Cytomorphic Study of Lymphocytic Thyroiditis: A Correlation between Cytological Grade and Biochemical Parameters
Dr. Aparna Bhardwaj,
Shri Guru Ram Rai institute of Medical and Health Science, Dehradun, Uttarakhand, India.
Introduction: Lymphocytic thyroiditis is an autoimmune disorder characterised by lymphocytic infiltration of the thyroid gland leading to follicular destruction in addition to immunological alterations attributed to the antibodies circulating in the serum against thyroid peroxidase, thyroglobulin, and thyroid stimulating hormone receptor antigens.
Aim: To study the cytomorphic spectrum of lymphocytic thyroiditis, and correlate the cytological grades with the levels of TSH, FT3, FT4 and Anti-TPO antibodies.
Materials and Methods: This study was carried out over a period of 24 months in Pathology department of SGRRIM & HS, Dehradun. Out of 58 cases diagnosed as lymphocytic thyroiditis on cytology and graded using Bhatia et al. grading system, the levels of TSH, FT3, FT4 and Thyroid Peroxidase Antibody were known in 31 cases. The cytological grades of lymphocytic thyroiditis were correlated with these parameters and statistical analysis was done using one way ANOVA.
Results: Out of 31 cases, majority of patients (30 cases, 96.7%) were females presenting in third decade of life. Cytologically, in 21 cases (67.7%) the patients had grade 2 thyroiditis, followed by grade 3 thyroiditis in 7 cases (22.6%). Anti-TPO was elevated in 26 cases (83.8%) and elevated level of TSH was seen in 17 cases (54.8%). On correlating the cytological grades with these parameters, p-value was found to be 1.00 which is statistically insignificant.
Conclusion: While Lymphocytic infiltration of thyroid follicles is pathognomonic and positivity for antithyroid antibodies is strongly associated with lymphocytic thyroiditis, no correlation was observed between the grades of thyroiditis and the levels of Anti-TPO, FT3, FT4 and TSH.