scholarly journals Prevalence of papillary thyroid cancer in subacute thyroiditis patients may be higher than it is presumed: retrospective analysis of 137 patients

2018 ◽  
Vol 52 (3) ◽  
pp. 257-262 ◽  
Author(s):  
Nurdan Gül ◽  
Ayşe Kubat Üzüm ◽  
Özlem Soyluk Selçukbiricik ◽  
Gülçin Yegen ◽  
Refik Tanakol ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Differentiated Thyroid Cancer ◽  
Histopathological Examination ◽  
Needle Aspiration ◽  
Subacute Thyroiditis ◽  
Papillary Thyroid ◽  
Small Series ◽  
Male Patients

Abstract Background The association of subacute thyroiditis (SAT) and papillary thyroid carcinoma is a rare finding. In this study, we aimed to investigate the prevalence of differentiated thyroid cancer in a cohort of patients followed with the diagnosis of SAT. Patients and methods We retrospectively screened medical records of Endocrinology and Metabolism outpatient clinic in the past 20 years for patients with SAT. Patients with nodules and suspicious ultrasonography findings who underwent fine needle aspiration biopsy (FNAB) and operated due to malignancy risk were identified. Results We identified 137 (100 females, 37 males) patients with reliable records to confirm the diagnosis of SAT. The mean age of female patients was 41.1 ± 9.1 (range, 20–64) and of male patients was 43.0 ± 9.3 (range, 20–65). One or more FNAB was performed in 23 of the patients (16.8%) at the beginning and/or during the follow-up period when needed. Seven patients with suspicious FNAB findings were operated, and histopathological examination of the nodules confirmed the diagnosis of papillary thyroid carcinoma in 6 patients (4.4%). Conclusions Our observations suggesting a relatively higher prevalence of thyroid cancer in a small series of SAT patients warrant further studies to identify the real frequency of differentiated thyroid cancer and its association with inflammatory pathogenesis of SAT. This finding is compatible with the trend of increased thyroid cancer incidence all over the world. A repeat ultrasonography after resolution of clinical and inflammatory findings, and FNAB should be recommended to all patients with suspicious nodules.

scholarly journals Cytohistological Concordance of Papillary Carcinoma of Thyroid and Its Variants

2021 ◽  
Vol 8 (04) ◽  
pp. 213-218
Author(s):  
Nameera Saleem ◽  
Naval Kishore Bajaj ◽  
Ezhil Arasi Nagamuthu
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Papillary Carcinoma ◽  
Fine Needle Aspiration ◽  
Histopathological Examination ◽  
Correct Diagnosis ◽  
Needle Aspiration ◽  
Papillary Thyroid ◽  
Fine Needle ◽  
Nuclear Features

BACKGROUND Papillary thyroid carcinoma is the most common malignancy of the thyroid gland. Fine Needle Aspiration Cytology (FNAC) is a rapid, safe and economic procedure, and has a sensitivity approaching of 93.5 % and specificity close to 90 % for diagnosing papillary thyroid carcinomas. This study aims at correlating the cytological and histological diagnosis to arrive at the rate of concordance and discordance, identify variants of papillary thyroid carcinoma (PTC) on cytology and discuss the cytological mimics of PTC. METHODS Data from cases was collected over a period of three years (2015 - 2018). A descriptive study was done. Cases from Osmania General Hospital representing histologically proven cases of papillary carcinoma thyroid along with their corresponding cytological findings were analysed. Cytosmears were obtained from fine needle aspiration of thyroid lesions using a 26-gauge needle, stained with haematoxylin and eosin (H&E). Thyroidectomy specimens were fixed in 10 % buffered formalin, grossed and paraffin embedded. After processing, sections obtained by microtomy were stained with H & E for histopathologic evaluation. RESULTS The institute received a total of 258 thyroid specimens for histopathology and 686 cases for thyroid FNAC over a period of three years. This study includes 70 cases which had both cytology and histopathology correlation at our institution. 65 cases were diagnosed as PTC on histopathology and correct diagnosis was made on cytology with 73.8 % concordance (48 / 65 cases) and discordance was seen in 26.1 % (17 / 65 cases). 5 cases were misdiagnosed on cytology as PTC, and on histopathological examination were diagnosed as non-PTC. CONCLUSIONS Fine needle aspiration shows variable accuracy for PTC, ranging from 65 % to 90 %. The architectural arrangement of cells in papillary fragments and presence of nuclear features in majority of cells is diagnostic of the conventional variant of PTC. The other variants however, pose a diagnostic dilemma on account of their architectural variation, altered cytomorphology and the scant presence of nuclear features. An increase in the awareness of cytomorphology of variants and also of the mimics of PTC helps improve the diagnostic accuracy on FNAC. KEYWORDS Papillary Thyroid Carcinoma, Variants of PTC, Cytohistopathological Correlation

