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VOLUME 7 , ISSUE 4 ( October-December, 2016 ) > List of Articles

RESEARCH ARTICLE

Association of Papillary Carcinoma of Thyroid and Nonspecific Chronic Lymphocytic Thyroiditis and Its Clinicopathological Effects

Nadeesha J Nawarathna, Suwin N Hewage, Palitha Ratnayake, Ranjith JK Seneviratne

Citation Information : Nawarathna NJ, Hewage SN, Ratnayake P, Seneviratne RJ. Association of Papillary Carcinoma of Thyroid and Nonspecific Chronic Lymphocytic Thyroiditis and Its Clinicopathological Effects. Int J Head Neck Surg 2016; 7 (4):213-219.

DOI: 10.5005/jp-journals-10001-1291

Published Online: 01-04-2012

Copyright Statement:  Copyright © 2016; The Author(s).


Abstract

Introduction

The most common differentiated malignant thyroid neoplasm is papillary carcinoma. Association of concurrent presence of chronic lymphocytic thyroiditis and its subtypes with differentiated epithelial thyroid carcinoma remains controversial.

Objective

To evaluate epidemiological factors of chronic lymphocytic thyroiditis and association between chronic lymphocytic thyroiditis and its subtypes with papillary thyroid carcinoma.

Materials and methods

A total of 684 patients who underwent thyroidectomy at Teaching Hospital Kandy, Sri Lanka, for a period of two-and-half years from 2013 January were reviewed. The clinical and pathological characteristics were analyzed. Chronic lymphocytic thyroiditis was diagnosed by histology.

Results

Thyroid malignancies were detected in 14.2% of thyroidectomy specimen, of which well-differentiated epithelial thyroid carcinoma was seen in 82%. Chronic lymphocytic thyroiditis was present in 31%, out of which 73.1% were nonspecific chronic lymphocytic thyroiditis and 26.9% were Hashimoto's thyroiditis. Gender, age, and presence of thyroiditis were significantly associated with papillary thyroid carcinoma. Males were more likely to have papillary carcinoma compared with females (p = 0.013). Those with nonspecific chronic lymphocytic thyroiditis were more likely to have papillary thyroid carcinoma (p = 0.002) compared with those without. With increasing age, proportion of lymphovascular invasion in patients with papillary thyroid carcinoma significantly (p = 0.010) decreases. None of the three factors mentioned were significant predictors of tumor focality, capsular or lymphovascular invasion.

Conclusion

Presence of nonspecific chronic lymphocytic thyroiditis is associated with papillary thyroid carcinoma at a given age and gender. Influence of nonspecific chronic lymphocytic thyroiditis on the prognosis of well-differentiated epithelial thyroid carcinoma needs to be investigated further with a larger sample size.

How to cite this article

Nawarathna NJ, Hewage SN, Ratnayake P, Seneviratne RJK. Association of Papillary Carcinoma of Thyroid and Nonspecific Chronic Lymphocytic Thyroiditis and Its Clinicopathological Effects. Int J Head Neck Surg 2016;7(4):213-219.

