Scholarlink

Background <p>Thyroid swellings are among the most common endocrine presentations, encompassing abroad spectrum of benign and malignant disorders. Accurate preoperative evaluation is essential to avoid unnecessary surgery and ensure early detection of malignancy. Ultrasonography (USG) and fine needle aspiration cytology (FNAC), when interpreted using standardized systems such as the Thyroid Imaging Reporting and Data System (TIRADS) and the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), are valuable tool in the diagnostic workup of thyroid nodules and correlating the findings with postoperative histopathological diagnosis.</p> Objectives <p>To evaluate the clinicopathological profile of patients with thyroid swellings and to correlate ultrasonographic (TIRADS) and cytological (Bethesda) findings with final histopathological diagnosis.</p> Materials and Methods <p>This observational cross-sectional study was conducted in a tertiary care teaching hospital in eastern India from January 2023 to March 2024. 40 patients presenting with thyroid swellings were evaluated through detailed clinical assessment, thyroid function tests, ultrasonography, and FNAC. Cytological findings were reported using the Bethesda System, and histopathological diagnoses of surgically excised specimens were correlated with preoperative findings. Statistical analysis was performed using SPSS version 27.0. Data has been summarized as mean and standard deviation for numerical variables and count and percentages for categorical variables. Chi-square test (with Yate’s correction when needed) was used to test the significant difference of proportions. p-value of ≤ 0.05 was considered as statistically significant.</p> Results <p>The majority of patients (45%) were between 31–40 years, with a female predominance (80%). Most swellings (95%) showed gradual progression over 6–12 months. Ultrasonographically, TIRADS-3 (30%) and TIRADS-4 (30%) were the most common categories. FNAC revealed 47.5% Bethesda II (benign) lesions, while Bethesda V and VI categories together constituted 17.5%. Histopathology showed colloid goitre (30%) and papillary carcinoma (30%) as the most frequent diagnoses. Histopathology showed 26% Bethesda II are malignant, 37% Bethesda III are malignant and 100% Bethesda IV, V and VI are malignant. A strong concordance was noted between higher TIRADS/Bethesda categories and malignancy on final histopathology (p &lt; 0.05). The sensitivity, specificity, positive predictive value and negative predictive value of FNAC using Bethesda category in predicting thyroid malignancy were 61.9%, 100%, 100% and 70.4% respectively. The overall diagnostic accuracy was 80%.</p> Conclusion <p>Ultrasonography and FNAC, when used complementarily and interpreted through standardized reporting systems, provide high diagnostic accuracy in evaluating thyroid swellings. The combined use of TIRADS and Bethesda systems enhances preoperative risk stratification and surgical decision-making. The current study was a feasible one and easier to conduct, compared to the larger, multicentric studies incorporating molecular and advanced imaging modalities for further validation.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

A Clinicopathological Study on Thyroid Swellings with Comparison of Findings of Ultrasonography and Bethesda Reporting System of Fine Needle Aspiration Cytology to Histopathology: a Cross-Sectional Study

  • 期刊论文

  • 发表日期：

    2026年6月22日

查看全文
  • Amit Kumar Shukla,
  • Debjit Jana,
  • Maumita De,
  • Krishna Kumar Yadav,
  • Divya Daga,
  • Diptanshu Mukherjee,
  • Saumendra Nath Bandyopadhyay,
  • Anukriti,
  • Snehasish Halder

摘要

Background

Thyroid swellings are among the most common endocrine presentations, encompassing abroad spectrum of benign and malignant disorders. Accurate preoperative evaluation is essential to avoid unnecessary surgery and ensure early detection of malignancy. Ultrasonography (USG) and fine needle aspiration cytology (FNAC), when interpreted using standardized systems such as the Thyroid Imaging Reporting and Data System (TIRADS) and the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), are valuable tool in the diagnostic workup of thyroid nodules and correlating the findings with postoperative histopathological diagnosis.

Objectives

To evaluate the clinicopathological profile of patients with thyroid swellings and to correlate ultrasonographic (TIRADS) and cytological (Bethesda) findings with final histopathological diagnosis.

Materials and Methods

This observational cross-sectional study was conducted in a tertiary care teaching hospital in eastern India from January 2023 to March 2024. 40 patients presenting with thyroid swellings were evaluated through detailed clinical assessment, thyroid function tests, ultrasonography, and FNAC. Cytological findings were reported using the Bethesda System, and histopathological diagnoses of surgically excised specimens were correlated with preoperative findings. Statistical analysis was performed using SPSS version 27.0. Data has been summarized as mean and standard deviation for numerical variables and count and percentages for categorical variables. Chi-square test (with Yate’s correction when needed) was used to test the significant difference of proportions. p-value of ≤ 0.05 was considered as statistically significant.

Results

The majority of patients (45%) were between 31–40 years, with a female predominance (80%). Most swellings (95%) showed gradual progression over 6–12 months. Ultrasonographically, TIRADS-3 (30%) and TIRADS-4 (30%) were the most common categories. FNAC revealed 47.5% Bethesda II (benign) lesions, while Bethesda V and VI categories together constituted 17.5%. Histopathology showed colloid goitre (30%) and papillary carcinoma (30%) as the most frequent diagnoses. Histopathology showed 26% Bethesda II are malignant, 37% Bethesda III are malignant and 100% Bethesda IV, V and VI are malignant. A strong concordance was noted between higher TIRADS/Bethesda categories and malignancy on final histopathology (p < 0.05). The sensitivity, specificity, positive predictive value and negative predictive value of FNAC using Bethesda category in predicting thyroid malignancy were 61.9%, 100%, 100% and 70.4% respectively. The overall diagnostic accuracy was 80%.

Conclusion

Ultrasonography and FNAC, when used complementarily and interpreted through standardized reporting systems, provide high diagnostic accuracy in evaluating thyroid swellings. The combined use of TIRADS and Bethesda systems enhances preoperative risk stratification and surgical decision-making. The current study was a feasible one and easier to conduct, compared to the larger, multicentric studies incorporating molecular and advanced imaging modalities for further validation.