scholarly journals Chronic lymphocytic thyroiditis: could it be influenced by a petrochemical complex? Data from a cytological study in South-Eastern Sicily

2015 ◽  
Vol 172 (4) ◽  
pp. 383-389 ◽  
Author(s):  
Salvatore Arena ◽  
Adele Latina ◽  
Roberto Baratta ◽  
Giuseppe Burgio ◽  
Damiano Gullo ◽  
...  
Keyword(s):  
Thyroid Neoplasms ◽  
Needle Aspiration ◽  
Control Area ◽  
Complex Data ◽  
Chronic Lymphocytic Thyroiditis ◽  
Lymphocytic Thyroiditis ◽  
Malignancy Risk ◽  
Petrochemical Complex ◽  
South Eastern ◽  
Few Data

IntroductionIn genetically predisposed individuals, exogenous factors (including pollution) influence the development of Hashimoto's thyroiditis/chronic lymphocytic thyroiditis (CLT). CLT may also be a risk factor for associated thyroid cancer. Few data are available on the role of pollution from petrochemical complexes, one of which is located in the Siracusa province (South-Eastern Sicily), in the pathogenesis of CLT.Aimsi) To study the frequency of CLT in fine-needle aspiration cytology (FNAC)-interrogated thyroid nodules from patients who were stably resident in their zones, comparing it in patients living in the petrochemical complex area (zone A) with that of patients from a control area (zone B). ii) To study the frequency of CLT in the FNAC categories of malignancy risk, comparing the two zones.Patients and methodsWe retrospectively evaluated cytologically adequate slides of 1323 nodules in 1013 outpatients who underwent ultrasound-guided FNAC from 2006 to 2012. We stratified by area of residence, gender, and FNAC categories of malignancy risk.ResultsCLT was detected with significantly greater frequency in either patients or nodules from zone A compared with zone B (32.0% vs 23.1%,P=0.002 or 28.2% vs 18.8%,P=0.0001), with a female preponderance (F=35.2% vs M=21.1% or 30.4% vs 20.4%, zone A and F=26.5% vs 12.3% or 21.6% vs 9.5%, zone B). Regardless of zone, CLT was approximately twofold more frequent in the suspiciously malignant+malignant classes (TH4+THY5=47.6%, zone A and 32.4%, zone B) compared with the benign+intermediate classes (THY2+THY3=27.3%, zone A and 18.2%, zone B), but with a clear stepwise THY2 through THY5 increase only in zone A (THY2=25.3%, THY5=66.7%; THY2=18.6%, THY5=28.6% in zone B).ConclusionsThe petrochemical complex-related pollution is an environmental factor involved in the development of CLT and, likely, in the CLT association with thyroid neoplasms.

scholarly journals Study of Correlation of Cytomorphological Features of Lymphocytic Thyroiditis with Biochemical Parameters and Vitamin D Deficiency

2021 ◽  
Author(s):  
Preeti Patni ◽  
Shreeshail Belagavi ◽  
Priyanka Mishra ◽  
Tanu Choudhary
Keyword(s):  
Vitamin D ◽  
Biochemical Parameters ◽  
Plasma Cells ◽  
Needle Aspiration ◽  
Thyroid Stimulating Hormone ◽  
Research Centre ◽  
Chronic Lymphocytic Thyroiditis ◽  
Cytological Evidence ◽  
Lymphocytic Thyroiditis ◽  
Northern India

Introduction: Fine Needle Aspiration Cytology (FNAC) of the thyroid is a reliable and common method used for diagnosis of chronic Lymphocytic Thyroiditis (LT) which is an autoimmune disease. Vitamin D (Vit D) deficiency, a prevalent health problem, is known to have correlation with various autoimmune diseases especially chronic LT. Aim: To evaluate the relationship between Vit D levels, biochemical parameters with cytomorphological features of LT. Materials and Methods: The present cohort study was conducted on 88 patients with cytological evidence of LT at a thyroid research centre in northern India between June 2017 to September 2018. Thyroid Stimulating Hormone (TSH), Antithyroid Peroxidase (ATPO) Antibody and Vit D levels along with patient’s clinical presentation, and thyroid ultrasound were evaluated for all subjects. The cytological grades and other cytomorphological features were correlated with these parameters. Results: Most of the patients were females (82, 93.2%) who presented with diffuse thyromegaly (69, 78.4%) and had hypothyroidism (58, 65.9%). By cytology grade I thyroiditis (40, 45.5%) was commonest followed by grade II (38, 43.2%). The Vit D deficiency and elevated ATPO were seen in 72 (81.8%) and 78 (88.6%) patients, respectively. Lowest level of Vit D (7.8±4.9 ng/mL) was seen in grade III patients. Significant correlation was observed between ATPO and Vit D levels with cytomorphological grades and some cytomorphological features like Hurthle cell change and plasma cells presence. While TSH levels correlated significantly with cytological grades only in hypothyroid group. Conclusion: This study found that Vit D deficiency and ATPO levels significantly correlates with cytological grades of thyroiditis and affect certain cytomorphological features like plasma cells presence, suggesting lower levels of Vit D and higher ATPO may be related to more active disease.

