Pathologic Spectrum of Lymphocytic Infiltration and Recurrence of Papillary Thyroid Carcinoma

Purpose The 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 Methods This 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. Results Of 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. Conclusion There 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.

[1]  Eun-Kyung Kim,et al.  Heterogeneous echogenicity of the thyroid parenchyma does not influence the detection of multi-focality in papillary thyroid carcinoma on preoperative ultrasound staging. , 2014, Ultrasound in medicine & biology.

[2]  Kyunghwa Han,et al.  Diagnostic Role of Conventional Ultrasonography and Shearwave Elastography in Asymptomatic Patients with Diffuse Thyroid Disease: Initial Experience with 57 Patients , 2013, Yonsei medical journal.

[3]  Eun-Kyung Kim,et al.  Heterogeneous echogenicity of the underlying thyroid parenchyma: how does this affect the analysis of a thyroid nodule? , 2013, BMC Cancer.

[4]  Jae Hoon Chung,et al.  Preoperative ultrasonographic features of papillary thyroid carcinoma predict biological behavior. , 2013, The Journal of clinical endocrinology and metabolism.

[5]  Ju-Han Lee,et al.  The association between papillary thyroid carcinoma and histologically proven Hashimoto's thyroiditis: a meta-analysis. , 2013, European journal of endocrinology.

[6]  W. Chung,et al.  Coexistence of Chronic Lymphocytic Thyroiditis with Papillary Thyroid Carcinoma: Clinical Manifestation and Prognostic Outcome , 2012, Journal of Korean medical science.

[7]  Eun-Kyung Kim,et al.  Mixed Echoic Thyroid Nodules on Ultrasound: Approach to Management , 2012, Yonsei medical journal.

[8]  S. Jung,et al.  Diagnostic value of antithyroid peroxidase antibody for incidental autoimmune thyroiditis based on histopathologic results , 2012, Endocrine.

[9]  Bo Hyun Kim,et al.  Preoperative ultrasonographic tumor characteristics as a predictive factor of tumor stage in papillary thyroid carcinoma , 2011, Head & neck.

[10]  M. R. Kim,et al.  Coexistence of Hashimoto's thyroiditis with papillary thyroid carcinoma: The influence of lymph node metastasis , 2011, Head & neck.

[11]  H. Moon,et al.  Minimal Extrathyroidal Extension in Patients with Papillary Thyroid Microcarcinoma: Is It a Real Prognostic Factor? , 2011, Annals of Surgical Oncology.

[12]  Y. Choi,et al.  Features of Papillary Thyroid Microcarcinoma in the Presence and Absence of Lymphocytic Thyroiditis , 2010, Endocrine pathology.

[13]  Tae Yong Kim,et al.  Coexistence of chronic lymphocytic thyroiditis is associated with lower recurrence rates in patients with papillary thyroid carcinoma , 2009, Clinical endocrinology.

[14]  W. Chung,et al.  Papillary Microcarcinoma of the Thyroid: Predicting Factors of Lateral Neck Node Metastasis , 2009, Annals of Surgical Oncology.

[15]  Herb Chen,et al.  Is Hashimoto's thyroiditis a risk factor for papillary thyroid cancer? , 2008, The Journal of surgical research.

[16]  P. Del Rio,et al.  The association between papillary carcinoma and chronic lymphocytic thyroiditis: does it modify the prognosis of cancer? , 2008, Minerva endocrinologica.

[17]  R. Dash,et al.  Lymphocytic Thyroiditis – is cytological grading significant? A correlation of grades with clinical, biochemical, ltrasonographic and radionuclide parameters , 2007, CytoJournal.

[18]  M. Fujiwara,et al.  Enhanced cellular proliferative activity and cell death in chronic thyroiditis and thyroid papillary carcinoma , 2005, Journal of Cancer Research and Clinical Oncology.

[19]  A. Miyauchi,et al.  Papillary Microcarcinoma of the Thyroid: How Should It Be Treated? , 2004, World Journal of Surgery.

[20]  A. Miyauchi,et al.  Preoperative Ultrasonographic Examination for Lymph Node Metastasis: Usefulness when Designing Lymph Node Dissection for Papillary Microcarcinoma of the Thyroid , 2004, World Journal of Surgery.

[21]  D. Tamimi The Association Between Chronic Lymphocytic Thyroiditis and Thyroid Tumors , 2002, International journal of surgical pathology.

[22]  Neeta Kumar,et al.  Aspiration cytology of Hashimoto's thyroiditis in an endemic area , 2002, Cytopathology : official journal of the British Society for Clinical Cytology.

[23]  E. Kebebew,et al.  Coexisting Chronic Lymphocytic Thyroiditis and Papillary Thyroid Cancer Revisited , 2001, World Journal of Surgery.

[24]  J. Shah,et al.  Coexistent Hashimoto's thyroiditis with papillary thyroid carcinoma: impact on presentation, management, and outcome. , 1999, Surgery.

[25]  P. Yeo,et al.  Influence of lymphocytic thyroiditis on the prognostic outcome of patients with papillary thyroid carcinoma. , 1999, The Journal of clinical endocrinology and metabolism.

[26]  J. Schölmerich,et al.  Coexistent thyroiditis is associated with lower tumour stage in thyroid carcinoma , 1998, European journal of clinical investigation.

[27]  K. Kashima,et al.  Chronic thyroiditis as a favorable prognostic factor in papillary thyroid carcinoma. , 1998, Thyroid : official journal of the American Thyroid Association.

[28]  M. Santoro,et al.  Expression of the RET/PTC Fusion Gene as a Marker for Papillary Carcinoma in Hashimoto's Thyroiditis , 1997, The Laryngoscope.

[29]  G. Daniels,et al.  Chronic autoimmune thyroiditis. , 1996, The New England journal of medicine.

[30]  F. Matsuzuka,et al.  The correlation between papillary thyroid carcinoma and lymphocytic infiltration in the thyroid gland. , 1995, The Journal of clinical endocrinology and metabolism.

[31]  S. Jhiang,et al.  Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. , 1994, The American journal of medicine.

[32]  V. Livolsi The pathology of autoimmune thyroid disease: a review. , 1994, Thyroid : official journal of the American Thyroid Association.

[33]  S. McKinney,et al.  Papillary and follicular thyroid cancer. Prognostic factors in 1,578 patients. , 1987, The American journal of medicine.

[34]  A. D. Thomson The pathology of Hashimoto's disease. , 1957, Proceedings of the Royal Society of Medicine.