scholarly journals Microcalcifications without a thyroid nodule as the sole sign of papillary thyroid carcinoma

2021 ◽  
Vol 2021 ◽  
Author(s):  
Stamatina Ioakim ◽  
Vasilis Constantinides ◽  
Meropi Toumba ◽  
Theodoros Lyssiotis ◽  
Angelos Kyriacou
Keyword(s):  
High Risk ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Gland ◽  
Thyroid Carcinoma ◽  
Histopathological Examination ◽  
Needle Aspiration ◽  
List Type ◽  
Papillary Thyroid ◽  
Resected Tissue ◽  
Current Guidelines

Summary Our objective is to demonstrate the importance of considering microcalcifications even without evidence of nodules as a potential sign of malignancy. Current guidelines, such as those of the British Thyroid Association, acknowledge the clinical significance of microcalcifications only when found within nodules. In this case, they are considered a suspicious feature, classifying the nodules as U5 (i.e. high risk) where fine-needle aspiration biopsy (FNAB) is warranted, following the high likelihood of cancer in these nodules. In addition, there is a dearth of evidence of ultrasound scan (USS) detection of microcalcifications in the thyroid gland outside of nodules, along with their associated clinical implications. Yet, this clinical manifestation is not so infrequent considering that we do encounter patients in the clinic showing these findings upon ultrasound examination. Three patients who presented to our clinic with thyroid-related symptoms were shown to have areas of microcalcifications without a nodule upon sonographic evaluation of their thyroid gland. These incidentally detected hyperechoic foci were later confirmed to correspond to areas of papillary thyroid carcinoma (PTC) on histopathological examination of resected tissue following thyroidectomy. Four more cases were identified with sonographic evidence of microcalcifications without nodules and given their clinical and other sonographic characteristics were managed with active surveillance instead. Learning points Echogenic foci known as microcalcifications may be visible without apparent association to nodular structures. Microcalcifications without nodules may not be an infrequent finding. Microcalcifications are frequently indicative of malignancy within the thyroid gland even without a clearly delineated nodule. Empirically, the usual guidelines for the management of thyroid nodules can be applied to the management of microcalcifications not confined to a nodule, but such a finding per se should be classified as a ‘high-risk’ sign.

scholarly journals Rationales for the Use of Cancer Stem Cells Markers in the Staging of Papillary Thyroid Carcinoma

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Noah Abd-Alkader Mahmood ◽  
Amer Talib Tawfeeq ◽  
Israa Mhdi Al-Sudani ◽  
Zaynab Saad Abd-Alghni
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Histopathological Examination ◽  
Standard Procedure ◽  
Tumor Stage ◽  
Needle Aspiration ◽  
Stem Cell Markers ◽  
Papillary Thyroid ◽  
Expression Levels ◽  
Cancer Stem Cell Markers

Fine needle aspiration biopsy (FNAB) is a standard procedure for the detection of thyroid nodules malignancy, yet 10-25% of the sample diagnosed may go undetermined or suspicious. The utility of cancer stem cell markers (CSCM) as a differential diagnosis molecular marker in nodules of suspicious decision in FNAB was hypothesized. Papillary thyroid carcinoma (PTC) and thyroid fibroadenoma (TFA) samples were selected to test the hypothesis. The samples employed in this study were from patients who had thyroid hyperplasia and a suspicious or undetermined diagnosis by FNAB. The patient underwent a successful thyroidectomy at Al-Yarmouk Teaching Hospital in Baghdad between January 2015 and December 2017. All nodule samples underwent a systematic histopathological examination after resection. Tumors diagnosed as PTC and those diagnosed as fibroadenoma (TFA) were selected for this study. Collectively 39 PTC and 11 TFA nodules were included. Quantitative reverse transcriptase real-time PCR (qRT-PCR) and immunohistochemistry (IHC) were used to determine levels of mRNA and proteins of CSCM ALDH1A1, CD44, ABCG2, and Oct3/4 in both types of tumors were used. This study revealed that the expression levels of CSCM were significantly increased in PTC tissues when compared to benign tissues and the positive correlation was found between the CSCM expression levels and tumor stage, size, and gender. In conclusion, for a more precise diagnosis, we suggest these markers be included in what is currently available to characterize malignancy from what is not in thyroid cancer, as well as for the staging process of PTC.

