In a September 2007 editorial, I described the important clinical work and research on autoimmune thyroiditis that Dr. Bo Wikland and his colleagues are conducting in Stockholm, Sweden. Since the editorial, Dr. Wikland has generously written two papers for Thyroid Science. In his first paper, he describes hypothyroidism caused by autoimmune thyroiditis in patients with "normal" blood test results, a condition he and his colleagues call "subchemical hypothyroidism." In his second paper, he presents an important hypothesis: that with these patients—who are clinically hypothyroid, biochemically euthyroid, but have laboratory evidence of autoimmune thyroiditis—we must suppress their TSH levels to stop the pathological activity in the thyroid gland and relieve their symptoms.

Now we are privileged to publish a highly informative paper that dovetails with his. It is written by Dr. P.O. Sandberg, a clinical and research colleague of Dr. Wikland's in Stockholm. Dr. Sandberg is a cytopathologist. In working with Dr. Wikland, he examines thyroid gland tissue samples in her laboratory for evidence of autoimmune thyroid disease.

In his paper, Dr. Sandberg explains the importance of examining tissue samples for structural evidence of autoimmune disease. He also shows us, in a photograph of lymphocyte-invaded thyroid tissues, what he often sees in tissue samples from afflicted patients.

Dr. Sandberg comments on the relative contributions of different procedures used in the diagnostic workups of thyroiditis patients. He discusses the features to look for during palpation of the thyroid gland, and what ultrasound may reveal both before and during its use in guiding fine-needle aspiration.

Dr. Sandberg’s paper provides an extraordinary learning opportunity for those of us who haven’t spent time with a cytopathologist in his or her lab. Most importantly, though, is that he makes clear the importance of fine-needle aspiration and the need for the involvement of more cytopathologists in patients’ diagnostic workups. We are grateful to him for contributing this important paper to Thyroid Science.

Keywords. Autoimmune thyroid disease • Chronic fatigue • Cytopathology • Fine-needle  aspiration • Ultrasonography

*Thanks to our Executive Editor, Jackie Yellin, for enabling us to expeditiously publish Dr. Sandberg’s paper.

Sandberg, P.O.: Fine-Needle Aspiration of the Thyroid Gland:
Its Role in the Investigation of Thyroid Autoimmunity.
Thyroid Science, 3(2):CLS1-2, 2008.

(Full Text Free in pdf format)

© 2008 Thyroid Science