Hashimoto’s Thyroiditis or Papillary Carcinoma

  • Yun ZhuEmail author
  • Tiesheng Wang


The nuclei of the oxyphilic or non-oxyphilic follicular epithelium in Hashimoto’s thyroiditis often exhibit considerable nuclear atypia, showing a range of nuclear changes that mimic those encountered in papillary thyroid carcinoma. Syncytial tissue fragments with or without any architectural configurations; enlarged nuclei with finely granular, powdery, or watery chromatin and nuclear contour irregularity; nuclear pseudoinclusions; nuclear grooves; and multiple micro- and/or macronucleoli could be applicable as the minimal criteria for the cytological diagnosis of papillary carcinoma. It is essential to remain in conservative diagnosis until the minimal criteria of papillary thyroid carcinoma is fulfilled. One single cytological feature of papillary carcinoma proves to be meaningless to conclude malignancy in Hashimoto’s thyroiditis since Hashimoto’s thyroiditis shows several overlapping features with papillary carcinoma.


Hashimoto’s thyroiditis Nuclear atypia Minimal criteria Diagnostic system Papillary carcinoma 


  1. 1.
    Kakudo K, Katoh R, Sakamoto A, Asa S, DeLellis RA, Carney JA, Naganuma H, Kameyama K, Takami H. Thyroid gland: international case conference. Endocr Pathol. 2002;13:131–4.CrossRefGoogle Scholar
  2. 2.
    Nikiforov Y, Seethala RR, Tallini G, et al. Nomenclature revision for encapsulated follicular variant of papillary thyroid carcinoma: terminology shift as paradigm for reducing overtreatment of indolent tumors. JAMA Oncol. 2016;2:1023–9.CrossRefGoogle Scholar
  3. 3.
    Nguyen GK, Ginsberg J, Crockford PM, et al. Hashimoto’s thyroiditis: cytodiagnostic accuracy and pitfalls. Diagn Cytopathol. 1997;16:531–6.CrossRefGoogle Scholar
  4. 4.
    Berho M, Suster S. Clear nuclear changes in Hashimoto’s thyroiditis. A clinicopathologic study of 12 cases. Ann Clin Lab Sci. 1995;25:513–21.PubMedGoogle Scholar
  5. 5.
    Lee J, Hasteh F. Oncocytic variant of papillary thyroid carcinoma associated with Hashimoto’s thyroiditis: a case report and review of the literature. Diagn Cytopathol. 2009;37:600–6.CrossRefGoogle Scholar
  6. 6.
    Kini SR. Thyroid cytopathology: an atlas and text. 2nd ed., 2015, p 212–3.Google Scholar
  7. 7.
    Harvey AM, Truong LD, Mody DR. Diagnostic pitfalls of Hashimoto’s/Lymphocytic thyroiditis on fine-needle aspirations and strategies to avoid overdiagnosis. Acta Cytol. 2012;56:352–60.CrossRefGoogle Scholar
  8. 8.
    Haberal AN, Toru S, Ozen O, et al. Diagnostic pitfalls in the evaluation of fine needle aspiration cytology of the thyroid: correlation with histopathology in 260 cases. Cytopathology. 2009;20:103–8.CrossRefGoogle Scholar
  9. 9.
    Anand A, Singh KR, Kushwaha JK, et al. Papillary thyroid cancer and Hashimoto’s thyroiditis: an association less understood. Indian J Surg Oncol. 2014;5:199–204.CrossRefGoogle Scholar
  10. 10.
    Rosai J, Kuhn E, Carcangiu ML. Pitfalls in thyroid tumour pathology. Histopathology. 2006;49:107–20.CrossRefGoogle Scholar

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© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of PathologyJiangsu Institute of Nuclear MedicineWuxiChina

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