Gutekunst R, Hafermann W, Mansky T, Scriba P C
Department of Internal Medicine, Medical University of Lübeck, FRG.
Acta Endocrinol (Copenh). 1989 Jul;121(1):129-35. doi: 10.1530/acta.0.1210129.
The value of ultrasonography compared with established diagnostic procedures was investigated by reviewing medical records of 92 patients (88 women and 4 men, age 11-81 years, mean age 47) with lymphocytic thyroiditis. Clinical manifestations of the disease and serum antimicrosomal antibodies and TSH were determined in all patients. The thyroid was examined by ultrasound. Both lobes were aspirated by a fine needle under sonographic control and smears examined cytologically. A total of 27 (29.3%) patients had no clinical symptoms. Antimicrosomal antibodies were undetable in 12 (13%) patients, 16 (17.4%) had low titres 1:32-) 1:100, and 64 (69.6%) greater than or equal to 1:320. TSH (reference values 0.3-3.9 mU/1) was les than 0.3 in 4 (4.3%) 0.3-3.9 in 4) (44.6%) , 4-20 in 26 (28.3%), and greater than 20 in 21 (22.8%) patients. Ultrasound revealed a scattered sonolucent echo in 87 (94.6%) patients, and in 45 (48.9%) a normal thyroid volume (women less than 18, men less than 25 ml). Cytology alone was diagnostic in 84 (91.3%) patients, In conclusion, ultrasound can suggest lymphocytic thyroiditis. If antimicrosomal antibodies are undetectable or titres are not significant and/or clinical symptoms are uncertain, fine-needle aspiration can confirm the sonographic finding. Epidemiological studies including ultrasonography are necessary to obtain reliable data on the prevalence of lymphocytic thyroiditis.