Fine-needle aspiration of goiter (benign and non-neoplastic) with thyroid function abnormalities

Abstract

Introduction: Thyroid nodule is the prime indication for FNA, which is also a cheap and effective investigation. The current study seeks an association between benign goiter and aberrant thyroid function tests (TFTs). Can thyroid FNA anticipate overt morbidity resulting from thyroid function abnormalities? Materials and Methods: FNA records of 173 patients were studied along with the TFT results. A slide review was undertaken where the FNA impression did not correspond to the TFT. Results: The female:male ratio was 149:24. Two (1.15%) had inadequate cellularity. Nearly 95/173 cases had abnormal TFTs. Multinodular goiter (126), Hashimoto's thyroiditis (43), and two and one cases of granulomatous and unclassified thyroiditis, respectively, constituted our diagnostic profile. Abnormalities in TFT did not correlate with age group, gender, or FNA diagnoses. However, hypothyroidism (clinical and subclinical) was significantly observed in Hashimoto's thyroiditis (HT) cases. Further, scant colloid and hurthle cell change were significantly correlated with HT. A histological correlation was obtained in 46 cases. Four neoplastic cases among which three papillary carcinomas arising in small focal areas within cysts were seen. Conclusions: The major observation in this study is the subset of euthyroid and subclinically hypothyroid cases (23/43, 53.48%) of Hashimoto's thyroiditis (P = 0.0021). If treated with thyroxine replacement, overt hypothyroidism, particularly in pregnant women who are at risk of developing antithyroid antibodies, may be prevented. Besides, the inadequacy rate (1.15%) in the current study is low. False negatives 3/46 (6.5%), though available on a meager and selected subset of the patient population is still within the range of published data.

Keywords

• fine-needle aspiration
• goiter
• hashimoto's thyroiditis
• hyperthyroidism
• hypothyroidism
• multinodular goiter