TSH and thyroid cancer (literature analysis and results of own research)

The aimwas to analyze the literature data on the TSH content in the blood serum of patients with differentiated thyroid carcinomas and to study the hormone content depending on the aggressiveness of the tumors, and also in the presence of some pathological changes in the extra-tumoral tissue that may affect the biological behavior of papillary carcinomas. Material and methods. A retrospective study of the cohort of patients who who had surgery for thyroid tumor. Results. The level of TSH in the serum of patients with papillary or follicular carcinomas is higher (but within the "normal" level) such in patients with nodular goiter. The highest level of hormone is recorded in the blood of women in the case of a combination of metastases in the lymph nodes with intra- and extrathyroid invasion, as well as in women over 45 with stage III/IV disease. In male patients, elevated TSH levels do not undergo significant modulations, depending on the metastatic and/or invasive properties of papillary carcinoma. The level of the hormone in the blood of women in the case of diagnosis in the extra-tumoral tissue of the gland expressed hyperplastic process or chronic thyroiditis is higher compared with patients who have not revealed pathomorphological changes in the gland tissue. Men also have an elevated level of TSH in the presence of chronic thyroiditis in the extra-tumoral tissue. When association of a tumor with adenoma or hyperplasia of the thyroid parenchyma, the content of tropic hormone does not differ from that of men from the comparison group; it is less when a single benign node or diffuse colloid goiter is present in the extra-tumoral tissue. Conclusions. In the blood of patients with thyroid carcinomas, especially in women with invasive papillary carcinomas, there is a higher level of TSH in the blood compared to that in patients with nodular goiter. The modulation of the content of trophic hormone can be affected by pathological changes in the extra-tumoral tissue that accompany the papillary carcinoma.

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DIFFERENTIATED THYROID CARCINOMAS ASSOCIATED WITH CHRONIC THYROIDITIS: BIOLOGICAL AND CLINICAL PROPERTIES

Experimental Oncology ◽

10.31768/2312-8852.2018.40(2):128-131 ◽

2018 ◽

Vol 40 (2) ◽

pp. 128-131 ◽

Cited By ~ 1

Author(s):

T M Myshunina ◽

B D Guda ◽

M Yu Bolgov ◽

N I Mikhailenko ◽

N D Tronko

Keyword(s):

Tumor Growth ◽

Lymph Nodes ◽

Papillary Carcinoma ◽

Tumor Size ◽

Follicular Carcinoma ◽

Disease Stage ◽

Chronic Thyroiditis ◽

Cervical Lymph Nodes ◽

Thyroid Carcinomas ◽

Carcinoma Metastasis

Aim: To determine biological and clinical features of papillary and follicular thyroid carcinomas associated or not associated with chronic thyroiditis. Materials and Methods: The study was conducted by retrospective analysis of medical histories of 2,459 patients with thyroid cancer. Tumor size, its category according to the TNM system, multi-focal properties of tumor growth, carcinoma invasiveness, as well as disease stage, rates of relapses and metastasis, and also cumulative survival rates were analyzed. Results: The tumor size in patients with papillary or follicular carcinoma associated with thyroiditis was smaller compared to the patients without thyroiditis. In the first case, the invasion frequency into extrathyroid structure and into the capsule was also lower. Multi-focal growth of both carcinoma types was registered more frequently in the presence of thyroiditis. The frequency of papillary carcinoma metastasis to lateral cervical lymph nodes was lower in the presence of thyroiditis, the frequency being equal for metastasis into lymph nodes of the VI lymph outflow zone in both groups of patients (with and without thyroiditis). In the presence of thyroiditis, the frequency of distant papillary carcinoma metastasis was decreased, no metastases were detected in patients with follicular carcinoma. In the group of patients with papillary carcinoma there was found no relation between the presence of thyroiditis and disease stage, relapse rates, and mortality levels; however, the risk of follicular carcinoma relapse was significantly lower in patients with thyroiditis. Conclusions: The presence of chronic thyroiditis in papillary carcinoma patients showed a certain positive impact on the course of the disease, in particular, primary tumor growth, invasion, and metastasis. Such effect is even more expressed in the patients with follicular thyroid carcinoma.

