Correlation of fine needle aspiration cytology findings with thyroid function test in cases of lymphocytic thyroiditis.

Neelam Sood,Jitendra Singh Nigam

doi:10.1155/2014/430510

Abstract

Background. Chronic lymphocytic thyroiditis is the second most common thyroid lesion diagnosed on FNAC after goiter. FNAC is reliable tool in the diagnosis of thyroid lesion. Objective. To correlate FNAC cytologic findings with TFT in the lymphocytic thyroiditis. Methods. 175 patients with thyroid swellings were referred for FNAC as well as TFT during 2011–2013. Fine needle aspiration cytology was performed using non-aspiration or aspiration techniques and TFT performed on Beckman culter access 2. Results. Lymphoid infiltrate was seen in 55 cases. The commonest age group of lymphocytic thyroiditis was 21–30 years with male : female ratio being 1 : 10. Anti-TPO and TSH were elevated in 96.16% (25/26) of cases with grade 3 lymphoid infiltrate, 94.12% (16/17) of cases with grade 2, and 91.67% (11/12) of cases with 1 grade. Increased anti-TPO with raised TSH without any lymphoid infiltrate was seen in 5 cases and 5 cases showed only raised TSH without raised anti-TPO and without any lymphoid infiltrate. We observed that grade 3 lymphocytic infiltration has correlation with anti-TPO and TSH together or TSH alone but not with anti-TPO alone. We also observed that anti-TPO and TSH together are significant even if no lymphocytic infiltration is present. Conclusion. Grade 3 lymphocytic infiltration has statistical correlation with anti-TPO and TSH together or TSH alone but not with anti-TPO alone. Anti TPO was adjunct to TSH in grade 3. The presence of Hurthle cell change, giant cells, and granulomas has no statistical correlation with lymphocytic thyroiditis.

Highlights

Hashimoto’s thyroiditis, a synonym of chronic lymphocytic thyroiditis or autoimmune thyroiditis, is the second most common thyroid lesion diagnosed on FNAC after goiter [1, 2]
Grade II was observed in seventeen cases (30.91%) and characterized by moderate degree of lymphoid infiltrate with evidence of follicular destruction, Hurthle cell change, giant cells, and so forth
Grade III thyroiditis was noted in twentysix (47.27%) cases and characterized by dense lymphoid infiltrates with germinal centers and with few residual follicular cells, Hurthle cell change, giant cells, and granulomas

Summary

Introduction

Hashimoto’s thyroiditis, a synonym of chronic lymphocytic thyroiditis or autoimmune thyroiditis, is the second most common thyroid lesion diagnosed on FNAC after goiter [1, 2]. Cytomorphologic features of thyroid FNAC were graded according to lymphocyte infiltrate as per the criteria mentioned in Table 1 [2] and correlate with TFT. Chronic lymphocytic thyroiditis is the second most common thyroid lesion diagnosed on FNAC after goiter. To correlate FNAC cytologic findings with TFT in the lymphocytic thyroiditis. We observed that grade 3 lymphocytic infiltration has correlation with anti-TPO and TSH together or TSH alone but not with anti-TPO alone. Grade 3 lymphocytic infiltration has statistical correlation with anti-TPO and TSH together or TSH alone but not with anti-TPO alone. The presence of Hurthle cell change, giant cells, and granulomas has no statistical correlation with lymphocytic thyroiditis

Methods

Results

Discussion

Conclusion