Cytomorphological variations in Hashimoto’s thyroiditis: A study of 164 cases

• Author Details:   
• Arunima Mallick ^*
• Sateesh Chavan S
• Sunita S Vernekar

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Background: Hashimoto’s thyroiditis is the second most common cause of hypothyroidism following goiter and FNAC has been found to be one of the essential procedures done to diagnose it. Our aim is to analyse the cytomorphological diversity of this disease along with the biochemical profile correlation and also to identify the salient features in this disease which are indicative of malignancy.

Materials and Methods: 164 FNAC smears cytologically diagnosed as Hashimoto’s thyroiditis (both air dried and alcohol fixed) were analysed to identify the cytomorphological features and correlated with biochemical values. Features indicative of malignancy have also been observed. Results have been formulated in suitable tables and charts.

Results: Majority of the cases were females between 31-40 years of age presenting predominantly with diffuse neck swelling and hypothyroidism. Predominant cytological features identified were lymphoid aggregates, Hurthle cells and anisocytosis. Also 48 cases have shown cytological features indicative of malignancy which includes nuclear grooving, intracytoplasmic lumina, transgressing blood vessels and pseudoinclusions. Most of the cases showed GRADE 2 thyroiditis with predominance of hypothyroidism as per the cytological grading laid down by Bhatia et al.

Conclusion: Hence we can say that Hashimoto’s thyroiditis is a disease which affects middle aged women predominantly presenting with hypothyroidism. FNAC plays an important role in diagnosing it even in limited settings. It becomes very important to diagnosing the varied cytological features, to indicate whether it has tendency to turn malignant, so that suitable mode of management can be putforth thereby preventing unnecessary surgeries.

Keywords: Hypothyroidism, Malignancy, Hurthle cells, Cytomorphological, Hashimoto’s thyroiditis.