scholarly journals Management of benign paediatric thyroid nodules: experience from paediatric ENT services of a tertiary care hospital

2021 ◽  
Vol 7 (4) ◽  
pp. 672
Author(s):  
Arunabha Chakravarti ◽  
Sneha Chandrasekhar
Keyword(s):  
Total Thyroidectomy ◽  
Thyroid Nodules ◽  
Residual Disease ◽  
Tertiary Care ◽  
Needle Aspiration ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Safe Procedure ◽  
Care Hospital ◽  
Radiological Investigation ◽  
Nerve Paralysis

<p class="abstract">Thyroid nodules are a common occurrence in adults but are rarely seen in children. We present here four cases of paediatric thyroid nodules. Patients were subjected to a thorough clinical evaluation, blood thyroid level testing, ultrasonography (USG) and fine needle aspiration cytology (FNAC). The size of the nodules ranged from 2 cm to 7.5 cm. All four nodules were reported as “benign” on FNAC, of which three under-went total thyroidectomy owing to the bi-laterality and large size of the nodules. None of the cases had post-operative complications of hypocalcemia or recurrent laryngeal nerve paralysis. Of the 3 patients taken up for surgery one patient was found to have papillary thyroid carcinoma. Subsequent radiological investigation showed no residual disease. All three operated cases were followed-up in the ENT outpatient department for at least 2 years and showed no signs of recurrence. One patient with a small thyroid nodule (2 cm) was managed non – surgically and has been kept on follow up since 12 months. In our experience, total thyroidectomy, even in a benign disease, in expert hands, is a safe procedure and the best management option in children with large goiter, to avoid recurrence and thereby a redo surgery.  </p>

scholarly journals Diagnostic Accuracy of the Bethesda System of Reporting Thyroid Cytopathology in the Evaluation of Thyroid Nodule in a Tertiary Care Hospital of Kolkata

2021 ◽  
Vol 8 (05) ◽  
pp. 241-245
Author(s):  
Sweta Verma ◽  
Mita Saha Dutta Chowdhury ◽  
Souradeep Ray ◽  
Ruma Guha
Keyword(s):  
Diagnostic Accuracy ◽  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Tertiary Care ◽  
Needle Aspiration ◽  
Care Hospital ◽  
Risk Of Malignancy ◽  
Needle Aspiration Cytology ◽  
Thyroid Cytopathology ◽  
The Bethesda System

BACKGROUND Thyroid cancer has the most rapidly increasing incidence of all major cancers in India. The overall prevalence of thyroid malignancy is approximately 1 - 5 % of all cancers in women and less than 2 % in men. Thyroid nodules are a common clinical finding and have a reported prevalence of 4 – 7 % in the general population. The vast majority of these nodules are non-neoplastic or benign and the risk of malignancy varies from 5 to 10 %. Fine needle aspiration cytology (FNAC) is an efficient and reliable means for the evaluation of thyroid nodules. A key challenge for clinicians is to choose which thyroid nodule is to be investigated further and treated. Early detection and treatment of malignant thyroid nodules is associated with excellent outcomes. The aim of our study is to compare and correlate between fine needle aspiration cytology and histopathology of resected specimen and to determine the diagnostic accuracy of TBSRTC (The Bethesda System for Reporting Thyroid Cytopathology) in thyroid nodule. METHODS This is a cross sectional validation study conducted in a tertiary care hospital (R.G. Kar Medical College) of Kolkata to find the sensitivity, specificity and diagnostic accuracy of TBSRTC in evaluation of thyroid nodule. RESULTS We have observed that TBSRTC is highly sensitive and specific in stratifying the malignancy risk of thyroid nodule. CONCLUSIONS It aids the clinician to choose the thyroid nodules which require further evaluation and intervention. It also guides the clinician to decide the operability of thyroid nodule. TBSRTC is highly accurate and is highly specific in stratifying the risk of malignancy of thyroid nodule. KEYWORDS TBSRTC, FNAC, Thyroid Nodules, Thyroid Cancer

scholarly journals Unusual renal tumor in an infant

2021 ◽  
Vol 8 (3) ◽  
pp. 409-411
Author(s):  
Madhumita Mukhopadhyay ◽  
Biswanath Mukhopadhyay ◽  
Brati Mukhopadhyay ◽  
Chhanda Das
Keyword(s):  
Renal Mass ◽  
Histopathological Examination ◽  
Mature Teratoma ◽  
Tertiary Care ◽  
Needle Aspiration ◽  
Good Prognosis ◽  
Immature Teratoma ◽  
Care Hospital ◽  
Radiological Investigation ◽  
High Index Of Suspicion

