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TİROİD NEOPLAZİLERİ VE HASHİMOTO TİROİDİTİ BİRLİKTELİĞİ

Year 2013, Volume: 14 Issue: 2, 1 - 4, 01.08.2013

Abstract

AMAÇ: Hashimoto tiroiditi (HT) immünolojik, genetik ya da çevresel faktörlerle immun toleransın bozulması ile ortaya çıkan otoimmun bir hastalıktır. Otoimmun tiroid hastalıklarının en sık formudur. Kadınlarda erkeklerden 5-10 kat daha fazladır. Tiroid neoplazileri ve HT arasındaki ilişki ise hala tartışmalı bir konudur. HT'nin Papiller Tiroid Kanser (PTK) gelişiminde bir risk faktörü olduğu söylenmektedir. Buna ek olarak literatürde HT ile beraber izlenen PTK dışı tiroid tümörleri de tanımlanmıştır. Bu çalışmada HT ve tiroid tümör birlikteliği ve izlenen tümör subtipleri, HT ve tümör birlikteliğinin klinikopatolojik parametrelerle ilişkisi kaynaklar eşliğinde tartışılmıştır. GEREÇ ve YÖNTEM: Çalışmada 1990-2011 yılları arasında laboratuvarımıza gelen tiroidektomi materyelleri içinde histopatolojik olarak Hashimoto tiroiditi tanısı alan 382 olguya ait materyaller ışık mikroskobik olarak incelenmiştir. Olgularda yaş, cins, preoperatif klinik tanı, operasyon şekli, varsa eşlik eden malignite ve malignitenin tipi araştırılmıştır.BULGULAR: Olguların %13,6'sında (52 olgu) tiroid neoplazisi saptanmıştır. Bu tümörlerin %71,1'i papiller (37 olgu) karsinom, %13,5'u (7 olgu) folliküler karsinom ve %15,4'ü (8 olgu) folliküler adenom morfolojisindedir. İzlenen tüm papiller karsinomların %70,2'sinde tümör çapı 1 cm'nin altındadır.SONUÇ: Sunulan çalışmada HT olgularının PTK ile görece olarak sık birlikteliği ve bu birlikteliğe sıklıkla küçük tümör boyutunun eşlik ettiği saptanmıştır. HT ve tiroid neoplazisi birlikteliği de literatürle uyumlu bulunmuştur

