Hashimoto’s Thyroiditis: A Correlation of Cytolomorphology with Clinical, Biochemical & Radiological Findings

Introduction: Hashimoto’s thyroiditis one of the most common causes of goiter & hypothyroidism, basically, is an autoimmune disorder, the hallmark being lymphocytic infiltration of thyroid follicles resulting in an autoimmune glandular destruction. This is seen more commonly in middle aged & young females. Clinically, it presents as a diffuse or nodular swelling being usually asymptomatic along with symptoms of hypothyroidism. Fine needle aspiration cytology (FNAC) is a simple, cost effective procedure & plays a significant role in diagnosis of chronic lymphocytic thyroiditis. Aims & Objective of study: To grade Hashimoto’s thyroiditis on cytology and study its significance in predicting thyroid injury. Materials & Methods: 50 patients were retrospectively studied over a period of 6 months and clinical, biochemical, radiological data were evaluated and grading was done based on Bhatia’s Grading system. Results: Of 50 patients, 47 were female. 29 of 50 patients had grade I lymphocytic thyroiditis. Many patients with grade I & II were asymptomatic (37/50; 74%) and presented with diffuse goiter (43/50; 86%). Most of the patients presented with diffuse enlargement of thyroid gland. Majority of patients with hypoechoic nodules on USG showed grade II lymphocytic thyroiditis on cytological examination. Conclusion: Hashimoto thyroiditis (HT) is present in an unexpectedly large no. of individuals. It is important to diagnose HT as patients subsequently become hypothyroid & require lifelong thyroxine supplementation. Chronic lymphocytic thyroiditis is the second most common thyroid lesion next to goiter & one of the most common cause of hypothyroidism. A combined approach of cytological grading of Hashimoto’s Thyroiditis along with ultrasonography and biochemical levels can detect subclinical hypothyroid state & provide a guide to therapy.