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Cytological Grading of Lymphocytic Thyroiditis and Its Correlation With Biochemical Parameters: An Experience From a
Danish Ashraf1, Poonam Sharma2, Rajat Gupta3
1Pathology, Sher-e-Kashmir Institute of Medical Sciences, Srinagar, IND.
Insights
Cytological grading confirms lymphocytic thyroiditis but doesn't correlate with thyroid hormone levels. A multidisciplinary approach is essential for accurate diagnosis of this common cause of hypothyroidism.
Area of Science:
- Endocrinology
- Cytopathology
- Thyroidology
Background:
- Chronic lymphocytic thyroiditis is the most frequent cause of acquired hypothyroidism.
- Fine-needle aspiration cytology (FNAC) is the gold standard for pre-surgical diagnosis of thyroid nodules.
- Thyroid hormone profiles can correlate with the cytological diagnosis of chronic lymphocytic thyroiditis.
Purpose of the Study:
- To investigate the cytomorphology of different grades of chronic lymphocytic thyroiditis.
- To correlate the cytological grades with the hormonal profile of patients.
Main Methods:
- Included 44 patients diagnosed with lymphocytic thyroiditis via FNAC.
- Graded lymphocytic thyroiditis cases based on cytomorphology.
- Correlated cytological grades with thyroid hormone profiles.
Main Results:
- The majority of patients were young adults (16-30 years) with a female predominance.
- Grade II cytological category was most common (70.46%).
- A hypothyroid profile was observed in 63% of patients, with a trend towards hypothyroidism in Grade II cases, though no statistically significant association was found between cytological grade and hormonal status.
Conclusions:
- Cytological grading is a reliable tool for confirming lymphocytic thyroiditis.
- No statistically significant correlation exists between cytological grades and thyroid hormonal status.
- A multidisciplinary approach, integrating clinical, cytological, and hormonal data, is crucial to avoid missed diagnoses of lymphocytic thyroiditis.
Background:
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.
Aim:
This study aims to study the cytomorphology of various grades of chronic lymphocytic thyroiditis and its correlation with the hormonal profile.
Methods:
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.
Results:
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.
Conclusions:
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.
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