The incidence of malignant tumors and leukemia was analyzed in 829 patients with chronic lymphocytic thyroiditis and in 829 individually age-matched and sex-matched patients with colloid goiter. Diagnoses were based on cytologic studies of specimens obtained by fine-needle aspiration biopsy. The patients were examined between 1959 and 1978 and were followed in the Swedish Cancer Register between 1959 and 1981. There was no increased risk for the total number of tumors in the thyroiditis group (53 observed vs. 52.7 expected) or in the colloid-goiter group (40 vs. 53.2, respectively; P not significant). There were six lung cancers in the thyroiditis group (2.9 expected, P not significant), and one in the group with colloid goiter. Patients with thyroiditis had an increased risk of myeloproliferative and lymphoproliferative neoplasms (12 observed vs. 3.0 expected, P less than 0.001). The risk of malignant thyroid lymphoma was greatly increased, with an estimated relative risk of 67 (4 observed vs. 0.06 expected, P less than 0.000001). There was no increased risk for any type of tumor among patients with colloid goiter.

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Aspiration biopsy cytology (ABC) is a diagnostic method that has been used extensively in Sweden for a quarter of a century. The technical steps involved in this biopsy procedure are described, and the differences from large needle biopsy techniques are pointed out. An overview is given of the different pathologic conditions that present as thyroid nodules and are recognizable by ABC. The accuracy of the method as a preoperative diagnostic tool has been shown to be superior to other clinical methods. ABC enables the surgeon not only to better select patients with thyroid nodules for surgery, but also to plan a definite operative strategy in papillary, medullary, and anaplastic neoplasms. In follicular neoplasms, however, the method cannot distinguish with certainty between adenoma and carcinoma. ABC has drastically reduced the number of diagnostic surgical operations for benign lesions. It requires no anesthesia. It has no complications and there is good patient acceptance, even in children.

In 79 cases of histologically verified anaplastic giant-cell carcinoma, symptoms, treatment, and prognosis were documented. Seventy-eight patients are dead, the mean survival time being 2.5 months. One patient is cured. It was concluded that surgery and/or radiotherapy alone are not sufficient. The results from an additional 8 patients also treated with methotexate indicate a positive therapeutic effect, the mean survival time being 9.4 months. Disappearance of recurrent tumor or pulmonary metastases was noted in 2 patients.Cancer 35 : 1293-1295, 1 975.