Clinicopathological study of Hashimoto thyroiditis – Retrospective study in a tertiary care hospital

Authors

DOI:

https://doi.org/10.37506/mw0pac04

Keywords:

Autoantibodies, goitre, Hashimoto thyroiditis, hypothyroidism

Abstract

Background: Hashimoto thyroiditis is an autoimmune disease in which thyroid cells are destroyed by both cell mediated and antibody mediated processes. It is the most common cause of hypothyroidism in iodine sufficient areas with an incidence of 0.3 -1.5 /1000 per year. During the histopathological evaluation of HT, thyroid neoplasms including papillary thyroid carcinoma(PTC) are detected incidentally which is  currently one of the primary area of  research in thyroid pathology . This study aimed to explore the role of histopathological study along with its correlation with clinical presentation ,biochemical and radiological parameters in the diagnosis of  HT.

Methods: This was a retrospective study conducted in a tertiary care hospital over a period of 5 years from June 2019 to June 2024.A total of 45 cases of thyroidectomy specimens were included in the study. All the thyroidectomy specimens which showed only features of Hashimoto thyroiditis on histopathological as the only pathology were included in the study. All the relevant clinical information ,radiological findings of thyroid gland, thyroid hormone assay and thyroid autoantibody studies were collected from the clinical records of the patients and analysed statistically.

Result: In our study ,most of the cases belonged  to the 31-40 years age group. Females were more affected than males. Majority of the patients presented with midline neck swelling and diffuse thyroid enlargement without nodularity. Autoantibody titre showed presence of antithyroglobulin antibodies anti-TPO antibodies in almost all cases .On microscopic examination of the thyroidectomy specimens, the most common finding were hurthle cell change and lymphoid follicles which were  present   in all cases .

Conclusion: majority of Hashimoto thyroiditis patients run a benign clinical course but in minor percentage of cases there is increased risk of development of malignancies particularly papillary thyroid carcinoma. Close follow up of these patients can lead to early diagnosis and prompt treatment for better management of the patients.

Author Biographies

  • Rajashree Pradhan, Associate Professor, Department of Pathology, College of Medicine and Sagore Dutta Hospital ,Kolkata, West Bengal.

    Associate  Professor, Department of Pathology, College of Medicine and Sagore Dutta Hospital ,Kolkata, West Bengal. India

    Email id: pradhanrajashree99@gmail.com   phone number:91-7980217205

  • Sajeeb Mondal, Associate Professor, Department of Pathology, Rampurhat government college and hospital NH14 Rampurhat,Birbhum,

    MD Pathology, Associate Professor, Department of Pathology, Rampurhat government college and hospital NH14 Rampurhat,Birbhum,West Bengal, 731224 India

     Email id: sjbmondal@gmail.com    phone no: 91-8777561521

  • Pratibha Bhunia, Assistant Professor,Department of Anaesthesia, College of Medicine and Sagore Dutta Hospital,,Kolkata

    MD Anaesthesia ,Assistant Professor ,Department of Anaesthesia, College of Medicine and Sagore Dutta Hospital,,Kolkata,West Bengal 700058 India

    Email id: pratibhabhunia1986@gmail.com  phone no: 7003649513

  • Upasana Mukherjee, Senior Resident,College of Medicine And Sagore Dutta Hospital

    MD Pathology, Senior Resident, Department of Pathology, College of Medicine and Sagore Dutta Hospital,,Kolkata,West Bengal 700058 India

References

Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA, et al. Serum TSH, T4, and Thyroid Antibodies in the United States Population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). The Journal of Clinical Endocrinology & Metabolism. 2002 Feb;87(2):489–99.

Fariduddin MM, Singh G. Thyroiditis [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK555975/

Ragusa F, Fallahi P, Elia G, Gonnella D, Paparo SR, Giusti C, et al. Hashimotos’ thyroiditis: Epidemiology, pathogenesis, clinic and therapy. Best Practice & Research Clinical Endocrinology & Metabolism [Internet]. 2019 Nov;33(6):101367. Available from: https://www.sciencedirect.com/science/article/pii/S1521690X19301186

Paes JE, Burman KD, Cohen J, Franklyn J, McHenry CR, Shoham S, et al. Acute Bacterial Suppurative Thyroiditis: A Clinical Review and Expert Opinion. Thyroid. 2010 Mar;20(3):247–55.

