Nontoxic Nodular Goiter and Papillary Thyroid Carcinoma Are Not Associated With Peripheral Blood Lymphocyte Sensitization to Thyroid Cells*

Abstract

We tested the claim that uni- and multinodular goiter (UNG and MNG) and papillary carcinoma (PC) of the thyroid are autoimmune thyroid diseases (AITD) similar to Graves' disease (GD) and Hashimoto's thyroiditis (HT). The expression of HLA-DR on cultured thyroid epithelial cells (thyrocytes) from UNG, MNG, and PC after coculture with autologous peripheral blood mononuclear cells (PBMC) was compared with that on GD and HT cells. The thyrocytes also were cultured with interferon-gamma (IFN gamma) alone. A cytotoxicity assay involving 51Cr-labeled thyrocytes, anti-HLA-DR, and complement was used to determine HLA-DR expression. Stimulation of thyrocytes with 200 U/mL IFN gamma induced HLA-DR (expressed as a cytotoxicity index) equally well on all thyrocytes [AITD (n = 6): IFN gamma, 23.8 +/- 7.7 (+/- SD); unstimulated, 3.6 +/- 2.0; UNG (n = 6), MNG (n = 9), and PC (n = 5): IFN gamma, 22.5 +/- 4.7; unstimulated, 4.0 +/- 3.0]. When cocultured with autologous PBMC, the values were: AITD, 24.9 +/- 10.1; UNG, MNG, and PC, 3.8 +/- 3.7 (P less than 0.001). The supernatants from the AITD cocultures had higher IFN gamma concentrations (by RIA) than those from the other cocultures. We conclude that in UNG, MNG, and PC, the peripheral blood helper T-lymphocytes are not sensitized to thyrocyte membrane antigen(s); consequently, little if any IFN gamma is produced in cocultures, and hence, there is no increase in thyrocyte HLA-DR expression, unlike the situation in AITD (GD and HT). Thus, UNG, MNG, and PC are not primarily autoimmune in nature, as defined by a lack of sensitization of the PBMC of such patients to thyroid antigen(s).

Non-suppressed thyrotropin and elevated thyroglobulin are independent predictors of recurrence in differentiated thyroid carcinoma

“…However, after controlling for other factors, the type of tumor was not an independent predictor for DTC recurrence in the present study. Frequent occurrence of focal lymphocytic infiltration in the thyroid gland is documented in papillary thyroid carcinoma patients (18). Matsubayashi et al (19) found that lymphocytic infiltration of the tumor was related to favorable prognosis in 95 Japanese patients, which contradicts the results of Kamma et al (20).…”

Ultrasonographic features and clinical characteristics of Warthin-like variant of papillary thyroid carcinoma

“…Likely, all of nine patients had chronic lymphocytic thyroiditis, which had been anticipated based on their underlying heterogeneous parenchyma of the thyroid gland. Even though the prognostic effect of lymphocytic thyroiditis accompanying PTC has been controversial [11,20,21], meticulous care is required in the evaluation of focal lesion with underlying lymphocytic thyroiditis [22]. It is difficult to differentiate WVPTC from dominant lymphocytic infiltration on FNA cytology and the background of lymphocytic thyroiditis may give rise to false negative reports [5,6,17].…”

Thyroid cell survival in coculture with autologous peripheral or intrathyroidal lymphocytes

“…It has also been found by RIA in supernatants of thyrocytes cocultured with autologous PB-lymphocytes after 5 or 7 days incubation (Otsubo et al, 1988;Aguayo et al, 1989). However, Otsubo et al (1988) found IFN-y in only 4/14 coculture supernatants.…”