: Two-month-old female presented with left loin swelling and pain. The swelling was 8cmx6cm and it was ballotable in nature. It was gradually increasing in size.: To find out the incidence of this rare, high index of suspicion, investigations including cytopathology and histopathology, early diagnosis and management.: The informed consent from the parents of the patient was taken. The study was carried out in a tertiary care hospital in Kolkata. On CT a heterogenous renal mass was detected. Fine Needle Aspiration cytology from the mass showed mature neural elements, squamous epithelium, mature fat cells a few atypical oval to spindle shaped cells. Cytologically diagnosed as mature teratoma. The tumor was excised. Histopathological examination revealed the diagnosis of immature teratoma. : Immature teratoma is one of the rare causes of Pediatric Kidney Tumor.Renal teratoma is an extremely uncommon tumor in infancy. But it is one of the differential diagnoses of renal mass in infants. Diagnosis may be suspected from radiological investigation and confirmed by histopathological examination. A good prognosis can be expected after proper management.

Clinico-Demographic Characteristics and Surgical Outcomes of Thyroid Swelling Patient Attended at a Tertiary Care Hospital in Dhaka City

2019 ◽  
Vol 6 (2) ◽  
pp. 97-100
Author(s):  
Ahmed Sharif ◽  
Md Rabiul Islam ◽  
Md Golam Faruque ◽  
Rashida Akter Khanam ◽  
Mohammmad Main Uddin ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Tertiary Care ◽  
Follicular Adenoma ◽  
Nodular Goiter ◽  
Demographic Characteristics ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Care Hospital ◽  
Age Group ◽  
Nerve Paralysis ◽  
Thyroid Swelling

Background: Thyroid swelling was found in different clinical presentation and demographic characteristics. Objective: The purpose of the present study was to see the clinical and demographic characteristics as well as the surgical outcomes of thyroid swelling patient. Methodology: The study was conducted at Mugda Medical College Hospital, Dhaka during the period of April 2017 to March 2018. The diagnosis of thyroid swelling was based on detailed history, thorough clinical examination and relevant investigations, Ultrasonogram and fine needle aspiration cytology (FNAC). All the patients were undergone surgical management and the outcomes were recorded. All the data were compiled and tabulated in order o obtained a statistical and comprehensive results of the study. Results: A total number of 45 patients were recruited for this study after fulfilling the inclusion and exclusion criteria. This study shows age of the patients ranged from 17 years to 65 years. The highest number of cases (35.6%) belongs to the age group of 31 to 40 years followed by 20% in the age group of 21 to 30 years. Female were higher in frequency (95.6) than male (4.4%). Most of the patients (54%) were from poor socio-economic status. The most common indication were nodular goiter (80%), papillary 13.3%, follicular adenoma 4.4%, and medullary (2.2%). In this study most of the findings showed solid mass in the thyroid gland (55.6%). In this series hemithyroidectomy carried out in 68.9% patients and occupied the top of the list followed by subtotal 22.2%. In this study highest number of complications were recurrent laryngeal nerve paralysis (8.9%). Conclusion: Young adult female patient is most commonly affected by thyroid swelling and mostly are benign nodular type goiter Journal of Current and Advance Medical Research 2019;6(2):97-100

scholarly journals An unexpected diagnosis of ectopic liver diagnosed by fine needle aspiration

CytoJournal ◽  
2016 ◽  
Vol 13 ◽  
pp. 29 ◽  
Author(s):  
Gonzalo Barazza ◽  
Douglas G. Adler ◽  
Rachel E. Factor
Keyword(s):  
Malignant Melanoma ◽  
Fine Needle Aspiration ◽  
Single Cells ◽  
Tertiary Care ◽  
Needle Aspiration ◽  
Pigment Cells ◽  
Care Hospital ◽  
Fine Needle ◽  
Arginase 1 ◽  
Ectopic Liver

The differential diagnosis of perigastric masses is broad, ranging from benign to malignant entities. Among the benign entities, accessory liver lobes and ectopic liver are unusual and often incidentally discovered. Here, we report a patient with malignant melanoma who was clinically suspected to have a perigastric metastasis or a gastrointestinal stromal tumor but was ultimately diagnosed by fine needle aspiration (FNA) to have benign ectopic liver. A 47-year-old male was diagnosed with malignant melanoma of the scalp in May 2015 at a tertiary care hospital. He was found to have a 2.6 cm enhancing mass adjacent to the fundus of the stomach and below the diaphragm by computed tomography imaging. To exclude metastasis, the patient was referred to endoscopy, and an endoscopic ultrasound-guided FNA was performed with rapid on-site evaluation (ROSE) by a cytopathologist. A relatively new FNA needle (Shark Core) was used, which produced useful core biopsy material. Cytopathology demonstrated flat sheets, single cells, and small clusters of polygonal cells. There was abundant granular cytoplasm, often containing pigment. Cells lacked pleomorphism. The smear findings appeared consistent with hepatocytes. The cell block demonstrated small core fragments of hepatic parenchyma with portal tracts. Immunohistochemistry for arginase-1 confirmed that this was hepatic tissue. ROSE was useful for communicating with the endoscopist that the mass was both far from, and not connected to, the liver. This is the first documented account of perigastric ectopic liver diagnosed by FNA. This entity should be considered in the differential of perigastric masses.

