The Warthin-Like Variant of Papillary Thyroid Carcinoma: A Comparison with Classic Type in the Patients with Coexisting Hashimoto’s Thyroiditis

Abstract

Background. The Warthin-like variant of papillary thyroid (WLPTC) is a rare subtype of papillary thyroid carcinoma (PTC) resembling Warthin tumors of the salivary glands. Due to its rarity, the clinicopathologic and molecular features of WLPTC remain unclear. Methods. Of the 2,139 patients who underwent surgical treatment for PTC from 2012 to 2013, 40 patients with WLPTC were identified and compared to 200 consecutive patients with classic PTC. BRAF mutation was tested with pyrosequencing. Results. There were no significant differences in age, predilection for women, multifocality, extrathyroidal extension, or lymph node metastasis between WLPTC and classic PTC. However, WLPTCs were more commonly associated with Hashimoto's thyroiditis than classic PTCs (93% versus 36%, resp., P < 0.001) and showed significantly lower rate of BRAF mutation when compared to classic PTCs (65% versus 84%, resp., P = 0.007). In classic PTC, the frequency of BRAF mutations was negatively correlated with coexisting Hashimoto's thyroiditis. When we compared WLPTC and classic PTC in the patients with coexisting Hashimoto's thyroiditis, there were no significant differences in clinicopathologic characteristics or the BRAF mutational rate between the two groups. Conclusions. Patients with WLPTC have similar demographic, clinical, pathologic, and molecular characteristics to those with classic PTC coexisting with Hashimoto's thyroiditis.

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

“…The mean nodule size was smaller than previous studies [5,6], but similar to the recent studies [8,11]. No BRAF V600E mutation was detected in patients with WVPTCs although three of nine had undergone BRAF V600E mutation analysis in this study: this trend is comparable to the findings of a previous study in which WVPTCs showed fewer mutations than conventional PTCs [11].…”

“…Our patients were somewhat older than those reported in previous studies, but showed similar wide range of age distribution [5,6,8,11]. The mean nodule size was smaller than previous studies [5,6], but similar to the recent studies [8,11].…”

“…Understanding the US features of WVPTC might be helpful for making an appropriate treatment plan. The clinical, cytological and histopathological features of WVPTC had been demonstrated [8,11]. However, to our knowledge, there were no reports about the imaging characteristics of WVPTC, in that this is a recently described histological subtype.…”

Warthin-like papillary thyroid carcinoma with immunoglobulin G4-positive plasma cells possibly related to Hashimoto’s thyroiditis

“…Meanwhile, the heavy lymphoplasmacytic infiltrate is among the defining characteristics of Warthin-like papillary thyroid carcinoma (WL-PTC) in microscopic analysis, and this variant is frequently accompanied by Hashimoto's thyroiditis [12,13]. Given that Hashimoto's thyroiditis with the heavy lymphoplasmacytic infiltration is a common comorbidity of IgG4-RT and WL-PTC, we hypothesize that WL-PTC may have a strong correlation with IgG4-RT.…”

Possible Mechanisms of the Association of Thyroiditis and Papillary Carcinoma of the Thyroid Gland

“…У хворих з тиреоїдитом Хашимото приб-лизно вдвічі частіше, ніж «класична» зуст-річається мультифокальна ПК [32]; у 3 рази -її Warthin-подібний варіант, за якого му тації BRAF відбуваються рідше, ніж у «кла сичній» [64]. Слід також відмітити, що у пацієнтів з хронічним тиреоїдитом у два рази частіше, ніж у хворих без такого реєстрували фолікулярну будову ПК [14], а її дифузно-склерозуючий варіант, який є однією з найагресивніших форм цього раку, як правило, супроводжується двобічним тиреоїдитом Хашимото [65].…”