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- DOI 10.18231/j.ijpo.2025.033
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Cytomorphological variations in Hashimoto’s thyroiditis: A study of 164 cases
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.
References
- Asokan V, Rajendran K, Sudalaimuthu M. Unique Features of Hashimoto’s Thyroiditis in Coastal South India – a study from a tertiary care hospital. Trop J Path Micro. 2020;6(8):466–71.
- Rathi M, Ahmad F, Budania SK, Awasthi S, Kumar A, Dutta S. Cytomorphological aspects of hashimoto's thyroiditis: Our experience at a tertiary center. Clin Med Insights: Pathol. 2014;7:1–
- Patil P, Mallappa LB, Ahmed SM. Comparative study of cytomorphological grading of hashimoto’s thyroiditis with thyroid hormone levels. Int J Contemp Med Res.2021;8(1):A8–11.
- Almahari SA, Maki R, Al-Teraifi N, Alshaikh S, Chandran N, Taha H. Hashimoto thyroiditis beyond cytology: a correlation between cytological, hormonal, serological, and radiological findings. J Thyroid Res. 2023;2023(1):5707120.
- Zhu F, Shen YB, Li FQ, Fang Y, Hu L, Wu YJ. The effects of Hashimoto thyroiditis on lymph node metastases in unifocal and multifocal papillary thyroid carcinoma: a retrospective Chinese cohort study. Medicine. 2016;95(6):e2674.
- Sharma AD, Navya BN, Alva SR. Correlation of Biochemical Parameters with Cytomorphological grading in Hashimoto’s Thyroiditis. Ann Pathol Lab Med. 2019;6(8):A439–43.
- Kumar N, Ray C, Jain S. Aspiration cytology of Hashimoto's thyroiditis in an endemic area. Cytopathology. 2002;13(1):31–9.
- Staii A, Mirocha S, Todorova-Koteva K, Glinberg S, Jaume JC. Hashimoto thyroiditis is more frequent than expected when diagnosed by cytology which uncovers a pre-clinical state. Thyroid Res. 2010;3(1):11.
- Bhatia A, Rajwanshi A, Dash RJ, Mittal BR, Saxena AK. Lymphocytic thyroiditis–is cytological grading significant? A correlation of grades with clinical, biochemical, ultrasonographic and radionuclide parameters. Cytojournal. 2007;4:10.
- Khatri A, Kaushik A, Tyagi N, Deshwal A, Shah WA. Prevalence of subclinical and overt hypothyroidism in antenatal women: A study from tertiary care center in North India. Ann Woman Child Health. 2016;2(2):A11–4.
- Devendrappa P, Reddy HS. Cytomorphological diversity in Hashimoto’s Thyroiditis. Indian J Pathol Oncol. 2017;4(2):227–31.
- Orell SR, Sterrett GF, Whitaker D. Fine needle aspiration cytology. (No Title). 2005 Jul 8.
- Poropatich C, Marcus D, Oertel YC. Hashimoto's thyroiditis: fine‐ needle aspirations of 50 asymptomatic cases. Diagn Cytopathology. 1994;11(2):141–5.
- Khageshan AP, Muzaffer Z. Cytolomorphological, Biochemical & Radiological Correlation in Hashimoto’s Thyroiditis. Indian J Pathol Oncol. 2016;3(1):73–6.
- Siriweera EH, Ratnatunga NV. Profile of Hashimoto′ s Thyroiditis in Sri Lankans: Is There an Increased Risk of Ancillary Pathologies in Hashimoto′ s Thyroiditis?. J Thyroid Res. 2010;2010(1):124264.
- Singh N, Kumar S, Negi VS, Siddaraju N. Cytomorphologic study of Hashimoto’s thyroiditis and its serologic correlation. Acta Cytol. 2009;53(5):507–16.
- Pabithadevi BM, Shantaraman K. Hashimoto’s Thyroiditis–A predominantly Multinodular Thyroid Disorder in Coastal South India. Ann Pathol Lab Med. 2018;5(3):A204–8.
- Ranabhat SK, Rijal NR, Dubey M, Dubey AK, Dwivedi N, Mohan AK, et al. Morphological Study of Hashimoto Thyroiditis in Fine Needle Aspiration Cytology Specimens. Int J Gen Med. 2023;16:3127–37.
- Chandanwale SS, Nair R, Gambhir A, Kaur S, Pandey A, Shetty A, Naragude P. Cytomorphological spectrum of thyroiditis: a review of 110 cases. J Thyroid Res. 2018;2018(1):5246516.
- Jayaram G, Iyengar KR, Sthaneshwar P, Hayati JN. Hashimoto's thyroiditis-A Malaysian perspective. J Cytol. 2007;24(3):119–24.
- Kumar V, Abbas AK, Fausto N, Aster JC. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier Health Sciences; 2014.
- 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(3):476–9.
- Harikrishnan V, Sudha V, Alphonsa J, Srinivasan C. Hashimoto Thyroiditis-Diffuse Vs Nodular? A Case Study In A Rural Tertiary Care Hospital. Ann Pathol Lab Med. 2018;5(4):A312–5.
