Pathologic Spectrum of Lymphocytic Infiltration and Recurrence of Papillary Thyroid Carcinoma

Abstract

PurposeThe aim of this study was to investigate the prognosis of papillary thyroid carcinoma (PTC) patients according to different pathologic grades of lymphocytic thyroiditis (LT).Materials and MethodsThis study included 144 PTC patients who underwent total thyroidectomy with radioactive iodine remnant ablation therapy. Pathologic grades of LT were separated at two points, chronic lymphocytic thyroiditis (CLT) and Hashimoto thyroiditis (HT). Patients were divided into two groupings according to the presence of the diseases (Grouping 1; patients with CLT or HT and without CLT or HT, Grouping 2; patients with HT and without HT). The groupings were compared according to recurrence, clinicopathologic and ultrasound (US) characteristics, and disease free survival.ResultsOf 144 patients, 41 had CLT and 19 had HT. There were 10 patients (6.9%) with tumor recurrence. In both groupings, the presence of calcification was more frequently associated with patients with LT (p=0.041 and 0.047, respectively). In Grouping 2, the mean age at diagnosis was older in patients without HT compared to patients with HT (p=0.032). On multivariate analysis, the presence of LT was not an independent predictor of recurrence in both groupings. For both groupings, pathologic tumor size and taller than wide shape on US were independent predictors of recurrence. The presence of LT in PTC patients did not affect recurrence.ConclusionThere was no relationship between PTC prognosis and different grades of LT. Pathologic tumor size and taller than wide shape on ultrasound were independent predictors of PTC recurrence regardless of concurrent LT.

Evaluation of Underlying Lymphocytic Thyroiditis With Histogram Analysis Using Grayscale Ultrasound Images

“…2,24 Unlike normal thyroid tissue, which reveals homogeneous high echogenicity on US images, lymphocytic thyroiditis shows destruction of follicular architecture and lymphocytic infiltrations, which result in heterogeneous decreased echogenicity. 8,18,29,30 In our study, even when experienced radiologists assessed the presence of lymphocytic thyroiditis on the basis of known US features of lymphocytic thyroiditis, their assessments were not consistent (generalized κ = -0.002-0.781). This finding indicated that visual inspection of grayscale US images had poor reproducibility, and diagnostic performances were variable among the 3 reviewers.…”

“…A real‐time US examination of the thyroid gland has been said to be sufficient for differentiation of diffuse thyroid disease from a normal thyroid gland 2 , 24 . Unlike normal thyroid tissue, which reveals homogeneous high echogenicity on US images, lymphocytic thyroiditis shows destruction of follicular architecture and lymphocytic infiltrations, which result in heterogeneous decreased echogenicity 8 , 18 , 29 , 30 . In our study, even when experienced radiologists assessed the presence of lymphocytic thyroiditis on the basis of known US features of lymphocytic thyroiditis, their assessments were not consistent (generalized κ = −0.002–0.781).…”

Association of Preoperative US Features and Recurrence in Patients with Classic Papillary Thyroid Carcinoma

“…Prophylactic central lymph node dissection was routinely performed at the time of total thyroidectomy for all included patients. (26,27). However, the association between preoperative US features and recurrence of classic PTC was the primary concern of the present study, and none of these concepts were documented in the previous studies (26,27).…”

Histogram and gray level co-occurrence matrix on gray-scale ultrasound images for diagnosing lymphocytic thyroiditis

“…HT was defined when histologic features showed CLT with follicular atrophy, diffuse destruction of thyroid follicles, fibrosis, and follicular cell regeneration. Peritumoral inflammatory response was not considered as LT change [2].…”