OBJECTIVETo compare the size of papillary thyroid carcinoma on ultrasonography(US)and the actual size measured during histological examination and to discuss the potential causes of such discrepancy.

METHODSA total of 148 patients with histologically confirmed papillary thyroid carcinoma underwent thyroid surgery in our center from December 2012 to May 2013. Patients were stratified based on the size,morphology,margin,cystic component,and presence of Hashimoto's disease to compare the discrepancy of the US and pathalogical measurements.

RESULTSThe mean sizes of the nodules measured by US and pathology were(1.58±0.94)cm and(1.33±0.84)cm,respectively(P=0.000). In 70.9%(105/148)of the nodules,the sizes measured by US were larger than those measured by pathology. In 17.6%(26/148)of the nodules,the sizes measured by US were smaller than those measured by pathology. In 1.1-1.4 cm size subgroup,the difference between mean ultrasound diameter and pathologic diameter was not significant [(1.21±0.11)cm vs.(1.11±0.32)cm,P=0.062]. In 0.1-1.0 cm size subgroup,the mean sizes of the nodules measured by US and pathology were(0.75±0.19)cm and(0.62±0.23)cm,respectively(P=0.000). In ≥1.5 cm size subgroup,the mean sizes of the nodules measured by US and pathology were(2.48±0.70)cm and(2.03±0.81)cm(P=0.000).

CONCLUSIONSThere is a significant discrepancy between US and pathologic size measurements for papillary thyroid carcinoma. However,for nodules sized 1.1-1.4 cm,the ultrasound and pathologic measurements are more likely to be consistent.

Carcinoma ; diagnostic imaging ; pathology ; Carcinoma, Papillary ; Hashimoto Disease ; Humans ; Thyroid Neoplasms ; diagnostic imaging ; pathology ; Ultrasonography

BACKGROUND AND OBJECTIVES: The relationship between Hashimoto thyroiditis (HT) and papillary thyroid cancer (PTC) is still controversial. Some studies suggested that molecular basis of the association between HT and PTC. BRAF(V600E) mutation is the most common genetic alteration founded in PTC. This study was to determine a role of BRAF(V600E) mutation in PTC with concurrent HT and their association with other clinicopathological factors. MATERIALS AND METHODS: We enrolled 452 patients who underwent thyroid surgery between 2009 and 2012 for classical PTC. The status of BRAF(V600E) mutation was evaluated by direct sequencing. HT was defined as presence of lymphocytic thyroiditis in pathology or positive serum anti-thyroid peroxidase antibody. RESULTS: Total 139 patients (30%) with PTC had coexistence HT. HT was significantly associated female (p=0.006), and younger age (p=0.045). BRAF(V600E) mutation was confirmed in 264 patients (58%). The frequency of BRAF(V600E) mutation was significantly lower in PTC with coexistence HT (48.2%) compared by PTC without HT (62.9%, p=0.004). However, there was no significant difference in clinicopathological feature of PTC according to the presence of HT in patients with BRAF(V600E) mutated PTC. BRAF(V600E) mutation was less frequent in PTC with coexistence HT. CONCLUSION: These findings suggested that HT and BRAF(V600E) mutation might be independent factors in development and progression of PTC.
Female ; Hashimoto Disease* ; Humans ; Pathology ; Peroxidase ; Thyroid Gland ; Thyroid Neoplasms ; Thyroiditis, Autoimmune

A 22-year-old female patient complained of neck discomfort for one week. Examination revealed bilateral neck masses. Color doppler ultrasound showed bilateral thyroid masses,which resulted in two thyroid lobes asymmetry. Bilateral cervical enlarged lymph nodes were not found. Thyroid function was normal. Complete left lobe and subtotal right lobe of thyroid gland were resected. The pathological results showed poorly differentiated carcinoma of left thyroid and papillary carcinoma of right thyroid with bilateral Hashimoto's thyroiditis. The patient received resection of residual thyroid and lymph nodes in another hospital, with no tumor or metastasis found. The patient without radiotherapy or chemotherapy was followed up for 34 months, and no progressive lesions were found.
Carcinoma, Papillary ; pathology ; Female ; Hashimoto Disease ; pathology ; Humans ; Lymph Nodes ; surgery ; Neck ; Thyroid Neoplasms ; pathology ; Thyroidectomy ; Young Adult

