Hashimoto's thyroiditis other diagnostic studies: Difference between revisions
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==Overview== | ==Overview== | ||
The histological analysis in Hashimoto's thyroiditis may show inflammatory cell infiltration and hurthle cells. Fine needle aspiration cytology helps to differentiate between the benign and malignant nodules. <ref name="pmid24434360">{{cite journal |vauthors=Caturegli P, De Remigis A, Rose NR |title=Hashimoto thyroiditis: clinical and diagnostic criteria |journal=Autoimmun Rev |volume=13 |issue=4-5 |pages=391–7 |year=2014 |pmid=24434360 |doi=10.1016/j.autrev.2014.01.007 |url=}}</ref><ref name="urlThyroiditis — NEJM">{{cite web |url=http://www.nejm.org/doi/full/10.1056/NEJMra021194 |title=Thyroiditis — NEJM |format= |work= |accessdate=}}</ref> | The histological analysis in Hashimoto's thyroiditis may show inflammatory cell infiltration and hurthle cells. [[FNA|Fine needle aspiration cytology]] helps to differentiate between the benign and malignant nodules. <ref name="pmid24434360">{{cite journal |vauthors=Caturegli P, De Remigis A, Rose NR |title=Hashimoto thyroiditis: clinical and diagnostic criteria |journal=Autoimmun Rev |volume=13 |issue=4-5 |pages=391–7 |year=2014 |pmid=24434360 |doi=10.1016/j.autrev.2014.01.007 |url=}}</ref><ref name="urlThyroiditis — NEJM">{{cite web |url=http://www.nejm.org/doi/full/10.1056/NEJMra021194 |title=Thyroiditis — NEJM |format= |work= |accessdate=}}</ref> | ||
==Other Diagnostic Studies== | ==Other Diagnostic Studies== | ||
===Fine needle aspiration cytology=== | ===Fine needle aspiration cytology=== | ||
Fine needle aspiration is usually done under ultrasound guidance and the sample is sent for cytology. It helps to differentiate benign thyroid nodules from the malignant lesions. | [[Needle aspiration biopsy|Fine needle aspiration]] is usually done under ultrasound guidance and the sample is sent for [[cytology]]. It helps to differentiate benign thyroid nodules from the malignant lesions. | ||
===Gross Pathology=== | ===Gross Pathology=== | ||
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[[Image:Hashimoto's thyroiditis 1.jpg|left|thumb|400px|A gross photograph of thyroid gland taken at autopsy. The gland is only slightly enlarged and has a firm texture.]] | [[Image:Hashimoto's thyroiditis 1.jpg|left|thumb|400px|A gross photograph of thyroid gland taken at autopsy. The gland is only slightly enlarged and has a firm texture.]] | ||
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===Microscopic Pathology=== | ===Microscopic Pathology=== | ||
Microscopically there is massive infiltration of the thyroid gland by lymphocytes and plasma cells. Germinal centers can often be seen in the gland. Thyroid follicles are usually absent and the few remaining follicles are devoid of colloid. | Microscopically there is massive infiltration of the thyroid gland by [[lymphocytes]] and [[Plasma cell|plasma cells]]. Germinal centers can often be seen in the gland. Thyroid follicles are usually absent and the few remaining follicles are devoid of colloid. | ||
[http://www.peir.net Images courtesy of Professor Peter Anderson DVM Ph.D. and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology] | [http://www.peir.net Images courtesy of Professor Peter Anderson DVM Ph.D. and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology] | ||
[[Image:Hashimoto's thyroiditis 2.jpg|left|thumb|400px|This is a low-power photomicrograph of thyroid from this case. Note that the tissue is more cellular than one would expect and there does not appear to be normal colloid-filled blue spaces in this gland.]] | [[Image:Hashimoto's thyroiditis 2.jpg|left|thumb|400px|This is a low-power photomicrograph of thyroid from this case. Note that the tissue is more cellular than one would expect and there does not appear to be normal colloid-filled blue spaces in this gland.]] | ||
