Chronic thyroiditis - current issue in the cytological diagnostics of the thyroid gland

Abstract

Introduction: Lowered and non-homogenous echogenicity in patients with chronic thyroiditis (CT) may cause problems in revealing focal lesions in ultrasound scans. Moreover, frequent anisocytosis of thyroid follicular cells and of oncocytes may falsely suggest neoplastic growth. The aim of the study was to evaluate the frequency of CT diagnosed in patients subjected to fine-needle aspiration biopsy (FNAB) of the thyroid in years 1994-2005, as well as to assess the cancer frequency in the operated patients with CT.
Material and methods: As much as 23 173 cytological reports and corresponding outcomes were analyzed and in patients treated surgically verified against postoperative histopathological examinations. Moreover, the analysis of cytological smears in CT with distinguishing its types (lymphocytic, epithelial-hyperplastic, colloidal, oxyphillic) was performed in 50 patients; the changes between subsequent FNABs in the picture of the smears were also assessed.
Results: The frequency of diagnosed CT had been increasing in the evaluated time span from 2.6% to 9.7% (p < 0.0001). There were 11 cases of papillary carcinoma found coexisting with CT. The analysis of cytological types of CT showed that the lymphocytic type prevailed over the others (lymphocytic - 43%, colloidal - 21%, epithelial-hyperplastic - 20%, oxyphilic - 16%, p < 0.001). The evolution in time of the cytological picture was observed.
Conclusion: The increase in the frequency of CT observed in smears obtained from the thyroid gland and the reports on the coexistence of CT with papillary carcinoma suggest the necessity of prudent diagnostics and follow-up of patients with CT.