Evidence-based Medicine: Time for a change? - Journal of Medical ...

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ORIGINAL ARTICLE Histological pattern of thyroid diseases in RIMS Hospital, Imphal: A report of ten years study. 1 Rajesh Singh Laishram, 1 O. Okendrajit Singh, 2 Janet Zoremnghaki, 3 Durlav Chandra Sharma, 4 S Thingbaijam Abstract Objective: The study was conducted to observe the different types of thyroid lesions in specimens received in Pathology department, RIMS, Imphal. Methods: This retrospective study was carried out on surgically resected thyroid specimens in RIMS Hospital, Imphal, during the period between January 2001 and December 2010. One hundred and eighty four histopathologically diagnosed thyroid lesions were reviewed and analysed in respect of age, gender and histological types. Cases with metastatic lesions in thyroid were excluded from the study. Results: In the study, of the184 histologically diagnosed thyroid diseases, 20(10.87%) cases were males and 164(89.13%) were females and male to female ratio was 1:8.2. Age range was from 8 to 88 years. Colloid goitre was the commonest thyroid lesion (45.11%) followed by follicular adenoma (8.70%).There were 13 cases of thyroiditis, eight of whom were lymphocytic thyroiditis and five were Hashimoto’s thyroiditis. The overall malignancy was seen in 19.02%, papillary carcinoma was the commonest comprising 1. Assistant Professor. 2. PGT. 3. Professor & Head, Deptt. of Pathology RIMS, IMphal. 4. Associate Professor Deptt. of ENT, RIMS, Lamphelpat, Imphal. Corresponding author: Dr. O. Okendrajit Singh Assistant Professor, Department of Pathology, Regional Institute of Medical Sciences, Lamphelpat, Imphal- 795004, Manipur, India. Mobile: +919436025356 e-mail: okendradr@yahoo.com of 29(82.85%) cases followed by medullary carcinoma in 3(8.57%) cases and there were 2.86% each of follicular carcinoma, anaplastic carcinoma and insular carcinoma. Conclusion: Thyroid diseases are more common in females than males. Colloid goitre is the most common lesion. Papillary thyroid carcinoma is the commonest malignant tumour and among the benign tumour, follicular adenoma is the commonest. Keywords: Thyroid diseases, Colloid goitre, Papillary carcinoma, Follicular adenoma Introduction: Thyroid diseases are progressively becoming one of the most frequent reasons for seeking medical advice. The worldwide prevalence of goitre in the general population is estimated to be 4-7% and most of them are colloid goitre with few malignancies mainly in solitary nodules. 1 Thyroid cancer is the most common endocrine tumour and its annual incidence estimated worldwide from 0.5-10 per 100,000. 2 It is more common in females than in males. There is a well-recognised spectrum of variable prognosis with different histological variants.Papillary carcinoma is the most common histological type of malignancy in most parts of the world. 3-5 This study was carried out to observe the pattern of various histological types of thyroid lesions from the specimens received in Pathology department, Regional Institute of Medical Sciences(RIMS), Imphal, Manipur. Materials and Methods: This retrospective study was done in the cases treated surgically 38 JMS * JMS Vol 25 * Vol * No. 25 3 * No. * September, 1 * June, 2010 2011
ORIGINAL ARTICLE for thyroid lesions in RIMS hospital, Imphal, Manipur. Histologically diagnosed thyroid lesions during the period between January 2001 and December 2010 were reviewed and analysed according to age, sex and histological types with the approval of the Institutional Ethics Committee. Cases with metastatic lesions in the thyroid were excluded from the study. All the slides had been stained with Hematoxylin and Eosin and special stains like Congo red were used when and where necessary. Result: In the present study, 184 histologically diagnosed thyroid diseases were reviewed. Table 1: Age and sex distribution of the cases Age Male Female Total Percentage(%) groups(yrs) 0-10 2 1 3 1.63 11-20 1 7 8 4.35 21-30 5 41 46 25 31-40 4 42 46 25 41-50 4 35 39 21.20 51-60 1 30 31 16.85 61-70 3 7 10 5.43 71-80 0 0 0 0 81-90 0 1 1 0.54 Total 20 164 184 100 Table 2: Histopathological types of lesions Histopathological diagnosis Number Percentage Nodular goitre 11 5.98 % Multinodular goitre 12 6.52 % Adenomatous goitre 12 6.52 % Colloid goitre 83 45.11 % Toxic goitre 1 0.54 % Hashimoto’s thyroiditis 5 2.72 % Lymphocytic thyroiditis 8 4.35 % Follicular adenoma 16 8.70 % Hyalinising trabecular adenoma 1 0.54 % Thyroid malignancy 35 19.02 % Total 184 100 Table 3: Histological types of thyroid malignancies Histopathological diagnosis Nos. % Papillary thyroid carcinoma 29 82.85 Medullary carcinoma 3 2.86 Follicular carcinoma 1 2.86 Anaplastic carcinoma 1 8.57 Insular carcinoma 1 2.86 Total 35 100 Table 4: Distribution of benign lesions in relation to age (years) Histopa- 0-10 11-20 21-30 31-40 41-50 51-60 61-70 71-80 81-90 thological lesions Nodular 0 0 2 7 1 1 0 0 0 goitre Multinodu- 1 1 0 3 4 3 0 0 0 lar goitre Adenoma- 0 0 5 0 2 5 0 0 0 tous goitre Colloid 0 3 19 19 23 15 4 0 0 goitre Toxic 0 0 0 0 0 1 0 0 0 goitre Hashim- 0 0 1 0 2 1 0 0 1 oto’s thyroiditis Lympho- 0 0 0 0 0 0 1 0 0 cytic thyroiditis Follicular 2 0 4 8 0 0 2 0 0 adenoma Hyalini- 0 0 0 1 0 0 0 0 0 sing trabecular adenoma Total 3 4 31 41 36 26 7 0 1 % 2.01 2.68 20.81 27.52 24.16 17.45 4.70 0 0.67 Out of which 20(10.87%) cases were males and 164(89.3%) were females, with a male to female ratio of 1:8.2. The ages ranged from 8 to88 years. Table 1. shows the age and sex distribution of the cases. Thyroid diseases were rare below the age of 20 years and only 11 cases were seen. The most common incidence was seen in the age group of 21-40 years with 92(50%) cases followed by age group of 41-50 years in 39 (21.2%) cases. Among females, the highest incidence of thyroid disease was found in the age group of 31-40 years and whereas in males it was 21- 30 years. The histopathological types of thyroid lesions are shown in Table 2. Colloid goitre was the commonest thyroid lesion (45.11%), followed by follicular adenoma in 16(8.70%).Thyroiditis was found in 13 cases, eight of which had lymphocytic thyroiditis and the remaining five had Hashimoto’s thyroiditis. Hyalinising trabecular adenoma and toxic goitre were found in one case (0.54%) each. Among the 184 patients, 35(19.02%) had thyroid malignancies,32 of these were in females with a male to female ratio of 1:10.67. Papillary thyroid carcinoma was the commonest JMS * Vol 25 * No. 13 * June, September, 2010 2011 39
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