Study of cytological findings of lymphocytic thyroiditis and its correlation with anti-thyroid peroxidase (anti-TPO) antibody levels and thyroid-stimulating hormone (TSH) levels:  A retrospective observational study.

Shreya  Pandey; Prakash  Dive; Dr Sudhamani. S

doi:10.51168/sjhrafrica.v6i9.2063

Authors

Dr. Shreya Pandey Senior Resident, Department of Pathology, D. Y. Patil School of Medicine and Hospital, Navi Mumbai, Maharashtra, India.
Dr. Prakash Dive Assistant Professor, Department of Pathology, D. Y. Patil School of Medicine and Hospital, Navi Mumbai, Maharashtra, India
Dr Sudhamani. S Professor and Head, Department of Pathology, D. Y. Patil School of Medicine and Hospital, Navi Mumbai, Maharashtra, India.

DOI:

https://doi.org/10.51168/sjhrafrica.v6i9.2063

Keywords:

Lymphocytic thyroiditis, Fine-Needle Aspiration Cytology (FNAC), Cytological grading, Thyroid-Stimulating Hormone (TSH) levels, Anti-Thyroid Peroxidase (Anti-TPO) antibodies

Abstract

Introduction: Lymphocytic thyroiditis is an autoimmune thyroid disorder marked by diffuse lymphocytic infiltration of the thyroid gland. It is the second most common thyroid pathology encountered on fine-needle aspiration cytology (FNAC), predominantly affecting women. The disorder presents with variable thyroid functional states, including hypothyroidism, euthyroidism, and hyperthyroidism.

Objective: To evaluate the cytological spectrum of lymphocytic thyroiditis and to correlate cytological grades with serum Anti-thyroid peroxidase (anti-TPO) antibody titers and thyroid-stimulating hormone (TSH) levels.

Materials and methods: A retrospective study was carried out over 30 months (2021–2023), including 44 FNAC-confirmed cases of lymphocytic thyroiditis. Cytological grading was performed using the system proposed by Bhatia et al., and correlation with Anti-TPO antibody levels and TSH values was assessed. Both parameters were measured using ADVIA Centaur XP immunoassay analyser employing chemiluminescent technology. Data were analysed with SPSS software, and statistical significance was set at p < 0.05.

Results: Of the 44 cases, 39 were females (88.63%), with the 21–30 years age group being most commonly affected (29.5 %). Cytological grading revealed Grade I in 18 cases (40.9%), Grade II in 17 cases (38.63%), and Grade III in 9 cases (20.45%). Elevated Anti-TPO antibody levels were observed in 11 cases overall, with the highest frequency in Grade III (88.88%). Raised TSH levels were detected in 13 patients, more frequently in Grade II (58.82%). Correlation between cytological grades and biochemical markers was statistically significant (p < 0.05).

Conclusion: Cytological grading in conjunction with biochemical evaluation provides a comprehensive assessment of lymphocytic thyroiditis, facilitating early diagnosis and appropriate management.

Recommendations: Routine integration of FNAC grading with Anti-TPO and TSH estimation is recommended for timely diagnosis, monitoring, and individualized patient management.

Author Biographies

Dr. Shreya Pandey , Senior Resident, Department of Pathology, D. Y. Patil School of Medicine and Hospital, Navi Mumbai, Maharashtra, India.

completed her MBBS in 2017 from the Himalayan Institute of Medical Sciences, Dehradun, and obtained her MD degree in pathology in 2025 from D.Y. Patil Medical College, Navi Mumbai. She served as the principal investigator for the research project titled “Nitroblue Tetrazolium Test as an assay of Neutrophil function in Diabetes mellitus patients”. Currently, she is a senior resident in the department of pathology at D.Y. Patil School of Medicine, Navi Mumbai.https://orcid.org/0009-0007-1333-157X.

Dr. Prakash Dive, Assistant Professor, Department of Pathology, D. Y. Patil School of Medicine and Hospital, Navi Mumbai, Maharashtra, India

has completed his M.B.B.S. from Topiwala National Medical College and B.Y. L. Nair Charitable Hospital, Mumbai in the year 2004. He also completed his M.D. Pathology from G.S. Medical College and K.E.M. Hospital, Mumbai, in the year 2010. He joined the prestigious D.Y. Patil School of Medicine, Hospital and Research Centre, Navi Mumbai, Maharashtra, as an Assistant Professor in the year 2022 and has been working as a teaching faculty to both M.B.B.S. and M.D. Pathology students with over 10 years of experience in the field of Pathology and Laboratory Medicine. He authored several publications in several journals to his credit and contributed to medical education.https://orcid.org/0009-0008-8193-170X

Dr Sudhamani. S, Professor and Head, Department of Pathology, D. Y. Patil School of Medicine and Hospital, Navi Mumbai, Maharashtra, India.

has completed MBBS and MD Pathology, both from JSS Medical College, Mysuru, under Mysuru University in 1999 and from Rajiv Gandhi University of Health Sciences, Karnataka in 2003, respectively.

She joined prestigious DY Patil Medical College, Hospital, and research center, Navi Mumbai, as an Assistant Professor in 2004 and, since then, has been teaching and guiding both MBBS and MD students in various projects and research activities. She has handled pivotal responsibilities, including Histopathology, cytology, clinical Pathology, and other academic activities. She has published more than 70 research papers in both National and international journals. Currently, she is serving as Professor and Head of the Department of Pathology in the same institute. https://orcid.org/0000-0002-5213-6394

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