- Sahoo N, Naik S, Mohanty P, Sahoo PN, Das P. The cytomorphological spectrum of Hashimoto thyroiditis and its correlation with serological parameters: A study in the coastal region. J Dr. NTR Univ Health Sci. 2020;9(1):25–31.
- Caturegli P, De Remigis A, Chuang K, Dembele M, Iwama A, Iwama S. Hashimoto's thyroiditis: celebrating the centennial through the lens of the Johns Hopkins hospital surgical pathology records. Thyroid. 2013;23(2):142–50.
- Paparodis R, Imam S, Todorova-Koteva K, Staii A, Jaume JC. Hashimoto's thyroiditis pathology and risk for thyroid cancer. Thyroid. 2014;24(7):1107–14.
- Sanyal D. Spectrum of Hashimoto's thyroiditis: Clinical, biochemical & cytomorphologic profile. Indian J Med Res. 2014;140(6):710–2.
- Thomas T, Sreedharan S, Khadilkar UN, Deviprasad D, Kamath MP, Bhojwani KM, et al. Clinical, biochemical & cytomorphologic study on Hashimoto's thyroiditis. Indian J Med Res. 2014;140(6):729–35. Mallick et al. / Indian Journal of Pathology and Oncology 2025;12(2):165–173 173
- Kini SR, Miller JM, Hamburger JI. Cytopathology of Hürthle cell lesions of the thyroid gland by fine needle aspiration. Acta Cytologica. 1981;25(6):647–52.
- Scopa CD, Melachrinou M, Saradopoulou C, Merino MJ. The significance of the grooved nucleus in thyroid lesions. Mod Pathol. 1993;6(6):691–4.
- Suster D, Mackinnon AC, Suster S. Thyroid Oncocytic (Hürthle Cell) Nodules with Longitudinal Nuclear Grooves: Clinicopathologic, Immunohistochemical, and Molecular Genetic Study of 15 Cases. Arch Pathol Lab Med. 2023;147(6):684-91.
- Perez-Montiel MD, Suster S. The spectrum of histologic changes in thyroid hyperplasia: a clinicopathologic study of 300 cases. Human Patho. 2008;39(7):1080-7.
- Silver SA, Bouseneirs AE. Cytologic criteria for differentiating neoplastic from non neoplastic Hurthle cell lesions by fine needle aspiration. In: Abstracts of the Annual Meeting of the United States and Canadian Army of Pathology; 1995; Toronto, Ontario. 44A
- Galera‐Davidson H. Diagnostic problems in thyroid FNAs. Diagn Cytopathol. 1997;17(6):422–8.
- Yang YJ, Khurana KK. Diagnostic utility of intracytoplasmic lumen and transgressing vessels in evaluation of Hürthle cell lesions by fine-needle aspiration. Arch Pathol Lab Med. 2001;125(8):1031–5.
- Bonilla AJ, Caudill JL, Goellner JR. Neoplastic versus nonneoplastic Hurthle cell lesions: the diagnostic role of transgressing vessels and intracytoplasmic inclusions. Acta Cytol. 1999;43:951.
- Manji N, Carr-Smith JD, Boelaert K, Allahabadia A, Armitage M, Chatterjee VK, et al. Influences of age, gender, smoking, and family history on autoimmune thyroid disease phenotype. J Clin Endocrinol Metab. 2006;91(12):4873–80.
- Elliott DD, Pitman MB, Bloom L, Faquin WC. Fine‐needle aspiration biopsy of Hurthle cell lesions of the thyroid gland: a cytomorphologic study of 139 cases with statistical analysis. Cancer. 2006;108(2):102–9.
- Anila KR, Nayak N, Jayasree K. Cytomorphologic spectrum of lymphocytic thyroiditis and correlation between cytological grading and biochemical parameters. J Cytol. 2016;33(3):145–9.
- Ashraf D, Sharma P, Gupta R, Bhardwaj S. Cytological Grading of Lymphocytic Thyroiditis and Its Correlation With Biochemical Parameters: An Experience From a Tertiary Care Center in North India. Cureus. 2024;16(4):e58669.
How to Cite This Article
Vancouver
Mallick A, S SC, Vernekar SS. Cytomorphological variations in Hashimoto’s thyroiditis: A study of 164 cases [Internet]. Indian J Pathol Oncol. 2025 [cited 2025 Oct 16];12(2):165-173. Available from: https://doi.org/10.18231/j.ijpo.2025.033
APA
Mallick, A., S, S. C., Vernekar, S. S. (2025). Cytomorphological variations in Hashimoto’s thyroiditis: A study of 164 cases. Indian J Pathol Oncol, 12(2), 165-173. https://doi.org/10.18231/j.ijpo.2025.033
MLA
Mallick, Arunima, S, Sateesh Chavan, Vernekar, Sunita S. "Cytomorphological variations in Hashimoto’s thyroiditis: A study of 164 cases." Indian J Pathol Oncol, vol. 12, no. 2, 2025, pp. 165-173. https://doi.org/10.18231/j.ijpo.2025.033
Chicago
Mallick, A., S, S. C., Vernekar, S. S.. "Cytomorphological variations in Hashimoto’s thyroiditis: A study of 164 cases." Indian J Pathol Oncol 12, no. 2 (2025): 165-173. https://doi.org/10.18231/j.ijpo.2025.033