scholarly journals Warthin-Like Papillary Carcinoma of the Thyroid Gland: Case Report and Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Panagiotis Paliogiannis ◽  
Federico Attene ◽  
Federica Trogu ◽  
Mario Trignano
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Gland ◽  
Thyroid Carcinoma ◽  
Papillary Carcinoma ◽  
Histopathological Examination ◽  
Lymph Node Involvement ◽  
Papillary Thyroid ◽  
Review Of The Literature

We present a case of Warthin-like papillary thyroid carcinoma in a 22-year-old woman and a review of the literature on the topic. The patient had the occasional discovery of a hypoechoic thyroid nodule of approximately 18 mm, characterized by irregular margins, hyperechoic spots, rich intra- and perilesional vascularization, and a suspicious enlarged right laterocervical lymph node. Fine-needle aspiration was performed for both lesions and the diagnosis of papillary thyroid carcinoma without lymph node involvement was made. The patient underwent thyroidectomy and central neck lymphadenectomy without complications. Histopathological examination suggested a Warthin-like papillary carcinoma of the thyroid gland, with all the removed lymph nodes being free of disease. The patient subsequently underwent iodine ablative therapy and she remains free of disease one year after surgery. Warthin-like papillary thyroid carcinoma is a recently described variant of papillary thyroid cancer that is frequently associated with lymphocytic thyroiditis. Morphologically, it resembles Warthin tumors of the salivary glands, with T and B lymphocytes infiltrating the stalks of papillae lined with oncocytic cells. Surgical and postoperative management is identical to that of classic differentiated thyroid cancer, while prognosis seems to be favourable.

scholarly journals Diagnostic importance of CD56 with fine-needle aspiration cytology in suspected papillary thyroid carcinoma cases

CytoJournal ◽  
2018 ◽  
Vol 15 ◽  
pp. 3 ◽  
Author(s):  
Ozgen Arslan Solmaz
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Histopathological Examination ◽  
Adult Population ◽  
Thyroid Tissue ◽  
Needle Aspiration ◽  
Papillary Thyroid ◽  
Fine Needle

Background: Palpable thyroid nodules can be found in 4%–7% of the adult population; however, <5% of thyroid nodules are malignant. Immunohistochemical markers, such as CD56, can be used to make a differential diagnosis between benign and malignant lesions. To increase the accuracy of the diagnosis and distinguish the malignant aspirates from the benign ones, chose to evaluate CD56, which is normally found in benign thyroid tissue. Methods: A total of 53 fine-needle aspirate samples from patients diagnosed with suspected papillary thyroid carcinoma (PTC) were included prospectively. These aspirates were immunocytochemically stained for CD56. Results: In histopathological examination, the fine-needle aspiration cytopathology specimens suspicious for PTC (after undergoing surgery) showed that 32 (60.4%) were benign and 21 (39.6%) were malignant. Thirty-one of the benign cases (96.87%) were CD56-positive, whereas the last case (3.13%) was CD56-negative. Staining was not seen in any of the malignant cases. Conclusions: We believe that CD56 is an important marker in the definitive diagnosis of suspected PTC cases, with CD56-positivity being interpreted in favor of benignity.

scholarly journals Papillary thyroid carcinoma of thyroglossal duct cyst; a case report and review of the literature

2012 ◽  
Vol 2 (4) ◽  
pp. 328-330
Author(s):  
VN Shelke ◽  
WK Raut
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Histopathological Examination ◽  
Needle Aspiration ◽  
Thyroglossal Duct Cyst ◽  
Papillary Thyroid ◽  
Duct Cyst ◽  
Thyroglossal Duct ◽  
Pathologic Evaluation ◽  
Thyroglossal Duct Remnants

