Diagnostic tests in thyroid disease
DOI:
https://doi.org/10.34631/sporl.63Keywords:
ultrasound, puncture, ThyroidAbstract
Introduction: thyroid diseases often a common element in the practice of cervico-facial surgeon, and specialist in endocrine surgery. 90% of thyroid nodules are benign, and essential for diagnosing the use of fine needle aspiration (FNA) and cervical ultrasound. We present a study which sought to determine the reliability of diagnostic tests (neck ultrasound and fine needle aspiration - FNA) used in the study of benign and malignant thyroid.
Methods: A it is a descriptive, observational and retrospective study, in which a review was conducted of patients surgically treated at the University Hospital of Vigo in the period January to October 2012, distributed by thyroid disease. We analyzed the results obtained from diagnostic tests (ultrasound and FNA), comparing them with those obtained by studying pathology.
Results: we reviewed a total of 109 medical records. In 100 patients (91.7%) underwent thyroid ultrasonography and 61 patients (55.9%) were performed FNA. The most frequent diagnosis obtained by puncture was benign follicular pathology in 40 patients (36.7%) (p = 0.005). The second diagnostic frequency corresponded to papillary carcinoma, being positive in 6 patients (5.5%) of the punctures. Regarding ultrasound, 78 patients (71.6%) had findings suggesting multinodular goitre, but only 50 were confirmed by histopathology (p = 0.374). In 13 patients (11.9%) the findings were suggestive of malignancy and then confirmed the diagnosis of papillary carcinoma in 34% of cases.
Conclusions: there are numerous studies supporting the validity and high performance of ultrasound and FNAC as diagnostic tests in thyroid diseases. We can gain significant benefits when planning for medical or surgical indication. In this study, we aimed to compare the effectiveness of both tests resulting in a wide range of applicability for the FNA and fairly high margin of error for ultrasound study.
References
Gomez Saez JM. “Diagnostic usefulness of Tumors makers in the Thyroid Cytological samples extracted by Fine-Needle Aspiration. Endocrine, Metabolic & Immune Disorders-Drug Targets. 2012; 10(1): 47-56.
Middleton W, Kurtz A, Hertzberg B. Neck Ultrasound. In: Ultrasound. Editorial Marban. 2005:pp245-252.
Young Kwan J, Kim E, Kim M, Hong S, et al.. The Role of ultrasound in Thyroid Nodules with a cytology reading of Suspicious for Papillary Thyroid Carcinoma. Thyroid. 2008;18(5): 517-521.
Cochand-Priollet B, Wassef M, Dahan H, et al.. Tumores de la glándula tiroidea: correlaciones citohistologicas y aporte de las nuevas técnicas. In: Enciclopedia Médico-Quirúrgica. Elsevier, E-20-878-A-10, 2000.
Lore J, Farrel M, Castillo N. Cirugía Endocrina In: Atla de cirugía de cabeza y cuello. Loré – Medina, Editorial Panamericana. 2004:pp 892-896.
Rosen J, Stone M. Contemporary diagnostic approach to the thyroid nodule. Journal of Surgical oncology. 2006;94:649-661.
Scola Yurrita B, Gómez Martin Zarco JM. Nódulo Tiroideo y Cáncer de tiroides. In: Patología quirúrgica de las glándulas paratiroides. Tratado de otorrinolaringología y patología cervicofacial, Basterra Alegria (Ed). Editorial Elsevier Masson. 2009:pp751-762.
Caraway NP, Sneige N, Saman NA. Diagnostic pitfalls in thyroid fine needle aspiration: A review of 394 cases. Diagn Cytopathol 1993; 9:345-350.
Kini SR. Guide to clinical aspiration biopsy. In: Thyroid. New York, Igaku Shoin, 1996.
Goellner JR, Gharib H, Grant CG, Jhonson DA. Fine needle aspiration cytology of the thyroid. Acta Cytol 1987; 31:587.
