Vijayanand, A (2013) Clinicopathological study of multinodular goitre. Masters thesis, Kilpauk Medical College, Chennai.
|
Text
220100413vijayanand.pdf Download (1MB) | Preview |
Abstract
INTRODUCTION: The thyroid gland is an endocrine gland situated in the lower part of front and the sides of the neck. Its main function is regulation of the basal metabolic rate, stimulates somatic and psychic growth and plays important role in calcium metabolism. The term thyroid is derived from Greek, which means shield (Thyros –shield, eidos – form).Normal thyroid gland is impalpable. Thyroid gland enlargement is the most common manifestation of the thyroid disease. The enlargement may be either generalized or localized, which again may be, toxic or nontoxic. The nontoxic goitre is further divided on etiological basis as endemic goitre and sporadic goitre. The endemic goitre is defined as one where more than 10% of population shows thyroidenlargement. Diseases of thyroid gland especially multinodular goitre due to deficiency of iodine are prevalent in India. Though exact incidence of nodular goitre is not available, WHO, in 1958, estimated that goitre was present in 200 million, which represented 7% of World’s population at that time. Nodular goitres are more common in women than in men and the nodularity increases with increasing age. Multinodular goitres (MNG) can become malignant but it is rare. AIMS AND OBJECTIVES: 1. To Study Age and Sex Distribution. 2. To Know Various Modes of Clinical Presentation. 3. To Compare and Correlate the Findings of Investigations with the Histopathology of Resected Specimen. 4. To Know the Incidence of Malignancy in Multinodular Goitre. 5. To Study the Principles and Management of Multinodular Goitre. MATERIALS AND METHODS: The material of the present study consists of patients admitted with nodular thyroid swelling from July 2010 to August 2012 at the surgical units of Government Royapettah hospital, Kilpauk medical college. Totally, 50 patients were admitted and treated during this period. Among these, 43 patients were female, and remaining 7 were males. After admission, a detailed history was taken and thorough clinical examination was carried out which was entered in the proforma. The patients were investigated. The investigations included Haemoglobin percentage, urine analysis, blood sugar estimation, blood urea estimation, blood grouping and Rh typing, serum cholesterol, x-ray of the neck-AP and lateral views and chest X-ray and ENT examination. All patients had a Thyroid profile and FNAC done. These patients underwent surgery and all the excised thyroid specimen were sent for histopathological examination. Patients were discharged after removing the sutures and were asked to come for follow up. Post-operative thyroid profile was done on 1st post-operative week and at 1 month. They were advised to take the needful medications accordingly. Only those patients with clinical evidence of multinodular goitre were taken up for the study randomly, excluding malignancies detected preoperatively and the results were compared with other studies. For all patients whose HPE – Reported as benign were treated with replacement dose of thyroxine and followed up. For one case whose HPE come as maligancy was treated with suppressive dose of thyroxine and followed up with thyroglobulin measurement and radioactive iodine scan. SUMMARY AND CONCLUSIONS: Fifty patients of MNG were evaluated with respect to age, sex, duration of swelling and were investigated with FNAC. Operated specimen subjected to histopathological examination and results were analysed. 1. MNG is the commonest thyroid disease in our hospital. 2. Multinodular goiter is more common in females (Female to male ratio 6:1) majority are in the age group of 21-40 years (56%). 3. The chief complaint in majority of the patients is swelling in front of the neck and few patients with pressure symptoms. 4. In majority (90%) of the patients, duration of the swelling prior to presentation was 6 months to 5 years. 5. Secondary thyrotoxicosis is seen in 26% (13 cases) 6. FNAC is very useful in the diagnosis and management of MNG. 7. Malignancy can still come as a surprise on post-operative histopathological examination, even when there is no suspicion of malignancy clinically and with FNAC. 8. The main indications of surgery in MNG are secondary thyrotoxicosis, risk of MNG turning into milignancy, pressure effect symptoms and cosmetic problem. 9. Total thyroidectomy is the surgery of choice for MNG.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | multinodular goitre ; Clinicopathological study. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Devi S |
| Date Deposited: | 06 Jun 2018 16:30 |
| Last Modified: | 06 Jun 2018 16:30 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/8247 |
Actions (login required)
 |
View Item |
