Authors : Dr. Subrat Kumar Patra; Dr. Shalini Das; Dr. Rajesh Gupta

Volume/Issue : Volume 10 - 2025, Issue 2 - February

Google Scholar : https://tinyurl.com/yc2ksrjp

Scribd : https://tinyurl.com/56n4nmzb

DOI : https://doi.org/10.5281/zenodo.14921199

Abstract : Background: Thyroid nodules are commonly encountered in clinical practice, with the challenge of distinguishing benign from malignant lesions. The objective of this study was to evaluate the correlation between sonographic features, Fine Needle Aspiration Cytology (FNAC), and histopathological findings to determine the most effective early diagnostic intervention in patients with thyroid swelling.  Material and Methods: A prospective observational study was conducted from 2023 to 2024, involving 60 patients with thyroid swelling. Sonographic evaluation, FNAC, and histopathological examination (HPE) were performed to assess the diagnostic accuracy of each method. The correlation between sonographic features (e.g., hypoechoic nodules, micro calcifications, irregular margins, increased vascularity) and the results of FNAC and HPE were analysed.  Results: The study found that hypoechoic nodules with micro calcifications and irregular margins were strongly associated with malignancy. FNAC demonstrated high sensitivity (85%) and specificity (90%), with the majority of malignant cases diagnosed as papillary thyroid carcinoma. Histopathological examination confirmed malignancy in 55% of the cases. The combination of sonography and FNAC provided the highest diagnostic accuracy, while histopathology served as the definitive confirmation.  Conclusion: Sonography and FNAC, when used together, provide the most reliable early diagnostic intervention for thyroid swelling. This multi-modal approach enables the accurate differentiation of benign and malignant thyroid nodules, facilitating appropriate management and reducing unnecessary surgeries.

Keywords : Thyroid swelling, Sonography, Fine Needle Aspiration Cytology, Histopathology, Diagnostic accuracy, Thyroid Nodule.

References :