PURPOSE: Thyroid papillary carcinoma is the most common endocrine tumor. There are many known factors affecting the pathophysiology of papillary carcinomas. In this study, we attempted to determine the clinical characteristics of papillary carcinomas with other benign pathologies. METHODS: From May 2007 to December 2012, a total of 994 patients underwent thyroidectomy and were diagnosed as papillary carcinomas. Retrospective study was performed using medical records. We categorized them according to five groups depending on associated benign disease, Papillary carcinoma with Graves disease (Group 1), Multinodular goiter (Group 2), Hashimoto thyroiditis (Group 3), Multinodular goiter and Hashimoto thyroiditis (Group 4), and Papillary carcinoma only (Group 5), and we performed a comparison analysis. RESULTS: T and N stage of group 2 were lower than those of group 5 and T stage of group 3 was lower than that of group 4. T and N stage of group 4 were lower than those of group 5 and extrathyroidal extension rate of group 4 was lower than that of group 5. CONCLUSION: Papillary carcinomas have variable clinical characteristics according to underlying benign thyroid disease. Conduct of advanced research regarding the mechanisms of the effect of benign thyroid disease on papillary carcinomas is needed.
Carcinoma, Papillary* ; Goiter ; Graves Disease ; Hashimoto Disease ; Humans ; Medical Records ; Pathology* ; Retrospective Studies ; Thyroid Diseases ; Thyroid Gland ; Thyroidectomy

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.
Adult ; Aged ; Carcinoma/*pathology/ultrasonography ; Carcinoma, Papillary/pathology/ultrasonography ; Female ; Hashimoto Disease/*pathology/ultrasonography ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Neoplasms/*pathology/ultrasonography

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.
Adult ; Aged ; Carcinoma/*pathology/ultrasonography ; Carcinoma, Papillary/pathology/ultrasonography ; Female ; Hashimoto Disease/*pathology/ultrasonography ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Neoplasms/*pathology/ultrasonography

Biopsy ; Female ; Glomerular Basement Membrane ; metabolism ; Hashimoto Disease ; metabolism ; pathology ; Humans ; Kidney Diseases ; metabolism ; pathology ; Middle Aged ; Proteinuria ; metabolism ; pathology ; Sjogren's Syndrome ; metabolism ; pathology

OBJECTIVETo study the immunoglobulin gene rearrangement patterns in Hashimoto's thyroiditis (HT) and primary thyroid lymphoma (PTL), and to analyze the relationship between the two diseases.

METHODSFormalin-fixed and paraffin-embedded tissues of 11 cases of PTL and 38 cases of HT as well as their clinical data, were retrieved. The latter group was further subcategorized into classic HT and suspicious PTL. Gene rearrangement studies for immunoglobulin heavy chains and light chains were carried out by polymerase chain reaction (PCR) using VH, FR3A and FR3kappa primers.

RESULTSThere was an increasing trend in immunoglobulin gene rearrangement rate for classic HT (10.7%), suspicious PTL (40.0%) and PTL (72.7%) groups. In general, a female predilection was observed. This sex predilection however was less obvious in the PTL group. There was no relationship between serum antibody (both thyroglobulin and thyroid peroxidase) titers and gene rearrangement patterns.

CONCLUSIONSHT and PTL show morphologic overlaps and may not be clearly distinguished on the basis of light microscopy alone. PCR-based immunoglobulin gene rearrangement study may be helpful in the detection of cases with early lymphomatous transformation of HT.

