Cytomorphological Spectrum of Lymphocytic Thyroiditis: A Cross-Sectional Study from a Tertiary Care Centre

Background: Fine needle aspiration cytology (FNAC) is a safe, minimally invasive, and reliable diagnostic modality for the evaluation of thyroid lesions. Chronic lymphocytic thyroiditis (CLT), including Hashimoto thyroiditis, represents one of the most common benign thyroid disorders encountered on FNAC. Cytological grading of lymphocytic thyroiditis may help in understanding disease severity and activity.Methods: Objectives: To study the cytomorphological spectrum of lymphocytic thyroiditis on FNAC, to grade the lesions based on established cytological criteria, and to analyse the association of cytological grades with age and gender.Materials and Methods: This cross-sectional study was conducted in the Department of Pathology, AIIMS Deoghar, from August 2023 to October 2025. A total of 110 thyroid FNAC cases diagnosed as lymphocytic thyroiditis were included. Smears were stained with Giemsa and Papanicolaou stains and independently evaluated by two experienced pathologists. Cytological grading was performed according to the Bhatia et al. grading system (Grades 1–3). Descriptive statistics were used, and associations between grading, age, and gender were analysed using the chi-square test. Result: Of the 110 cases, Grade 1 lymphocytic thyroiditis was the most common (45.5%), followed by Grade 2 (36.4%) and Grade 3 (18.2%). A marked female predominance was observed (95.5%), with a female-to-male ratio of 21:1. Most cases occurred in the 11–35-year age group. No statistically significant association was found between cytological grade and gender (p = 0.726) or age group (p = 0.561).Conclusion: Lymphocytic thyroiditis shows a wide cytomorphological spectrum with a predominance of low-grade lesions and marked female preponderance. FNAC with cytological grading is a valuable tool for accurate diagnosis and assessment of disease severity, potentially. However, cytological grading does not appear to correlate significantly with age or gender. Further studies incorporating serological and clinical follow-up data are recommended to better elucidate the prognostic significance of cytological grading.