PROBLEMS IN THE CYTOLOGIC DIAGNOSIS OF THE COLD THYROID-NODULE IN PATIENTS WITH LYMPHOCYTIC THYROIDITIS

  • 1 January 1981
    • journal article
    • research article
    • Vol. 25  (5) , 506-512
Abstract
The cytologic diagnosis of the coexistence of lymphocytic thyroiditis (LT) and thyroid neoplasms presented certain problems. Fine needle aspirations of 117 cold nodules were reviewed because they were or should have been diagnosed as LT. Of 5 cases of LT plus lymphoma, 2 were correctly diagnosed and 3 were diagnosed as LT only. All 7 cases of LT plus papillary carcinoma were correctly identified, as were 4 of those in patients operated upon for LT plus a cellular neoplasm. From a total of 1600 biopsies, 7 probable and 6 possible cancers were LT at operation. The causes of diagnostic error were identified as similarity of epithelial cells nuclear atypia in LT and cellular neoplasm, inexperience and inadequate sampling. The presence of diffuse thyroid abnormality, of significant titers of antithyroglobulin and antimicrosomal antibodies and of chemical evidence of thyroid insufficiency should alert the examiner to the possibility of LT. Large needle biopsy may clarify difficult cases.

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