Cytological diagnosis of thyroid disease

2019 ◽  
Vol 43 (3) ◽  
pp. 30-38
Author(s):  
M. E. Bronstein
Keyword(s):  
Thyroid Gland ◽  
Microscopic Examination ◽  
Nodular Goiter ◽  
Needle Aspiration ◽  
Glass Slide ◽  
Malignant Neoplasms ◽  
Cytological Diagnosis ◽  
Pathological Changes ◽  
Medical Sciences ◽  
Puncture Biopsy

Cytological diagnosis of various human diseases is widely used in modern medicine, especially for early preoperative diagnosis of tumors of different organs and tissues. A fine-needle aspiration puncture biopsy followed by microscopic examination of its cytogram is one of the integral parts of diagnostic cytology, including the diagnosis of thyroid diseases (thyroid gland). The methods used to verify various thyroid pathology options (palpation, ultrasound - ultrasound, scintigraphy, biochemical and immunological tests, etc.) do not always allow us to clarify the nature of pathological changes in the thyroid gland. For example, cold nodes (according to the scan) only in some cases turn out to be malignant neoplasms of the thyroid gland, like the bulk of nodular goiter in patients from regions endemic to goiter; in most cases there is no need for their prompt removal. And only a microscopic examination of thyroid puncture points, especially its nodular formations, allows you to clarify the diagnosis and make an adequate decision on the nature of the treatment measures. Thin-needle aspiration puncture biopsy of the thyroid gland is a non-invasive morphological diagnostic tool that allows you to make a correct diagnosis with almost 100% probability. At the same time, since the thyroid gland is an epithelial organ, in the structures of which the cells are closely “fused” with each other, cellular connections are broken with difficulty, which makes it extremely difficult to obtain informative material for subsequent microscopic examination. To facilitate the process of obtaining material on the needle, which is performed by puncture biopsy, in the Endocrinology Research Center of the Russian Academy of Medical Sciences, notches were started at a distance of about 0.5-0.7 cm from the sharp end of the needle (Candidate of Medical Sciences A.V. Antonov), which allows you to take material like a harpoon, without aspiration and receive a plentiful punctate. With ischemia of the punctured area of the gland, it is possible to obtain abundant punctate with virtually no impurity of peripheral blood (Ph.D. I.V. Panteleev). The material thus obtained is applied to a fat-free glass slide and a smear is obtained using a polished glass slide (similar to a blood smear). Air-dried strokes are stained according to May — Grunwald — Giemsa. Every year we examine from 1.5 to 2.5 thousand puncture biopsies from patients with various pathologies. The information content of the obtained material largely depends on the experience and skill of the surgeon. Scanty punctate, as a rule, is uninformative and can only describe the punctate without an opinion on the nature of pathological changes in the thyroid gland. Abundant cellular punctate from different points of the gland, especially if there is a suspicion of diffuse and / or combined pathology, makes it possible to make a final diagnosis.

scholarly journals Morphological diagnosis of thyroid disease (lecture)

1999 ◽  
Vol 45 (5) ◽  
pp. 34-38
Author(s):  
M. E. Bronstein
Keyword(s):  
Thyroid Gland ◽  
Microscopic Examination ◽  
Thyroid Tissue ◽  
Needle Puncture ◽  
Pathological Changes ◽  
Fine Needle ◽  
Puncture Biopsy ◽  
Morphological Diagnosis ◽  
Fine Needle Puncture ◽  
Morphological Diagnostics

Morphological methods for studying the thyroid gland (thyroid gland) can clarify its structure and the nature of the pathological changes that developed in it, and thereby verify the diagnosis. There are 2 main methods of morphological diagnostics: microscopic examination of punctate obtained using a fine-needle puncture biopsy (aspiration and non-aspiration), and macro and microscopic examination of removed thyroid tissue.

scholarly journals Certain peculiarities of parenchymal-stromal correlations in the thyroid gland with nodular forms of goiter with its rucurrent and non-recurrent course

2020 ◽  
Vol 19 (1) ◽  
pp. 53-60
Author(s):  
N. P. Tkachuk ◽  
I. S. Davydenko
Keyword(s):  
Thyroid Gland ◽  
Slow Growth ◽  
Thyroid Tissue ◽  
Nodular Goiter ◽  
Specific Weight ◽  
Pathological Changes ◽  
Normal Thyroid Tissue ◽  
Normal Thyroid ◽  
Stromal Component ◽  
Correlation Parameters