scholarly journals Malignancy Rate of Bethesda Class III Thyroid Nodules Based on the Presence of Chronic Lymphocytic Thyroiditis in Surgical Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Yoon Young Cho ◽  
Yun Jae Chung ◽  
Hee Sung Kim
Keyword(s):  
Thyroid Nodules ◽  
Chronic Lymphocytic Thyroiditis ◽  
Class Iii ◽  
Lymphocytic Thyroiditis ◽  
Malignancy Rate ◽  
Malignancy Risk ◽  
Follicular Lesions ◽  
Premalignant Condition ◽  
Thyroid Malignancies ◽  
Undetermined Significance

BackgroundHashimoto’s thyroiditis (HT), also known as chronic lymphocytic thyroiditis (CLT), may interfere with the accurate cytological diagnosis of thyroid nodules. Recently, HT has been considered a premalignant condition for thyroid cancer development. The diagnosis of atypia of undetermined significance/follicular lesions of undetermined significance (AUS/FLUS) thyroid nodules is challenging and evidence for the malignancy risk of AUS/FLUS thyroid nodules coexisting with CLT is scarce. Therefore, we assessed the malignancy risk of AUS/FLUS thyroid nodules according to the presence of background CLT.MethodsThis study included 357 surgically resected thyroid nodules with AUS/FLUS cytology. Cases with concomitant malignant nodules were excluded. CLT was defined based on the pathologic report after thyroid surgery.ResultsAmong 357 tumors, 130 tumors (36%) were confirmed to have coexisting CLT, and 170 tumors (48%) were determined to be malignant after thyroidectomy. Malignancy rates were similar in both groups (48% in each) regardless of background CLT (62/130 with CLT vs. 108/227 without CLT). In the group with CLT, thyroiditis was more frequent in the final pathology (12% with CLT vs. 1% without CLT, P = 0.003). In multivariate analysis, positive BRAFV600E mutation, highly suspicious sonographic features (K-TIRADS 5), and smaller thyroid nodules were significant factors for thyroid malignancies.ConclusionThe malignancy rate of thyroid nodules with AUS/FLUS cytology was comparable irrespective of the presence of underlying CLT.

Warthin-like Papillary Carcinoma of the Thyroid

2000 ◽  
Vol 124 (8) ◽  
pp. 1192-1195 ◽  
Author(s):  
Zubair W. Baloch ◽  
Virginia A. LiVolsi
Keyword(s):  
Papillary Carcinoma ◽  
Fine Needle Aspiration ◽  
Distant Metastases ◽  
Lymphocytic Infiltration ◽  
Cyst Formation ◽  
Needle Aspiration ◽  
Chronic Lymphocytic Thyroiditis ◽  
Fine Needle ◽  
Lymphocytic Thyroiditis ◽  
Immunological Mechanisms

