"Comparison of ultrasound findings with cytologic results in Thyroid nodules "

Abstract

The nodular thyroid diseas is one of the most common disturbances o the thyroid gland wheras malignant tumors are among the most unusual entities of it. Not only differentiation of these two spectra but also the problems to achieve early diagnosis and treatment, have been a matter of concern, research, and controversy. Two hundred patients were assessed at the Cancer institute of Imam Khomeini Hospital as a retrospective research, considering the aim of evaluating and comparing the results of ultrasound and fine needle aspiration cytology with the postoperative histopathologic report. The ultrosound 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. The cases mentioned as recurrent cancer or metastases of previous thyroid cancer were omitted from the study. In this research we found a sensitivity, specificity, accuracy of 92.3% , 76.4% and 88.1%, 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. Moreover, the incidence of false negatives in malignant cases of the studied sample was 7.7% (11/43). This rate was very higher in mixed and cystic lesions compared to benign ones (20% versus 5.7%). According to ultrasound findings, we showed that micro-calcificantion had a significant higher frequency in malignant nodules in comparision 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 very higher than high echogenicity producting nodules.