Chandanwale Shirish S, Gore Charusheela R, Bamanikar Sunita A, Gupta Nidhi, Gupta Kanika
Address: Department of Pathology, Padm. Dr. D. Y. Patil Medical College, Pimpri, Pune, Maharashtra, India.
Cytojournal. 2014 Apr 29;11:9. doi: 10.4103/1742-6413.131741. eCollection 2014.
Hashimoto's thyroiditis (HT) is an autoimmune disease and it is more prevalent in Asians. The incidence of HT seems to be increasing in the recent times. It is one of the most common cause of hypothyroidism. The purpose of this study is to review the cytomorphologic spectrum of HT and correlate it with clinical findings including thyroid function and antibody profile.
We retrospectively analyzed the fine-needle aspiration (FNA) features of 52 HT patients. Based on cytomorphologic features patients were categorized into three groups. Clinical findings including thyroid function and thyroid peroxidase (TPO) antibody profile were correlated with cytomorphologic features in all three groups.
Majority of the patients were females and in 2(nd), 3(rd) and 4(th) decades. Diffuse goiter and thyroid hypofunction were the common findings. Significant number of patients had thyroid hyperfunction. Increased lymphocytes on the background and lymphocytic infiltration of thyroid follicular cell clusters in cytology smears were diagnostic of HT. The 32 patients showed elevated titers of TPO antibodies. In the early stages and mild form of the disease, results of thyroid function and anti TPO antibodies are quite variable.
HT is a disease of young and middle age and mostly occur in females. Clinical findings alone may not be adequate for definitive diagnosis. FNA is the gold standard for diagnosis. In the presence of abundant colloid, follicular hyperplasia or co-existing neoplasm, careful interpretation of cytology smears should be done. Aspiration from more than one site minimizes the diagnostic pitfalls.
桥本甲状腺炎（HT）是一种自身免疫性疾病，在亚洲人中更为普遍。近年来，HT的发病率似乎在上升。它是甲状腺功能减退最常见的原因之一。本研究的目的是回顾HT的细胞形态学谱，并将其与包括甲状腺功能和抗体谱在内的临床发现相关联。
我们回顾性分析了52例HT患者的细针穿刺（FNA）特征。根据细胞形态学特征，将患者分为三组。在所有三组中，将包括甲状腺功能和甲状腺过氧化物酶（TPO）抗体谱在内的临床发现与细胞形态学特征相关联。
大多数患者为女性，年龄在20、30和40岁。弥漫性甲状腺肿和甲状腺功能减退是常见表现。相当数量的患者有甲状腺功能亢进。细胞学涂片背景中淋巴细胞增多以及甲状腺滤泡细胞簇的淋巴细胞浸润可诊断为HT。32例患者TPO抗体滴度升高。在疾病的早期和轻度形式中，甲状腺功能和抗TPO抗体的结果变化很大。
HT是一种中青年疾病，主要发生在女性。仅靠临床发现可能不足以做出明确诊断。FNA是诊断的金标准。在存在大量胶质、滤泡增生或并存肿瘤的情况下，应仔细解读细胞学涂片。从多个部位穿刺可最大限度地减少诊断陷阱。