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  1. Hashimoto's thyroiditis: celebrating the centennial through the lens of the Johns Hopkins hospital surgical pathology records. Thyroid 2013 Feb;23(2):142-150.
  2. Coexistence of papillary thyroid cancer with Hashimoto thyroiditis. Langenbecks Arch Surg 2013 Mar;398(3):389-394.
  3. Relation of thyroid neoplasms to Hashimoto disease of the thyroid gland. AMA Arch Surg 1955 Feb;70(2):291-297.
  4. The relation of thyroid carcinoma and chronic thyroiditis. Surg Gynecol Obstet 1965 Aug;121:243-252.
  5. Coexistent Hashimoto's thyroiditis with papillary thyroid carcinoma: impact on presentation, management, and outcome. Surgery 1999 Dec;126(6):1070-1076.
  6. The incidence of thyroid carcinoma in Hashimoto's thyroiditis. Am Surg 1987 Aug;53(8):442-445.
  7. Association of chronic lymphocytic thyroiditis and thyroid papillary carcinoma. A study of surgical cases among Japanese, and white and African Americans. Cancer 1995 Dec;76(11):2312-2318.
  8. Is Hashimoto's thyroiditis a risk factor for papillary thyroid cancer? J Surg Res 2008 Nov;150(1):49-52.
  9. Elevated risk of papillary thyroid cancer in Korean patients with Hashimoto's thyroiditis. Head Neck 2011 May;33(5):691-695.
  10. Higher serum thyroid stimulating hormone level in thyroid nodule patients is associated with greater risks of differentiated thyroid cancer and advanced tumour stage. J Clin Endocrinol Metab 2008 Mar;93(3):809-814.
  11. Cancer risks in patients with chronic lymphocytic thyroiditis. N Engl J Med 1985 Mar;312(10):601-604.
  12. Clinical features of thyroid autoimmunity are associated with thyroiditis on histology and are not predictive of malignancy in 570 patients with indeterminate nodules on cytology who had a thyroidectomy. Clin Endocrinol (Oxf) 2007 Sep;67(3):363-369.
  13. Struma lymphomatosa and carcinoma of the thyroid. Surg Gynecol Obstet 1978 Sep;147(3):350-352.
  14. Hashimoto's thyroiditis is not associated with increased risk of thyroid cancer in patients with thyroid nodules. A single-center prospective study. Thyroid 2010 Jun;20(6):601-606.
  15. Detection and molecular characterization of thyroid cancer precursor lesions in a specific subset of Hashimoto's thyroiditis. Br J Cancer 2004 Sep;91(6):1096-1104.
  16. Hashimoto's thyroiditis with papillary thyroid carcinoma (papillary thyroid carcinoma)-like nuclear alterations express molecular markers of papillary thyroid carcinoma. Histopathology 2004 Jul;45(1):39-46.
  17. Iodine prophylaxis, goitre and thyroid autoimmunity in Sri Lanka. Ceylon Med J 2005 Mar;50(1):20-23.
  18. Chronic thyroiditis as a favorable prognostic factor in papillary thyroid carcinoma. Thyroid 1998 Mar;8(3):197-202.
  19. Influence of lymphocytic thyroiditis on the prognostic outcome of patients with papillary thyroid carcinoma. J Clin Endocrinol Metab 1999 Feb;84(2):458-463.
  20. Coexistent thyroiditis is associated with lower tumour stage in thyroid carcinoma. Eur J Clin Invest 1998 Oct;28(10):838-844.
  21. The association between papillary carcinoma and chronic lymphocytic thyroiditis: does it modify the prognosis of cancer. Minerva Endocrinol 2008 Mar;33(1):1-5.
  22. Coexisting chronic lymphocytic thyroiditis and papillary thyroid cancer revisited. World J Surg 2001 May;25(5):632-637.
  23. Morphologic assessment of thyroid disease by cytology and pattern of thyroid enlargement in Sri Lanka. J Ceylon Coll Physicians 1998;31(1-2):31-40.
  24. The prevalence of autoimmune thyroiditis after universal salt iodination in Sri Lanka. Ceylon Med J 2012 Sep;57(3):116-119.
  25. Changing patterns of thyroid cancer in Sri Lanka. Has the iodination program helped? Ceylon Med J 2003 Dec;48(4):125-128.
  26. Coexistence of papillary carcinoma and Hashimoto's thyroiditis. Acta Clin Croat 2009 Mar;48(1):9-12.
  27. Thyroidectomy for Hashimoto's thyroiditis. complications and associated cancers. Thyroid 2008 Jul;18(7):729-734.
  28. Surgical procedures in patients with thyroid autoimmune disease. Srp Arh Celok Lek 2005 Oct;133(Suppl 1):77-83.
  29. Coexistent carcinoma of the thyroid gland and Hashimoto's thyroiditis. Surg Gynecol Obstet 1983 Sep;157(3):228-232.
  30. Predictive factors of level IIb lymph node metastasis in patients with papillary thyroid carcinoma. Ann Surg Oncol 2009 May;16(5):1344-1347.
  31. Prognostic factors affecting neck lymph node recurrence and distant metastasis in papillary microcarcinoma of the thyroid: results of a study in 445 patients. Thyroid 2009 Jul;19(7):707-716.
  32. Natural history and clinical outcome of differentiated thyroid carcinoma: a retrospective analysis of 1503 patients treated at a single institution. Ann Oncol 2009 Oct;20(10):1728-1735.
  33. The correlation between papillary thyroid carcinoma and lymphocytic infiltration in the thyroid gland. J Clin Endocrinol Metab 1995 Dec;80(12):3421-3424.
  34. The tight relationship between papillary thyroid cancer, autoimmunity and inflammation: clinical and molecular studies. Clin Endocrinol (Oxf) 2010 May;72(5):702-708.
  35. Well-differentiated thyroid carcinoma with concomitant Hashimoto's thyroiditis present with less aggressive clinical stage and low recurrence. Endocr Pathol 2011 Sep;22(3):144-149.
  36. A National Cancer Data Base report on 53,856 cases of thyroid carcinoma treated in the U.S., 1985–1995. Cancer 1998 Dec;83(12):2638-2648.
  37. Prognostic factors for thyroid carcinoma: a population-based study of 15,698 cases from the Surveillance, Epidemiology and End Results (SEER) program 1973–1991. Cancer 1997 Feb;79(3):564-573.
  38. Current approaches to primary therapy for papillary and follicular thyroid cancer. J Clin Endocrinol Metab 2001 Apr;86(4):1447-1463.
  39. Prognostic indicators in differentiated thyroid carcinoma. Cancer Control 2000 May-Jun;7(3):229-239.
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