open access

Vol 66, No 1 (2015)
Case report
Published online: 2015-03-02
Submitted: 2014-06-30
Accepted: 2014-09-01
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Flow cytometry in the differential diagnostics of Hashimoto’s thyroiditis and MALT lymphoma of the thyroid

Zbigniew Adamczewski, Mariusz Stasiołek, Marek Dedecjus, Piotr Smolewski, Andrzej Lewiński
DOI: 10.5603/EP.2015.0001
·
Endokrynologia Polska 2015;66(1):73-78.

open access

Vol 66, No 1 (2015)
Case report
Published online: 2015-03-02
Submitted: 2014-06-30
Accepted: 2014-09-01

Abstract

Introduction: A combination of traditional cytology methods with fluorescence activated cell sorting (FACS) analysis of fine-needle aspiration biopsy (FNAB) material is considered a powerful diagnostic tool in the differential diagnosis of thyroid lesions suspected of mucosa-associated lymphoid tissue lymphoma (MALT-L). The aim of this study was to demonstrate the FACS-based diagnostic process of thyroid lesions in a clinical situation where ultrasound and cytological examinations did not allow differentiation between Hashimoto’s thyroiditis (HT) and MALT-L.

Material and methods: The patients analysed in this study presented significantly different clinical courses of thyroid disease: quickly enlarging painless tumour of the thyroid right lobe in the first case, and chronic HT with palpable tumour in the thyroid isthmus in the second patient. Due to the suspicion of MALT-L resulting from indeterminate ultrasound and FNAB-cytology results, FNAB material was obtained from all the previously examined thyroid lesions and directly subjected to FACS assessment, encompassing κ/λ light chain restriction analysis, as well as measurements of B and T cell surface antigens.

Results: The FACS analysis of FNAB material obtained from our patients did not show any definite signs of light chain restriction. Although one of the samples showed a borderline value of κ/λ ratio (κ/λ = 0.31), further immunophenotyping confirmed clonal expansion in none of the examined thyroid regions. Histopathological findings documented the diagnosis of HT in both clinical cases.

Conclusion: We believe that FACS represents a useful and reliable complementary diagnostic measure in FNAB-based differential diagnosis of lymphoproliferative thyroid disorders.

Abstract

Introduction: A combination of traditional cytology methods with fluorescence activated cell sorting (FACS) analysis of fine-needle aspiration biopsy (FNAB) material is considered a powerful diagnostic tool in the differential diagnosis of thyroid lesions suspected of mucosa-associated lymphoid tissue lymphoma (MALT-L). The aim of this study was to demonstrate the FACS-based diagnostic process of thyroid lesions in a clinical situation where ultrasound and cytological examinations did not allow differentiation between Hashimoto’s thyroiditis (HT) and MALT-L.

Material and methods: The patients analysed in this study presented significantly different clinical courses of thyroid disease: quickly enlarging painless tumour of the thyroid right lobe in the first case, and chronic HT with palpable tumour in the thyroid isthmus in the second patient. Due to the suspicion of MALT-L resulting from indeterminate ultrasound and FNAB-cytology results, FNAB material was obtained from all the previously examined thyroid lesions and directly subjected to FACS assessment, encompassing κ/λ light chain restriction analysis, as well as measurements of B and T cell surface antigens.

Results: The FACS analysis of FNAB material obtained from our patients did not show any definite signs of light chain restriction. Although one of the samples showed a borderline value of κ/λ ratio (κ/λ = 0.31), further immunophenotyping confirmed clonal expansion in none of the examined thyroid regions. Histopathological findings documented the diagnosis of HT in both clinical cases.

Conclusion: We believe that FACS represents a useful and reliable complementary diagnostic measure in FNAB-based differential diagnosis of lymphoproliferative thyroid disorders.

Get Citation

Keywords

fine needle aspiration biopsy; fluorescence activated cell sorting; Hashimoto’s thyroiditis; MALT

About this article
Title

Flow cytometry in the differential diagnostics of Hashimoto’s thyroiditis and MALT lymphoma of the thyroid

Journal

Endokrynologia Polska

Issue

Vol 66, No 1 (2015)

Pages

73-78

Published online

2015-03-02

DOI

10.5603/EP.2015.0001

Bibliographic record

Endokrynologia Polska 2015;66(1):73-78.

Keywords

fine needle aspiration biopsy
fluorescence activated cell sorting
Hashimoto’s thyroiditis
MALT

Authors

Zbigniew Adamczewski
Mariusz Stasiołek
Marek Dedecjus
Piotr Smolewski
Andrzej Lewiński

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