scholarly journals A seven year experience in patients undergoing total thyroidectomy for benign diseases in a single unit of tertiary care centre: a retrospective case study

2019 ◽  
Vol 7 (9) ◽  
pp. 3317
Author(s):  
Dheer S. Kalwaniya ◽  
Jaspreet S. Bajwa ◽  
Gowtham K. Gowda ◽  
Akshay Narayan ◽  
Rohit Choudhary
Keyword(s):  
Total Thyroidectomy ◽  
Single Unit ◽  
Tertiary Care ◽  
Average Weight ◽  
New Delhi ◽  
Safe Procedure ◽  
Tertiary Care Centre ◽  
Retrospective Case ◽  
Benign Diseases ◽  
Female Ratio

Background: Thyroidectomy is a common surgical procedure performed worldwide by surgeons with varied training. It is the experience and the skills by which a surgeon performs, the indication of surgery and the extent of surgery which determines the outcome and the complication rates.Method: This study is a retrospective study performed from January 2012 to December 2018 when a total of 170 patients underwent total thyroidectomy via kocher’s incision for benign diseases with clinically in hypothyroid state at Safdarjung Hospital, New Delhi in a single unit of a tertiary care hospital.Results: The male: female ratio was 1:7.09 with average age of patients being 40years. The overall complication rate was 18.82% (32 patients). Postoperative transient hypocalcaemia being the most common complication. There was no case of permanent hypocalcaemia. There was no injury to any nerve (recurrent or superior laryngeal). Transient recurrent laryngeal paresis was noted in 4(2.35%) which resolved with conservative management. Complications like wound infection, sympathetic chain injury were not noted. The characteristic feature of this study was five cases of giant secondary retrosternal goitre which had average weight of greater than 500 grams which were operated using kocher’s incision. The average weight of other 165 patients was 70grams +/- 12 grams. There were no major post-operative complications except for post-operative recurrent laryngeal nerve paresis and seroma formation which was evacuated after 3 weeks of surgery.Conclusion: Hence, from this it is concluded that it is the surgical experience and skills of the surgeon which make total thyroidectomy a safe procedure providing permanent cure with a low post-operative morbidity risk even with large sized retrosternal thyroid glands which can be operated via neck incision.

scholarly journals Comparison of endoscopic ultrasound-guided fine-needle aspiration by capillary action, suction, and no suction methods: a randomized blinded study

2017 ◽  
Vol 05 (10) ◽  
pp. E980-E984 ◽  
Author(s):  
Rinkesh Bansal ◽  
Narendra Choudhary ◽  
Rajesh Puri ◽  
Saurabh Patle ◽  
Suraj Bhagat ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Randomized Study ◽  
Tertiary Care ◽  
Needle Aspiration ◽  
Care Hospital ◽  
Capillary Suction ◽  
Capillary Action ◽  
Fine Needle

Abstract Background and study aim Different types of endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) techniques are used in clinical practice; the best method in terms of outcome has not been determined. The aim of the study was to compare the diagnostic adequacy of aspirated material, and the cytopathological and EUS morphological features between capillary action, suction, and no-suction FNA methods. Patients and methods This was a prospective, single-blinded, randomized study conducted at a tertiary care hospital. Patients were randomized to the three groups: capillary action, suction, and no suction. A total of 300 patients were included, with 100 patients in each arm. Results A total of 300 patients (195 males) underwent EUS-FNA of 235 lymph nodes and 65 pancreatic masses (distribution not statistically different between the groups). The mean age was 52 ± 14 years. A 22 gauge needle was used in the majority (93 %) of procedures. There was no statistical difference between the three groups regarding lymph node size at the largest axis and ratio, type of needle, echo features, echogenicity, calcification, necrosis, shape, borders (lymph nodes), number of passes, and cellularity. Diagnostic adequacy of the specimen was 91 %, 91 %, and 94 % in the capillary, suction, and no suction groups, respectively (P = 0.67). Significantly more slides and blood clots were generated by the suction method compared with the other methods. Conclusion The capillary action, suction, and no suction methods of EUS-FNA are similar in terms of diagnostic adequacy of the specimen. The suction method has the disadvantages of causing more bleeding and generating more slides.

Sign in / Sign up

Export Citation Format

Share Document