Cytomorphological Correlational Study of Thyroid Disorders with Imaging and Biochemical Serum Markers

The thyroid disorders are diagnosed through ultrasonography and USG guided fine-needle aspiration cytology (FNAC) worldwide with implementation of the Bethesda system of reporting Thyroid cytology as an excellent less invasive primary line of investigation.1 The thyroid is an important and prime endocrine organ. The swelling of the thyroid gland is the commonest manifestation of various disorders affecting the thyroid, including non-neoplastic lesions and neoplastic both benign and malignant disorders.2 Bethesda categorization in FNAC aids in the decision for the management along with thyroid profile and radiological imaging. The Bethesda system of reporting thyroid cytology after FNAC is a uniform reporting system of thyroid cytology. FNAC is cheap, cost-effective, less invasive and less time-consuming.3,4 The thyroid gland composed histologically of 20-40 thyroid follicles, they produce triiodothyronine(T3) and thyroxin (T4) which are in turn regulated by thyroid-stimulating hormone (TSH) which is produced by the anterior pituitary gland. Thyroid lesions can be categorized as euthyroid, hypothyroid or hyperthyroid based on T3, T4, and TSH levels.5 The current goal in thyroid nodule evaluation is to determine whether it is benign or malignant. High resolution ultrasonography (USG) is the first line of investigation in evaluation of thyroid nodules. Thyroid imaging reporting and data system (TIRADS) is an USG-based risk stratification system for classification of thyroid nodules. Subjects with high-risk category of TIRADS undergo USG-guided fine needle aspiration cytology. Conventional FNAC usually yields fewer results compared to USG-guided FNAC.1 Data regarding sonographic classification of thyroid nodule and its cytological association with respect to biochemical findings and final histopathological diagnosis is less studied in the Indian population. Hence, justifying the correlation of various thyroid lesions involving FNAC, biochemical markers, and imaging by USG