SONOGRAPHIC ASSESSMENT OF VARIOUS THYROID NODULES AND THEIR CORRELATION TO HISTOPATHOLOGICAL EXAMINATION

RAMARAPPU SOWMYA; VULCHI HEMANTH; VATTIGUNTA NIRUPAMA

doi:10.22159/ijcpr.2025v17i5.7061

Authors

RAMARAPPU SOWMYA Department of Otorhinolaryngology, Dr. Patnam Mahender Reddy Institute of Medical Sciences, Chevella, Rangareddy-501503, Telanana, India
VULCHI HEMANTH Department of Otorhinolaryngology, Dr. Patnam Mahender Reddy Institute of Medical Sciences, Chevella, Rangareddy-501503, Telanana, India
VATTIGUNTA NIRUPAMA Department of Otorhinolaryngology, Dr. Patnam Mahender Reddy Institute of Medical Sciences, Chevella, Rangareddy-501503, Telanana, India

DOI:

https://doi.org/10.22159/ijcpr.2025v17i5.7061

Keywords:

Thyroid nodules, Ultrasound, Fine needle aspiration cytology

Abstract

Objective: High-resolution ultrasonography (USG) and fine-needle aspiration cytology (FNAC) are cornerstone tools for initial evaluation, while histopathological examination (HPE) serves as the definitive diagnostic method. This study is to compare the efficacy of both these methods in the diagnosis of thyroid nodules.

Methods: This prospective cross-sectional study included 100 patients with thyroid nodules evaluated at a tertiary care center over 18 mo. Each patient underwent USG, FNAC, and subsequent surgical histopathology when indicated. Sonographic features such as echogenicity, margin irregularity, calcifications, shape, and vascularity were assessed. Nodules were classified using TI-RADS and FNAC results interpreted using the Bethesda system. Final histopathology served as the gold standard.

Results: The study population was predominantly female (75%), with an average age of 42.6 years. Solitary nodules were more common (72%), primarily affecting the right lobe. Sonographic features such as hypoechogenicity, irregular margins, microcalcifications, taller-than-wide shape, and increased central vascularity were significantly associated with malignancy (p<0.05). Higher TI-RADS (4 and 5) and Bethesda categories (V and VI) strongly correlated with malignant histopathology (p<0.0001). A rising trend in malignancy risk was observed with ascending TI-RADS and Bethesda scores.

Conclusion: This study reaffirms the diagnostic value of USG and FNAC in thyroid nodule evaluation. Significant correlation between TI-RADS and Bethesda classifications with histopathological outcomes underscores their complementary role in malignancy risk stratification and clinical decision-making.

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References

1. Zamora EA, Khare S, Cassaro S. Thyroid nodule. In: Treasure Island, FL: StatPearls; 2025.

2. Tan GH, Gharib H. Thyroid incidentalomas: management approaches to nonpalpable nodules discovered incidentally on thyroid imaging. Ann Intern Med. 1997 Feb 1;126(3):226-31. doi: 10.7326/0003-4819-126-3-199702010-00009, PMID 9027275.

3. Tran NQ, Le BH, Hoang CK, Nguyen HT, Thai TT. Prevalence of thyroid nodules and associated clinical characteristics: findings from a large sample of people undergoing health checkups at a university hospital in Vietnam. Risk Manag Healthc Policy. 2023;16:899-907. doi: 10.2147/RMHP.S410964, PMID 37220482.

4. Dean DS, Gharib H. Epidemiology of thyroid nodules. Best Pract Res Clin Endocrinol Metab. 2008 Dec;22(6):901-11. doi: 10.1016/j.beem.2008.09.019, PMID 19041821.

5. Tamhane S, Gharib H. Thyroid nodule update on diagnosis and management. Clin Diabetes Endocrinol. 2016 Oct 3;2:17. doi: 10.1186/s40842-016-0035-7, PMID 28702251.

6. Bomeli SR, Le Beau SO, Ferris RL. Evaluation of a thyroid nodule. Otolaryngol Clin North Am. 2010 Apr;43(2):229-38. doi: 10.1016/j.otc.2010.01.002, PMID 20510711.

7. Unnikrishnan AG, Kalra S, Baruah M, Nair G, Nair V, Bantwal G. Endocrine society of India management guidelines for patients with thyroid nodules: a position statement. Indian J Endocrinol Metab. 2011 Jan;15(1):2-8. doi: 10.4103/2230-8210.77566, PMID 21584159.

8. Chandana DA, Gomathi R, Prakashiny S. Epidemiological and histopathological study of thyroid lesions in a Tertiary Care Hospital in South India. Trop J Pathol Microbiol. 2020;6(6):381-6. doi: 10.17511/jopm.2020.i06.03.

9. Isse HM, Lukande R, Sereke SG, Odubu FJ, Nassanga R, Bugeza S. Correlation of the ultrasound thyroid imaging reporting and data system with cytology findings among patients in Uganda. Thyroid Res. 2023 Sep 1;16(1):26. doi: 10.1186/s13044-023-00169-1, PMID 37653537.

10. Kovacevic DO, Skurla MS. Sonographic diagnosis of thyroid nodules: correlation with the results of sonographically guided fine needle aspiration biopsy. J Clin Ultrasound. 2007 Feb;35(2):63-7. doi: 10.1002/jcu.20287, PMID 17206727.

11. Singaporewalla RM, Hwee J, Lang TU, Desai V. Clinico-pathological correlation of thyroid nodule ultrasound and cytology using the TIRADS and Bethesda classifications. World J Surg. 2017 Jul;41(7):1807-11. doi: 10.1007/s00268-017-3919-5, PMID 28251273.

12. Bahaj AS, Alkaff HH, Melebari BN, Melebari AN, Sayed SI, Mujtaba SS. Role of fine needle aspiration cytology in evaluating thyroid nodules. A retrospective study from a tertiary care center of Western region, Saudi Arabia. Saudi Med J. 2020 Oct;41(10):1098-103. doi: 10.15537/smj.2020.10.25417, PMID 33026051.

13. George NA, Suresh S, Jiji V, Renu S, Thomas S, Janardhan D. Correlation of TIRADS and bethesda scoring systems with final histopathology of thyroid nodules an institutional experience. Indian J Otolaryngol Head Neck Surg. 2022 Dec;74Suppl 3:5753-8. doi: 10.1007/s12070-021-02380-8, PMID 36742706.