High rates of false negative cytological diagnosis and incidental multifocal microcarcinoma in solitary thyroid nodule and multinodular goitre, justifying a preference for total thyroidectomy

Educational objectives: To become familiar with the diagnostic workup of a patient presenting with solitary thyroid nodule and to discuss the current controversies related to the treatment, including total versus less than total thyroidectomy and role of postoperative radioactive iodine.

Download Full-text

A Japanese Family with DICER1 Syndrome Found in Childhood-Onset Multinodular Goitre

Hormone Research in Paediatrics ◽

10.1159/000511140 ◽

2020 ◽

pp. 1-6

Author(s):

Keisuke Nagasaki ◽

Nao Shibata ◽

Hiromi Nyuzuki ◽

Sunao Sasaki ◽

Yohei Ogawa ◽

...

Keyword(s):

Natural History ◽

Thyroid Nodule ◽

Total Thyroidectomy ◽

Thyroid Nodules ◽

Lung Metastases ◽

Germ Cell Tumour ◽

Maternal Grandmother ◽

Multinodular Goitre ◽

Childhood Onset ◽

History Of

Introduction: Germline DICER1 mutations have recently been identified in familial multinodular goitre (MNG). The natural history of thyroid nodules in DICER1 carriers in children is unclear. The purpose of this study was to describe the clinical and genetic findings of childhood-onset MNG with DICER1 carrier in a patient who underwent total thyroidectomy. Case Presentation: The 6-year-old proband had a thyroid nodule, and the number and size of nodules increased over 3 years. A total thyroidectomy was chosen because of the rapid rise in thyroglobulin levels, discomfort when swallowing, and the mother’s history of poorly differentiated thyroid cancer (PDTC). Histopathology revealed adenomatous goitre without malignant cells. Her mother, maternal aunt, and maternal grandmother also had thyroid nodules removed during adolescence. Also, her mother had PDTC with lung metastases, and her maternal aunt had an ovarian germ cell tumour. DICER1 mutation analysis identified a heterozygous novel nonsense mutation (c.4509C>G, p.Y1503X) for the patient, her mother, her maternal grandmother, and her asymptomatic elder brother. Y1503X was identified in all resected thyroid tissues, while heterozygous D1709G, D1810V, and E1813K mutations were identified in individual nodules. Discussion/Conclusion: A thyroid nodule was detected in chemotherapy- or radiotherapy-naïve patient with DICER1 carrier aged 6 years, and MNG developed over 3 years. This pedigree highlights the natural history of nodular disease in DICER1 carriers and identifies a possible association between DICER1 and more aggressive malignancies.

Download Full-text

FNAC OF THYROID NODULE

The Professional Medical Journal ◽

10.29309/tpmj/2010.17.04.2976 ◽

2010 ◽

Vol 17 (04) ◽

pp. 589-597

Author(s):

MUHAMMAD TARIQ ◽

MUHAMMAD ZAFAR IQBAL ◽

MUHAMMAD ZULIFQAR ALI ◽

MUHAMMAD ANWAR CH ◽

RAO SULMAN KHAN ◽

...

Keyword(s):

Thyroid Nodule ◽

Predictive Value ◽

Histopathological Examination ◽

Benign Lesion ◽

False Negative ◽

Specific Information ◽

Fine Needle ◽

Study Results ◽

Solitary Thyroid Nodule ◽

Malignant Lesions

Introduction: Clinically, solitary thyroid nodules are common, being present in up to 50% of the elderly population. The majority are benign with thyroid cancer representing an uncommon clinical problem. If euthyroid, then fine needle biopsy provides direct specific information about the cytology of the nodule from which the histology can be inferred. Objectives: To determine the accuracy of fine needle aspiration cytology (FNAC) in the diagnosis of solitary thyroid nodule and to avoid unnecessary surgery. Material and Method: Setting: This study was conducted in the Department of Surgery, Sheikh Zayed Medical College/ hospital Rahim Yar Khan. Duration of Study: September 2008 to August 2009 (one year). Sample Size: Fifty patients were included in the study. Study design: Prospective analytical study. Results: The results obtained were compared with histopathology and efficacy of FNAC was checked by calculating sensitivity, specificity, positive predictive value and negative predictive value. Out of 50 cases, FNAC showed 43 cases as benign and 7 cases as malignant lesions, while histopathological examination revealed 42 benign and 8 malignant lesions. FNAC was able to correctly pick 41 benign lesions, while 2 cases of benign lesion turned out to be malignant on histopathology (False negative).Out of total 8 cases which turned out to be malignant onhistopathology, FNAC was able to pick 6 cases, while one benign lesion was misdiagnosed as malignant (false positive). The analysis of study showed a sensitivity of 75% and specificity 97.6% of FNAC in detecting malignancy in solitary thyroid nodule. Conclusions: This study concluded that FNAC is highly effective in detecting thyroid malignancy in solitary thyroid nodule with a sensitivity of 75% and specificity of97.6%.

