Cytohistopathological Correlation of Thyroid with Immunohistochemistry in the Diagnosis of Follicle Derived Thyroid Neoplasms

Abstract

Histopathologic evaluation of thyroid using Haematoxylin and Eosin (HandE) staining is the gold standard diagnostic tool for detecting thyroid neoplasms. However morphological overlapping is quite common between follicular patterned lesions. Consequently, histopathological evaluation has constraints in bringing out the contrast between these benign and malignant follicular-patterned thyroid lesions, making the distinction between these two groups quite subtle and arduous. Although a wide range of sensitivity and specificity values of these markers has been reported by different studies along the time, none of those studies demonstrated conclusive results. The study is aimed to correlate the FNAC findings with histopathology and to find out the expression of immunohistochemical markers such as Hector Battifora Mesothelial Cell1 (HBME-1), CD56 and Cytokeratin-19 (CK19) in follicular patterned thyroid neoplasms. newlineThis study design is Cross Sectional study and carried out in a Tertiary Teaching Hospital, Kerala. A total of 250 Patients who underwent FNAC followed by histopathology were enrolled in the study. All the patients underwent FNAC under standard protocol and diagnosis was made based on TBSRTC. Excision biopsies were processed under routine histopathological techniques and diagnosis were made. Immunohistochemistry was performed by using CK19, HBME-1 and CD56 antibodies in 55 cases of follicular derived neoplasm of thyroid. newlineOut of 250 cases, 232 (92.8%) cases were females and 18 (7.2%) cases were males. 191 cases (76.4%) were diagnosed as Nodular Goitre, four cases (1.6%) were Hashiomoto s thyroiditis, Follicular Adenoma was diagnosed in 18 (7.2%) cases, CPTC in 22 cases (8.8%), FVPTC in 10 (4%) cases and FTC in 5 (2%) cases. Out of the 37 malignancies, CK19 positivity was demonstrated in 30 cases (80.1%). Loss of CD56 expression was noted in 27 malignant cases (72.97%). HBME-1 staining was observed in 97.3% (36/37) malignant cases and was absent in 88.89% (16/18) benign cases. CD56 and HBME-1 is a helpful bi