References

  • 1. Ahmed R, Al-Shaikh S, Akhtar M. Hashimoto thyroiditis: a century later. Adv Anat Pathol 2012 May;19(3):181-6.
  • 2. Maceri DR, Sullivan MJ, McClatchney KD. Autoimmun thyroiditis:pathophysiology and relationship to thyroid cancer. Laryngoscope 1986;96(1):82-6.
  • 3. Berho M, Suster S. Clear nuclear changes in Hashimoto's thyroiditis. A clinicopathologic study of 12 cases. Ann Clin Lab Sci 1995;25(6):513-21.
  • 4. Ito M, Naruke Y, Mihara Y, So K, Miyashita T, Origuchi T, Nakashima M, Livolsi V. Thyroid papillary carcinoma with solid sclerosing change in IgG4-related sclerosing disease. Pathol Int 2011 Oct;61(10):589-92.
  • 5. Rosai J. Surgical pathology. Mosby, St Louis, 1996:499-551.
  • 6. Holm LA, Blomgren H, Löwhagen T. Cancer risks in patients with chronic lymphocytic thyroiditis. N Engl J Med 1985;312(10):601-4.
  • 7. Büyükaşık O, Hasdemir AO, Yalçın E, Celep B, Sengül S, Yandakçı K, Tunç G, Küçükpınar T, Alkoy S, Cöl C. The association between thyroid malignancy and chronic lymphocytic thyroiditis: should it alter the surgical approach? Endokrynol Pol 2011;62(4):303-8.
  • 8. Arif S, Blanes A, Diaz-Cano SJ. Hashimoto's thyroiditis shares features with early papillary thyroid carcinoma. Histopathology 2002 Oct;41(4):357-62.
  • 9. Kim KW, Park YJ, Kim EH, Park SY, Park do J, Ahn SH, Park do J, Jang HC, Cho BY. Elevated risk of papillary thyroid cancer in Korean patients with Hashimoto's thyroiditis. Head Neck 2011 May;33(5):691-5.
  • 10. Wirtschafter A, Schmidt R, Rosen D, Kundu N, Santoro M, Fusco A, Multhaupt H, Atkins JP, Rosen MR, Keane WM, Rothstein JL. Expression of the RET/PTC fusion gene as a marker for papillary carcinoma in Hashimoto's thyroiditis. Laryngoscope 1997 Jan;107(1):95-100.
  • 11. Di Pasquale M, Rothstein JL, Palazzo JP. Pathologic features of Hashimoto's-associated papillary thyroid carcinomas. Hum Pathol 2001 Jan;32(1):24-30.
  • 12. Dailey ME, Lindsay S, Skahen R. Relation of thyroid neoplasms to Hashimoto disease of the thyroid gland. AMAArch Surg 1955 Feb;70(2):291-7.
  • 13. Vollenwelder I, Hedinger C. Solid cell nests in Hashimoto's thyroiditis. Virchow's Arc. A. Pathol Anat Histopathol 1988;412(4):357-63.
  • 14. Strauss M, Laurian N, Antebi E. Coexistent carcinoma of the thyroid gland and Hashimoto's thyroiditis. Surg Gynecol Obstet 1983;157:228-32.
  • 15. Ott RA, Mc Call AR, Mc Henry C, Jarosz H, Armin A, Lawrence AM, Paloyan E. The incidence of thyroid carcinoma in Hashimoto's thyroiditis. Am Surg 1987;53(8):442-5,
  • 16. Ahn D, Heo SJ, Park JH, Kim JH, Sohn JH, Park JY, Park SK, Park J. Clinical relationship between Hashimoto's thyroiditis and papillary thyroid cancer. Acta Oncol 2011 Nov;50(8):1228-34.
  • 17. Larson SD, Jackson LN, Riall TS, Uchida T, Thomas RP, Qiu S, Evers BM. Increased incidence of welldifferentiated thyroid cancer associated with Hashimoto thyroiditis and the role of the PI3k/Akt pathway. J Am Coll Surg 2007 May;204(5):764-73.
  • 18. Pisani T, Bononi M, Pantellini F, Vecchione A, Giovagnoli MR. Thyroiditis and oncocytic carcinoma: incidental association? A case report. Anticancer Res 2002 Nov-Dec;22(6B):3525-7.
  • 19. Lee J, Hasteh F. Oncocytic variant of papillary thyroid carcinoma associated with Hashimoto's thyroiditis: a case report and review of the literature. Diagn Cytopathol 2009 Aug;37(8):600-6.
  • 20. Segal K, Ben-Bassat M, Avraham A, Har-El G, Sidi J. Hashimoto's thyroiditis and carcinoma of the thyroid gland. Int Surg 1985;70(3):205-9.
  • 21. Kim EY, Kim WG, Kim WB, Kim TY, Kim JM, Ryu JS, Hong SJ, Gong G, Shong YK. Coexistence of chronic lymphocytic thyroiditis is associated with lower recurrence rates in patients with papillary thyroid carcinoma. Clin Endocrinol (Oxf) 2009 Oct;71(4):581- 6.
  • 22. Kim SS, Lee BJ, Lee JC, Kim SJ, Jeon YK, Kim MR, Huh JE, Mok JY, Kim BH, Kim YK, Kim IJ. Coexistence of Hashimoto's thyroiditis with papillary thyroid carcinoma: the influence of lymph node metastasis. Head Neck 2011 Sep;33(9):1272-7.