Female ; Gender Identity ; Gene Rearrangement ; Hashimoto Disease ; genetics ; Humans ; Lymphoma ; genetics ; pathology ; Male ; Middle Aged ; Sex Characteristics ; Thyroid Neoplasms ; genetics ; pathology ; Thyroiditis, Autoimmune ; genetics

UNLABELLED: A female patient of 56 years old had hoarseness that seems worse after talking excessively,which occasionally associated with slightly sore throat and pharyngeal foreign body sensation. The symptoms are not associated with sore throat, fever, night sweats, not drinking cough, breathing and swallowing difficulties, but no cough, bloody sputum. Neck ultrasound can be showed: goiter and real echo uneven thickening, increased blood supply pan; the right thyroid lobe multiple cysts pan. Enhanced CT shows occupying lesions were found out in the right side of the supraglottic larynx gap and the right lobe of the thyroid, nature to be determined. Full thyroid function showed: thyroid microsomal antibodies 278.2 u/ml, the rest of the indicators in the normal range. Other routine preoperative examinations were normal. Immunohistochemistry: CD45(++) CD68(+) CD99(++) EMA(-) CK(-) Sclc(-) TTF-1(--) CgA(-) SY(-) NSE(--) S-100(-) ESA(-). Supported by immunohistochemistry, hyperplasia organizations was diffuse lymphoid tissue. Through expert consultation by superior hospital the pathology showed: Hashimoto's thyroiditis with thyroid papillary carcinoma (lesions of the right thyroid); Lesion on the right side of the throat gene rearrangement results show: B lymphocyte clonal consider mucosa-associated extranodal marginal zone B-cell lymphoma the gene rearrangement that the right side of the throat disease is: B lymphocyte clonal, be considerd mucosa-associated extranodal marginal zone B-cell lymphoma. DIAGNOSIS throat B-cell lymphoma; thyroid papillary carcinoma (right side); Hashimoto's thyroiditis (right side).
Carcinoma ; pathology ; Carcinoma, Papillary ; pathology ; Female ; Hashimoto Disease ; pathology ; Humans ; Immunohistochemistry ; Lymphoma, B-Cell, Marginal Zone ; genetics ; pathology ; Middle Aged ; Neck ; Neoplasms, Multiple Primary ; pathology ; Pharyngeal Neoplasms ; pathology ; Pharynx ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; pathology

OBJECTIVETo investigate and analyze the variation trends in the pathological composition of thyroid cancer patients treated in Tianjin Cancer Hospital from 1954 to 2009.

METHODSTo retrospectively analyze the incidence and clinical features of different pathological types of thyroid cancers in 4342 patients between different time periods from 1954 to 2009.

RESULTSIn the four main pathological types of thyroid cancers, the component ratio of papillary thyroid cancer in every period was 68.1%, 78.3%, 81.3%, 82.1%, 85.8%, respectively, while the morbidity of patients with papillary thyroid carcinoma concurrent with Hashimoto's thyroiditis was increased, so was the proportion of tumors in diameter < or = 2 cm. The proportion of follicular thyroid carcinoma and anaplastic thyroid carcinoma was decreasing accordingly; however, the proportion of medullary thyroid carcinoma did not change significantly.

CONCLUSIONSThe pathological classification of the thyroid carcinoma patients has significant changes in the 4342 cases treated in our Hospital from 1954 to 2009. The proportion of papillary carcinoma is increased, while that of follicular carcinoma and anaplastic carcinoma is decreased. The reasons might attribute to the improved level of consultations and iodized diet or other factors.

Adenocarcinoma, Follicular ; epidemiology ; pathology ; Carcinoma ; epidemiology ; pathology ; Carcinoma, Medullary ; epidemiology ; pathology ; Carcinoma, Papillary ; epidemiology ; pathology ; China ; epidemiology ; Female ; Hashimoto Disease ; complications ; epidemiology ; pathology ; Humans ; Incidence ; Male ; Retrospective Studies ; Thyroid Neoplasms ; complications ; epidemiology ; pathology ; Tumor Burden