Ashraf Danish, Sharma Poonam, Gupta Rajat, Bhardwaj Subhash
Pathology, Sher-e-Kashmir Institute of Medical Sciences, Srinagar, IND.
Pathology, All India Institute of Medical Sciences, Vijaypur, Jammu, IND.
Cureus. 2024 Apr 21;16(4):e58669. doi: 10.7759/cureus.58669. eCollection 2024 Apr.
Chronic lymphocytic thyroiditis is the most common cause of acquired hypothyroidism. The clinical management of thyroid nodules, with or without chronic lymphocytic thyroiditis, mainly depends on clinical data, ultrasonography, and fine-needle aspiration cytology (FNAC), the latter being the gold standard for the pre-surgical diagnosis of thyroidal nodules. The grading of chronic lymphocytic thyroiditis can be divided into three categories. The spectrum of the thyroid profile can be correlated to the cytological diagnosis of chronic lymphocytic thyroiditis.
This study aims to study the cytomorphology of various grades of chronic lymphocytic thyroiditis and its correlation with the hormonal profile.
In this study, 44 patients with a diagnosis of lymphocytic thyroiditis on FNAC were included. The cases of lymphocytic thyroiditis were graded cytomorphologically, and correlation with the thyroid hormone profile was done.
The majority of the patients were between 16 and 30 years age group, with a female predominance. The majority of the patients presented with diffuse enlargement of the thyroid gland. The maximum number of cases was graded in the grade II cytological category (70.46%). A hypothyroid profile was present in 63% of patients, followed by an euthyroid profile. The majority of patients with grade II thyroiditis also had a hypothyroid profile. However, no significant association was found between cytological grading and hormonal status.
Cytological grading is a clear, easy-to-use diagnostic tool for confirmation of lymphocytic thyroiditis. However, the cytological grades show no statistically significant correlation with thyroid hormonal status. Lymphocytic thyroiditis should be diagnosed with a multidisciplinary approach, as clinical features and hormonal profile when used alone may result in a missed diagnosis.
慢性淋巴细胞性甲状腺炎是后天性甲状腺功能减退最常见的病因。甲状腺结节的临床处理，无论有无慢性淋巴细胞性甲状腺炎，主要取决于临床资料、超声检查以及细针穿刺抽吸细胞学检查（FNAC），后者是甲状腺结节术前诊断的金标准。慢性淋巴细胞性甲状腺炎的分级可分为三类。甲状腺检查结果的范围可与慢性淋巴细胞性甲状腺炎的细胞学诊断相关联。
本研究旨在探讨不同分级的慢性淋巴细胞性甲状腺炎的细胞形态学及其与激素水平的相关性。
本研究纳入44例经FNAC诊断为淋巴细胞性甲状腺炎的患者。对淋巴细胞性甲状腺炎病例进行细胞形态学分级，并与甲状腺激素水平进行相关性分析。
大多数患者年龄在16至30岁之间，以女性为主。大多数患者表现为甲状腺弥漫性肿大。细胞学分类中II级的病例数最多（70.46%）。63%的患者甲状腺功能减退，其次是甲状腺功能正常。大多数II级甲状腺炎患者也有甲状腺功能减退。然而，细胞学分级与激素状态之间未发现显著关联。
细胞学分级是确诊淋巴细胞性甲状腺炎的一种清晰、易用的诊断工具。然而，细胞学分级与甲状腺激素状态无统计学显著相关性。淋巴细胞性甲状腺炎应采用多学科方法进行诊断，因为单独使用临床特征和激素水平可能导致漏诊。
