Cytomorphological Spectrum of Thyroiditis: A Review of 110 Cases

Abstract

Introduction Different types of thyroiditis may share some parallel clinical and biochemical features. Timely intervention can significantly reduce morbidity and mortality. Aim Aim of this study is to find the frequency of various thyroiditis, study the cytomorphological features and correlate with clinical findings including radiological findings, thyroid function test, and anti-thyroid peroxidase antibodies (Anti-TPO antibodies). Materials and Methods The study included consecutive 110 cases of thyroiditis. Detailed cytomorphological features were studied and correlated with ultrasonography findings, thyroid function test, anti-thyroid peroxidase antibodies (anti-TPO) and histopathological features where thyroidectomy specimens were received for histopathological examination. Results The majority were Hashimoto's thyroiditis (n = 100) and females (n = 103). Other forms of thyroiditis were Hashimoto's thyroiditis with colloid goiter (n = 5), De Quervain's thyroiditis (n = 3), and one case each of postpartum thyroiditis and Hashimoto's thyroiditis with associated malignancy. The majority of patients were in the age group of 21–40 (n = 70) and the majority (n = 73) had diffuse enlargement of thyroid. The majority of patients were hypothyroid (n = 52). The serum anti-TPO antibodies were elevated in 47 patients out of 71 patients. In the 48 patients who underwent ultrasonography, 38 were diagnosed as having thyroiditis. The most consistent cytomorphological features seen in fine-needle aspiration smears of Hashimoto's thyroiditis were increased background lymphocytes, lymphocytic infiltration of thyroid follicular cell clusters, and Hurthle cells. Conclusion The diagnostic cytological features in Hashimoto's thyroiditis are increased background lymphocytes, lymphocytic infiltration of thyroid follicular cell clusters, and Hurthle cells. FNAC remains the “Gold Standard” for diagnosing Hashimoto's thyroiditis. Clinical history, thyroid function, and biochemical parameters are the key for diagnosis of other forms of thyroiditis.

Cytomorphological spectrum of Hashimoto's thyroiditis and its correlation with hormonal profile and hematological parameters

“…The peak age incidence of HT in our study was the third to fourth decade of life, which is in accordance with other Indian studies unlike the Western literature (fifth decade of life). [2910] Female predominance was seen in our study with a female: male ratio of 14.7:1, similar to other studies. Diffusely enlarged thyroid is the most common presentation of this form of thyroiditis.…”

“…Hormonal assays done in our study showed a majority (74%) of the patients to be hypothyroid in agreement with previous studies. [21011] The state where T3 and T4 are normal with TSH being above the defined upper limit of the reference range is called subclinical hypothyroidism, representing an early phase of hormonal imbalance. In this study, 39.6% of the cases presented with SCH, similar to a study of Bhatia et al [2].…”

Cytological grading of lymphocytic thyroiditis and its correlation with thyroid hormonal status

“…On assessing thyroid hormonal status, majority of the patients were hypothyroid similar to many other studies. 8,12,14 Patients with subclinical hypothyroidism in our study were 11 (14.10%). In a study by Shetty et al, 12 39.6% of the cases presented with subclinical hypothyroidism which is higher than our study.…”

Pembrolizumab-Induced Thyroiditis Shows PD-L1Expressing Histiocytes and Infiltrating T Cells in Thyroid Tissue - A Case Report

“…In thyroiditis de Quervain, histiocytes, plasma cells and T lymphocytes dominate the active phase (13). Cytomorphical features of fine needle aspiration include many giant cells, which are considered histiocytes (14). Immune cells in the specimen of our patient consisted mostly of CD3+ T lymphocytes (predominantly CD4+ helper T-cells, about 10% CD8+ suppressor T-cells), while plasma T cells were only sparsely observed.…”