In spite of a considerable efficacy of conservative treatment of goiter, surgery remains the main method of treatment of such patients. Though, on the one hand, total thyroidectomy inevitably results in the development of postsurgical hypothyroidism, on the other hand – in case organ-saving surgery is performed the risk of postsurgical relapse arises. Modern morphological methods are directed to detection of oncological risk of nodular formations, and recommendations concerning an adequate volume of surgery taking into account probability of relapse are practically lacking. Therefore, the objective of the study was finding criteria of a relapsing risk by means of investigation of morphological peculiarities of the parenchymal-stromal correlations in the thyroid gland with recurrent nodular and primary nodular (multinodular) goiter without signs of functional disorders. In the course of the research according to the examined correlation parameters of the parenchyma and stroma various forms of nodular goiter were found to differ from the thyroid tissue without pathological changes by a number of parameters. In particular, specific weight of the parenchyma on an average increases reliably in the tissue of nodular goiter with its various variants in comparison with the thyroid gland without pathological changes. Together with the increase of the parenchymal specific weight in nodular goiter the amount of colloid on an average decreases, and a specific dependence on the kind of goiter is observed – colloid volume decreases from goiter with slow growth to goiter with quick growth, and it is the smallest with goiter relapse. Quantitative analysis of the goiter tissue stromal component demonstrates a considerable increase of its specific volume in comparison with normal thyroid tissue. Evaluation of changes of the morphometric parameters in the thyroid follicles found that in case of nodular goiter with slow growth the percentage of follicles with colloid is close to 100%. On an average it does not differ from that of the normal thyroid tissue. At the same time, in case of nodular goiter with quick growth the percentage of follicles with colloid decreases sharply, and in case of relapse it appears to be still less than that in nodular goiter with quick growth. Besides, with nodular goiter the diameter of follicles on an average increases in comparison with the normal thyroid tissue. In a number of cases it can be estimated as macrofollicular goiter. At the same time, the diameter of follicles is smaller in nodular goiter with quick growth. It is still less in case of goiter relapse. The size of follicles becomes sharply diverse in case of nodular goiter with slow growth, but it decreases in case of nodular goiter with quick growth and relapse. Consequently, recurrent nodular goiter is mostly similar to that of primary nodular goiter with a quick growth, though certain differences between them exist. The peculiarities found enable to suggest that nodular goiter with a quick growth possesses more chances for relapse.

scholarly journals Fine needle puncture biopsy and imaging methods of the thyroid gland in the diagnosis of nodular goiter

1993 ◽  
Vol 39 (6) ◽  
pp. 30-33
Author(s):  
S. L. Vnotchenko ◽  
T. A. Okeanova ◽  
M. E. Bronshtein ◽  
S. B. Nefedov ◽  
G. I. Fedoseeva
Keyword(s):  
Thyroid Gland ◽  
Ultrasound Examination ◽  
Nodular Goiter ◽  
Needle Puncture ◽  
Single Adenoma ◽  
Fine Needle ◽  
Cytological Data ◽  
Puncture Biopsy ◽  
Cystic Changes ◽  
Operational Data

A retrospective analysis of the results of puncture thyroid biopsy is presented in 256 patients operated on for nodular goiter. Cytological data coincided with histological in 84.8% of cases. Coincidences were most frequent with (multiple) nodular colloid goiter and thyroid cysts (95.7 = 100%) and the least with a single adenoma (65.4%) of predominantly follicular structure. In thyroid cancer, the data correlated in 75% of cases. The presence of cystic changes in the adenoma made the study less informative. The results of an ultrasound examination of the thyroid gland coincided with operational data in 87.5% of patients with (multiple) nodular goiter and in 86.1% of patients with adenomas. Ultrasonography as a method of imaging the thyroid gland is preferable to scintigraphy (scanning) and is the optimal complement to the thyroid puncture biopsy.

scholarly journals A study to determine the incidence of carcinoma of the thyroid gland in patients treated for multinodular goiter

2019 ◽  
Vol 6 (9) ◽  
pp. 3289
Author(s):  
Vikram Yogish ◽  
Challa Teja ◽  
Himanshi Grover
Keyword(s):  
Thyroid Gland ◽  
Multinodular Goiter ◽  
Tamil Nadu ◽  
Complete Blood Count ◽  
Histopathological Examination ◽  
Nodular Goiter ◽  
Needle Aspiration ◽  
Thyroid Function Tests ◽  
College Hospital ◽  
Detailed History

