Cytomorphological Features and Grading of Lymphocytic Thyroiditis: A Cross-Sectional Study among Patients in a Tertiary Care Hospital in Chengalpattu District

Abstract

Introduction: Chronic lymphocytic thyroiditis is the second most common thyroid disorder diagnosed using Fine Needle Aspiration Cytology (FNAC) after benign follicular nodule. Fine needle aspiration cytology (FNAC) serves as a crucial diagnostic modality due to its simplicity, safety, and accuracy.

Objective: The main objective of this study was to grade chronic lymphocytic thyroiditis on FNAC smears using predefined criteria formulated by Bhatia A et al and to find out its association with clinical parameters.

Methods: This cross-sectional study included all the FNAC smears diagnosed with lymphocytic thyroiditis during the five years study period from January 2019 to December 2023. Relevant clinical and pathological data were retrieved from the medical records of the department and all the cases of lymphocytic thyroiditis were graded based on the pre-defined cytomorphological criteria by Bhatia A et al. Pearson chi-square test was employed to determine the association of cytological grading with several clinical parameters.

Results: Of the 194 cases of lymphocytic thyroiditis reported in FNAC, females (94%) were commonly affected and majority (49%) were in the age group of 30-50 years. Most cases were clinically hypothyroid (59%) and presented with diffuse swelling (74%) of the thyroid gland. On further cytological grading, most cases (69%) of lymphocytic thyroiditis belonged to grade II. Correlation of cytological grade with thyroid functional status (P value: 0.49), age of patients (P value: 0.46) and clinical presentation (P value: 0.18) were found to be statistically not significant.

Conclusions:  Cytological grading of lymphocytic thyroiditis reflects on the autoimmune activity within the thyroid gland and is not significantly related to the age of patient, nature of thyroid swelling or thyroid functional status.