Evaluation of Benign and Malignant Thyroid Nodules using Ultrasound and Biopsy

Abstract

The nodular thyroid disease is one of the most common pathology of the thyroid gland whereas malignant tumors are among the most unusual entities of it. Not only differentiation of these two entities but also the problems to achieve early diagnosis and treatment, have been a matter of concern, research, and controversy. This study was aim to compare the cytological results of ultrasound-guided fine- needle aspiration (US-FNA) cytology of thyroid nodules to sonographic findings and determine whether US findings are helpful in simulating cytological results. Considering the aim of evaluation and comparing the results of ultrasound and fine needle aspiration cytology with the postoperative histopathologic report. The ultrasound findings included location, number, size, feature, echogenicity, and presence of calcification; and those of the fine needle aspiration cytology consisted of benign, malignant, and suspicious samples. One hundred patients (88 females and 12 males, age of 20 to 70 years ) were assessed in the Mafraq Hospital- Abudhabi- UAE, the ultrasound scan was carried out by an ultrasound machine (GE logic E9) with linear transducer with high frequency of (6-15 MHz), color and power Doppler were used. FNA cytology results were divided into two groups: benign or malignant.The duration of the study was from Jan 2015 to Aug 2015. In this study a sensitivity, specificity, accuracy of 70.0%, 90.1%, and 80.1%, respectively, for fine needle aspiration cytology and also showed that the sensitivity and accuracy of fine needle aspiration cytology in diagnosis of malignant lesions of solid nodules was more than in cystic or mixed nodules of thyroid. According to ultrasound findings, micro-calcification had a significant higher frequency in malignant nodules in comparison with the benign ones (4% in benign lesions versus 35% in malignant ones).The rate of malignancy in solid lesions revealed a significant increment compared to cystic and mixed nodules (p<0.0001). Moreover, the potential for malignancy in nodules with low echogenicity was higher than high echogenicity producing nodules. In conclusion Sonographic findings can be useful when used alongside cytological results, especially in nodules with cytological results that are benign or suspicious for malignancy.