Thyroid disorders in the United Arab Emirates : a study of the incidence of varying pathology of the thyroid gland and the place of Fine Needle Aspiration in diagnosis
This study was planned to investigate the incidence of varying thyroid pathology in the United Arab Emirates and the role of Fine Needle Aspiration in the diagnosis of these diseases. Congenital hypothyroidism represents one of the most common preventable causes of mental retardation. In this study, the incidence of congenital hypothyroidism among infants born in the United Arab Emirates was sought. A total of 49,466 newborn infants was screened, 24,531 female and 24,935 male. 41% were United Arab Emirates' nationals. The recall rate was 0.46%. The total number of cases confirmed as congenital hypothyroidism was 1:1904 for the whole group and 1:1843 among United Arab Emirates nationals. Confirmed cases were 16 females and 10 males, with a female to male ratio of 1.6/1. They were from 23 families; 16 (60%) of the couples being in consanguineous marriage. Fine Needle Aspiration Cytology in the United Arab Emirates, is considered as the most important and initial step in the diagnosis and management of patients presenting with thyroid nodular enlargement. In this study the cytological diagnosis and the criteria used for this diagnosis in 441 patients presenting with thyroid gland enlargement was reviewed. The technique used for aspiration was that modified by Abdul Aal and Dessouki (1990). Cystic thyroid lesion was the cytological diagnosis in 17 cases, thyroiditis in 31 cases, nodular goitre in 239 cases, follicular neoplasm in 48 cases, follicular carcinoma in 5 cases, Hurthle cell neoplasm in 8 cases, papillary carcinoma in 18 cases, medullar carcinoma in 5 cases, undifferentiated carcinoma in one case and metastatic carcinoma in 2 cases. The cases where diagnosis cannot be made due to unsatisfactory smears were grouped separately and included 67 patients. The accuracy of the cytological diagnosis was tested against the histological diagnosis made on surgical thyroidectomy specimens whenever available. Accurate cytological diagnosis was achieved in 100% of the cases diagnosed as having follicular carcinoma, papillary carcinoma, Hurthle cell neoplasm, medullary carcinoma, undifferentiated carcinoma and metastatic carcinoma. Moreover, cytology was very valuable in detecting the histological variants in many cases of papillary, medullary and metastatic carcinoma.