Download Full-text

Effectiveness of the Pattern-Based Approach in the Cytodiagnosis of Salivary Gland Lesions

Acta Cytologica ◽

10.1159/000445521 ◽

2016 ◽

Vol 60 (2) ◽

pp. 107-117 ◽

Cited By ~ 1

Author(s):

K. Amita ◽

S. Vijay Shankar ◽

M. Sanjay ◽

B.M. Sarvesh

Keyword(s):

Salivary Gland ◽

False Negative ◽

Needle Aspiration ◽

Cross Sectional Study ◽

Cytological Diagnosis ◽

Aspiration Cytology ◽

Cross Sectional ◽

Prior Informed Consent ◽

Needle Aspiration Cytology ◽

Sensitivity Specificity

Objective: The aim of this study is to investigate, primarily, the effectiveness of the application of pattern-based analysis in the diagnosis of salivary gland (SG) lesions. Secondarily, an attempt was made to study the cytomorphology of the various lesions in detail and discuss the pitfalls and solutions involved in the challenging conditions at cytology. Materials and Methods: This was a prospective, cross-sectional study. All SG lesions over 2 years were subjected to fine-needle aspiration cytology with patients' prior informed consent. The lesions were classified based on the predominant pattern, and a provisional diagnosis was made. The secondary pattern and other features, such as background, were then taken note of, and a combined cytological diagnosis was rendered. The entire spectrum of lesions was divided into 6 morphological categories. Results: We had a total of 72 SG lesions. The most commonly affected gland was the parotid gland in 79.16% (57/72) of the cases. Surgery was performed in 26 cases (36.11%). A concordant diagnosis was obtained in 22 cases. The sensitivity, specificity and diagnostic accuracy by the pattern-based approach was 75, 100 and 88.46%, respectively. There were no false-positive cases, but 2 false-negative cases were recorded. Conclusion: The precise cytological preoperative diagnosis of SG lesions is important for the management of patients. The pattern-based approach can be used routinely in the cytological diagnosis of SG lesions.

Download Full-text

Ultrasonography Guided Fine Needle Aspiration Cytology as a Valuable Tool for Management of Solitary Thyroid Nodule

International Journal of Current Research and Review ◽

10.31782/ijcrr.2020.122014 ◽

2020 ◽

Vol 12 (20) ◽

pp. 95-97

Author(s):

Meenakshi Kekre ◽

Anant Kekre

Keyword(s):

Thyroid Nodule ◽

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

Needle Aspiration ◽

Aspiration Cytology ◽

Fine Needle ◽

Solitary Thyroid Nodule ◽

Needle Aspiration Cytology

Download Full-text

Ultrasound Characterization of a Solitary Thyroid Nodule According to British Thyroid Association (BTA) - Derived Criteria: A Simple Test of Reliability on a Small Cohort

The Medical Journal of Cairo University ◽

10.21608/mjcu.2021.184546 ◽

2021 ◽

Vol 89 (6) ◽

pp. 1063-1077

Author(s):

LAMYA A. EISSA, M.D.; NOORALDEEN ALSAMAHI, M.S. ◽

MOHAMED SAMY BARAKAT, M.D.; DINA ABDALLAH, M.D. ◽

MUHAMMED MAHMOUD EL-SHAFEI, M.D.

Keyword(s):

Thyroid Nodule ◽

Simple Test ◽

Solitary Thyroid Nodule ◽

Small Cohort

Download Full-text

Solitary thyroid nodule: an overview of one year study at a tertiary care hospital

International Surgery Journal ◽

10.18203/2349-2902.isj20193648 ◽

2019 ◽

Vol 6 (9) ◽

pp. 3117

Author(s):

Shyam Sundar Tandri ◽

Ayathu V. S. Sai Mahesh

Keyword(s):

Thyroid Nodule ◽

Tertiary Care Hospital ◽

Demographic Data ◽

Tertiary Care ◽

Common Finding ◽

Clinical Approach ◽

Care Hospital ◽

Cross Sectional ◽

Solitary Thyroid Nodule ◽

One Year

Background: Thyroid nodules are a common finding in general practice. These nodules are either solitary or multinodular. In the present study thorough evaluation of all the cases presenting with a solitary thyroid nodule (STN) is done. The clear overview of prevalence of STN, associated risk factors, its distribution and its percentage of malignancy, clinic-pathological correlation and findings on ultra-sonogram.Methods: A one year cross sectional study at a tertiary care hospital was done after ethical committee approval. All cases of thyroid with solitary thyroid nodule were included and socio demographic data, clinical examination and USG data was noted. Thyroid hormone profile, FNAC and HPE was performed for every case enrolled and data was noted. The data was analyzed using SPSS version 22.Results: 350 cases were enrolled with 44.42% prevalence and 61.43% were females. Maximum age group was 31-40 years with swelling as the most common sign. 81.14% were euthyroid, 6.3% of cases had lymph node involvement. Micro calcification in 69.7% of nodules and 78.65 were solid. 40.3% of the STN were of colloid on FNAC and 6% were malignant. Malignancy on HPE was 14.6% and papillary carcinoma was the most commonest and follicular least.Conclusions: All cases of STN require a thorough clinical approach supported by ultra-sonogram, FNAC and detailed HPE after surgery for evaluation of benign and malignant lesions. Fine needle aspiration cytology has become an invaluable, minimally invasive and reliable tool in the preoperative assessment of patients with suspicion of malignancy.

Download Full-text