Cytological Diagnosis of Thyroid Follicular Lesion and Its Correlation with Histological Findings

Abstract

Introduction: Follicular neoplasms represent a wide clinical spectrum of diseases, with tremendous overlap in clinicopathologic diagnosis, management, and prognosis. Suspicious sonographic features in conjunction with FNAC of thyroid nodules provide the most accurate preoperative diagnosis to guide therapy. Keeping the perception in mind, we summarize our experience with thyroid nodules that were defined as cellular follicular lesions by comparing the clinical, sonographic, and cytological features that were examined histologically to define the most reliable criteria of malignancy. Aim of the Study: The aim of the study was to find out the cytological diagnosis of thyroid follicular lesions and their correlation with histological findings. Methods: This cross-sectional observational study was conducted at the department of Otolaryngology, National institute of ENT, Tejgaon, Dhaka following approval of the protocol for the duration of 6 months. A total of 30 patients were included and they were subjected to details history taking, physical examination, and necessary investigations. We analyzed the data using SPSS version 23, and Chi-square test was used to analyze the significance level of P (<0.05). Results: A total of 30 consecutive patients with a follicular lesion on FNAC (5 men and 25 women) were included in this study. Their mean (SD) age was 46.7 (±13.0) years. Thyroid cancer was diagnosed on histopathology in 8 patients (27%). Papillary cancer was the most common cytologic finding in 6 patients [75%]) and 2 patients (25%) had a diagnosis of follicular cancer. Of the 6 patients with papillary cancer, 2 (33%) had a follicular variant of papillary cancer. The benign histologic diagnoses were follicular adenoma in 6 cases (27%), thyroiditis in 3 cases (13%), and nodular goiter in 13 (60%). The presence of a solitary nodule was not predictive of malignancy (p=0.57). Solid echo structure (p<0.02), presence of microcalcification (p<0.01), and hypoechoic nodules ...