Cytolomorphological, Biochemical & Radiological Correlation in Hashimoto's Thyroiditis

Abstract

Background: Hashimoto’s thyroiditis is synonymous with chronic lymphocytic thyroiditis and autoimmune thyroiditis. It is an autoimmune disease that affects women more frequently than men and is associated with hypothyroidism, euthyroidism or occasionally hyperthyroidism. The prevalence rate of Hashimoto’s thyroiditis is 1–4% with incidence of 30–60/100000 population per year. Hashimoto’s thyroiditis can be graded on cytomorphological features of FNAC. In this study an attempt has been made to correlate the grades of Hashimoto’s thyroiditis with biochemical and ultrasonography findings. Methods: A total of 80 patients diagnosed on FNAC as Hashimoto’s thyroiditis were included in the study. Quantitatively FNAC smears were evaluated and graded based on the criteria given by Bhatia et al. Thyroid function test (TFT) was used to determine the blood concentrations of thyroid hormones. USG of thyroid gland was performed by using high resolution ultrasound machine with 5 – 10 MHz Broad band linear transducer. Results: Females (95%) were affected more than males (5%). Maximum number of cases were seen between 2nd to 4th decade of life. 32.5% patients had grade I thyroiditis. 41.25% had grade II disease. Grade III thyroiditis was noted in 26.24% patients. 50% cases were biochemically hypothyroid, 42.64% cases were euthyroid and 7.35 % cases were hyperthyroid. Diffuse thyroiditis was observed in 50.81% cases, goitre was observed in 34.42% cases, thyroid nodules were observed in 8.19% cases and normal study was seen in 6.55% cases by ultrasonography. Conclusions: Higher grades of Hashimoto’s thyroiditis in FNAC are more associated with abnormal biochemical findings. Diffuse thyroiditis can occur in the early stage of the disease (grade I) even before overt thyroid failure and is the strong predictor of the autoimmune process even when the disorder has not been suspected clinically. A combined approach of cytological grading of Hashimoto’s thyroiditis along w