Sood Neelam, Nigam Jitendra Singh
Department of Pathology, D.D.U. Hospital, Harinagar, New Delhi, India.
Department of Pathology, Saraswathi Institute of Medical Sciences, Anwarpur, Pilkhuwa, Hapur, Uttar Pradesh 245304, India.
J Thyroid Res. 2014;2014:430510. doi: 10.1155/2014/430510. Epub 2014 Apr 6.
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.
背景。慢性淋巴细胞性甲状腺炎是细针穿刺抽吸活检（FNAC）诊断出的仅次于甲状腺肿的第二常见甲状腺病变。FNAC是诊断甲状腺病变的可靠工具。目的。将淋巴细胞性甲状腺炎的FNAC细胞学检查结果与甲状腺功能检测（TFT）结果进行关联。方法。2011年至2013年期间，175例甲状腺肿大患者接受了FNAC及TFT检查。采用非抽吸或抽吸技术进行细针穿刺抽吸细胞学检查，并在贝克曼库尔特Access 2仪器上进行TFT检查。结果。55例可见淋巴细胞浸润。淋巴细胞性甲状腺炎最常见的年龄组为21至30岁，男女比例为1∶10。在3级淋巴细胞浸润的病例中，96.16%（25/26）的抗甲状腺过氧化物酶抗体（Anti-TPO）和促甲状腺激素（TSH）升高；2级病例中，94.12%（16/17）升高；1级病例中，91.67%（11/12）升高。5例Anti-TPO升高且TSH升高但无淋巴细胞浸润，5例仅TSH升高，Anti-TPO未升高且无淋巴细胞浸润。我们观察到3级淋巴细胞浸润与Anti-TPO和TSH共同升高或仅TSH升高相关，但与单独的Anti-TPO无关。我们还观察到，即使没有淋巴细胞浸润，Anti-TPO和TSH共同升高也具有显著意义。结论。3级淋巴细胞浸润与Anti-TPO和TSH共同升高或仅TSH升高具有统计学相关性，但与单独的Anti-TPO无关。在3级中，Anti-TPO是TSH的辅助指标。许特尔细胞改变、巨细胞和肉芽肿的存在与淋巴细胞性甲状腺炎无统计学相关性。