Abstract Background.—Warthin-like papillary carcinoma of thyroid is characterized by distinct papillary formations lined by tumor cells with oncocytic cytoplasm, nuclear features of papillary carcinoma, and brisk lymphoplasmacytic infiltrates in the papillary stalks. This tumor derives its name from its close resemblance to Warthin tumor of major salivary glands. Design.—The clinicopathologic features of 17 patients with Warthin-like papillary carcinoma were studied. Results.—Fifteen tumors occurred in women and 2 arose in men (age range, 23–63 years). The lesions ranged in size from 3 mm to 2.5 cm. Fine-needle aspiration biopsies were performed in 7 cases; 4 were diagnosed as papillary carcinoma, 2 as consistent with lymphocytic thyroiditis, and 1 as atypical cells. All 17 tumors were confined to the thyroid; 6 showed prominent cyst formation and the remaining tumors were solid. In each case, the tumor arose in a background of lymphocytic thyroiditis. Nodal metastases were identified in 3 cases; however, none showed distant metastases. In 7 cases, foci of papillary microcarcinoma and follicular variant of papillary carcinoma were found in other areas of the thyroid. Conclusions.—Warthin-like tumors can be mistaken for benign lymphoepithelial lesions of the thyroid, Hürthle cell carcinoma, and tall cell variant of papillary carcinoma in both fine-needle aspiration and histology specimens. Follow-up information on the previously reported cases has suggested that these tumors behave similarly to usual papillary carcinoma. The extensive lymphocytic infiltration in these tumors and their association with chronic lymphocytic thyroiditis may suggest a role for immunological mechanisms in the pathogenesis of thyroid tumors.

scholarly journals Oncocytic follicular nodules of the thyroid with or without chronic lymphocytic thyroiditis: An institutional experience

CytoJournal ◽  
2013 ◽  
Vol 10 ◽  
pp. 2 ◽  
Author(s):  
Sule Canberk ◽  
A. Carruth Griffin ◽  
Abha Goyal ◽  
He Wang ◽  
Kathleen Montone ◽  
...  
Keyword(s):  
Needle Aspiration ◽  
Lesion Size ◽  
Surgical Pathology ◽  
Follicular Neoplasm ◽  
Chronic Lymphocytic Thyroiditis ◽  
Clinicopathologic Features ◽  
Lymphocytic Thyroiditis ◽  
Risk Of Malignancy ◽  
Thyroid Fna

Background: Oncocytic follicular (OF) cells can be a prominent component of fine needle aspiration (FNA) specimens from neoplasms (adenomas and carcinomas) and nodules arising in multinodular goiter and chronic lymphocytic thyroiditis (CLT). Because OF cells can be present in non-neoplastic and neoplastic thyroid lesions it can be challenging to differentiate between these two in FNA specimens. The aims of this study were to determine the risk of malignancy in cases diagnosed as either oncocytic follicular neoplasm (OFN) or hyperplastic/adenomatoid nodule with OF on FNA and to identify clinicopathologic features that may help in predicting malignancy in such cases, especially the presence or absence of CLT. Design: We retrospectively searched the computerized laboratory information system at our institution between 1998 and 2009 for thyroid US guided FNA specimens in which the term “oncocytic/oncocytes” was mentioned in the final cytopathologic diagnosis. A total of 340 cases were selected for this study. The following data points were collected: Patient demographics, site of thyroid biopsy, size of lesion, FNA diagnosis, histopathologic follow-up and presence of CLT. Surgical pathology follow-up (SPFU) was available in 269 (79%) cases. Results: Two hundred and sixty patients were females and 80 males (average age 53 years). The lesion size was <3.0 cm in 241 (71%) and ≥ 3.0 cm in 99 (29%) cases. Cytologic diagnoses included: Follicular neoplasm with oncocytic features (FNOF) 321 and suggestive of FNOF 19 cases; a secondary cytologic diagnosis of CLT was made in 20 cases. SPFU was available in 269 (79%) cases; it was benign in 213 (213/267 = 79%) and malignant in 56 (56/269 = 21%) cases. The background thyroid showed CLT in 67 (25%) cases; 24% (48/196) neoplasms occurred with versus 76% (147/196) without CLT. The rate of malignancy was lower in nodules measuring less than 3.0 cm as compared to those equal or greater than 3.0 cm in size (17% vs. 28% respectively). The presence of CLT did not significantly alter the rate of malignancy in both FNA and surgical pathology specimens. Conclusions: Based on this study, nodule size and not CLT appears to be an important clinicopathologic features in the management of thyroid FNA specimens diagnosed as OFN.

