Correlation between cytologic results and thyroid autoantibodies, calcitonin, and thyroid function tests in patients with thyroid nodules

2018 ◽  
Author(s):  
Pinar Karakaya ◽  
Bahar Pehlivan ◽  
Meral Mert ◽  
Bulent Yaprak ◽  
Yildiz Okuturlar ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Thyroid Nodules ◽  
Thyroid Autoantibodies ◽  
Thyroid Function Tests ◽  
Function Tests

scholarly journals Case Report of Postpartum Thyroid Nodule Size Reduction

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A923-A923
Author(s):  
Jana Havranova ◽  
Thomas Gallagher ◽  
Mohammad Ishaq Arastu
Keyword(s):  
Thyroid Gland ◽  
Thyroid Nodule ◽  
Thyroid Function ◽  
Thyroid Nodules ◽  
Late Pregnancy ◽  
Needle Aspiration ◽  
White Coat Hypertension ◽  
Thyroid Function Tests ◽  
Function Tests ◽  
True Association

Abstract Introduction: Thyroid nodules are very common. They occur more commonly in women with an increased prevalence of thyroid nodules reported in pregnancy. Most thyroid nodules diagnosed during pregnancy are benign. Pregnancy causes major physiological changes including changes in the levels of thyroid hormones and the elevation of thyroid binding globulin. Thyroid nodules may also occur in people with abnormal thyroid function tests manifesting as hyperthyroidism or hypothyroidism. We present a unique case of a new diagnosis of a large thyroid nodule that has significantly decreased in size after 20 months postpartum. Case description: Patient is a 31 year old female with past medical history of anxiety and white coat hypertension who was diagnosed with a 3.3 x 2.3 x 2.1 cm thyroid nodule a month following delivery. Patient did not have any abnormalities in her thyroid function tests before, during, or after pregnancy. She remained euthyroid throughout the pregnancy and in the postpartum period. Fine needle aspiration biopsy of the nodule showed atypia of undetermined significance (Bethesda Category III). The specimen was further analyzed by afirma testing that confirmed benign pathology. Twenty months postpartum, the thyroid nodule significantly decreased in size to 1.9 x 1.4 x 1.2 cm. Conclusion: Thyroid hormone levels physiologically change during pregnancy and this may affect the growth of thyroid nodules. We just presented a patient who exhibited a significant decrease in the size of her thyroid nodule. Sahin et al. showed that while the size of the thyroid nodule increases during pregnancy the number of nodules remains unaffected. Kung et al. showed that pregnancy is associated with an increase in the size of preexisting thyroid nodules as well as the number of newly developed thyroid nodules. Vanucchi et al. showed that although the thyroid gland becomes larger, particularly in late pregnancy, the sizes of any preexisting thyroid nodules remained unchanged and patients’ thyroid gland size returned to normal after delivery. The current literature provides conflicting data on this topic. The true association between pregnancy and thyroid nodules is unknown. Contemporary literature is ambiguous on this topic and more scientific studies are required to find the true association between pregnancy, the formation of thyroid nodules, and increase in the size or number of thyroid nodules.

scholarly journals Effect of Early Referral to an Endocrinologist on Efficiency and Cost of Evaluation and Development of Treatment Plan in Patients with Thyroid Nodules

1998 ◽  
Vol 83 (11) ◽  
pp. 3803-3807 ◽  
Author(s):  
Robert Ortiz ◽  
Kenneth H. Hupart ◽  
Charles R. DeFesi ◽  
Martin I. Surks
Keyword(s):  
Thyroid Nodule ◽  
Thyroid Function ◽  
Thyroid Nodules ◽  
Total Direct Cost ◽  
Thyroid Function Tests ◽  
Early Referral ◽  
Diagnosis And Management ◽  
Function Tests ◽  
Radionuclide Uptake ◽  
Unnecessary Testing

Radionuclide uptake and scan and sonogram, frequently ordered before referral to an endocrinologist, are expensive and poor predictors of thyroid nodule malignancy. We estimated costs of excessive imaging and other studies by reviewing the records of all patients (n = 70) referred to a single, consulting endocrinologist, for thyroid nodule evaluation in a 2-yr interval and subsequently, presenting only pertinent histories and results of physical examinations, thyroid function tests, and thyroid autoantibodies, to a second, reviewing endocrinologist (RE) who was blinded to diagnosis and management. Concordance in diagnosis and management between consulting endocrinologist and RE was 87.1% and 93.4%, respectively. Accuracy of diagnosis, loss of patient’s time (8.7 h, average), and cost of unnecessary testing, defined as tests not required by the RE for diagnosis and management according to published guidelines, were determined. Unnecessary testing included 153 physician’s office or diagnostic laboratory visits, 44 sets of thyroid function tests, 32 radionuclide uptake and scan, 39 thyroid sonograms, and 3 computed tomography scans. The total direct cost of unnecessary tests was estimated at $27,290 ($390/patient) in addition to costs of 30 unnecessary physician’s office visits. Only 2 of 8 surgical referrals required surgery, whereas 6 other patients required surgery, including 3 with papillary carcinoma. We conclude that early referral to an endocrinologist of patients with suspected thyroid nodules results in significant savings in cost of evaluation, patient’s time, and increased diagnostic precision. Six of the 8 patients referred for surgery before endocrine consultation had benign thyroid disease that did not require surgery. Six additional patients were referred to surgery, 3 of whom had papillary thyroid carcinoma. Early referral of patients with suspected thyroid nodules to an endocrinologist results in significant savings in both cost and patient’s time as well as increased precision of diagnosis.

