Correlation of Biochemical Parameters with Cytomorphological grading in Hashimoto’s Thyroiditis
Keywords:
FNAC, Hashimoto’s thyroiditis, autoimmune disorder, cytomorphology
Abstract
Background: Hashimoto’s thyroiditis (HT) is one of the most common cause of hypothyroidism in iodine sufficient areas. Diagnosis of HT is based on clinical, cytomorphological and biochemical parameters. Fine Needle Aspiration Cytology (FNAC) of thyroid provides a safe and accurate method for diagnosis of HT. Cytological grading of HT helps in assessing the severity of the disease and can predict the thyroid functional status. Methods: Retrospectively, 50 diagnosed cases of HT on FNAC were studied over a period of 6 months in a tertiary care hospital. Clinical, biochemical parameters such as T3, T4 and TSH values were collected. Cytological grading of FNAC smears was done based on Bhatia et al cytological grading system into three grades. These grades were compared with the clinical and biochemical parameters of HT. Result: Of 50 patients, 47 were females. Maximum number of cases were seen between 36 -45 years. Most of the patients presented with goiter. 31 out of 50 (62%) cases were grade II thyroiditis, of them most cases were hypothyroid. 17 out of 50 cases (34%) were grade I thyroiditis, of which most cases were euthyroid biochemically. Conclusion: Higher the grades of HT in cytology the more abnormal are the biochemical parameters. A combined approach of cytological grading along with clinical and biochemical parameters can detect subclinical hypothyroid state which provides a guide to therapy.References
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2. Gayathri BN, Kalyani R, Harendra KM, Krishna PK. Fine needle aspiration cytology of Hashimoto's thyroiditis–A diagnostic pitfall with review of literature. Journal of Cytology/Indian Academy of Cytologists. 2011 Oct;28(4):210.
3.The Endocrine System, Robbins and Cotran Pathologic Basis of Diseases, South-East Asia Edition V.Kumar, A.K Abbas pp1073-1139, Elsevier, New Delhi, India ,9th Edition, 2014.
4. Prasannan M, Kumar SA. International Journal of Sciences & Applied Research.
5. Rathi M, Ahmad F, Budania SK, Awasthi S, Kumar A, Dutta S. Cytomorphological aspects of Hashimoto's thyroiditis: Our experience at a tertiary center. Clinical Medicine Insights: Pathology. 2014 Jan;7:CPath-S13580.
6. Bhatia A, Rajwanshi A, Dash RJ, Mittal BR. Lymphocytic Thyroiditis–is cytological grading significant? A correlation of grades with clinical, biochemical, ltrasonographic and radionuclide parameters. Cytojournal. 2007;4:10.
7. Hamburger JI, Husain MU, Nishiyama R, Nunez C, Solomon D. Increasing the accuracy of fine-needle biopsy for thyroid nodules. Archives of pathology & laboratory medicine. 1989 Sep;113(9):1035-41.
8. Sood N, Nigam JS. Correlation of fine needle aspiration cytology findings with thyroid function test in cases of lymphocytic thyroiditis. Journal of thyroid Research. 2014;2014.
9. Chandanwale SS, Nair R, Gambhir A, Kaur S, Pandey A, Shetty A, Naragude P. Cytomorphological Spectrum of Thyroiditis: A Review of 110 Cases. Journal of thyroid
10.Singh N, Kumar S, Negi VS, Siddaraju N. Cytomorphologic Study of Hashimoto’s Thyroiditis and Its Serologic Correlation. Acta cytologica. 2009;53(5):507-16.
11. Friedman M, Shimaoka K, Rao U, Tsukada K, Gavigan M, Tamura K:Diagnosis of lymphocytic thyroiditis(nodular presentation) by needle aspiration. Acta Cytolo1981,25:513-22.
12. Ekambaram M, Kumar B, Chowdhary N, Siddaraju N, Kumar S. Significance of eosinophils in diagnosing Hashimoto's thyroiditis on fine-needle aspiration cytology. Indian Journal of Pathology and Microbiology. 2010 Jul 1;53(3):476.
13. Khageshan A.P, Muzaffer Z. Cytomorphological, Biochemical and Raiological Correlation in Hashimoto’s Thyroiditis. Indian Journal of Pathology and Oncology.2016Jan;3(1):73-6.
Published
2019-09-08
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