International Journal of Current Research and Review | 2021
Correlative Evaluation between Clinical and Pathological Diagnosis in Multinodular Goiter
Abstract
Introduction: Multinodular goitre is an enlarged, diffusely heterogeneous thyroid tissue. Initial presentation may include diffuse enlargement, but asymmetrical nodularity develops later on. Objective: To correlate between clinical features, FNAC and histopathology findings in cases of multinodular goitre. As far as the Study Design is concerned it is a prospective observational study. Materials and Methods: All clinically diagnosed cases of multinodular goitre were included in the study. All cases underwent FNAC and subsequent thyroidectomy after routine pre-operative work up such as CBC, Urine, BT, CT, FT3, FT4 and ultra TSH, blood sugar, BUN and ultrasonography of neck etc. The surgical specimens of thyroidectomy were subjected to histopathological examination in all cases. Result: The commonest presenting symptom was neck swelling (100%) and associated pain (48%). The pressure symptoms on food, air passage and recurrent laryngeal nerve like dysphagia, dyspnoea and hoarseness of voice were noted in 42, 22, and 22 per cent of cases respectively with a mean 28.6± 11.54. A significant association of these pressure symptoms was seen with colloid goitre (74%). Hyperthyroidism (14%) was in association with multinodular goitre. On fine needle aspiration cytology (FNAC) the most common finding was nodular colloid goitre 64%, followed by Hashimoto’s thyroiditis 11% and follicular neoplasm 4%. On histopathological examination of the resected thyroid specimen, colloid nodular goitre was seen at 74% and Hashimoto’s thyroiditis in 18%. 1 % of cases had papillary and follicular carcinoma each. Conclusion: Multinodular goitre was more common in females belonging to the age group of 30 to 40 years. The most common (48%) presenting symptom was swelling in front of the neck and associated pain. Pressure symptoms were significantly associated with colloid goitre. Associated hyperthyroidism was in (14%) multinodular goitre cases. The FNAC is a useful investigation for initial diagnosis in cases of multinodular goitre but it could not differentiate between follicular neoplasms. Therefore, histopathology remains an imperative investigation to rule out malignancy in multinodular goitre.