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Background: Accurate characterization of thyroid nodules is crucial for appropriate management and treatment decisions. Ultrasound (USG), cytology and histopathology are widely used diagnostic modalities, but their combined utility in identifying benign and malignant thyroid nodules needs further investigation. Methods: This prospective observational study included patients with thyroid nodules detected on ultrasound, a cytological diagnosis on FNAC and histopathology. Sonographic features assessed included nodule composition, echogenicity, shape, margin characteristics, echogenic foci. Cytological specimens were classified according to the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). Results: Ill-defined margins (33.3%) and solid composition (100%)were observed exclusively in malignant nodules.Hypoechoic echogenicity (50%) and "taller than wide" shape (33.3%) were more common in malignant nodules, while benign nodules exhibited anechoic (42.9%), hyperechoic (28.6%), and "wider than tall" (100%) appearances.Echogenic foci were present only in malignant cases.A significant proportion of benign nodules (42.9%) were classified as low-risk TIRADS 1, while most malignant nodules (83.3%) were higher-risk TIRADS 4. Conclusions: Certain sonographic features, including ill-defined margins, solid composition, hypoechogenicity, "taller than wide" shape, and echogenic foci, were associated with malignancy.However, some overlap with benign nodules was observed, highlighting the importance of integrating cytological and histopathological evaluation for accurate diagnosis and risk stratification.
Chouhan et al. (Wed,) studied this question.
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