Coexistence of Hashimoto Thyroiditis with Thyroid Neoplasm

Year 2013, Volume: 14 Issue: 2, 1 - 4, 01.08.2013

Abstract

OBJECTIVE: Hashimoto's thyroiditis (HT) is an autoimmune disease which becomes evident by impaired immune tolerance because of immunologic, genetic and environmental factors. HT is the most frequent form of autoimmune thyroid diseases. It occurs more frequently in women with prevalence ratios ranging from 5 to 10:1. Relationship between HT and thyroid tumors is still controversial. It's said that there is a higher risk in HT for growing papillary thyroid carcinoma. In addition, the non-papillary thyroid carcinomas that are analyzed with HT are defined in literature. In this study coexistence of HT and thyroid tumor and also tumor subtypes are analyzed. Furthermore relationship between this coexistence and clinicopathologic parameters are discussed with reference to the literature. MATERIAL and METHODS: In this study, the slides of 382 cases that were diagnosed as HT in the thyroidectomy specimens between 1990-2011 are analyzed by light microscopy. Age, sex, preoperative diagnosis and operation types are investigated in addition to the malignancy. RESULTS: In this study 382 cases of HT were analyzed retrospectively. In 13,6% of cases (52 cases) thyroid neoplasm was detected. Of these tumors 71,1% (37 cases) were papillary carcinoma, 13,5 % (7 cases) were follicular carcinoma and 15,4% (8 cases) were follicular adenoma. In 70,2% of cases tumor diameter is under 1 cm in all papillary carcinomas. CONCLUSION: In this study, relatively frequent coexistence of thyroid neoplasm and HT besides collocation of frequent small tumor diameter is determined. Coexistence of HT and thyroid neoplasm has been found consistent with literature.