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Synchronous intrathyroidal parathyroid carcinoma and thyroid carcinoma: case report and review of the literature

BMC Endocrine Disorders ◽

10.1186/s12902-021-00724-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Nadia De Falco ◽

Giuseppe Santangelo ◽

Fabrizio Chirico ◽

Angelo Cangiano ◽

Maria Giulia Sommella ◽

...

Keyword(s):

Literature Review ◽

Thyroid Carcinoma ◽

Papillary Carcinoma ◽

Parathyroid Carcinoma ◽

Malignant Tumors ◽

Gamma Probe ◽

Differentiated Thyroid Carcinoma ◽

Thyroid Carcinomas ◽

First Case ◽

Well Differentiated

Abstract Background Parathyroid carcinoma is a rare endocrine malignancy, rarer when synchronous with a non medullary well differentiated thyroid carcinoma. Parathyroid carcinoma accounts of 0.005% of all malignant tumors and it is responsible for less than 1% of primary hyperparathyroidism. The intrathyroidal localization of a parathyroid gland is not frequent with a reported prevalence of 0.2%. Carcinoma of parathyroids with intrathyroidal localization represents an even rarer finding, reported in only 16 cases described in literature. The rare constellation of synchronous parathyroid and thyroid carcinomas has prompted us to report our experience and perform literature review. Case presentation We herein report a case of a 63-years-old man with multinodular goiter and biochemical diagnosis of hyperparathyroidism. Total thyroidectomy with radio-guide technique using gamma probe after intraoperative sesta-MIBI administration and intraoperative PTH level was performed. The high radiation levels in the posterior thyroid lobe discovered an intrathyroidal parathyroid. Microscopic examination revealed a parathyroid main cell carcinoma at the posterior thyroidal left basal lobe, a classic papillary carcinoma at the same lobe and follicular variant of papillary carcinoma at the thyroidal right lobe. To the best of our knowledge, this is the first case documenting a synchronous multicentric non medullary thyroid carcinomas and intrathyroidal parathyroid carcinoma. Conclusions Our experience was reported and literature review underlining challenging difficulties in diagnostic workup and surgical management was carried out.

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Lymphocytic Infiltration in Pediatric Thyroid Carcinomas

Pediatric and Developmental Pathology ◽

10.1007/s10024-003-3028-3 ◽

2004 ◽

Vol 7 (5) ◽

pp. 487-492 ◽

Cited By ~ 10

Author(s):

Van H. Savell ◽

Stephen M. Hughes ◽

Charles Bower ◽

David M. Parham

Keyword(s):

Papillary Carcinoma ◽

Follicular Carcinoma ◽

Thyroid Neoplasms ◽

Lymphocytic Infiltration ◽

Lymphocytic Infiltrate ◽

Low Grade ◽

Lymphoid Infiltrate ◽

Thyroid Carcinomas ◽

Thyroid Papillary ◽

Adults And Children

Lymphocytic thyroiditis has been associated with an increase in the incidence of thyroid papillary carcinoma in some reports, mostly series of both adults and children. Relatively little is written about thyroiditis and follicular carcinomas. We have seen several cases of pediatric follicular thyroid carcinomas, that had an associated lymphocytic infiltrate, which led us to examine all primary malignant thyroid neoplasms in our surgical files from 1984 through 2000 to examine this relationship. We also investigated the nature of the lymphocytic infiltrate with routine immunohistochemistry. Ten patients (five male, five female, ages 4.5–21 years of age) had a thyroid carcinoma resection, six (three males and three females) with papillary carcinoma and four patients (two males and two females) with low-grade follicular carcinoma. Seven samples (one male had two cases with tumor) from patients who had a papillary carcinoma resection with tissue blocks available were identified (one patient had slides but no blocks), as were all four patients with a follicular carcinoma. The thyroid of all patients with a follicular carcinoma contained a lymphocytic infiltrate; only four of the seven papillary carcinoma samples had an associated lymphoid infiltrate. In all cases with a lymphoid infiltrate, the infiltrate was present in both lobes (both adjacent and separate from the tumor). B lymphocytes were present in the lymphoid infiltrate of three of four patients with follicular carcinomas and in 1 of 3 cases of papillary carcinomas. T cells were dispersed throughout all the tumors with lymphoid infiltrates. We conclude that pediatric follicular carcinomas have an associated lymphocytic infiltrate in the tumor and/or adjacent thyroid, more commonly than papillary carcinomas.

