Ultrasonography related to clinical and laboratory findings in lymphocytic thyroiditis

Abstract

Abstract. The value of ultrasonography compared with established diagnostic procedures was investigated by reviewing medical records of 92 patients (88 women and 4 men, age 11–81 years, mean age 47) with lymphocytic thyroiditis. Clinical manifestations of the disease and serum antimicrosomal antibodies and TSH were determined in all patients. The thyroid was examined by ultrasound. Both lobes were aspirated by a fine needle under sonographic control and smears examined cytologically. A total of 27 (29.3%) patients had no clinical symptoms. Antimicrocosmal antibodies were undetectable in 12 (13%) patients, 16 (17.4%) had low titres 1:32–1:100, and 64 (69.6%) ≥ 1:320. TSH (reference values 0.3–3.9 mU/l) was < 0.3 in 4 (4.3%) 0.3–3.9 in 41 (44.6%), 4–20 in 26 (28.3%), and > 20 in 21 (22.8%) patients. Ultrasound revealed a scattered sonolucent echo in 87 (94.6%) patients, and in 45 (48.9%) a normal thyroid volume (women < 18, men < 25 ml). Cytology alone was diagnostic in 84 (91.3%) patients. In conclusion, ultrasound can suggest lymphocytic thyroiditis. If antimicrosomal antibodies are undetectable or titres are not significant and/or clinical symptoms are uncertain, fine-needle aspiration can confirm the sonographic finding. Epidemiological studies including ultrasonography are necessary to obtain reliable data on the prevalence of lymphocytic thyroiditis.