Table 1.
Comparison of Differential Diagnosis Indices for HT in the Hyperthyroidism Stage and GD
| Tests | Hashimoto’s Thyroiditis in the Hyperthyroidism Stage (HT) | Graves’ Diseases (GD) | |
|---|---|---|---|
| Blood tests | TRAb (U/L) | Increase | Significant increase, 10x the normal value (on the average) |
| TgAb (U/L) | Significant increase, 30x the normal value (on the average) | Increase | |
| TPOAb (U/L) | Significant increase | Increase | |
| Imaging | Echogenic features in the thyroid | Focal reduced echogenicity Nodular-like Diffusely reduced echogenicity Diffusely enhanced echogenicity |
Focal reduced echogenicity Diffusely reduced echogenicity Echo of the parenchyma thickened |
| Blood flow distribution in the thyroid | Grade II-III | Grade III (Thyroid inferno) | |
| PSV (cm/s) | Increase | Significant increase | |
| EDV (cm/s) | Increase | Significant increase | |
| %AREA | Relatively high | Relatively low | |
| MEAN | Relatively low | Relatively high | |
| Lymph nodes around the thyroid | Lymph nodes in cervical areas V and VI | N/A | |
| I131 | Thyroid I131 uptake rate | Increase Suppressed by T3 |
Significant increase Not suppressed by T3 |
| Thyroid iodine conversion rate | N/A | Peak moving forward | |
| Pathology | FNAC | Diffuse lymphocytic infiltration Formation of germinal centers Enlarged epithelial cells Enlarged nuclear volume Eosinophilic cytoplasm formation (Askanazy or Hurthle cells) |
High columnar epithelial cells Abundant cytoplasm, cytoplasmic vacuoles, and minimal colloid infiltration of lymphocytes/plasma cells Glandular epithelial cells without atrophy or degeneration |
Abbreviations: PSV, the peak systolic velocity; EDV, the end diastolic velocity; %AREA, the area ratio of low-strain region; MEAN, the average relative value; FNAC, fine needle aspiration cytology.