Serpell JW, Cheng MSP. Fine-needle aspiration cytology of thyroid nodules: how useful is it? ANZ Journal of Surgery. 2003;73(7):480-3.