[Pitfalls in cytologic diagnosis of thyroid disease associated with pregnancy]

The activation of the hypothalamo-pituitary thyroidal axis during pregnancy and puerperal period may provoke an unusual morphological response that is hard to distinguish from malignancy. Moreover, autoimmune thyroiditis (postpartum thyroiditis--PPT) becomes manifest or aggravated in some predisposed women prone to contract thyroiditis with the termination of the physiological gestation immunosuppression. In five cytologically investigated women (some of whom were examined repeatedly) during the postpartum period less typical goitre and lymphoplasmacytic thyroiditis were observed. In two of them, a tumour was diagnosed (borderline oncocytic lesion and medullary carcinoma). Evaluating the dynamics of the process in the patients investigated repeatedly and the histological findings in others we conclude: 1) given thorough clinical observation and favorable development of the cytology picture the less typical lesions may be treated conservatively. 2) The diagnostic features of malignancy are maintained in the puerperal period. Taking into account the age distribution of thyroid malignancies this risk should be taken into account in the puerperal period too.