Lymphocytic thyroiditis – is cytological grading significant? A correlation of grades with clinical, biochemical, ultrasonographic and radionuclide parameters

Abstract

BackgroundClinical, biochemical, ultrasonographic, radionuclide and cytomorphological observations in Lymphocytic thyroiditis (LT), to define the cytological grading criteria on smears and correlation of grades with above parameters.MethodsThis prospective study was conducted on 76 patients attending the Fine needle aspiration cytology clinic of a tertiary care institute in North India. The various parameters like patients' clinical presentation, thyroid antimicrosomal antibodies, hormonal profiles, radionuclide thyroid scan and thyroid ultrasound were studied. Fine needle aspiration of thyroid gland and grading of thyroiditis was done on smears. The grades were correlated with above parameters and the correlation indices were evaluated statistically.ResultsMost of the patients were females (70, 92.11%) who presented with a diffuse goiter (68, 89.47%). Hypothyroid features (56, 73.68%) and elevated TSH (75, 98.68%) were common, but radioiodide uptake was low or normal in majority of patients. Thyroid antimicrosomal antibody was elevated in 46/70 (65.71%) patients. Cytomorphology in fine needle aspirates was diagnostic of lymphocytic thyroiditis in 75 (98.68%) patients. Most of them had grade I/II disease by cytology. No correlation was observed between grades of cytomorphology and clinical, biochemical, ultrasonographic and radionuclide parameters.ConclusionDespite the availability of several tests for diagnosis of LT, FNAC remains the gold standard. The grades of thyroiditis at cytology however do not correlate with clinical, biochemical, radionuclide and ultrasonographic parameters.

Chronic lymphocytic thyroiditis: could it be influenced by a petrochemical complex? Data from a cytological study in South-Eastern Sicily

“…Additional finding that could or could not be present were as follows: follicular atrophy, plasma cells, multinucleated giant cells, epithelioid cell clusters, intralobular fibrosis, and Hürtle-cell metaplasia. This metaplasia may display some chromatin clearing, nuclear atypia, nuclear grooves, and prominent nucleoli sometimes overlapping with malignant lesions (7,8). Because inherent to the diagnostic purpose of FNAC, evaluated nodules have to be assigned to a cytological class (or category) of malignancy risk, the association of CLT with these classes was virtually automatic.…”

Diagnostic Pitfalls of Hashimoto’s/Lymphocytic Thyroiditis on Fine-Needle Aspirations and Strategies to Avoid Overdiagnosis

“…Histologic findings of H/LT include a diffuse lymphoid infiltration, scattered plasma cells or histiocytes, fibrosis, atrophy of follicular cells, and oncocytic changes of follicular cells (Hürthle or Askanazy cells) [3,4,5]. Clinically, H/LT may be characterized by a diffuse and non-tender goiter, hypothyroidism, and the presence of thyroglobulin and peroxidase antibodies detected in serum [5].…”

Surgical Indications for Goiter with Background Hashimoto’s Thyroiditis: Institutional Experience

“…Only 32% of patients were positive for HT on FNAC, and all of those were diffuse goiters. FNAC was not used as inclusion criterion in the study, as the diagnostic sensitivity in HT varies from 78% to 98.7% [16,17]. One or more thyroid nodules measuring ≥3 cm was our definition for a large thyroid nodule and was an indication for surgery even in the absence of pressure symptoms.…”