Autoimmune thyroiditis – Correlation of clinico-radiological presentation, thyroid profile and cytomorphological spectrum
Journal Title: International Archives of Integrated Medicine - Year 2018, Vol 5, Issue 1
Abstract
Background: Thyroiditis is the second most common thyroid lesion next to endemic goitre diagnosed on FNA in iodine (I2) deficient areas. Although FNAC is the gold standard for diagnosis of thyroiditis, accurate diagnosis of a thyroid lesion at FNAC requires not just an in depth study of the cytomorphology but also a thorough clinico- radiological and serologic correlation. Aim: To study and correlate the clinical, radiologic, serologic and cytomorphological spectrum of autoimmune thyroiditis. Materials and methods: Retrospective study involving 150 cases was conducted. Clinical history (age, sex, symptoms with their duration and other signs, other significant medical/surgical history), TFT, were noted from the medical record available with the patient and also from Endocrinology department records. Results: Incidence of autoimmune thyroiditis was found to be 13.4%. Majority of the patients were females (96.7%), 53.3% of cases were seen in the age group of 21-40 years. 80.6% patients had a diffusely enlarged thyroid gland clinically. 92.7% patients showed grade I/II goitre. USG also showed a diffuse enlargement in 85.3% cases. Of the 150 patients with autoimmune thyroiditis, 110(73.3%) patients were euthyroid while 32 (21.3%) patients were hypothyroid at the time of FNAC. Only 8(5.3%) patients showed evidence of hyperthyroidism. 8% patients showed subclinical hypothyroidism. Prevalence of euthyroid autoimmune thyroiditis appeared high in our study. Among the cytomorphological features, presence of lymphocytes was consistently seen in all cases of chronic lymphocytic thyroiditis /mixed thyroiditis. Hurthle cells were seen in 68.6%, eosinophils were seen in 16.6%, giant cells and granulomas were noted in 29.3% and 8.6% cases respectively. L:E ratio was high in 101 (67.3%) cases ranging from 2:1 to 10. TFC destruction and grade III thyroiditis showed a significant association. Conclusion: Autoimmune thyroiditis was seen more commonly in females. Majority cases were seen in age group of 21-40 years of age. Lymphocytes, germinal centre cells, thyroid follicular destruction and Hurthle cells form important cytological features, while giant cells, eosinophils, granulomas were other cytomorphologic features in the diagnosis of autoimmune thyroiditis. Clinically and radiologically most of patients showed diffuse enlargement of thyroid gland. Majority of patients in our study were euthyroid at time of presentation. Prevalence of euthyroid autoimmune thyroiditis appeared high in our study. TFC destruction and grade III thyroiditis showed a significant association.
Authors and Affiliations
Shweta P. Bijwe, Arunkumar D. Chopwad
Keywords
Related Articles
- EP ID EP413505
- DOI -
- Views 106
- Downloads 0
A rare case of agenesis of dorsal pancreas
Dorsal pancreatic agenesis is an extremely rare congenital entity. Very few cases have been published in the literature about this congenital anomaly. Agenesis of the dorsal pancreas is associated with various anomalies,...
Role of Magnetic Resonance Imaging in Evaluation of Epilepsy
Introduction: Seizures have been classified in several ways, according to their etiology, i.e., idiopathic (primary) or symptomatic (secondary); their site of origin; their clinical form (general...
Age wise prevalence of developmental coordination disorder in school going children in west India
Background: Children with movement skill difficulties that have not been diagnosed with a general medical condition. This difficulty in motor skill competence, observed in children who are developing well intellectually,...
Compliance and tolerability evaluation of diacerein versus s-adenosyl methionine in osteoarthritis patients
Background: Diacerein and S-adenosyl methionine (SAMe) are symptomatic slow-acting drugs in osteoarthritis (SYSADOA). Diacerein is a semisynthetic, anthraquinone derivative, an interleukin 1beta inhibitor with anti-infla...
Evaluation of role of topical 0.2% Glyceryl trinitrate ointment and topical 2% Diltiazem ointment in healing of anal fissure
Backround: The patho-physiology of anal fissure is thought to be related to trauma to the anoderm from any cause. A tear in the anoderm causes acute pain, which results in spasm of the internal anal sphincter and decreas...