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DNA repair proteins may differentiate papillary thyroid cancer from chronic lymphocytic thyroiditis and nodular colloidal goiter

Scientific Reports ◽

10.1038/s41598-021-89403-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Bahri Evren ◽

Sami Yılmaz ◽

Neşe Karadağ ◽

Ayşe Çıkım Sertkaya ◽

Ömercan Topaloğlu ◽

...

Keyword(s):

Dna Repair ◽

Thyroid Cancer ◽

Papillary Carcinoma ◽

Staining Intensity ◽

Follicular Cell ◽

Papillary Thyroid ◽

Chronic Thyroiditis ◽

Dna Repair Proteins ◽

The Difference ◽

Repair Genes

AbstractMalignant thyroid lesions are the most common malignancy of the endocrine glands with increasing rates in the last two decades. Papillary thyroid cancer is the most common thyroid malignancy. In our study, we aimed to quantitatively evaluate the levels of DNA repair proteins MSH2, MLH1, MGMT, which are representative blocks of patients diagnosed with papillary carcinoma, chronic thyroiditis, or colloidal goiter. Total or subtotal thyroidectomy material of 90 patients diagnosed with papillary carcinoma, nodular colloidal goiter, or chronic thyroiditis between 2009 and 2012 were retrospectively evaluated. Tissue samples obtained from paraffin blocks were stained with MGMT, MSH2, MLH1 proteins and their immunohistochemistry was evaluated. Prepared sections were examined qualitatively by an impartial pathologist and a clinician, taking into account the staining method under the trinocular light microscope. Although there was no statistically significant difference in MGMT, MSH2, MLH1, follicular cell positivity, staining intensity, and immunoreactivity values, papillary carcinoma cases showed a higher rate of follicular cell positivity, and this difference was more pronounced between papillary carcinoma and colloidal goiter. In the MSH2 follicular cell positivity evaluation, the difference between chronic thyroiditis and colloidal goiter was significant (p = 0.023). The difference between chronic thyroiditis and colloidal goiter was significant in the MSH2 staining intensity evaluation (p = 0.001). The difference between chronic thyroiditis and colloidal goiter was significant in MLH1 immunoreactivity evaluation (p = 0.012). Papillary carcinoma cases were demonstrated by nuclear staining only for MSH2 and MLH1 proteins as opposed to hyperplastic nodules. The higher levels of expression of DNA repair genes in malignant tumors compared to benign tumors are attributed to the functional activation of DNA repair genes. Further studies are needed for DNA repair proteins to be a potential test in the development and progression of thyroid cancer.

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Certain peculiarities of parenchymal-stromal correlations in the thyroid gland with nodular forms of goiter with its rucurrent and non-recurrent course

Clinical anatomy and operative surgery ◽

10.24061/1727-0847.19.1.2020.9 ◽

2020 ◽

Vol 19 (1) ◽

pp. 53-60

Author(s):

N. P. Tkachuk ◽

I. S. Davydenko

Keyword(s):

