Background: Fine needle aspiration cytology (FNAC) is considered
a superior and more cost-effective tool for diagnosis of chronic
lymphocytic thyroiditis. Chronic lymphocytic thyroiditis is an
autoimmune disorder where in which thyroid follicles are rapidly
destroyed. Aim: To assess cytomorphological spectrum of chronic
lymphocytic thyroiditis with respect to the clinical, biochemical,
ultrasonographic, and radionuclide parameters.Material and Methods:
Hospital based descriptive cross-sectional study was conducted on
172 cases of chronic lymphocytic thyroiditis. Results: Majority were
females presenting in 3rd to 4th decade. Cases diagnosed on FNAC
were 155 and on histopathology were 17. Among FNAC diagnosed
cases, commonest clinical presentation was diffuse (65.6%) followed
by Nodular (30.9%). Only 50% showed hypothyroidism followed by
hyperthyroidism (30%) and majority cases (73.55%) showed grade
2 follicular destruction. Cases diagnosed on histopathology mainly
presented as nodules. Cellular changes in follicular & hurthle cells
led to false positive diagnosis of neoplasia in 6 cases. Four cases
of papillary cancer with thyroiditis were misdiagnosed as goitre
and follicular neoplasm on FNAC. Conclusion: FNAC remains first
line diagnostic modality for thyroiditis. The cytological grades of
follicular destruction in thyroiditis can predict functional status.
Few cases might be missed due to inherent procedural limitations,
changing clinical presentation and associated neoplasms. On FNAC,
presence of colloid, follicular hyperplasia and neoplasm could lead
to diagnostic pitfalls, hence thorough cytological evaluation and
integrated approach is necessary.
Keywords: Hashimoto Thyroiditis; Hurthle cells; TMA; FNAC.