title: Cytological diagnosis of thyroid nodules in Hashimoto thyroiditis in elderly patients.
abstract: BACKGROUND
  Long standing Hashimoto Thyroiditis (HT) causes shrinking and atrophy of the thyroid, but may also lead to diffuse enlargement of the gland and/or formation of nodules. These nodules should be differentiated from papillary thyroid carcinoma (PTC) and primary thyroidal non-Hodgkin lymphoma (PTL), which are possible complications of HT, and require pre-surgical diagnoses and different treatments.
  
  
  METHODS
  Thirty-four elderly patients (≥ 65 yrs) with HT and diffuse or nodular enlargement of the thyroid underwent ultrasound (US)-guided FNC. Smears were routinely stained and evaluated; additional passes were used for flow cytometry (FC) assessment of lymphoid infiltrate in 6 cases.
  
  
  RESULTS
  The cytological diagnosis was HT in 12 cases with prevalence of Hurtle cells in 2 cases, PTC in 1 case and PTL in 2 cases. FC assessed the reactive, non-lymphomatous nature of the lymphoid infiltrate in 5 cases and demonstrated light chain restriction, hence the lymphomatous nature of the lymphoid infiltrate in 2 cases of PTL.
  
  
  CONCLUSIONS
  FNC plays a key role in the clinical surveillance and pre-surgical diagnosis of diffuse enlargement and nodular presentation of HT in elderly patients. FNC can correctly diagnose HT, PTC and PTL indicating the need for surgery and its extension in suspicious or neoplastic cases, leaving other cases to the medical treatment and clinical surveillance.
authors.forename: Alessia
authors.initials: A
authors.lastname: Caleo
authors.forename: Elena
authors.initials: E
authors.lastname: Vigliar
authors.forename: Mario
authors.initials: M
authors.lastname: Vitale
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Di Crescenzo
authors.forename: Mariapia
authors.initials: M
authors.lastname: Cinelli
authors.forename: Chiara
authors.initials: C
authors.lastname: Carlomagno
authors.forename: Alfredo
authors.initials: A
authors.lastname: Garzi
authors.forename: Pio
authors.initials: P
authors.lastname: Zeppa
mesh_terms: D000368:Aged; D044963:Biopsy, Fine-Needle; D002277:Carcinoma / Q000473:pathology; D002291:Carcinoma, Papillary; D005260:Female; D050031:Hashimoto Disease / Q000473:pathology*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology; D008297:Male; D011300:Preoperative Care; D000077273:Thyroid Cancer, Papillary; D013961:Thyroid Gland / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000473:pathology; D016606:Thyroid Nodule / Q000473:pathology*