Histopathological Characters Of Solitary Thyroid Nodule In Patient Undergoing Surgery At 3 Years (2015 - 2017) In Al - Nasiriyah City

  • Alaa Jamel Hasin
  • Marwah Yaseen Ayyed
  • Kareem Dhuyool Farawn


Background: The morbidity of solitary  thyroid nodule to be benign or malignantaffecting different age group and gender are generallynotwellestablished need to more focus about details histopathology and identified the characters of histopathology.  Aim of study: To know histopathological characters of solitary thyroid nodule in patients undergoing in Nasiriya city at (2015_2016_2017). Patients and method: This cross-sectional analytical  study was carried out at the department of general surgery, Al_Hussain teaching hospital. It is retrospective study during 3 years ago(2015,2016,2017). The study include the collection samples of known cases of solitary thyroid nodule from operation room in ,Al_Hussain teaching hospital for 3 years about 162 cases  and send it into histopathology in lab. In same hospital in Nasiriya city about 360 km south Baghdad the capital, and take the result of histopathology from lab. In same hospital. The study include different ages All age groups were included in this study. Classified into :
  • Child and adolescence less than 18 years old
  • Young adult(18_45) years old
  • Old adult (45_65) years old
  • Elderly (65years old and above)
And both sexes (male and female). Results: A total samples collection to study are 162 of patients with STN during three years (2015-2017),The female (157) and the male( 5 ). majority of  the studied population were female (96.9%), and most of them were at age of 18-45 years (67.9%), followed by the old adult  29.6%, while the other groups were having an equal percent of 1.25%., a studied total number were attending the Al-Hussien teaching hospital mostly coming at the 2016followed by 2017 then 2015.were most of them at the 2016 (41.1%), followed by 2017 (39%), while the 2015 were the smallest proportions of the contributors. most of the presented cases were with follicular adenoma (57.4%) followed by papillary carcinoma (35.2%) then follicular carcinoma (5.6%), while medullary Ca were the littlest proportion (1.9%). Child and elderly show no case of lymph node involvement, highest proportion were among adult cases, while the old adult show only (6,3%) L.N involvement , where M.Ca showing no L.N involvement, while(15.8%) of the papillary carcinoma show L.N involvement, regarding follicular Carcinoma only 11.1% of them showing L.N involvement. Conclusion: This study showed that solitary thyroid  nodules are benign more than malignant found as follicular adenoma, and the most common  type of thyroid cancer was papillary thyroid carcinoma. There was no cases of anaplastic carcinoma.


_ Andeisen.k,D; Billiar.R.T.; Dunn.L.D.; etal; Thyroid ,Parathyroid and Adrenal in : Schwartz’s principles of surgery , 10th Edition, McGraw-Hill Education, 2015 ; 1521_1522 , 1534.

_ Standring. S. ; Neck, in : GRAY’S anatomy The anatomical basis of clinical practice, 41th Edition, Elsevier limited , 2016; page 470_471.

_ Netter H.F . ; thyroid gland and larynx in : Atlas of human anatomy, 6th Edition, Sunders, anim print of Elsevier Inc, 2014; page 76.

_ ((By courtesy of Mr Peter Helliwell and Dr Joseph Mathew, Department of Histopathology, Royal Cornwall Hospitals Trust, UK.)

_ Hall.E.J. ; thyroid metabolichormones in : Guyton and hall textbook of medical physiology , 13th Edition , Elsevier, Inc, 2016 ; 951_959.

_ Williams. S. N ; Bul Strode . K. Ch. ; O’CoNNell R. P. ; the thyroid and parathyroid gland in : Bailey and Love’s Short practice of surgery , 26th Edition, Taylor, Francis group , L.LC , 2013; page 741_777.

_ Oertli. D. ; udelsman R. ; evaluation of hyperthyroidism and hyperthyroid goiter in surgery of n thyroid and parathyroid Glands , 2nd edition, springer_venlag berlin heidelbery, 2012, 29.

_ Gupta M, Gupta S, Gupta VB. Correlation of fine needle aspiration cytology with histopathology in the diagnosis of solitary thyroid nodule. J Thyroid Res 2010;2010:379051.

_ Tai JD, Yang JL, Wu SC, Wang BW, Chang CJ. Risk factors for malignancy in patients with solitary thyroid nodules and their impact on the management. J Cancer Res Ther. 2012;8:379–83

_S.Anitha,T.R. , and Ravimonan. Astudy of incidence of malignancy in solitary nodule of thyroid. International journal of contemporary medical Research 2016;3(4):993_995.

_ Niedziela M. Pathogenesis, diagnosis and management of thyroid nodules in children. EndocrRelat Cancer. 2006;13:427–453.

_ Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease. St. Louis, Mo: Elsevier Saunders. p. 1117.

_ Rosai J, Carcangiu ML, DeLellis RA. Atlas of tumor pathology, 3rd series, fas 5. Washington, DC: Armed Forces Institute of Pathology; 1992. Tumors of the thyroid gland; pp. 21–48.

