Maedica (Bucur). 2012 Dec;7(4):277-83.

Some clinical aspects in chronic autoimmune thyroiditis associated with thyroid differentiated cancer.

Maedica

Ioana Zosin, Ioana Golu, Marioara Cornianu, Mihaela Vlad, Melania Balasa

PMID: 23483569 PMCID: PMC3593276

Abstract

BACKGROUND: The coexistence of Hashimoto's thyroiditis (HT) with differentiated thyroid cancer (DTC) was reported with a heterogeneous incidence. The wide distribution of this association may be related to differences in the level of morphological examination, autoimmunity used criteria, patient selection, surgical indication, genetic background, geographical and environmental factors.Some consider the coexistence of these two entities a coincidental one, others suspecting a causative link between these conditions.

METHODS: This retrospective paper included 216 patients with HT, issued from an iodine-replete area. 21 cases of nodular HT were investigated by means of: thyroid functional tests (TFT), immunological determinations, thyroid ultrasonography (US) and cytological analysis.ALL CASES WERE OPERATED BECAUSE OF DIFFERENT REASONS: compressive symptoms and signs, suspicious sonographic features and certain cytological smears (malignant, indeterminate and non-diagnostic).

RESULTS: The morphologic investigation revealed 9 patients with DTC and 12 cases with benign thyroid disease (BTD).None of the US analyzed characteristics provided sufficient accuracy for the diagnosis of DTC in cases with HT. The preoperative cytological examination by means of fine-needle-aspiration biopsy (FNAB) showed a better sensitivity and specificity vs. US criteria.

CONCLUSION: The coexistence of HT with DTC represents a clinical reality with yet unknown significance. The difficulty of diagnosis imposes the corroboration of different types of investigations. The best diagnostic accuracy seems to be offered by thyroid US and thyroid cytological investigation.

Keywords: Hashimoto thyroiditis; differentiated thyroid cancer; fine-needle aspiration biopsy of thyroid; thyroid ultrasonography

References

1. AJR Am J Roentgenol. 2010 Jul;195(1):216-22 - PubMed
2. J Am Coll Surg. 2007 May;204(5):764-73; discussion 773-5 - PubMed
3. Thyroid. 2006 Feb;16(2):109-42 - PubMed
4. Hormones (Athens). 2010 Oct-Dec;9(4):312-7 - PubMed
5. Radiology. 2005 Dec;237(3):794-800 - PubMed
6. Int J Surg Pathol. 2002 Apr;10(2):141-6 - PubMed
7. J Clin Endocrinol Metab. 2008 Mar;93(3):809-14 - PubMed
8. Minerva Endocrinol. 2008 Mar;33(1):1-5 - PubMed
9. Hormones (Athens). 2010 Apr-Jun;9(2):109-17 - PubMed
10. Histopathology. 2002 Oct;41(4):357-62 - PubMed
11. Eur J Endocrinol. 2005 Nov;153(5):637-42 - PubMed
12. Clin Endocrinol (Oxf). 2004 Jan;60(1):21-8 - PubMed
13. J Ultrasound Med. 2003 Feb;22(2):127-31; quiz 132-4 - PubMed
14. Acta Clin Croat. 2009 Mar;48(1):9-12 - PubMed
15. Surgery. 1999 Dec;126(6):1070-6; discussion 1076-7 - PubMed
16. Ultrasound Q. 2005 Sep;21(3):157-65 - PubMed
17. Ann Ital Chir. 2006 Nov-Dec;77(6):469-71 - PubMed
18. J Clin Endocrinol Metab. 1995 Dec;80(12):3421-4 - PubMed
19. Otolaryngol Head Neck Surg. 2001 May;124(5):531-6 - PubMed
20. J Thyroid Res. 2011 Feb 17;2011:387062 - PubMed
21. Thyroid. 2011 Jan;21(1):37-41 - PubMed
22. Arch Surg. 1989 Sep;124(9):1045-7 - PubMed
23. Oncol Res. 2009;17(10):495-503 - PubMed
24. Endocr J. 2008 Mar;55(1):135-42 - PubMed
25. Thyroid. 2010 Aug;20(8):873-8 - PubMed
26. Endokrynol Pol. 2010 Nov-Dec;61(6):658-64 - PubMed
27. Radiology. 1988 Sep;168(3):765-8 - PubMed
28. Intern Med. 2007;46(9):547-50 - PubMed
29. Thyroid. 2009 Nov;19(11):1167-214 - PubMed
30. Endocr Pathol. 2011 Sep;22(3):144-9 - PubMed
31. J Clin Endocrinol Metab. 2002 May;87(5):1941-6 - PubMed
32. AMA Arch Surg. 1955 Feb;70(2):291-7 - PubMed
33. Nat Clin Pract Endocrinol Metab. 2008 Aug;4(8):454-60 - PubMed
34. Clin Endocrinol (Oxf). 2009 Oct;71(4):581-6 - PubMed
35. Head Neck. 2011 Sep;33(9):1272-7 - PubMed
36. Immunol Ser. 1990;52:213-28 - PubMed

Show all 36 references

Publication Types

• Journal Article