Thyroid gland plays a vital role in maintaining physiology. It is important to diagnose thyroid disorders as most of them can be managed by medical or surgical methods. With improving awareness thyroid diseases are being increasingly diagnosed making it one of the most common endocrine disorder worldwide.
It is a retrospective study done at department of Pathology, JLNMC, Ajmer, Rajasthan from January 2014 to September 2018 .Material for this study constituted of 270 specimens of thyroid received after thyroidectomy or lobectomy. After proper fixation gross features of all specimens were noted and sections were taken from representative areas, which were then processed and routinely stained with H&E.
Out of 270 thyroid specimens received 26(9.62%) were congenital lesions, 23(8.51%) were inflammatory lesions, 207(76.66%) were benign lesions and 14(5.18%) were malignant lesions. Most common diagnosis was goiter 140 (51.8%) followed by follicular adenoma 42(15.5%). Female: male ratio was 8:1. Most common age group for congenital lesions was <10years, for Inflammatory lesions 31-40 years, for benign diseases 21-50 years and for malignancies of thyroid it was 31-40 years.
The pattern of thyroid lesions as seen in the present study suggests that benign thyroid diseases are more common than malignancies and occur mainly in females of younger age-group. Follicular adenoma is the commonest benign tumor while papillary carcinoma is the commonest malignancy. It is advisable that all cases of thyroid lesions should be carefully evaluated to exclude possibility of thyroid cancer.
Keywords: Thyroid, Multinodular goiter,Thyroid neoplasm.
Thyroid gland affects wide variety of organs and functions of body and plays a vital role in maintaining physiology. As most of the thyroid disorders can be managed by medical or surgical methods hence it is important to diagnose them. [1] In India there are about 42 million cases of thyroid diseases. [2]
With improving awareness thyroid diseases are being increasingly diagnosed making them one of the most common non-communicable disease and most common endocrine disorder worldwide [3].
Thyroid cancers are relatively uncommon accounting for 1.5% of all cancers but they account for 92% of all endocrine cancers.[4]
It is a retrospective study done at department of Pathology, Jawaharlal nehru medical college, Ajmer, Rajasthan from January 2014 to September 2018 with the aim to studying the burden of thyroid diseases in the region, to analyse thyroid diseases based on their age-sex distribution and histomorphology and to identify the common lesions of thyroid.
Material for this study constituted of 270 specimens of thyroid received after thyroidectomy or lobectomy. After proper fixation gross features of all specimens were noted and sections were taken from representative areas, which were then processed and routinely stained with hematoxyline and eosin (H&E).
Out of 270 thyroid specimens received 26(9.62%) were congenital lesions, 23(8.51%) were inflammatory lesions, 207(76.66%) were benign lesions, 14(5.18%) were malignant lesions. (Fig. 1) Most common diagnosis was Goiter 140 (51.8%) followed by follicular adenoma 42(15.5%). [Table 1]. Also 240(88.8%) were females and remaining 30 (11.1%) were males, making Female: Male ratio 8:1 in the present study. (Fig. 2)
Congenital lesions were seen most commonly in age group of <10years. Inflammatory lesions were seen mostly in age group of 31-40 years. Age group of 21-50 years accounted for most of the benign lesions whereas maximum cases of malignancy were seen in age group of 31-40 years, although significant cases were also found in the young age group of 11-20 years and older age group of 61-70 years.(Fig 3-6)
Table 1: Histomorphological distribution of thyroid lesions
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| Thyroglossal cyst | 26 | 9.60 |
| Colloid goitre | 94 | 34.8 |
| Nodular goitre | 44 | 16.3 |
| Multinodular goitre | 02 | 0.74 |
| Diffuse toxic goitre | 03 | 1.11 |
| Adenomatous goitre | 12 | 4.44 |
| Adenomatous hyperplasia | 01 | 0.37 |
| Benign cystic lesion | 01 | 0.37 |
| Hashimoto’s thyroiditis | 16 | 5.92 |
| De-Quverian’s thyroiditis | 02 | 0.74 |
| Lymphocytic thyroiditis | 04 | 1.48 |
| Autoimmune thyroiditis | 01 | 0.37 |
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| Follicular adenoma | 42 | 15.5 |
| Hurthle cell adenoma | 03 | 1.11 |
| Colloid cyst adenoma | 06 | 2.22 |
| Papillary carcinoma | 10 | 3.70 |
| Follicular carcinoma | 02 | 0.74 |
| Medullary carcinoma | 01 | 0.37 |
Figure 1: Distribution of thyroid lesions
Figure 2: Sex-wise distribution of thyroid lesions
Figure 3: Age-wise distribution of congenital diseases of thyroid.
Figure 4: Age-wise distribution of inflammatory thyroid diseases
Figure 5: Age-wise distribution of benign diseases of thyroid
Figure 6: Age-wise distribution of malignant diseases of thyroid
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This study was conducted in the department of Pathology, Jawaharlal Nehru Medical College, Ajmer. For this study 270 thyroid specimens were evaluated by detailed history and histopathological examination. Diseases of thyroid are very common worldwide with varying incidences depending upon iodine deficiency status.[5]
Female: male ratio of thyroid diseases in our study was found to be 8:1. Similar results such as F:M ratio of 6.3:1, 9.6:1, 6:1 and 8.4:1 were found in studies conducted by Tangde A et al1(2019), Pathivada et al [6](2018), Raheem N et al [7] (2018) and Joseph E et al [3] (2016) respectively.
In our study we found non-neoplastic diseases of thyroid to widely outnumber neoplastic diseases and this is in accordance with studies done by Abdulkader et al[8](2014), Chukudebelu et al[9] (2012) and Tangde A et al[1].
In our study the age of patients ranged from <10-80 years. Most of the congenital lesions were seen in age group of <10 years and most common diagnosis was thyroglossal cyst. Inflammatory diseases were most common in age group of 31-40yrs. Similar results were seen in studies conducted by Raheem N et al7(2018) and Tangde A etal[1] (2019).
The most common disease of thyroid was found to be colloid goitre. Most of the cases of benign lesions were seen amongst 21-50 years of age group. Similar results were found in studies conducted by Joseph E et al [3](2016) and Darwish et al [10] (2006).
In our study we found peak incidence of thyroid malignancies in the age group of 31-40 years and significant number of cases were also seen in age groups of 11-20 years and 61-70 years. Similar results were seen in studies conducted by Beigh A et al [4] (2018) and Darwish et al[10] (2006).
In our study, benign lesions predominated over malignant lesions amongst neoplastic thyroid diseases. The most common malignancy diagnosed was papillary carcinoma it constituted 76.92% of all malignancies. Similar results were seen in studies conducted by Abdulhkam et al [11], Gupta A et al [12] (2016), Abdulkader et al [8] (2014) and Chukudebelu et al[9] (2012).
Follicular adenoma was the commonest benign thyroid neoplasms in our study accounting for 15.5% of all neoplasms. This is in accordance with studies done by Beigh et al[4] (2018) and Pathivada et al[6] (2018)
The pattern of thyroid lesions as seen in the present study suggests that benign thyroid diseases are more common than malignancies and occur mainly in females of younger age groups. The most common disease of thyroid is colloid goiter. Follicular adenoma is the commonest benign tumor while papillary carcinoma is the commonest malignant tumour. It is advisable that all cases of thyroid lesions should be carefully evaluated to exclude possibility of thyroid cancer.
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