Thyroid Gland ◽

Slow Growth ◽

Thyroid Tissue ◽

Nodular Goiter ◽

Specific Weight ◽

Pathological Changes ◽

Normal Thyroid Tissue ◽

Normal Thyroid ◽

Stromal Component ◽

Correlation Parameters

In spite of a considerable efficacy of conservative treatment of goiter, surgery remains the main method of treatment of such patients. Though, on the one hand, total thyroidectomy inevitably results in the development of postsurgical hypothyroidism, on the other hand – in case organ-saving surgery is performed the risk of postsurgical relapse arises. Modern morphological methods are directed to detection of oncological risk of nodular formations, and recommendations concerning an adequate volume of surgery taking into account probability of relapse are practically lacking. Therefore, the objective of the study was finding criteria of a relapsing risk by means of investigation of morphological peculiarities of the parenchymal-stromal correlations in the thyroid gland with recurrent nodular and primary nodular (multinodular) goiter without signs of functional disorders. In the course of the research according to the examined correlation parameters of the parenchyma and stroma various forms of nodular goiter were found to differ from the thyroid tissue without pathological changes by a number of parameters. In particular, specific weight of the parenchyma on an average increases reliably in the tissue of nodular goiter with its various variants in comparison with the thyroid gland without pathological changes. Together with the increase of the parenchymal specific weight in nodular goiter the amount of colloid on an average decreases, and a specific dependence on the kind of goiter is observed – colloid volume decreases from goiter with slow growth to goiter with quick growth, and it is the smallest with goiter relapse. Quantitative analysis of the goiter tissue stromal component demonstrates a considerable increase of its specific volume in comparison with normal thyroid tissue. Evaluation of changes of the morphometric parameters in the thyroid follicles found that in case of nodular goiter with slow growth the percentage of follicles with colloid is close to 100%. On an average it does not differ from that of the normal thyroid tissue. At the same time, in case of nodular goiter with quick growth the percentage of follicles with colloid decreases sharply, and in case of relapse it appears to be still less than that in nodular goiter with quick growth. Besides, with nodular goiter the diameter of follicles on an average increases in comparison with the normal thyroid tissue. In a number of cases it can be estimated as macrofollicular goiter. At the same time, the diameter of follicles is smaller in nodular goiter with quick growth. It is still less in case of goiter relapse. The size of follicles becomes sharply diverse in case of nodular goiter with slow growth, but it decreases in case of nodular goiter with quick growth and relapse. Consequently, recurrent nodular goiter is mostly similar to that of primary nodular goiter with a quick growth, though certain differences between them exist. The peculiarities found enable to suggest that nodular goiter with a quick growth possesses more chances for relapse.

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Clinicopathological study of thyroid swelling and its management

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20201290 ◽

2020 ◽

Vol 6 (4) ◽

pp. 727

Author(s):

Seema Patel ◽

Varsha J. Gattani ◽

Ashok Z. Nitnaware

Keyword(s):

Papillary Carcinoma ◽

Surgical Management ◽

False Negative ◽

Malignant Lesion ◽

Nodular Goiter ◽

Follicular Neoplasm ◽

Histopathological Diagnosis ◽

Predictive Values ◽

Neoplastic Lesion ◽

Thyroid Swelling

Background: There is high prevalence of thyroid lesions in India. In this study, an attempt is made to find out the clinical spectrum of thyroid swellings in central India, diagnostic accuracy of fine needle aspiration cytology (FNAC), appropriate surgical management and to compare it with postoperative histopathological diagnosis so as to determine its role in surgical management.Methods: In this prospective study, 100 subjects presenting to ENT OPD of GMC, Nagpur during the period from September 2017 to August 2019 with thyroid swelling who were fit to undergo surgery and willing to participate in the study were selected. After detailed evaluation and routine investigations, thyroid function test (TFT), FNAC, ultrasonography (USG) neck, all the subjects underwent required thyroidectomy. The postoperative histopathological examination (HPE) report was correlated with cytological report. Results: In 100 subjects, majority of subjects were from 4th decade (32%) with female: male ratio=6.14:1. FNAC findings were colloid goiter (61%), nodular goiter (19%), follicular neoplasm (10%), and papillary carcinoma (9%). On HPE, colloid goitre (57%) was most common non-neoplastic lesion and papillary carcinoma (65.21 %) was most common malignant lesion. Hemithyroidectomy (70%) was most common procedure done. Transient hypocalcemia (5%), recurrent laryngeal nerve (RLN) paresis (2%) were the postoperative complications encountered. Sensitivity, specificity, accuracy, positive and negative predictive values of FNAC to diagnose malignancy were 55.6%, 100%, 91%, 100% and 90% respectively.Conclusions: FNAC is an easy, rapid, reliable, cost-effective, minimally invasive and readily repeatable technique for diagnosis of thyroid swellings. The common false negative diagnosis is seen in follicular pattern cases, cystic papillary thyroid carcinoma (PTC) and papillary microcarcinoma.