References

  • 1. Ahmed R, Al-Shaikh S, Akhtar M. Hashimoto thyroiditis: a century later. Adv Anat Pathol 2012 May;19(3):181-6.
  • 2. Maceri DR, Sullivan MJ, McClatchney KD. Autoimmun thyroiditis:pathophysiology and relationship to thyroid cancer. Laryngoscope 1986;96(1):82-6.
  • 3. Berho M, Suster S. Clear nuclear changes in Hashimoto's thyroiditis. A clinicopathologic study of 12 cases. Ann Clin Lab Sci 1995;25(6):513-21.
  • 4. Ito M, Naruke Y, Mihara Y, So K, Miyashita T, Origuchi T, Nakashima M, Livolsi V. Thyroid papillary carcinoma with solid sclerosing change in IgG4-related sclerosing disease. Pathol Int 2011 Oct;61(10):589-92.
  • 5. Rosai J. Surgical pathology. Mosby, St Louis, 1996:499-551.
  • 6. Holm LA, Blomgren H, Löwhagen T. Cancer risks in patients with chronic lymphocytic thyroiditis. N Engl J Med 1985;312(10):601-4.
  • 7. Büyükaşık O, Hasdemir AO, Yalçın E, Celep B, Sengül S, Yandakçı K, Tunç G, Küçükpınar T, Alkoy S, Cöl C. The association between thyroid malignancy and chronic lymphocytic thyroiditis: should it alter the surgical approach? Endokrynol Pol 2011;62(4):303-8.
  • 8. Arif S, Blanes A, Diaz-Cano SJ. Hashimoto's thyroiditis shares features with early papillary thyroid carcinoma. Histopathology 2002 Oct;41(4):357-62.
  • 9. Kim KW, Park YJ, Kim EH, Park SY, Park do J, Ahn SH, Park do J, Jang HC, Cho BY. Elevated risk of papillary thyroid cancer in Korean patients with Hashimoto's thyroiditis. Head Neck 2011 May;33(5):691-5.
  • 10. Wirtschafter A, Schmidt R, Rosen D, Kundu N, Santoro M, Fusco A, Multhaupt H, Atkins JP, Rosen MR, Keane WM, Rothstein JL. Expression of the RET/PTC fusion gene as a marker for papillary carcinoma in Hashimoto's thyroiditis. Laryngoscope 1997 Jan;107(1):95-100.
  • 11. Di Pasquale M, Rothstein JL, Palazzo JP. Pathologic features of Hashimoto's-associated papillary thyroid carcinomas. Hum Pathol 2001 Jan;32(1):24-30.
  • 12. Dailey ME, Lindsay S, Skahen R. Relation of thyroid neoplasms to Hashimoto disease of the thyroid gland. AMAArch Surg 1955 Feb;70(2):291-7.
  • 13. Vollenwelder I, Hedinger C. Solid cell nests in Hashimoto's thyroiditis. Virchow's Arc. A. Pathol Anat Histopathol 1988;412(4):357-63.
  • 14. Strauss M, Laurian N, Antebi E. Coexistent carcinoma of the thyroid gland and Hashimoto's thyroiditis. Surg Gynecol Obstet 1983;157:228-32.
  • 15. Ott RA, Mc Call AR, Mc Henry C, Jarosz H, Armin A, Lawrence AM, Paloyan E. The incidence of thyroid carcinoma in Hashimoto's thyroiditis. Am Surg 1987;53(8):442-5,
  • 16. Ahn D, Heo SJ, Park JH, Kim JH, Sohn JH, Park JY, Park SK, Park J. Clinical relationship between Hashimoto's thyroiditis and papillary thyroid cancer. Acta Oncol 2011 Nov;50(8):1228-34.
  • 17. Larson SD, Jackson LN, Riall TS, Uchida T, Thomas RP, Qiu S, Evers BM. Increased incidence of welldifferentiated thyroid cancer associated with Hashimoto thyroiditis and the role of the PI3k/Akt pathway. J Am Coll Surg 2007 May;204(5):764-73.
  • 18. Pisani T, Bononi M, Pantellini F, Vecchione A, Giovagnoli MR. Thyroiditis and oncocytic carcinoma: incidental association? A case report. Anticancer Res 2002 Nov-Dec;22(6B):3525-7.
  • 19. Lee J, Hasteh F. Oncocytic variant of papillary thyroid carcinoma associated with Hashimoto's thyroiditis: a case report and review of the literature. Diagn Cytopathol 2009 Aug;37(8):600-6.
  • 20. Segal K, Ben-Bassat M, Avraham A, Har-El G, Sidi J. Hashimoto's thyroiditis and carcinoma of the thyroid gland. Int Surg 1985;70(3):205-9.
  • 21. Kim EY, Kim WG, Kim WB, Kim TY, Kim JM, Ryu JS, Hong SJ, Gong G, Shong YK. Coexistence of chronic lymphocytic thyroiditis is associated with lower recurrence rates in patients with papillary thyroid carcinoma. Clin Endocrinol (Oxf) 2009 Oct;71(4):581- 6.
  • 22. Kim SS, Lee BJ, Lee JC, Kim SJ, Jeon YK, Kim MR, Huh JE, Mok JY, Kim BH, Kim YK, Kim IJ. Coexistence of Hashimoto's thyroiditis with papillary thyroid carcinoma: the influence of lymph node metastasis. Head Neck 2011 Sep;33(9):1272-7.
There are 22 citations in total.

Details

Other ID JA53KF25CH
Journal Section Research Article
Authors

Funda Taşlı This is me

Enver Vardar This is me

Güliz Özkök This is me

Publication Date August 1, 2013
Published in Issue Year 2013 Volume: 14 Issue: 2

Cite

EndNote Taşlı F, Vardar E, Özkök G (August 1, 2013) Coexistence of Hashimoto Thyroiditis with Thyroid Neoplasm. Meandros Medical And Dental Journal 14 2 1–4.