Background: Benign thyroid lesions exhibit diverse histomorphological features reflecting a range of non-neoplastic and neoplastic processes. They are far more common than malignant thyroid disease; yet regional histopathological data from South-East Nigeria remain limited. This study analyses the histomorphological spectrum of benign thyroid lesions diagnosed over a six-year period in Abakaliki, Ebonyi State, with attention to age- and sex-specific patterns and their year-on-year trends.

Methods: This retrospective, descriptive, analytical study reviewed 148 benign thyroid specimens identified from 12,850 surgical specimens processed in the Department of Anatomic Pathology, Alex-Ekwueme Federal University Teaching Hospital, Abakaliki, between January 2016 and December 2021. Haematoxylin- and eosin-stained slides were independently reviewed by two histopathologists; special stains or immunohistochemistry were used where indicated. Patient age, sex, and final diagnosis were extracted for each case. Chi-square tests were used to assess associations between age group and lesion category and between sex and diagnosis.

Results: Benign thyroid lesions accounted for 148/12,850 (1.15%) of all surgical specimens received over the study period. Females predominated (123/148, 83.1%), giving a female-to-male ratio of 4.9:1. Patient age ranged from 5 to 69 years (mean 35.9 ± 11.3 years), with the 41–50-year (32.4%) and 31–40-year (29.7%) groups most affected. Multinodular goitre was the most frequent diagnosis (62/148, 41.9%), followed by simple colloid goitre (41/148, 27.7%); goitre of any type accounted for 110/148 (74.3%) of all lesions. Age group was significantly associated with lesion category (goitrous versus non-goitrous lesions; χ² = 35.3, df = 6, p < 0.001), with goitres disproportionately concentrated in patients aged 21–50 years, while thyroglossal cysts and Graves’ disease showed a different age distribution. Case volume rose steadily over the study period, from 16 cases in 2016 to 36 cases in 2021.

Conclusion: Multinodular and simple colloid goitre remain the predominant benign thyroid lesions in this environment, disproportionately affecting women in their reproductive and working years. The significant association between age group and lesion category suggests that age-targeted case-finding could improve early detection, while the sustained rise in caseload over the study period highlights a growing burden with implications for local histopathology service planning.

Keywords: Benign thyroid lesions, Multinodular goitre, Goitre, Ebonyi State, Histomorphology, Nigeria.