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[[Image:Hashimoto's thyroiditis 3.jpg|left|thumb|400px|This is a higher-power photomicrograph of thyroid from this case. Note a large number of blue-staining inflammatory cells in this tissue. These cells appear to be forming germinal centers. Some residual thyroid gland tissue can be seen in this section (arrows).]] | [[Image:Hashimoto's thyroiditis 3.jpg|left|thumb|400px|This is a higher-power photomicrograph of thyroid from this case. Note a large number of blue-staining inflammatory cells in this tissue. These cells appear to be forming germinal centers. Some residual thyroid gland tissue can be seen in this section (arrows).]] | ||
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[[Image:Hashimoto's thyroiditis 4.jpg|left|thumb|400px|This is another view of thyroid gland filled with inflammatory cells forming germinal centers (arrows).]] | [[Image:Hashimoto's thyroiditis 4.jpg|left|thumb|400px|This is another view of thyroid gland filled with inflammatory cells forming germinal centers (arrows).]] | ||
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[[Image:Hashimoto's thyroiditis 5.jpg|left|thumb|400px|This is a higher-power photomicrograph of thyroid from this case showing the inflammatory cells and the residual thyroid tissue.]] | [[Image:Hashimoto's thyroiditis 5.jpg|left|thumb|400px|This is a higher-power photomicrograph of thyroid from this case showing the inflammatory cells and the residual thyroid tissue.]] | ||
<br clear="left"/> | <br clear="left" /> | ||
[[Image:Hashimoto's thyroiditis 6.jpg|left|thumb|400px|This is another higher-power photomicrograph of thyroid from this case showing the inflammatory cells and the residual thyroid tissue.]] | [[Image:Hashimoto's thyroiditis 6.jpg|left|thumb|400px|This is another higher-power photomicrograph of thyroid from this case showing the inflammatory cells and the residual thyroid tissue.]] | ||
<br clear="left"/> | <br clear="left" /> | ||
[[Image:Hashimoto's thyroiditis 7.jpg||left|thumb|400px|This is a high-power photomicrograph showing the inflammatory cells infiltrating into the residual thyroid tissue (arrows).]] | [[Image:Hashimoto's thyroiditis 7.jpg||left|thumb|400px|This is a high-power photomicrograph showing the inflammatory cells infiltrating into the residual thyroid tissue (arrows).]] | ||
<br clear="left"/> | <br clear="left" /> | ||
[[Image:Hashimoto's thyroiditis 8.jpg | [[Image:Hashimoto's thyroiditis 8.jpg|left|thumb|400px|This is a high-power photomicrograph showing the lymphocytes and plasma cells surrounding the thyroid gland epithelium. ]] | ||
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[[Image: Hashimoto's thyroiditis 9.jpg | [[Image: Hashimoto's thyroiditis 9.jpg|left|thumb|400px|This high-power photomicrograph shows more clearly the lymphocytes and plasma cells surrounding the thyroid gland epithelium. Large, eosinophilic, degenerating thyroid gland cells (Hurthle cells) can be seen in this section (arrows). ]] | ||
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==References== | ==References== | ||
Revision as of 17:55, 20 July 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Furqan M M. M.B.B.S[2]
Overview
The histological analysis in Hashimoto's thyroiditis may show inflammatory cell infiltration and hurthle cells. Fine needle aspiration cytology helps to differentiate between the benign and malignant nodules. [1][2]
Other Diagnostic Studies
Fine needle aspiration cytology
Fine needle aspiration is usually done under ultrasound guidance and the sample is sent for cytology. It helps to differentiate benign thyroid nodules from the malignant lesions.
Gross Pathology
- The gland is usually diffusely enlarged, firm, and slightly lobular. The capsule is intact, and the cut surface is light-tan and has a slight lobular pattern.
- At autopsy, significant subarachnoid hemorrhage from the ruptured berry aneurysm was documented. In addition, the thyroid gland was mildly enlarged and firm. On cut section, the tissue was slightly pale.
Microscopic Pathology
Microscopically there is massive infiltration of the thyroid gland by lymphocytes and plasma cells. Germinal centers can often be seen in the gland. Thyroid follicles are usually absent and the few remaining follicles are devoid of colloid.
References
- ↑ Caturegli P, De Remigis A, Rose NR (2014). "Hashimoto thyroiditis: clinical and diagnostic criteria". Autoimmun Rev. 13 (4–5): 391–7. doi:10.1016/j.autrev.2014.01.007. PMID 24434360.
- ↑ "Thyroiditis — NEJM".