Inada M, Nishikawa M, Naito K, Ishii H, Tanaka K, Imura H
J Clin Endocrinol Metab. 1981 Mar;52(3):431-5. doi: 10.1210/jcem-52-3-431.
The histological abnormalities on percutaneous needle biopsy of the thyroid were investigated in two patients (cases 1 and 2) with transient thyrotoxicosis and low radioactive iodine uptake by the thyroid and in a patient (case 3) with transient hypothyroidism which might be the consequence of transient thyrotoxicosis. The most characteristic findings of lymphocytic thyroiditis, such as extensive lymphocyte infiltration with collapsed follicles and degeneration of follicular cells of the thyroid, were found in case 1, in whom the thyroid biopsy was performed in the thyrotoxic phase. Ashkanazy cells were not present and fibrosis was not observed in this specimen. Histological examination of the thyroid biopsy specimen, which was obtained in the recovery phase in case 1, revealed well preserved thyroid follicles and slight lymphocytic infiltration. In addition, papillary infoldings of cuboidal epithelium were found in cases 2 and 3, in whom the thyroid biopsy was done in the hypothyroid phase. The follow-up biopsy of the thyroid was performed in the recovery phase in case 3. The biopsy specimen showed focal lymphocytic infiltration and the follicles lined by low cuboidal cells without papillary infoldings. In all biopsy specimens, there was no evidence of subacute thyroiditis, as characterized by granulomatous changes and breakdown of colloid follicles with foreign body giant cell reaction. The present findings revealed that the histological abnormalities, such as lymphocytic infiltration and follicular epithelial changes of the thyroid, observed in the patients with painless thyroiditis, can improve spontaneously during the course of several months.
对两名患有短暂性甲状腺毒症且甲状腺放射性碘摄取低的患者（病例1和病例2）以及一名可能是短暂性甲状腺毒症后果的短暂性甲状腺功能减退患者（病例3）进行了甲状腺经皮针吸活检的组织学异常研究。在病例1中发现了淋巴细胞性甲状腺炎的最典型表现，如广泛的淋巴细胞浸润伴滤泡塌陷和甲状腺滤泡细胞变性，该病例在甲状腺毒症期进行了甲状腺活检。此标本中未发现Askanazy细胞，也未观察到纤维化。对病例1恢复期获取的甲状腺活检标本进行组织学检查，发现甲状腺滤泡保存良好，淋巴细胞浸润轻微。此外，在病例2和病例3中发现了立方上皮的乳头样折叠，这两名患者在甲状腺功能减退期进行了甲状腺活检。病例3在恢复期进行了甲状腺随访活检。活检标本显示局灶性淋巴细胞浸润，滤泡由低立方细胞衬里，无乳头样折叠。在所有活检标本中，均无亚急性甲状腺炎的证据，亚急性甲状腺炎的特征为肉芽肿性改变、胶体滤泡破裂伴异物巨细胞反应。目前的研究结果表明，无痛性甲状腺炎患者中观察到的甲状腺组织学异常，如淋巴细胞浸润和滤泡上皮改变，可在数月内自发改善。