Background: In the population today, the presence of multi nodular goiter (MNG) is found in quite a few people and this may be due to various reasons. The patients should be thoroughly evaluated and a detailed history must be collected. Surgical treatment is offered to patients for various reasons. The objective of this research article is, to determine the incidence and the type of carcinoma of the thyroid gland in patients treated for multinodular goiter.Methods: A total of 105 patients who had multinodular goiter were studied. The study was carried out at SRM Medical College Hospital and Research Center, Kattankulathur, Tamil Nadu, India, from March 2016 to February 2019, for a period of three years. A detailed history was obtained and a thorough clinical evaluation was done. Investigations such as, complete blood count, thyroid function tests, ultrasound of the neck, and fine needle aspiration cytology were done. The patients then underwent total thyroidectomy and the operated specimens were subjected to histopathological examination (HPE). Out of the total of 105 patients that were studied, 21 patients were found to have carcinoma of the thyroid gland. The statistics were analysed using SPSS package 16.0.Results: From the results it was seen that papillary carcinoma of the thyroid gland was most commonly found in the operated specimens. The findings were compared with other studies.Conclusions: In patients with multinodulargoiter, a thorough evaluation and a detailed histopathological examination of the operated specimens must be done.

scholarly journals Thyroid incidentaloma: next to be neglected or investigated?

2021 ◽  
Vol 17 (4) ◽  
pp. 361-371
Author(s):  
S.I. Rybakov
Keyword(s):  
Clinical Practice ◽  
Thyroid Gland ◽  
Nodular Goiter ◽  
Point Of View ◽  
Malignant Neoplasms ◽  
Thyroid Incidentaloma ◽  
Benign Adenoma ◽  
Definition Of ◽  
Instrumental Methods ◽  
Additional Formation

In modern clinical practice, thyroid incidentaloma is an unpalpated node in the thyroid gland, which is detected accidentally by technical means of imaging when examining a patient for other, non-thyroid diseases. Its dimensions are limited to 10 mm, the limit above which it can already be palpated by a qualified professional. In the author’s view, such a definition narrows the concept of incidentaloma, primarily from a nosological point of view. Under the definition of the node can be micro- or macrofollicular nodular goiter, tumor, benign (adenoma) or malignant (carcinoma), the focus of thyroiditis, cyst, inflammatory focus (infiltrate, abscess), calcifications. When enumerating the me­thods of detection by incidental, the palpation method is excluded and the nodes in the thyroid gland detected with its help are not only up to 10 mm in size but also larger, which should also be called incidental. The same can be said about the nodes that are accidentally found on the neck during operations for diseases of the trachea, cervical esophagus, salivary glands. Speaking of incidentalomas, which are detected at autopsy, it should be noted that some of them are larger than 10 mm. All these positions do not fit into the definition of thyroid incidentaloma only as an unpalpated node in the thyroid gland up to 10 mm, which is determined by instrumental imaging methods. Therefore, the concept of thyroid incidentaloma is broader and more capacious than formulated by its modern definition. Incidental thyroid disease should be considered any additional formation in it, regardless of its size, detected by any non-target method of research. Unpalpated and, as a rule, clinically “dumb” nodes up to 10 mm, determined by instrumental methods, can be considered as one of the subspecies of the incidentaloma. The frequency of their detection has increased sharply in recent years, some are malignant neoplasms with an unpredictable course, tactical approaches to them have not been finalized.

scholarly journals Diagnostic tactics for thyroid nodules

2012 ◽  
Vol 93 (1) ◽  
pp. 103-107
Author(s):  
L A Timofeeva
Keyword(s):  
Thyroid Gland ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Malignant Tumors ◽  
Nodular Goiter ◽  
Needle Aspiration ◽  
Regional Lymph Nodes ◽  
Fine Needle ◽  
Cut Surface ◽  
Ultrasound Investigation