_ Maitra A, Abbas AK. The endocrine system. In: Kumar V, Abbas AK, Fausto N, editors. Robbins and Cotran Pathologic Basis of Disease. 7th ed. Phildelphia: Saunders; 2004. pp. 1155–226.

_ Crile G, Jr, Pontius KI, Hawk WA. Factors influencing the survival of patients with follicular carcinoma of the thyroid gland. SurgGynecol Obstet. 1985;160:409–413.

_ Danies L. and Welch H.G. ;increasing incidence of thyroid cancer in united states .JAMA 2006;295(18):2164_2167.

_Schneider DF,Chen H (2013) New developments in the diagnosis and treatment of thyroid cancer.CA cancer J clin.

_ Burgess JR, Dwyer T, McArdle K, et al. The changing incidence and spectrum of thyroid carcinoma in Tasmania (1978–1998) during a transition from iodine sufficiency to iodine deficiency. J ClinEndocrinolMetab. 2000;85:1513–1517.

. Keh SM, El-Shunnar SK, Palmer T, Ahsan SF. Incidence of malignancy in solitary thyroid nodules. J I.aryngo/ Oto/. 2015 Jul. 129 (7):677-81 . IMedlinel.

. Ibrahim FalihNoori; Clinical Predictors of Malignancy in Solitary Thyroid Nodule, A Study of 146 Cases.in Medical Journal of Babylon, ISSN 2312-6760©2015, University of Babylon Accepted 27 March, 2017, Vol. 14- No. 1 : 99 – 112 , 2017.

_ Lennard TWJ. The thyroid gland. In: Garden OJ, Patterson-Brown S, editors. A Companion to Specialist Surgical Practice. Philadelphia: Elsevier; 2006. p. 43-77.

_Veness MJ, Porter GS, Morgan GJ. Anaplastic thyroid carcinoma: dismal outcome despite current treatment approach. ANZ J Surg 74:559-562, 2004 .

_ Hundahl SA, Cady B, Cunningham MP, et al. Initial results from a prospective cohort study of 5583 cases of thyroid carcinoma treated in the United States during 1996. Cancer 89:202-217, 2000

_ Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, Mazzaferri EL, McIver B, Pacini F, Schlumberger M, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19:1167–1214. doi: 10.1089/thy.2009.0110.

_ Hay ID, Hutchinson ME, Gonzalez-Losada T, McIver B, Reinalda ME, Grant CS, Thompson GB, Sebo TJ, Goellner JR. Papillary thyroid microcarcinoma: a study of 900 cases observed in a 60-year period. Surgery. 2008;144:980–987. doi: 10.1016/j.surg.2008.08.035.

_Gauhar,Tooba ,Chaudary.Abhiseck,Mohammed Asif Maqbool,Hafiz,Asad,and et al.(2014).Papillary thyroid carcinoma.Journal of Thyroid Disorders and therapy.03.10.4172/2167_7948.1000141.

_ D'Avanzo A, Treseler P, Ituarte PH, et al. Follicular thyroid carcinoma: Histology and prognosis. Cancer. 2004;100:1123–1129.

_ Lin JD. Papillary thyroid carcinoma with lymph node metastases. Growth Factors. 2007 Feb;25(1):41-9. Review. PubMed PMID: 17454149.

_ Lee DJ, Lee KH, Kim JH, Kwon KH, Yoon DY, Rho YS. Posterosuperior lesion has a high risk of lateral and central nodal metastasis in solitary papillary thyroid cancer. World J Surg. 2015;39:387–392.

_Nie X, Tan Z, Ge M, Jiang L, Wang J, Zheng C. Risk factors analyses for lateral lymph node metastases in papillary thyroid carcinomas: a retrospective study of 356 patients. Arch EndocrinolMetab. 2016;60:492–499.

_Manole D, Schildknecht B, Gosnell B, Adams E &Derwahl M. Estrogen promotes growth of human thyroid tumor cells by different molecular mechanisms. Journal of Clinical Endocrinology and Metabolism 2001 86 1072–1077.

_ Zeng Q, Chen G, Vlantis A, Tse G & van Hasselt C. The contributions of oestrogen receptor isoforms to the development of papillary and anaplastic thyroid carcinomas. Journal of Pathology 2008 214 425–433.

_Derwahl M, Nicula D. Estrogen and its role in thyroid cancer. EndocrRelat Cancer. 2014 Oct;21(5):T273-83. doi: 10.1530/ERC-14-0053. Epub 2014 Jul 22. PMID: 25052473.

_Hemashankara Rao, B. and srinivasachakravarthy,k.(2016). Study of incidence in between benign and malignant tumors of solitary thyroid nodule. International journal of Research in medical sciences. 4. 5288_5293. 10.18203/2320_2016. Ijrms 20164196.

_ Ibrahim M. Mustafa; Mohamed S.Abood M.D. Abd El Rahman H.sadiq M.D. and et al….Detection of malignancy in solitary thyroid nodule .General surgery department;Faculty of medicine; Zagazing University:Z.U.M.J.VOL.20;N.3;May;2014.