1. Bhise SV, Shaikh A, Hippargekar PM, Kothule S. A Prospective Study of Ultrasonographic and FNAC Correlation of Thyroid Swellings with Histopathology. Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):1942-1948. doi: 10.1007/s12070-020-01922-w. Epub 2020 Jun 24. PMID: 36452634; PMCID: PMC9702162.
2. Sengupta A, Pal R, Kar S, Zaman FA, Sengupta S, Pal S. Fine needle aspiration cytology as the primary diagnostic tool in thyroid enlargement. J Nat Sci Biol Med. 2011 Jan;2(1):113-8. doi: 10.4103/0976-9668.82308. PMID: 22470244; PMCID: PMC3312690.
3. Saw AK, Kerketta ZH, Rani K, Murari K, Srivastava K, Kumar A, Lnu S, Baxla A, Kumar N, Noor N. Evaluation of the Efficacy of Thyroid Imaging Reporting and Data Systems Classification in Risk Stratification and in the Management of Thyroid Swelling by Comparing It With Fine-Needle Aspiration Cytology and Histopathological Examination. Cureus. 2024 May 9;16(5):e59949. doi: 10.7759/cureus.59949. PMID: 38854328; PMCID: PMC11162270.
4. Singh A, Haritwal A, Murali B. Correlation between cytology and histopathology of the salivary glam. Australas Med J. 2011;4(2):66-71. doi: 10.4066/AMJ.2011.518. Epub 2011 Feb 28. PMID: 23386881; PMCID: PMC3562925.
5. De D, Dutta S, Tarafdar S, Kar SS, Das U, Basu K, Mukhopadhyay P, Ghosh S. Comparison between Sonographic Features and Fine Needle Aspiration Cytology with Histopathology in the Diagnosis of Solitary Thyroid Nodule. Indian J Endocrinol Metab. 2020 Jul-Aug;24(4):349-354. doi: 10.4103/ijem.IJEM_349_20. Epub 2020 Aug 27. PMID: 33088759; PMCID: PMC7540823.
6. Kumar A, Khan J, Kaur G, Khalilullah M, Saha AK, Kumar A. Ultrasonography-Guided Fine Needle Aspiration Cytology Versus Histopathology: Diagnostic Consistency in Salivary Gland Neoplasms. Cureus. 2024 Sep 16;16(9):e69552. doi: 10.7759/cureus.69552. PMID: 39421107; PMCID: PMC11485025.
7. Kohale MG, Dhobale AV, Bankar NJ, Bhatt N, Salgar AH. Sensitivity and Specificity Analysis of Fine Needle Aspiration Cytology (FNAC) for Thyroid Swelling. Cureus. 2024 Feb 26;16(2):e54913. doi: 10.7759/cureus.54913. PMID: 38544658; PMCID: PMC10966418.
8. Jamaiyar A, Yogesh K. How accurate is fine-needle aspiration cytology (FNAC) for thyroid lesion: A correlation of FNAC with histopathology. J Family Med Prim Care. 2023 Jan;12(1):15-20. doi: 10.4103/jfmpc.jfmpc_1413_21. Epub 2023 Feb 15. PMID: 37025221; PMCID: PMC10071938.
9. Singh P, Gupta N, Dass A, Handa U, Singhal S. Correlation of fine needle aspiration cytology with histopathology in patients undergoing thyroid surgery. Otolaryngol Pol. 2020 Aug 3;75(2):1-5. doi: 10.5604/01.3001.0014.3433. PMID: 33724232.
10. Tripura NG, Malik A, Khanna G, Mohil RS. Role of ultrasonography (USG) and color Doppler in the evaluation of thyroid nodules and its association with USG-guided FNAC - A cross-sectional study. J Family Med Prim Care. 2024 Mar;13(3):919-923. doi: 10.4103/jfmpc.jfmpc_981_23. Epub 2024 Apr 4. PMID: 38736785; PMCID: PMC11086758.
11. Gedik GK, Bozkurt FM, Ugur O, Grassetto G, Rubello D. The additional diagnostic value of a single-session combined scintigraphic and ultrasonographic examination in patients with thyroid and parathyroid diseases. Panminerva Med. 2008 Sep;50(3):199-205. PMID: 18927523.
12. Singh R, Deo SVS, Dhamija E, Mathur S, Thulkar S. To Evaluate the Accuracy of Axillary Staging Using Ultrasound and Ultrasound-Guided Fine-Needle Aspiration Cytology (USG-FNAC) in Early Breast Cancer Patients-a Prospective Study. Indian J Surg Oncol. 2020 Dec;11(4):726-734. doi: 10.1007/s13193-020-01222-3. Epub 2020 Oct 19. PMID: 33281412; PMCID: PMC7714810.
13. Patel KA, Anandani G, Sharma BS, Parmar RA. Study of Fine Needle Aspiration Cytology (FNAC) of Thyroid Gland According to the Bethesda System. Cureus. 2023 Apr 10;15(4):e37371. doi: 10.7759/cureus.37371. PMID: 37181959; PMCID: PMC10171125.
14. Harshvardhan R, Jorwal V, Gupta S, Sharma V, Sehra R, Agarwal S. Assessment of Accuracy of Fine Needle Aspiration Cytology and Ultrasonography in Relation to Histopathology in Cases of Solitary Thyroid Nodule. Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):2422-2429. doi: 10.1007/s12070-020-02215-y. Epub 2020 Oct 13. PMID: 36452598; PMCID: PMC9702415.
15. Alhassan R, Al Busaidi N, Al Rawahi AH, Al Musalhi H, Al Muqbali A, Shanmugam P, Ramadhan FA. Features and diagnostic accuracy of fine needle aspiration cytology of thyroid nodules: retrospective study from Oman. Ann Saudi Med. 2022 Jul-Aug;42(4):246-251. doi: 10.5144/0256-4947.2022.246. Epub 2022 Aug 4. PMID: 35933603; PMCID: PMC9357295.