Aim. To determine the optimal diagnostic tactics for nodules of the thyroid gland. Methods. Examined were 1124 patients with thyroid nodules in the age from 14 to 60 years and older, of whom 159 - with malignant tumors, 180 - with adenomas, 620 - with colloid nodes, 165 - with cysts. Among the surveyed group were 844 women and 280 men. The group of healthy individuals included 400 people. The material for cytology was obtained by fine-needle aspiration biopsy (1004 studies), from smears from the cut surface of the tumor (76 studies) and from puncture biopsies of enlarged regional lymph nodes (44 studies). Results. During ultrasound investigation hypoechoic, heterogeneity, roughness and blurred contours, the presence of the internal structure of small echo-negative inclusions are characteristic for thyroid cancer. As the number of these features increases the likelihood of confirmation of a malignant tumor of the thyroid increases as well. The ultrasound picture of nodular colloid goiter is characterized by a single nodule or multiple nodules in the tissue of the thyroid gland of low or isoechoic density, sometimes with a limiting «rim». The presence of the latter feature causes difficulties in the differential diagnosis between nodular goiter and thyroid adenoma. Out of the 907 informative cases in 144 patients (15.8%) cancer was diagnosed cytologically. Conclusion. A complex diagnostic approach to the examination of thyroid nodules using fine-needle aspiration puncture biopsy of the nodules under the control of ultrasound and subsequent cytological investigation of the punctate provides valuable information on the nature of pathological changes of the thyroid gland.

scholarly journals A STUDY ON DIAGNOSTIC ACCURACY OF ULTRASOUND GUIDED FINE NEEDLE ASPIRATION CYTOLOGY FINDINGS WITH HISTOPATHOLOGY FINDINGS IN NODULAR GOITER OF THYROID

2020 ◽  
pp. 7-10
Author(s):  
Sudhansu Sarkar ◽  
Mintu Mallick
Keyword(s):  
Thyroid Gland ◽  
Systemic Disease ◽  
Word Meaning ◽  
Nodular Goiter ◽  
Needle Aspiration ◽  
Iodine Intake ◽  
Cystic Mass ◽  
Endocrine Disorders ◽  
Tumour Mass ◽  
Latin Word

The word ‘Thyroid’ originated from ‘Thyreos’, a Greek word meaning shield. It was first used by Thomas Wharton(1614-1673) of London, UK. He named it as Glandularis thyroideis in 1656 in his book “Adenographia.” In old times, it was called Struma(Latin word of swollen gland), bronchocele (a cystic mass in the neck) and goiter (Latin word-gutter meaning throat).The last name is in use even today [1] .Diseases of the thyroid gland are common and comprise a spectrum of entities causing systemic disease (Grave’s disease) or a localised abnormality in the thyroid gland such as nodular enlargement (goitre) or a tumour mass. After diabetes mellitus, the thyroid gland is the most common organ to cause endocrine disorders [2]. Thyroid disorders are the most common endocrine diseases particularly in countries where iodine intake through diet is low.

scholarly journals Histomorphologic spectrum of thyroid lesions in surgically treated thyroid specimens

2019 ◽  
Vol 10 (1) ◽  
pp. 54-59
Author(s):  
Wasim Selimul Haque ◽  
Shamoli Yasmin ◽  
SK Md Jaynul Islam ◽  
Susane Giti
Keyword(s):  
Thyroid Gland ◽  
Papillary Carcinoma ◽  
Follicular Adenoma ◽  
Nodular Goiter ◽  
Follicular Carcinoma ◽  
Anaplastic Carcinoma ◽  
Malignant Neoplasms ◽  
Histopathological Diagnosis ◽  
Thyroid Lesion ◽  
Thyroid Lesions

Background: Diseases involving thyroid gland are myriad- they span from functional to goiterous which again can be non-neoplastic or neoplastic. The pattern and prevalence of these disorders depend on various factors like age, sex, ethnicity and geographic location of residence. The aim of the present study was to determine the pattern of thyroid lesions in surgically resected thyroid specimens. Methods: This retrospective study was conducted at Department of Histopathology ofArmed Forces Institute of Pathology (AFIP), Dhaka, Bangladesh. All thyroidectomy specimens received in the Department of Histopathology over the period from 1st January 2018 to 30th June 2019 were included in the study. Data including age, sex and histopathological diagnosis were collected from the records and histopathology slides of all cases were reviewed to verify diagnosis. Data were then analyzed by standard statistical methods. Results: A total of 377 specimens were collected, 301 specimens were from females and 76 from males (female to male ratio 4.01:1). The age ranged from 13 years to 82 years (mean 38.44±12.89 years). Nodular goiter (274, 72.62%) was the commonest thyroid lesion; other benign lesions included follicular adenoma (18) and Hashimoto thyroiditis (17). Overall malignancy was 18.03% (68). Papillary carcinoma (61, 89.70%) constituted majority of the malignant neoplasms. Other malignant neoplasms included follicular carcinoma (3 cases including 1 case of Hurthle cell carcinoma), anaplastic carcinoma (2) and medullary carcinoma and non-Hodgkin lymphoma 1 each. Conclusion: Our study revealed that the prevalent form of thyroid diseases is nodular goiter that mostly affects females. Papillary carcinoma is the commonest malignancy of thyroid gland which also predominantly affects females. Birdem Med J 2020; 10(1): 54-59

