Fine needle aspiration cytology is used as a diagnostic modality in all the following thyroid malignancies except:

Ans: B (FollicularCa) Ref: Bailey B Love's Short Practice of Surgery, 25th Edition 792 Sabiston Textbook of Surgery, 19th Edition 909Explanation:The distinction between a follicular carcinoma and an adenoma can only be made by histological examinationInvasion of the capsule or of pericapsular blood vessels is necessary to diagnose Carcinoma which can be demonstrated only by histopathology.Intraoperative frozen section is not usefulFOLLICULAR CANCERSecond most common thyroid malignancy (most common-Papillary)Cinical Features40-60 yearsFemale:Male=3:lMost commonly presents as asymptomatic thyroid noduleCan be associated with Multinodular Goitre in 10%Diagnosis: Only on Histopathological examinationManagementBased on size of the lesion*<2cm - Hemithyroidectomy followed by Histopathological examination.If HPE showsAdenoma - No further treatment Carcinoma - proceed with Total Thyroidectomy>2cm- Total thyroidectomyThyroid OperationsAll thyroid operations can be assembled from three basic elements:Total lobectomyIsthmusectomySubtotal lobectomyTotal thyroidectomy = 2xtotal lobectomy + isthmusectomySubtotal thyroidectomy = 2xsubtotal lobectomy + isthmusectomyNear-total thryroidectomv = total lobectomy +isthmusectomy + subtotalLobectomyLobectomy = total lobectomy + isthmusectomy