Diagnostic role of fine needle aspiration cytology in thyroiditis along with Thyroid hormone assay.
Keywords:
Thyroiditis, Hashimotos, Hypothyroidism, FNAC, Cytomorphology
Abstract
Background - Thyroiditis is the inflammation of the thyroid gland. Hashimoto’s thyroiditis (HT) is the most common cause of hypothyroidism in those areas of the world where iodine levels are sufficient. Hashimoto’s thyroiditis, a synonym of chronic lymphocytic thyroiditis or autoimmune thyroiditis, is the second most common thyroid lesion diagnosed on FNAC after goiter. FNAC plays a significant role in the diagnosis of thyroid lesions due to its simplicity and low cost. Fine needle aspiration cytology (FNAC) is highly sensitive in diagnosing HT, with a diagnostic accuracy rate of 92%.AIMS AND OBJECTIVE- To correlate FNAC cytologic findings with TFT in different types of thyroiditis.Method - All the patients with thyroid swellings were referred to department of pathology for FNAC as well as thyroid hormone assay. FNAC was performed using nonaspiration or aspiration techniques by 23 G needle with 10 mL syringe. Air-dried smears were stained with Giemsa stain and wet ethanol fixed smears were stained with, PAP hematoxylin and eosin. Cytomorphologic features were reviewed and graded. The level of T4,T3 & T.S.H. is correlated with cytomorphological findings of different types & grades of thyroiditis in our study.Conclusion Fine needle aspiration cytology (FNAC) is highly sensitive & specific technique in diagnosing HT and other types of thyroiditis. A correct cytological diagnosis was achieved in the majority of cases in this study, thus obviating the need for a surgical intervention & provided life long hormonal therapy in justified cases.References
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2) A. Bhatia, A. Rajwanshi, R. J. Dash, B. R. Mittal, and A. K. Saxena, “Lymphocytic Thyroiditis—is cytological grading significant? A correlation of grades with clinical, biochemical, ultrasonographic and radionuclide parameters,” CytoJournal, vol. 4, article 10, 2007.
3) B. N. Gayathri, R. Kalyani, M. L. Harendra Kumar, and K. Krishna Prasad, “Fine needle aspiration cytology of Hashimoto's thyroiditis—a diagnostic pitfall with review of literature,” Journal of Cytology, vol. 28, no. 4, pp. 210–213, 2011.
4) Kumarasinghe MP, De Silva S. Pitfalls in the cytological diagnosis of autoimmune thyroiditis. Pathology.1999;31:1–7.
5) R. O. K. Schade, S. G. Owen, G. A. Smart, and R. Hall, “The relation of thyroid auto-immunity to round-celled infiltration of the thyroid gland,” Journal of Clinical Pathology, vol. 13, pp. 499–501, 1960. View at Google Scholar • View at Scopus
6) Kocjan G. Lymphoid Infiltrate. In: Schroder G, editor. Fine needle aspiration cytology: diagnostic principles and dilemmas. 1st ed. Germany: Springer; 2006. pp. 99–101.
7) Neelam Sood and Jitendra Singh Nigam, “Correlation of Fine Needle Aspiration Cytology Findings with Thyroid Function Test in Cases of Lymphocytic Thyroiditis,” Journal of Thyroid Research; 2014, p. 5.
8) Ekambaram M, Kumar B, Chowdhary N, Siddaraju N, Kumar S. Significance of eosinophils in diagnosing Hashimoto's thyroiditis on fine needle aspiration cytology. Indian J Pathol Microbiol.2010;53:476–9.
9) Marwaha RK, Tandon N, Karak AK, Gupta N, Verma K, Kochupillai N. Hashimoto's thyroiditis: countrywide screening of goitrous healthy young girls in postiodization phase of India. J Clin Endocrinol Metab. 2000;85:3798–802.
10) Benvenga S, Trimarchi F. Changed presentation of Hashimoto's thyroiditis in North-Eastern Sicily and Calabria (Southern Italy) based on a 31-year experience. Thyroid. 2008;18:429–41.
11) Orell SR, Sterrett GF, Darell W. Thyroid. In: Orell SR, Sterrett GF, Darell W, editors. Fine needle aspiration cytology. 4th ed. India: Elsevier Science Ltd; 2005. p. 136–8.
Published
2016-03-10
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