Differential diagnosis of Hashimoto's thyroiditis: The importance of pathological anatomy

Hashimoto's thyroiditis (HT) represents a complex, multifactorial autoimmune disease characterized by a broad spectrum of clinical and imaging presentations. These manifestations tend to be clinically perplexing, necessitating additional tests. In cases where a malignancy is suspected or obstructive symptoms are present, surgical management may be required. Histopathologically, HT is hallmarked by significant lymphocytic infiltration of the thyroid gland, typically with prominent germinal centers, small lymphocytes, centrocytes, centroblasts, plasma cells, and occasionally immunoblasts. The degree of fibrosis varies, giving the gland a lobulated appearance and, in some cases, resulting in a fibrous variant, which, biochemically, is usually accompanied by hypothyroidism.

This review provided a diagnostic and differential approach to HT, highlighting the utility of histopathological examination.

Histopathological analysis helps broaden the diagnostic and therapeutic horizon in individuals with HT.