Medium power: DQ stain
Clusters of Hürthle cells with round, eccentrically located nuclei, variation in nuclear size, occasional prominent nucleoli, and abundant granular cytoplasm
Dual population of Hurthle cells and lymphocytes are key findings in chronic lymphocytic thyroiditis
Low power: Pap stain
Clusters of Hürthle cells infiltrated by lymphocytes. Note increased lymphocytes in the background
High power: Pap stain
Clusters of Hürthle cells infiltrated by lymphocytes.
Note lymphoid tangles
High power: Pap stain
Clusters of Hürthle cells infiltrated by lymphocytes. Note crush artifact from smearing of the lymphocytes
High power: Pap stain
Clusters of Hürthle cells infiltrated by lymphocytes
Medium power: Pap stain
Germinal center seen in chronic lymphocytic thyroiditis
High power: Pap stain
Germinal center, crush artifact, lymphoid tangles and increased number of lymphocytes in the background may all be seen in chronic lymphocytic thyroiditis
Look for lymphocytes infiltrating epithelial cells
Features
• Dual population of oncocytes and lymphocytes
• May be scant to moderately cellular
• Florid phase can even resemble a lymph node aspirate
• Hürthle cells typically present
• Immature to mature Hürthle cells
• Follicular cells hyperplastic or degenerated
• Follicular cells with small degenerated nuclear features
• Hürthle cells may show nuclear atypia
– Enlarged irregular nuclei
– Prominent nucleoli
– Pleomorphism
– Typically granular cytoplasm
• Chronic inflammation
– Lymphoplasmacytic infiltrate
– May have follicular centers
– May have lymphoid tangles
– May have lymphohistiocytic aggregates
– May have lymphoglandular bodies
– May have granulomas and multinucleated giant cells
• Colloid scant to moderate
• Hashimoto lymphocytic thyroiditis is usually a clinical diagnosis and characterized by presence of antithyroid antibodies (antithyroglobulin/ antiperoxidase antibodies)
Mac Donald L et al. Acta Cytol. 1999 May-Jun;43(3):400-6.
Ravinsky E et al. Acta Cytol. 1988 Nov-Dec;32(6):854-61.