BACKGROUNDIn clinical practice, disorders of thyroid are common worldwide and incidence of which varies with geographical as well as nutritional factors. About twelve percent of Indian adults have palpable goitre. Nowadays, thyroidectomy is a routine surgical procedure offering the chances of cure to many patients having goitre.Aim of the study is to find out the common indications of thyroidectomy in our centre and to study the frequency and histopathological spectrum of follicular cell derived lesions in thyroidectomy specimens.
BACKGROUND Nodular enlargement of thyroid gland is a frequent surgical problem worldwide and it is most often caused by nodular hyperplasia due to impaired synthesis of thyroid hormone. An autonomous nodule may develop in 10% of long-standing multi-nodular goitre and produce hyperthyroidism. Sometimes nodular hyperplasia displays features that may be confused for a neoplastic process.The aim of this study is to find out the frequency of different types of non-neoplastic and neoplastic thyroid lesions developing in association with multi-nodular goitre. MATERIALS AND METHODSAll thyroidectomy specimens received in our Institution from January 2011 to December 2015 and which showed multi-nodular hyperplasia on histopathological examination were included. RESULT Nodular hyperplasia either alone or in combination with any other thyroid lesion was observed in 70.8% (n = 1529) of the total thyroidectomy specimens. Chronic lymphocytic thyroiditis was observed in 12.7% cases and important tumour-like thyroid lesions observed were cellular nodule (6.2%), Hurthle cell nodule (0.5%), papillary hyperplasia (0.5%) and pseudo-nuclear clearing (0.1%). Important thyroid neoplasms observed in association with multi-nodular goitre were Papillary carcinoma (3%), Hurthle cell adenoma (0.5%), Follicular adenoma (0.2%) and Medullary carcinoma (0.1%). Incidence rate of thyroid malignancy in association with nodular hyperplasia was 3.8%. CONCLUSIONMore than two-third of the neoplasms observed were papillary micro-carcinomas; this highlights the importance of thorough sampling of thyroidectomy specimens. However, comparatively thyroid neoplasms in nodular hyperplasia had a lower incidence rate in this study and the peak incidence of nodular hyperplasia associated papillary carcinoma was in younger age group. This difference may be attributed to improved public awareness and health welfare facilities available in Kerala.
BACKGROUND The microscopic distinction between benign and malignant lesions by conventional histology is at times difficult. Diagnosis of papillary carcinoma is based on specific nuclear features however, focal presence of the same features in other follicular epithelial lesions make the distinction of papillary carcinoma thyroid from other lesions difficult. Morphologic overlap between follicular lesions especially the follicular variant of papillary carcinoma and FC is quite common. Cellular nodules may exhibit similar nuclear features like that of papillary carcinoma thyroid due to defects in processing, in which case, distinction between the two becomes difficult. Follicular thyroid lesions have in common many morphological features, which frankly put a burden on the pathologi st while trying to make a diagnosis by H&E. The objective of this study is to evaluate the expression of CD56 in follicular cell derived lesions of thyroid. MATERIALS AND METHODS This is a descriptive study conducted on the thyroid specimens received in the Department of Pathology, Government Medical College, Kottayam with a histological diagnosis indicating follicular cell derived lesion during a period of 18 months (May 2016-October 2017). RESULTS Among the 40 cases in the study group, 9 cases were non-neoplastic; all of which were cellular nodules (22.5%). Of the 31 cases of thyroid neoplasms, 25 cases were Papillary carcinoma thyroid and its variants which included 4 cases of papillary microcarcinoma (10%), 6 cases (15%) were follicular variant and 1 case (2.5%) of diffuse sclerosing variant. Six cases were Follicular carcinoma (15%). CD56 showed a positive expression in 88.88% cases of non-neoplastic lesions, a negative expression in 96% cases of Papillary carcinoma and its variants and a positive expression in 66.66% cases of follicular carcinoma. CONCLUSION Based on the findings of the present study, CD56 may be considered as a relevant marker of papillary carcinoma-thyroid and its variants and is useful in distinguishing papillary carcinoma-thyroid and hyperplasia/follicular carcinoma
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