Chronic lymphocytic thyroiditis

2020 ◽  
Author(s):  
Mehdi Hasnaoui ◽  
Mohamed Masmoudi ◽  
Takwa Belaid ◽  
Khalifa Mighri
Keyword(s):  
Chronic Lymphocytic Thyroiditis ◽  
Lymphocytic Thyroiditis

scholarly journals Epidemiological Study on the Incidence of Chronic Lymphocytic Thyroiditis in Childhood

1976 ◽  
Vol 52 (10) ◽  
pp. 1040-1045 ◽  
Author(s):  
Hiroo NIIMI ◽  
Nozomu SASAKI ◽  
Susumu MATSUMOTO ◽  
Toshio KADOMURA ◽  
Yooko NAKAMURA
Keyword(s):  
Epidemiological Study ◽  
Chronic Lymphocytic Thyroiditis ◽  
Lymphocytic Thyroiditis

Lymphoepithelial Cysts of the Thyroid Gland

2003 ◽  
Vol 127 (4) ◽  
pp. e205-e208
Author(s):  
Elliot Carter ◽  
Ozlem Ulusarac
Keyword(s):  
Thyroid Gland ◽  
Chronic Lymphocytic Thyroiditis ◽  
Chronic Thyroiditis ◽  
Lymphocytic Thyroiditis ◽  
Gland Tissue ◽  
Lymphoepithelial Cysts ◽  
Stratified Squamous Epithelium ◽  
Branchial Cleft ◽  
Solid Cell ◽  
Branchial Cleft Cysts

Abstract We report a case of multiple lymphoepithelial cysts of the thyroid gland in a patient with severe chronic lymphocytic thyroiditis. Lymphoepithelial cysts of the thyroid gland are rare lesions that are histologically similar to branchial cleft cysts found in the lateral neck. The cysts have an epithelial lining that is usually stratified squamous epithelium but may be focally respiratory-type epithelium. Abundant lymphoid tissue is present beneath the epithelium, and lymphoid follicles with reactive germinal centers are common features in the walls of the cysts. Because of their similarity to branchial cleft cysts and the presence of intrathyroidal branchiae-derived structures such as thymus and parathyroid gland tissue in the vicinity of some cysts, lymphoepithelial cysts of the thyroid have been postulated to arise from remnants of branchial derivatives; origination from solid cell nest remnants of the ultimobranchial bodies has been raised as a possibility. A definitive origin, however, has not been established. An association with chronic thyroiditis has been noted in 8 of the previously reported 16 cases occurring in a background of Hashimoto or chronic lymphocytic thyroiditis.

scholarly journals Identifying Risk Factors for a High Lymph Node Ratio (over 0.8) in Papillary Thyroid Carcinoma Patients

2020 ◽  
Author(s):  
Yuewu Liu ◽  
LY Zhang ◽  
xiaoyi li ◽  
hongfeng liu
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Lymph Node Ratio ◽  
Male Gender ◽  
Chronic Lymphocytic Thyroiditis ◽  
Papillary Thyroid ◽  
Central Lymph Node ◽  
Lymphocytic Thyroiditis ◽  
Node Ratio ◽  
Central Lymph

Abstract Background Despite the majority of papillary thyroid carcinoma (PTC) patients has an excellent prognosis, central lymph node metastases (CLNM) are common. The relationship between CLNM and prognosis is still controversial, however, a certain lymph node ratio (LNR) has been reported to show significantly worse prognosis for PTC patients. Therefore, the extent of CLNM seems to play an important role in predicting the recurrence and survival of PTC. The aim of this study is to determine the risk factors for a high LNR (over 0.8) in central compartment in PTC patients. Methods A retrospective cohort study was conducted on PTC patients who underwent total thyroidectomy or lobectomy plus central lymph node dissection (CLND) between January 2011 and December 2015. Patients with an LNR over 0.8 was defined as Group A, and patients with an LNR 0 was defined as group B. The clinical and pathological factors such as gender, age, tumor size, tumor number, extracapsular spread (ECS), MACIS score, and co-existence of chronic lymphocytic thyroiditis （CLT）were compared between different LNR groups.Results Univariate analysis found high LNR to be associated with male gender, young age(<40 years) ,larger tumor (≥1 cm), ECS and absence of chronic lymphocytic thyroiditis. Multivariate logistic regression showed male gender (p = 0.007, OR = 3.79), young age(<40 years) (p = 0.000, OR = 0.159), larger tumor (≥1 cm) (p =0.033, OR = 2.530), and absence of chronic lymphocytic thyroiditis (p = 0.036, OR = 0.321) to be independent predictors for high LNR in PTC patients Conclusions Male gender, younger age (<40 years), larger tumor (≥1 cm) and absence of chronic lymphocytic thyroiditis were risk factors of high LNR. We recommend a prophylactic CLND should be considered in PTC patients with such risk factors.

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