Cytological diagnosis of thyroid nodules in Hashimoto thyroiditis in elderly patients

BMC Surgery

Research Article

Chiara Carlomagno¹  Mario Vitale²  Pio Zeppa²  Alfredo Garzi²  Vincenzo Di Crescenzo²  Alessia Caleo²  Elena Vigliar³  Mariapia Cinelli⁴ 

[1] Clinical Medicine and Surgery, University of Naples "Federico II", Italy;Department of Medicine and Surgery, University of Salerno, Italy;Departments of Biomorphological and Functional Sciences, University of Naples "Federico II", Italy;Public Health, University of Naples "Federico II", Italy;

关键词: Papillary Thyroid Carcinoma;    Thyroid Nodule;    Thyroid Stimulate Hormone;    Cytological Diagnosis;    Hashimoto Thyroiditis;   

DOI  :  10.1186/1471-2482-13-S2-S41

来源: Springer

【 摘 要 】

BackgroundLong standing Hashimoto Thyroiditis (HT) causes shrinking and atrophy of the thyroid, but may also lead to diffuse enlargement of the gland and/or formation of nodules. These nodules should be differentiated from papillary thyroid carcinoma (PTC) and primary thyroidal non-Hodgkin lymphoma (PTL), which are possible complications of HT, and require pre-surgical diagnoses and different treatments.This study focuses on the role of fine-needle cytology (FNC) in the clinical surveillance and pre-surgical diagnosis of HT with diffuse and nodular enlargement of the gland in elderly patients.MethodsThirty-four elderly patients (≥ 65 yrs) with HT and diffuse or nodular enlargement of the thyroid underwent ultrasound (US)-guided FNC. Smears were routinely stained and evaluated; additional passes were used for flow cytometry (FC) assessment of lymphoid infiltrate in 6 cases.ResultsThe cytological diagnosis was HT in 12 cases with prevalence of Hurtle cells in 2 cases, PTC in 1 case and PTL in 2 cases. FC assessed the reactive, non-lymphomatous nature of the lymphoid infiltrate in 5 cases and demonstrated light chain restriction, hence the lymphomatous nature of the lymphoid infiltrate in 2 cases of PTL.ConclusionsFNC plays a key role in the clinical surveillance and pre-surgical diagnosis of diffuse enlargement and nodular presentation of HT in elderly patients. FNC can correctly diagnose HT, PTC and PTL indicating the need for surgery and its extension in suspicious or neoplastic cases, leaving other cases to the medical treatment and clinical surveillance.

【 授权许可】

Unknown   
© Caleo et al; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.