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Amphicrine carcinoma of the stomach and intestine: a clinicopathologic and pan-cancer transcriptome analysis of a distinct entity

Cancer Cell International ◽

10.1186/s12935-019-1031-7 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 5

Author(s):

Dan Huang ◽

Fei Ren ◽

Shujuan Ni ◽

Cong Tan ◽

Weiwei Weng ◽

...

Keyword(s):

Neuroendocrine Tumors ◽

Expression Patterns ◽

Biological Behavior ◽

Low Grade ◽

High Grade ◽

Clinicopathologic Characteristics ◽

Signet Ring ◽

Cancer Transcriptome ◽

Male Patients ◽

Pan Cancer

Abstract Background and aim Amphicrine carcinoma, in which endocrine and epithelial cell constituents are present within the same cell, is very rare. This study characterized the clinicopathologic and survival analysis of this tumor, further compared the genetic diversities among amphicrine carcinoma and other tumors. Materials and methods The clinicopathologic characteristics and survival outcomes of amphicrine carcinoma in this study were analyzed. The pan-cancer transcriptome assay was utilized to compare the genetic expression profile of this entity with that of conventional adenocarcinoma or neuroendocrine tumors. Results Ten cases (all in male patients) were identified in the stomach or intestine, with a median patient age of 62 years. There were characteristic patterns in the tumors: tubular, fusion or single-file growth of goblet- or signet ring-like cells. Four tumors were classified as low-grade and 6 as high-grade according to the histologic architecture. All cases were positive for neuroendocrine markers (synaptophysin and chromogranin A) and showed intracellular mucin in the amphicrine components. Four cases exhibited mRNA expression patterns showing transcriptional homogeneity with conventional adenocarcinomas and genetic diversity from neuroendocrine tumors. During the follow-up period, 3 patients died of disease, all of whom had high-grade tumors. Patients with high-grade amphicrine carcinoma had worse outcomes than those with low-grade tumors. Conclusions This study confirms the morphological, immunostaining and transcriptome alterations in amphicrine carcinoma distinct from those in conventional adenocarcinomas and neuroendocrine tumors, but additional studies are warranted to determine the biological behavior and therapeutic response.

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Papillary carcinoma in a thyroglossal duct remnant with normal thyroid gland

The Journal of Laryngology & Otology ◽

10.1017/s0022215100125605 ◽

1993 ◽

Vol 107 (12) ◽

pp. 1174-1176 ◽

Cited By ~ 18

Author(s):

Kadriye Yildiz ◽

Haydar Köksal ◽

Yavuz Özoran ◽

Hayrettin Muhtar ◽

Münir Telatar

Keyword(s):

Thyroid Gland ◽

Papillary Carcinoma ◽

Papillary Thyroid ◽

Thyroglossal Duct ◽

Normal Thyroid ◽

Thyroid Carcinomas ◽

First Report ◽

Thyroglossal Duct Remnant

Carcinoma in the thyroglossal duct remnant is relatively uncommon. Since the first report by Uchermann (1915), more than 150 cases of carcinoma have been reported, and the majority have been papillary thyroid carcinomas (Li Volsi etal., 1974; McNicol etal., 1988). In this report, we present a case of papillary carcinoma in the thyroglossal duct with a normal thyroid gland

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