Clinicopathological and Radiological Profile of Multinodular Goitre – A Prospective Study

Main Article Content

Koustav Mondal
Chiranjib Das

Abstract

Introduction


Multinodular goitre (MNG) is defined as multiple palpable distinct nodules in the enlarged thyroid gland. MNG can harbour malignancy in 1-10% cases. We undertook the present study to correlate the clinical, radiological and cytological features of MNG with that of final histopathological diagnosis.


Materials and Methods


A prospective cohort study was done in a tertiary care hospital in northern part of West Bengal from January 2018 to December 2019. Patients aged between 12 years and 75 years, presenting with MNG on clinical examination, were included in the study. We compared the pre-operative ultrasonography (USG) of neck and fine needle aspiration cytology (FNAC) reports with post-operative histopathological examination (HPE) report.


Results


Among 100 patients 80 were female and 20 were male. Most patients were in 41-50 years age group. For detection of malignancy in MNG, USG had 40% sensitivity, 97.78% specificity, 66.67% positive predictive value (PPV), 93.62% negative predictive value (NPV), and 92% diagnostic accuracy. Sensitivity, specificity, PPV, NPV and diagnostic accuracy of FNAC for detection of malignancy in MNG were 20%, 93.33%, 25%, 91.3% and 86% respectively. When USG features were combined with FNAC features non-diagnostic result decreased from 6% to 2% and diagnostic accuracy for detecting malignancy in MNG increased from 86% to 90%.


Conclusion


USG and FNAC are complementary to each other in the diagnostic workup of MNG. USG guided FNAC is still better for reaching final diagnosis and exclusion of malignancy.

Article Details

How to Cite
1.
Mondal K, Das C. Clinicopathological and Radiological Profile of Multinodular Goitre – A Prospective Study. BJOHNS [Internet]. 2021Sep.27 [cited 2024May18];29(2):164-8. Available from: https://bjohns.in/journal3/index.php/bjohns/article/view/479
Section
Main article
Author Biography

Koustav Mondal, Assistant Professor, Department of General Surgery

Assistant Professor, Department of General Surgery, Maharaja Jitendra Narayan Medical College and Hospital, Cooch Behar, West Bengal, India.

References

Abu-Eshy SA, Khan AR, Khan GM, al-Humaidi MA, al-Shehri MY, Malatani TS. Thyroid malignancy in multi-nodular goitre and in a solitary nodule. J R Coll Surg Edinb. 1995; 40:310-2

Taylor S. The evolution of nodular goiter. J Clin Endocrinol Metab. 1953; 13(10):1232-47

Zambudio AR, Rodríguez J, Riquelme J, Soria T, Canteras M, Parrilla P. Prospective study of postoperative complications after total thyroidectomy for multinodular goiters by surgeons with experience in endocrine surgery. Ann Surg. 2004; 240:18-25

Amudhan J, Vijay A, Latha G, Anandan H. Clinicopathological Study on Multinodular Goiter: A Prospective Study. Int J Sci Stud. 2017; 5(1):83-5

Cappel RJ, Bouvy ND, Bonjer HJ, Muiswinkel JM, Chadha S. Fine needle aspiration of thyroid nodules: How accurate it is and what are the causes of discrepant cases? Cytopathology 2001; 12:399-405

Prades JM, Dumollard JM, Timoshenko A, Chelikh L, Michel F, Estour B, et al. Multinodular goiter: surgical management and histopathological findings. Eur Arch Otorhinolaryngol. 2002; 259:217-21

Martinek A, Dvorackova J, Honka M, Horacek J, Klvana P. Importance of guided fine needle aspiration cytology (FNAC) for the diagnostics of thyroid nodules – own experience. Biomed Pap Med Fac Univ Palacky Plomouc Czech Repub. 2004; 148(1):45-50

B R Ashwini, Vernekar Sunita, Kulkarni Mohan H, T Kiran. Comparitive Study of Conventional and Ultrasound-guided Fine Needle Aspiration Cytology of Thyroid in a Tertiary Care Center of North Karnataka. Int J Cur Res Rev. 2012; 04(21):64-9

Nilakantan A, Venkatesh MD, Raghavan D et al. Ultrasonography: Its role in nodular thyroid disease. Indian J Otolaryngol Head Neck Surg. 2007;59:332-35

Rabal Fueyo A, Vilanova Serra M, Lerma Puertas E, et al. Diagnostic accuracy of ultrasound and fine-needle aspiration in the study of thyroid nodule and multinodular goitre. Endocrinol Diab Metab. 2018; 1:e24

Sanjeeva KK, Chandra B, Balakrishna MA, et al. Clinicoepidemiological study and treatment outcome of multinodular goitre at a tertiary care hospital. Journal of Clinical and Diagnostic Research. 2015; 9(6):22-5.

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