Comparison of sonographically guided percutaneous sodium tetradecyl sulfate injection with ethanol injection in the treatment of benign nonfunctioning thyroid nodules.

PURPOSE: To compare the efficacy of percutaneous sodium tetradecyl sulfate (STS) injection with ethanol injection in the treatment of benign nonfunctioning thyroid nodules. MATERIALS AND METHODS: This prospective study included 47 patients with 50 benign thyroid nodules. The lesions were randomly assigned into two groups: 20 in the ethanol arm and 30 in the STS arm. The mean lesion volume was 25.6 mL ± 28.5 (range, 4-122.1 mL) in the ethanol arm and 25.4 mL ± 27 (range, 0.72-129 mL) in the STS arm. One sitting of sclerosant injection was done in 20 lesions, and two injections, three injections, four injections, five injections, six injections, seven injections, and eight sittings of injections were done in 9 lesions, 4 lesions, 8 lesions, 4 lesions, 2 lesions, 2 lesions, and 1 lesion. The mean volumes of the instilled ethanol and STS were 5.3 mL and 7.8 mL, respectively, per sitting. Follow-up sonography was performed at 1, 3, 6, and 12 months after the procedure. RESULTS: The final 12-month follow-up lesion volumes were 4.1 mL ± 3.7 (range, 0.3-15.2 mL) in the ethanol group and 4.4 mL ± 5.8 (range, 0.01-29.6 mL) in the STS group (P = .85). The mean volume reduction was 84% and 82.8% in the two groups. No significant adverse effects were seen in either of the two groups. CONCLUSIONS: Sonographically guided percutaneous ethanol and STS injections are not significantly different from each other in terms of the volume reduction achieved in benign nonfunctioning thyroid nodules.

Clinico-cytopathological spectrum of hepatocellular carcinoma, its correlation with serum alpha-fetoprotein level, and hepatitis B and C viral markers.

Fine-needle aspirationbiopsy (FNAB) is now widely accepted as a diagnostic modality for the treatment of hepatocellular carcinoma (HCC). The most common diagnostic problem in HCC is distinguishing it from a metastatic carcinoma. The literature from India on HCC is scanty. Hence, we studied the cytomorphological features of HCC and metastatic carcinoma. The study included 37 cases of space-occupying lesions (SOLs) of the liver as demonstrated by ultrasound or computed tomography (CT) scan. Cytomorphological features of these SOLs were analyzed in all subsequent to FNAB. Hepatitis B surface antigen (HBsAg), anti-hepatitis C virus antibody (anti-HCV) and alpha-fetoprotein (AFP) were determined in all the cases by enzyme-linked immunosorbent assay (ELISA). The cytopathological diagnosis was HCC in 22 and metastatic carcinoma of the liver in 15. The individual cytomorphological features and which helped to make a definite diagnosis of HCC were: a high nuclear cytoplasmic ratio (81.8%), predominantly trabecular pattern (63.6%) and atypical naked nuclei (100%). Other features were prominent multiple nucleoli (63.3%), hyperchromasia (100%) and moderate anisonucleosis (59%). AFP was elevated in 81.8% of the cases with a mean of 634.8+812.7 ng/ml. HBsAg by ELISA was found to be positive in 72.7% of cases while only 1 case (4.5%) was positive for anti-HCV. In 1 case (4.5%), there was dual infection due to hepatitis B virus (HBV) and HCV. No viral cause was found in 18.3% of cases.