Tiroid Papiller Kanseri ile Kronik Lenfositik Tiroidit Birlikteliği

Year 2007, Volume: 1 Issue: 3, 151 - 154, 20.11.2007

Reyhan Ersoy

Abstract

Tiroid kanseri ile lenfositik tiroidit arasındaki etiyolojik ilişki bir tartışma konusu olmaya devam etmektedir. Lenfositik tiroiditin neop-lazma sekonder olarak mı geliştiği ya da tiroiditin tiroid kanseri için predispozan mı olduğu konusu hala açıklığa kavuşmamıştır. Kronik lenfositik tiroiditli hastalarda, tiroid kanseri insidansı konusunda pek çok seride çok farklı sonuçlar bildirilmiştir. Bu birliktelikte immünolojik ve otoimmün mekanizmalann rolü olduğu öne sürülmektedir. Biz papiller tiroid kanserli (PTK) hasta grubumuzda kronik lenfositik tiroidit varlığını araştırmayı ve bu birlikteliğin görüldüğü hastaların tümör özelliklerini belirlemeyi amaçladık.

Ankara Atatürk Eğitim ve Araştırma Hastanesinde üç yıllık dönemde (2004-2007) medüller tiroid kanseri dışında, differansiye tiroid kanserleri nedeniyle operasyon uygulanmış olgu serimizi retrospektif olarak gözden geçirdik. Papiller tiroid kanseri nedeniyle öpere edilen 58 hasta, cerrahi öncesi ve sonrası klinik verileri, laboratuvar tesderi ve patolojik bulgulan ile değerlendirildi.

Elli sekiz hastanın 16’sında tiroid kanseri ile birlikte lenfositik tiroidit birlikte görülmekte idi. Bu on altı hastada saptanan toplam 17 tümörün histopatolojik incelemesinde; 15 tümörde PTK, 2 tümörde PTK-folliküler varyant saptandı. Tümör boyutları 11 tümörde <10mm, 6 tümörde >10 mm idi.

Çalışma grubumuzda PTK ve lenfositik tiroidit birlikteliğini %27.6 (58 hastada 16 olgu) olarak saptadık. Bu çalışmada olgu serimiz sunuldu ve ilgili literatür gözden geçirildi.

Abstract
The etiologic relationship between thyroid carcinoma and lymphocytic thyroiditis still remains a point of dispute, because it is unclear whether thyroiditis is induced secondarily by neoplasm. The incidence of thyroid carcinoma in chronic lymphocytic thyroiditis has been variously reported in many published series. The role of immunological and autoimmune mechanisms has been suggested about this topic. We aimed to evaluate the coexistent papillary thyroid carcinoma (PTC) with chronic lymphocytic thyroiditis, and described the tumor characteristics, in our patients with PTC.
We examined the relationship by retrospectively reviewing our series of patients treated for differentiated nonmedullary thyroid carcinoma at Ankara Ataturk Training and Research Hospital over a 3-year period (2004-2007). Fifty-eight patients with PTC undergoing surgery were examined. The clinical data, laboratory tests and pathologic findings performed before and after surgery were evaluated.
There were 16 patients of thyroid cancer associated with lymphocytic thyroiditis. Fifteen PTC and 2 FTC-follicular variant were determined in 17 tumors of 16 patients histopathologically. Tumor size were <10 mm in 11, and >10mm in 6 tumors.
We estimate the coexistence of PTC and lymphocytic thyroiditis in 27.6% (16 of 58) in our study group. In this study, we present our case series and also review the associated literature.

Keywords

Hashimoto hastalığı, tiroid kanseri, prevalans

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