Caturegli P, De Remigis A, Rose NR. Hashimoto thyroiditis: Clinical and diagnostic criteria. Autoimmunity Reviews. 2014 Apr;13(4-5):391–7.

Pearce EN, Farwell AP, Braverman LE. Thyroiditis. New England Journal of Medicine. 2003 Jun 26;348(26):2646–55.

Lee JH, Kim Y, Choi JW, Kim YS. The association between papillary thyroid carcinoma and histologically proven Hashimoto’s thyroiditis: a meta-analysis. European Journal of Endocrinology. 2013 Mar;168(3):343–9.

Zhang L, Li H, Ji Q, Zhu Y, Wang Z, Wang Y, et al. The clinical features of papillary thyroid cancer in Hashimoto’s thyroiditis patients from an area with a high prevalence of Hashimoto’s disease. BMC Cancer. 2012 Dec;12(1).

Jun Soo Jeong, Hyun Ki Kim, Lee CR, Park S, Jae Hyun Park, Kang S, et al. Coexistence of Chronic Lymphocytic Thyroiditis with Papillary Thyroid Carcinoma: Clinical Manifestation and Prognostic Outcome. Journal of Korean Medical Science. 2012 Jan 1;27(8):883–3.

Jara SM, Carson KA, Pai SI, Agrawal N, Richmon JD, Prescott JD, et al. The relationship between chronic lymphocytic thyroiditis and central neck lymph node metastasis in North American patients with papillary thyroid carcinoma. Surgery [Internet]. 2013 Dec 1 [cited 2024 Jul 7];154(6):1272–80; discussion 1280-1282. Available from: https://pubmed.ncbi.nlm.nih.gov/24238047/

Park JY, Kim DW, Park HK, Ha TK, Jung SJ, Kim DH, et al. Comparison of T stage, N stage, multifocality, and bilaterality in papillary thyroid carcinoma patients according to the presence of coexisting lymphocytic thyroiditis. Endocrine Research. 2014 Dec 22;40(3):151–5.

Hashimoto thyroiditis [Internet]. www.pathologyoutlines.com. Available from: https://www.pathologyoutlines.com/topic/thyroidhashimotosthyroiditis.html

Caturegli P, De Remigis A, Chuang K, Dembele M, Iwama A, Iwama S. Hashimoto’s Thyroiditis: Celebrating the Centennial Through the Lens of the Johns Hopkins Hospital Surgical Pathology Records. Thyroid. 2013 Feb;23(2):142–50.

Unnikrishnan A, Menon U. Thyroid disorders in India: An epidemiological perspective. Indian Journal of Endocrinology and Metabolism [Internet]. 2011;15(6):78. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3169866/

Weetman AP. An update on the pathogenesis of Hashimoto’s thyroiditis. Journal of Endocrinological Investigation. 2020 Dec 17;44(5).

Jain P, Vasudevan G, Pai K.Clinicopathological Study of Hashimoto Thyroiditis.J Clin of Diagn Res.2020; 14(4):EC01-EC05. https://www.doi.org/10.7860/JCDR/2020/41227/13628

OMIDAN N, ZAHIR ST, FATEH A. Cytological and Pathological Evaluation of Hashimoto’s Thyroiditis. Mædica [Internet]. 2019 Jun 1;14(2):98–103. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709394/

Purnaiah M, Rakesh G. Clinical study of Hasihmoto's thyroiditis & its management. J. Evid. Based Med. Healthc. 2016; 3(21), 931-935.

Shankar O , Balraj N , Rakesh G , Clinical study of Hashimoto's thyroiditis IAIM 2016 3:98-103.

Lekha DBS. Clinical Study of Hashimotos Thyroiditis. IOSR Journal of Dental and Medical Sciences. 2017 Mar;16(03):20–5.

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Published

2025-03-11

How to Cite

Clinicopathological study of Hashimoto thyroiditis – Retrospective study in a tertiary care hospital. (2025). Indian Journal of Public Health Research & Development, 16(2), 238-242. https://doi.org/10.37506/mw0pac04