Clinical and cytomorphological study of Dequervains thyroiditis

Abstract

In 1904, deQuervain described an inflammatory process of the thyroid gland which was characterized by the presence of discrete granulomata.This nonspecific inflammation is of viral origin and commonly resolves spontaneously in the course of 2 or 3 months. Subacute granulomatous thyroiditis (SGT) is usually diagnosed clinically, the cytologic literature on this condition is therefore rare. SGT requires no specific treatment other than symptomatic management. Hence the important objective in the cytological diagnosis of this disease is differentiating it from otherconditions clinically mimicking this disease to avoid unnecessary treatment and surgery. In this study, 23 cases were evaluated and FNA was performed using a 23 gauge needle with a syringe holder.The slides were stained with PAP stain (Methanol fixed) and Leishman stain (Air dried) and studied by 2 pathologists. The cytological diagnosis of SGT was made. All the 23 cases showed classical cytological features of SGT. The procedure was simple and a quick diagnosis could be made within a span of 4 hours in all the cases. The diagnosis was correlating clinically in all the 23 cases.19/23 (83%) cases presented with diffuse thyroid enlargement.4/23 (17%) cases had unilateral thyroid enlargement.Painful thyroid enlargement in 22/23(96%) cases.Fever in 16/23(70%)cases.The duration of the symptoms ranged from 10 days to 2 months.Male : Female ratio was 1:5. 22/23 cases (96%) were hyperthyroid. 1/23 (4 %) were euthyroid.ESR was > 50mm/hr in 16/23 (70% )cases. The cytopathologic confirmation of the diagnosis was very useful for both patient assurance and proper management.