scholarly journals Sonographic Echo-pattern of the Thyroid Gland among the Non-nodular Goitrous Patients Having Abnormal thyrotropin Level at their First Diagnosis

2018 ◽  
Vol 18 (2) ◽  
pp. 152-155
Author(s):  
Nasrin Begum ◽  
Kabiruzzaman Shah ◽  
Parvez Ahmed ◽  
Mosharruf Hossain ◽  
Shariful Islam Chowdhury ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Thyroid Function ◽  
Nodular Goiter ◽  
Sampling Technique ◽  
Needle Aspiration ◽  
Thyroid Function Tests ◽  
Normal Range ◽  
Management Algorithm ◽  
Function Tests ◽  
Thyrotropin Level

Objective: This study was done to observe the high resolution sonographic echo-pattern of the thyroid gland among the non-nodular goitrous patients having abnormal thyrotropin (TSH) level at their first diagnosis.Method: This study was conducted at the Institute of Nuclear medicine and Allied Sciences, Rajshahi, Bangladesh during the period between 1st January, 2014 and 31st March, 2015. The goitrous patients are referred at this Institute by the clinicians for radionuclide thyroid scan, HRUS of thyroid gland and thyroid function tests. Under the basis of convenient sampling technique, 62 patients are included as sample. Their age, gender, HRUS echo-patterns of goiter and thyrotropin levels are recorded and analyzed with statistical software IBM SPSS v. 16.Results: Among the total enrolled patients (n=62), 57 (91.9 %) were female and five (8.1 %) were male. Mean (± SD) age was 28 ± 11.85 years (range=8 to 69 years). Regarding thyrotropin level among the sample patients (n=62), 53 (85.5 %) had above normal range and 9 (14.5 %) had below normal range. In relation to sonographic echo-pattern of the non-nodular goitrous patients (n=62), 43 (69.4 %) had hypoechoic feature, 15 (24.2 %) had non-homogenous feature and four (6.5 %) had both hypoechoic and non-homogenous feature. Among the 43 goitrous patients with hypoechoic feature, 38 had thyrotropin above normal range and five had below normal range; among the 15 goitrous patients with non-homogenous feature, 12 had thyrotropin above normal range and three had below normal range and among the four goitrous patients with both hypoechoic and non-homogenous feature, three had thyrotropin above normal range and one had below normal range.Conclusion: The results of this study will be helpful in the relevant prospective studies which will be concerned with developing non-nodular goiter management algorithm, in addition to the role of other parameters like thyroid function tests especially thyrotropin level, circulating thyroid autoantibodies detection and fine needle aspiration biopsy (FNAB) cytology findings.Bangladesh J. Nuclear Med. 18(2): 152-155, July 2015

Case Report on Colloidal Nodular Goiter

2019 ◽  
Vol 32 (02) ◽  
pp. 112-117
Author(s):  
Bindu Sharma ◽  
Reteka Sexena
Keyword(s):  
Case Report ◽  
Thyroid Gland ◽  
Nodular Goiter ◽  
Needle Aspiration ◽  
Normal Range ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Number Of Factors ◽  
Needle Aspiration Cytology ◽  
Thyroid Profile

AbstractGoiter refers to an enlarged thyroid gland which can be caused by a number of factors such as biosynthetic defects, iodine deficiency, autoimmune disease and nodular diseases. A case of a woman with colloidal nodular goiter treated successfully with Homoeopathy is reported here. Her thyroid profile was within normal range, and fine-needle aspiration cytology was clearly suggestive of colloidal nodular goiter. She was treated with homoeopathic medicines following holistic concepts of homoeopathy, and the result was significant reduction in size of thyroid nodule. Lycopodium initiated the action, and Sulphur potentiated the cure.

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