Every article I have read, Hashimoto’s thyroiditis (HT) is characterized by (1) lymphatic infiltration, (2) formation of intrathyroidal secondary lymphatic follicles which present with a mantle zone and well-formed germinal centers, (3) obvious signs of activity within the GC (eg, lymphoblasts in mitosis), and (4) Hurthle cell changes. In the studies I've read, 100% of patients whose thyroids were excise showed these changes.
Thus, it appears to me, that an absence of germinal centers would be inconsistent with reactive changes as a result of HT (because there is no reaction occurring). If not consistent with HT, what would nodular growth with calcifications, lymphatic infiltration with absence of GC be consistent with?
I would very much appreciate comments and suggested articles.
Thanks.
According to a pathologist of the National Institute of Medical Sciences and Nutrition in Mexico, it is better to use the term autoimmune thyroiditis, the classic form being the one you already mentioned as Hashimoto's thyroiditis, characterized by GC formation. The other form is characterized by diffuse lymphocytic thyroid gland infiltration, and finally, the last one is the fibrous form, characterized by diffuse fibrous infiltration; some authores consider the last one related to a localized form of Riedel thyroiditis, which does not decrease in size with thyroid hormone treatment..
In relation to articles, you can enter Pub Med in the web, and pick out the articles you decide to read. Some of them are not free, but you can read its summary.
Also, atrophic thyroiditis is considered another variant of autoimmune thyroiditis. (The fourth one).
de Quervain's thyroiditis you mean as i think
second the positivity of the germinal center in the thyroid measure by positive staining to immunoglobulin heavy or light chain inside the germinal center. I think that's more applicable than mitosis of lymphocyte as mention question.
with the best regard
Quervains thyroiditis has a viral and not an autoimmune etiology. Although, in genetically susceptible patients, it can start an autoimmune process with Graves disease and autoimmune hypothyroidism (Few cases).