Thyroglossal duct remnants are the most common midline neck swellings, but malignancy arising in them is a rare finding. Among the carcinomas arising in the thyroglossal duct cyst, papillary thyroid carcinoma is the commonest. Most of the cases of papillary thyroid carcinoma of thyroglossal duct cyst are asymptomatic and clinically diagnosed as thyroglossal duct cyst. It may remain undetected on fine needle aspiration cytology and ultrasonography; therefore diagnosis is established only after pathologic evaluation of biopsy. Hence careful histopathological examination of the excised specimen with high level of suspicion is mandatory in these cases. We are report a case of papillary thyroid carcinoma of thyroglossal duct cyst in a 30-year-old female.Journal of Pathology of Nepal (2012) Vol. 2, 328-330DOI: http://dx.doi.org/10.3126/jpn.v2i4.6889

Assessment Of Plasma B-Catenin Concentration As Biomarker Of Thyroid Cancer*

2015 ◽  
Vol 87 (7) ◽  
Author(s):  
Michał Bełdowski
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Histopathological Examination ◽  
Nodular Goiter ◽  
Diagnostic Methods ◽  
Control Group ◽  
Papillary Thyroid ◽  
It Use ◽  
Cellular Expression

AbstractNew diagnostic methods for thyroid diseases are still being searched for. Immunohistochemical diagnosis is expanded by the introduction of new biomarkers including ß-catenin (B-Cat). Associations are indicated between the cellular expression of this biomarker and tumor stage, nodal metastases and the degree of tumor cell differentiation. Reports are scarce regarding the plasma level of this biomarker in malignant neoplastic diseases.was to analyze the plasma B-Cat concentration and the possibility of it use in the diagnostics of patients with nodular goiter and papillary thyroid carcinoma.Plasma B-Cat concentration was determined in 64 patients with goiter and 15 healthy volunteers. The final histopathological examination revealed 41 cases of papillary thyroid carcinoma (PTC) and 13 cases of nodular goiter (NG).A significant increase in B-Cat (p <0.05) in both groups compared to the control group. No differences in the concentrations of biomarker was demonstrated between the PTC and NG groups. After determining the AUC for the tested biomarker, the B-Cat ratio of the area value 0.721 was the strong diagnostic test.Changes in the plasma B-Cat concentration can be the biomarker of thyroid cancer but it cannot be used for the detection of papillary thyroid carcinoma becouse of concomitant tumor-like lesions in the thyroid gland.

scholarly journals Papillary thyroid cancer case masked by subacute thyroiditis

2014 ◽  
Vol 58 (8) ◽  
pp. 851-854 ◽  
Author(s):  
Bekir Ucan ◽  
Tuncay Delibasi ◽  
Erman Cakal ◽  
Muyesser Sayki Arslan ◽  
Nujen Colak Bozkurt ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Papillary Thyroid Cancer ◽  
Needle Aspiration ◽  
Subacute Thyroiditis ◽  
Cervical Region ◽  
Cancer Case ◽  
Papillary Thyroid ◽  
Posterior Aspect

Subacute thyroiditis (SAT) association with thyroid carcinoma has been rarely reported in the literature. We present a patient with SAT and papillary thyroid cancer that was suspected by ultrasonographic evaluation (US) following SAT treatment. A fifty-four-year old female patient referred to our department due to tachycardia, jitteriness and pain in cervical region for the past one month. SAT diagnosis was established by physical examination, laboratory and ultrasonographic findings. After treatment, control thyroid US revealed regression of the hypoechogenic regions seen in both lobes, and a previously unreported hypoechogenic lesion with microcalcification focus that had irregular borders and was not clearly separated from the surrounding parenchyma located in the posterior aspect of the lobe (Elasto score: 4, Strain index: 7.08). Fine needle aspiration biopsy was taken from this nodule; cytology was assessed to be compatible with papillary thyroid carcinoma. Postsurgical pathology evaluation showed a papillary microcarcinoma. SAT may produce ultrasound changes that obscure the coexistence of papillary carcinoma. We recommend that patients with SAT have ultrasonography after they recover. Hypoechogenic regions bigger than 1 cm that are present in the follow-up post-therapy US should be assessed by biopsy.

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