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INTRODUCTION: Hashimoto's thyroiditis (HT) is the most common cause of goitrous hypothyroidism in iodine sufficient areas. The diagnosis of HT is important because it progresses to hypothyroidism, and also, it is associated with thyroid lymphoma and papillary thyroid carcinoma. Apart from thyroid antibodies, assessment of thyroid function test (TFT) levels, ultrasonography (USG), and cytological analysis can help in early diagnosis and management of HT. AIMS AND OBJECTIVES OF THIS STUDY: To know the age incidence and clinical presentation of HT, its association with thyroid hormone levels and with thyroid antibodies and its correlation with the cytologic grade of HT. MATERIALS AND METHODS: Consecutive convenient method of sampling was adopted at the cytology clinic. Fine-needle aspiration cytology of patients presenting with thyroid enlargement was done using standard technique and aseptic precautions. RESULTS: Out of 875 cases of thyroid cytology, 134 cases were diagnosed as HT over a 4-year period. A strong female preponderance was observed. A significant proportion of them (103/134) presented in the first four decades of life. Majority of cases (60.63%) were hypothyroid, while 15.74% were hyperthyroid and 23.62% were euthyroid. Apart from thyroid enlargement, although a majority of patients presented with symptoms related to the thyroid, a significant number of patients (38.80%) were asymptomatic. CONCLUSIONS: A combined approach of cytological grading of HT along with USG, TFT levels, and thyroid antibodies can detect hypothyroid and subclinical hypothyroid or euthyroid state of HT and provide an appropriate guide to therapy.
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CONTEXT: As in any medical disorder, in non-Hodgkin lymphomas (NHLs) also, precise analysis of causes of death is needed to focus research efforts and improve morbidity and mortality. AIMS: The aim of this study was to review the clinical presentation, mode of death and the immunophenotype of the autopsy cases of NHL. SETTINGS AND DESIGN: Autopsy cases wherein NHL was diagnosed, were selected for study. SUBJECTS AND METHODS: Autopsy cases which were diagnosed as NHL, either antemortem or after autopsy during a 7 years period at a tertiary care referral centre were studied and reviewed. STATISTICAL ANALYSIS USED: Descriptive statistical analysis used. RESULTS: The autopsy findings seen in eight cases of NHL were reviewed. Except one, all cases were above 40 years age. Infective etiology (62%) followed by cardiorespiratory failure (38%) was the cause of death observed in these patients. In three cases, the antemortem diagnosis of NHL was missed as the patients were being treated for acute febrile illness and were referred late to the Tertiary Care Centre. One of these was a case of extra-nodal primary splenic lymphoma. CONCLUSION: As NHL present with nonspecific symptoms, these tumours may not be detected in early stages and hence may not be treated appropriately. These patients have weakened immunity and hence are prone to infection and sepsis which can be a major cause of mortality. This autopsy study experience has shown that NHL can masquerade as acute febrile illness which if not detected early and treated adequately can turn fatal.