scholarly journals A Case of Euthyroid Graves’ Ophthalmopathy in a Patient Sero-Negative for TSH Receptor Autoantibody

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Asami Hotta ◽  
Tomohiro Tanaka ◽  
Haruka Kato ◽  
Shota Kakoi ◽  
Yuki Shimizu ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Pulse Therapy ◽  
Tsh Receptor ◽  
Thyroid Autoantibodies ◽  
Thyroid Function Tests ◽  
Normal Thyroid Function ◽  
Function Tests ◽  
Graves Ophthalmopathy ◽  
History Of ◽  
Serum Tsh

We report of a case of Graves’ ophthalmopathy presented solely with symptoms of the eyes with normal thyroid function tests and negative immunoreactive TSH receptor autoantibody. 40-year-old male was referred to our hospital due to 2-month history of ocular focusing deficit without any signs or symptoms of hyper- or hypothyroidism. Serum thyroid function tests and 99mTc uptake were both within the normal range. Anti-thyroid autoantibodies were all negative except for the cell-based assay for serum TSH receptor stimulating activity. Since orbital CT scan and MRI gave typical results compatible with Graves’ ophthalmopathy, we treated the patients with corticosteroid pulse therapy and orbital radiation therapy, leading to a partial improvement of the symptoms. This case gives insights into the potential pathophysiologic mechanism underlying Graves’ ophthalmopathy and casts light upon the difficulties of establishing the diagnosis in a euthyroid case with minimal positive results for anti-thyroid autoantibodies.

LACK OF A THRESHOLD SIZE FOR AUTONOMOUSLY FUNCTIONING THYROID NODULES THAT EXCLUDES HYPERTHYROIDISM

2019 ◽  
Vol 25 (12) ◽  
pp. 1263-1267 ◽  
Author(s):  
Poorani Nallam Goundan ◽  
Stephanie L. Lee
Keyword(s):  
Thyroid Function ◽  
Thyroid Nodules ◽  
Thyroid Stimulating Hormone ◽  
Cystic Degeneration ◽  
Thyroid Function Tests ◽  
Threshold Size ◽  
Function Tests ◽  
Autonomously Functioning Thyroid Nodules ◽  
Tsh Levels ◽  
Stimulating Hormone

Objective: To correlate the size of autonomously functioning thyroid nodules (AFTNs) with thyroid function tests. Methods: A retrospective analysis was performed of data from patients with a diagnosis of a single AFTN who were seen in a university-based endocrinology clinic between January 1, 2003, and December 31, 2015. Patients with a nuclear thyroid scan confirming the presence of an AFTN without significant cystic degeneration were included in the study. Results: The volume of the AFTN and the corresponding thyroid function tests were compared in 32 patients who met inclusion criteria. There was no correlation between the volume of the AFTN and thyroid-stimulating hormone (TSH) levels ( r2 = 0.044). There was also no volume threshold below which an AFTN was always associated with a TSH within the reference range. Conclusion: The results agree with the findings of other recent studies comparing the volume of AFTNs with TSH levels, suggesting that smaller nodules can still demonstrate subclinical and overt hyperthyroidism and that a normal TSH level does not preclude the presence of an AFTN. Abbreviations: AFTN = autonomously functioning thyroid nodule; T3 = triiodothyronine; T4 = thyroxine; TSH = thyroid-stimulating hormone

scholarly journals Correlation Between Cytologic Results and Thyroid Autoantibodies, Calcitonin, and Thyroid Function Tests in Patients with Thyroid Nodules

2018 ◽  
Vol 6 (02) ◽  
Author(s):  
Pinar Karakaya ◽  
Bahar Ozdemir ◽  
Bulent Yaprak ◽  
Meral Mert
Keyword(s):  
Thyroid Function ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Thyroid Function Tests ◽  
Pathologic Evaluation ◽  
Function Tests ◽  
Multiple Category ◽  
Bethesda Classification ◽  
Range Interval ◽  
Undetermined Significance

Abstract Background: Fine needle aspiration biopsy (FNAB) is currently a widely accepted screening procedure in diagnosis of thyroid nodules, there has been confusion related to diagnostic terminology in the assessment of samples. This confusion has been caused by multiple category names, descriptive reports without assigning to a category, and different terminologies used for surgical pathology. We aimed to evaluate correlations between US characteristics, cytologic results of FNAB, and thyroid antibodies, calcitonin, and thyroid function tests in patients presented with thyroid nodules, and to contribute in diagnosis, treatment, and patient follow-up. Methods: A total of 1639 patients with thyroid nodules who applied to outpatient clinic of endocrinology between dates April and May 2017, had FNAB under US guideline, and their pathologic evaluation was performed according to Bethesda classification. Serological and hormonal tests were also performed for each patient. Results: The mean age of study group was 50 (range interval= 14-90) years. The median of node-diameter1 was 17.5 (range=1-51) mm, and median of node-diameter2 was 12 (range=8-33) mm. Of US characteristics, echogenicity, microcalcification, irregular borders, and solitary nodules were determined in 4.4%, 54%, 71.2%, and 86.6% of cohort respectively. Elevated anti-TPO was determined in 64.6%. Cytologic readings were reported as 15.8% nondiagnostic, 53.8% atypia of undetermined significance/follicular lesion of undetermined significance, 28.8% benign, 0.4% suspicious for follicular nodule, and 1.2% malign.   Conclusion: Measurement of thyroid autoantiboides, calcitonin, and thyroid function tests have good correlations with Bethesda classification in patients with thyroid nodules.

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