Association between Hashimoto’s thyroiditis and papillary thyroid carcinoma: a retrospective analysis of 305 patients

Abstract

Background The association between Hashimoto’s thyroiditis (HT) and papillary thyroid carcinoma (PTC) is a controversial question that is still under debate, its pathological significance and the eventual clinical implications of this association remaining unclear. Methods The data regarding 305 patients were retrospectively analyzed. The patients were divided in two different groups. A first group made up of 142 patients undergoing surgery for differentiated thyroid carcinoma was compared to a control group of 142 analogous subjects operated for normofunctioning goiter. A second group was made up of 163 patients who had undergone total thyroidectomy (TT) with pre-operative diagnosis of HT. Results In the first group of patients an association with HT was found in 28,6% of the patients with final histopathological diagnosis of PTC versus 7,7% of the patients with histopathological diagnosis of multinodular goiter, which was a significant difference ( p < 0.001). In the second group, the association with PTC was found in 43 (40,2%) cases of HT nodular variant and in 3 cases (8,1%) of HT diffuse variant ( p < 0.001). Conclusions The relationship between HT and PTC is still far from clear and represents an unresolved issue. Our own study has underlined the frequent coexistence of these two pathologies, an aspect not to be neglected in clinical practice. Patients receiving HT diagnosis should undergo careful follow-up and, especially those with the nodular variant, should undergo a frequent both clinical and cytological evaluation of the nodular lesions, taking always into great consideration the surgical approach of total thyroidectomy.

A Nomogram Predicting Central Lymph Node Metastasis for Patients with Papillary Thyroid Cancer

“…Currently, a range of works 13,21,30,31 , especially retrospective study, have determined a high concurrence rate of HT and PTC from surgical specimens but the relationship between these two diseases, as well as HT and CLNM, has been controversial. Immunologically, emerging evidence has shown that an abnormal in ammatory response, especially the imbalanced subsets of T cells, NK cells, and cytokines were presenting in HT condition 12,32 , which could potentially affect the tumor microenvironment and subsequent prognosis.…”

On the basis of Hashimoto's thyroiditis, to form papillary thyroid carcinoma, metastasized and then to de-differentiate into poorly differentiated squamous cell carcinoma

“…There is overwhelming evidence to show that HT is closely related to thyroid cancer, especially PCT (2)(3)(4)(5)(6)(7)(21)(22)(23). Giuseppa G et al found that in a study of 305 cases of PTC divided into two groups, up to 40.2% of the patients coexisted both diffuse HT and PTC in one group, and the results of this study indicated that the coexistence of HT and PTC was very high (4). Several other studies have also shown that HT is closely related to PTC (2,5,21,22).…”

“…Up to 40% of PTC is accompanied by HT and/or CLT. On the basis of immune in ammation, thyroid cancer, especially PTC could be induced (3)(4)(5)(6). However, the association between thyroid cancer and concomitant autoimmune thyroiditis is controversial (4,7).…”

A Case of Follicular Tumor of Uncertain Malignant Potential (FT-UMP) with Glomeruloid Features Showing Capsular Mucinous Degeneration

“…None of the FTC used as controls showed mucinous Alcian Blue positive material in the foci of invasion, and neither it has been reported in previous literature. We could hypothesize that some enzymes secreted by the tumor, such as some metalloproteases, could induce stromal degradation, thus facilitating the invasion [ 9 – 11 ]. This hypothesis needs to be further investigated on a larger number of cases, even to confirm if this is a typical feature of “glomeruloid FTC.”…”