Gupta Anshu, Singhal Manish, Kalhan Shivani, Gupta Atul, Singhal Onis, Kaur Viplesh
Department of Pathology, Saraswathi Institute of Medical Sciences, Hapur, Ghaziabad, India.
J Cytol. 2013 Apr;30(2):125-9. doi: 10.4103/0970-9371.112657.
Fine needle aspiration cytology (FNAC) of the thyroid is an established first-line test for thyroid lesions. Marginal vacuoles (MVs) have been associated with hyperactivity of the thyroid, but some studies have pointed towards their nonspecific status.
To assess the presence of MVs in diffuse thyroid enlargements and evaluate the strength of correlation between MVs, levels of thyroid hormone and cytological diagnosis.
Ninety-seven cases of diffuse thyromegaly were studied. Cytomorphological features were examined with special attention to MVs. MVs were graded as scant, moderate and abundant. Hormonal status of the patients was recorded. The presence and grading of MVs was correlated with cytological diagnosis and hormonal status. The strength of association was studied by applying the Chi-square test and test of proportion; a P ≤ 0.05 was considered significant.
Abundant MVs were not associated with hypothyroidism in this study; 79% of these cases were hyperthyroid. The correlation between moderate/insignificant MVs and functional status of the thyroid gland was inconclusive. Further, abundant MVs in thyroid FNACs were seen in cases of primary hyperplasia and Hashimoto's thyroiditis. There was a significant correlation between the presence of abundant/moderate MVs and primary hyperplasia and their absence in colloid goiter (P = 0.01 and 0.004, respectively).
A significant association was found between abundant MVs and a hyperthyroid state. Moderate/absent MVs in diffuse goiters were not found to correlate with thyroid function. Thus, all diffuse goiters with prominent MVs require hormonal evaluation to rule out hyperfunction of the thyroid.
甲状腺细针穿刺细胞学检查（FNAC）是甲状腺病变既定的一线检查方法。边缘空泡（MVs）与甲状腺功能亢进有关，但一些研究指出其状态不具有特异性。
评估弥漫性甲状腺肿大中MVs的存在情况，并评估MVs、甲状腺激素水平与细胞学诊断之间的相关性强度。
研究了97例弥漫性甲状腺肿大病例。检查细胞形态学特征，特别关注MVs。MVs分为稀少、中等和丰富三个等级。记录患者的激素状态。MVs的存在和分级与细胞学诊断及激素状态相关。通过应用卡方检验和比例检验研究关联强度；P≤0.05被认为具有显著性。
在本研究中，丰富的MVs与甲状腺功能减退无关；这些病例中有79%为甲状腺功能亢进。中等程度/不显著的MVs与甲状腺功能状态之间的相关性尚无定论。此外，在原发性增生和桥本甲状腺炎病例的甲状腺FNAC中可见丰富的MVs。丰富/中等程度的MVs的存在与原发性增生之间存在显著相关性，而在胶样甲状腺肿中则不存在（分别为P = 0.01和0.004）。
发现丰富的MVs与甲状腺功能亢进状态之间存在显著关联。未发现弥漫性甲状腺肿中中等程度/不存在的MVs与甲状腺功能相关。因此，所有具有明显MVs的弥漫性甲状腺肿都需要进行激素评估以排除甲状腺功能亢进。
