Clinicopathological study of asymptomatic thyroid swelling and its correlation with thyroid function tests

Abstract

Background: Thyroid swelling without symptomatic manifestation is common occurrence and could affect 5 to 20% patients in endemic areas. Majority of them are non neoplastic and may not require surgery. Less than 5% of thyroid nodules are malignant. Methods: Present study was conducted to correlate clinical findings, HRUSG findings, thyroid profile and FNAC findings in patients of asymptomatic thyroid swelling. Results: Proportion of euthyroid patients was higher compared to hyperthyroid and hypothyroid diagnosed as colloid goiter on FNAC findings (82.4% vs. 0.0% and 12.9%). Proportion of hypothyroid was higher compared to euthyroid and hyperthyroid diagnosed as Follicular adenoma (3.2% vs. 0.0% and 1.2%) and colloid goiter with cystic changes (48.4% vs. 0.0% and 10.6%). Proportion of hyperthyroid compared to hypothyroid and euthyroid patients were higher diagnosed as thyroiditis (75.0% vs. 32.3% and 5.9%) and papillary/medullary CA (25.0% vs. 3.2 and 0.0%). A statistically significant association of FNAC diagnosis and thyroid profile of patients with asymptomatic thyroid swelling was found. Conclusions: The present study showed that thyroid dysfunction could play a significant role in determining the underlying pathology behind thyroid swelling and must be evaluated at the earliest using thyroid function tests as the first line of diagnostic tool. In case of suspected thyroid profile; USG neck and FNAC should be done. In view of lack of studies correlating thyroid and clinicopathological profiles of thyroid swellings, further studies to potentiate the present study findings are recommended.