Clinicopathological Study of Hashimoto Thyroiditis

Introduction: Thyroiditis comprises various group of disorders with some form of thyroid inflammation. Hashimoto thyroiditis is the most common and clinically significant type of thyroiditis seen commonly in middle age females and also one of the most common cause of goitre seen in iodine sufficient regions. Endemic goitre a major health problem, still prevalent in various regions of india even after implementation of widespread national salt iodisation programme by government of india. This study performed in tertiary centre of western coastal area where seafood is the staple diet of large no. of people and inspite of widespread use of iodised salt large no. of patients dignosed with HT. The proposed study is intended to further establish the role of histopathological study along with its correlation with clinical, biological and radiological parameters in the diagnosis of Hashimoto thyroiditis. Aim: To record the morphological features along with its correlation with clinical, biochemical and ultrasonographic picture of this disease in western coastal endemic area for goitre and document morphological variation, if any and also to identify any thyroid neoplasm that may develop in the background of HT. Materials and Methods: In this study detail study of case files of patients with histological diagnosis of Hashimoto thyroiditis is conducted with respect to their clinical presentation, thyroid profile, antibody titre and ultrasonographic features. Results: A total 55 patients with histopathological diagnosis of HT were included in the study. The histological slides were reviewed and reclassified into two groups based on hurthle cell change. Thus, 35 cases were diagnosed as HT while remaining were categorised as chronic lymphocytic thyroiditis. Ninety seven percent of patients were females and majority of them presented within 5 years of onset of symptoms. An amount of 68% patients had diffuse goitre, 33% were clinically euthyroid and 60.6% were biochemically hypothyroid. Antibody titre were elevated in 78% patients. In most of the cases USG picture showed hypoechogenecity with increased vascularity. Histopathological features were diagnostic and characteristic. Conclusion: In the present study majority of patients were females in the middle age group with clinical presentation of diffuse goitre and inspite, of widespread use of iodised salt in this studied population large no. of patients diagnosed with Hashimoto thyroiditis. Therefore, author conclude that all females of middle age group in an endemic area for goitre should be screened and also histologically confirmed by biopsy for this thyroiditis.