Fine needle aspiration biopsy cytology in thyroiditis - With mention on FNA in different setting

Abstract

The cytopathologic characteristics as seen in fine needle aspirate smears of 50 thyroiditis patients were reviewed, with emphasis on pitfalls. Fortyeight patients were female and only 2 patients were males. Of these, 46% were in 4th decade of life. Fifty two percent came within a period of 6 months of illness of which 46.15% were hypothyroid at presentation. The cytologic diagnoses were as follows : Hashimotos thyroiditis (H.T.) 13; lymphocytic thyroiditis (L.T.) 11; subacute thyroiditis 2; acute thyroiditis 1; and suspicious benign lesions 23. Thirty patients were operated. Twenty three erroneous diagnoses were uncovered by (i) repeat FNA in 3 cases (ii) smear examination by single senior cytopathologist in 8 cases and (iii) histopathological examination of operated thyroid specimen in 12 cases. Prerequisites for accurate cytological diagnosis is adequate and representative sample. Cytodiagnostic pitfalls occured mainly in cases of H.T. Examination of FNA slides of suspicious thyroiditis cases by single senior cytopathologist was the key factor in achieving diagnostic accuracy. The ease of doing FNA and its diagnostic accuracy mandate continued use of FNA in the diagnostic management of patients with thyroidits.