Observational Study on Clinicopathological Spectrum of Thyroid Lesions in Tertiary Cancer Care Centre at Marathwada Region of Maharashtra, India

Abstract

Introduction: The thyroid has the potential to develop variety of non-neoplastic lesions as well as benign and malignant neoplasms. Thyroid gland may be affected by various disorders like developmental, inflammatory, hyperplastic and neoplastic conditions. The follicular-derived neoplasm is the most common type of thyroid neoplasm. In the new edition of World Health Organisation (WHO) classification 2017, it could be identified as benign follicular tumours (follicular adenoma, hyalinising trabecular tumour), borderline follicular tumours {Follicular Tumour of Uncertain Malignant Potential (FT-UMP), Well-Differentiated Tumour of Uncertain Malignant Potential (WDT-UMP), and Non-invasive Follicular Thyroid Neoplasm with Papillary Nuclear Features (NIFTP)}, papillary carcinoma, follicular carcinoma. Considering wide variation and several borderline and uncertain potentially malignant cases in the present observational study, authors analysed all the spectrum of thyroid lesions which included lymphoma, goiter, anaplastic carcinoma, metastatic carcinoma to thyroid gland, NIFTP etc., apart from thyroid malignancies encountered commonly. Aim: To study histopathological features of spectrum of thyroid lesions; both non-neoplastic and neoplastic. Materials and Methods: Present retrospective observational descriptive study was carried out at Department of Pathology, Tertiary Care Cancer Hospital in Marathwada region of Maharashtra, India, from January 2018 to September 2020. Total 84 patients who had undergone thyroidectomy were included in the analysis. Patient’s clinical details like age, radiological findings, tumour marker studies, if any were taken into consideration before evaluating specimens and slides. Results: Clinically, all 84 cases presented with swelling on anterior aspect of neck. Radiological features were not evaluated pertaining to lack of electronic medical records at the hospital. Results were analysed for multiple parameters like age, sex, lymph node involvement, type of thyroid malignancies, presence of parathyroid gland, etc. Female preponderance was noted in all thyroid lesions including malignancies, out of 84 patients, 64 were females and 20 were males. Out of 84 cases studied, 26 cases were of papillary thyroid carcinoma; followed by 21 cases showing non-neoplastic thyroid swelling like colloid goiter, multinodular goiter or thyroiditis. Carcinoma cases were more in number than goiter in present study, pertaining to our centre being Tertiary Care Cancer Centre. Conclusion: Histopathology evaluation of specimen’s remains gold standard for diagnosis however, it has to be interpreted on the background of clinical and radiological data. IHC studies though rarely needed are useful in cases of anaplastic carcinoma, lymphoma and metastasis to thyroid.

Keywords

• anaplastic
• lymphoma
• goiter