Chronic lymphocytic thyroiditis, also known as Hashimoto's thyroiditis, is an autoimmune disease more commonly observed in women aged 30 to 50. It is a leading cause of hypothyroidism. Histologically, it is characterized by extensive lymphocyte and plasma cell infiltration of thyroid follicular structures, along with the formation of lymphoid follicles and germinal centers.
Clinical Manifestations
The condition typically presents as a painless, diffuse goiter that is symmetrical, firm, and smooth on the surface. In the early stages, there are often no clinical symptoms, but hypothyroidism may develop in the later stages of the disease course. Larger goiters may lead to compressive symptoms.
Diagnosis
Thyroid enlargement and reduced radioactive iodine uptake (131I) are commonly observed. Elevated levels of serum thyroid peroxidase antibodies (TPOAb) and/or thyroglobulin antibodies (TgAb) can aid in diagnosis. Fine-needle aspiration biopsy may be performed for confirmation in complex or unclear cases.
Treatment
Treatment is often unnecessary, and regular follow-up observation is typically sufficient. Long-term administration of levothyroxine may be required for patients with clinical or subclinical hypothyroidism. Surgical intervention may be considered for cases with compressive symptoms or suspected malignancy.