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Incidence and types of thyroid tumour in chronic lymphocytic thyroiditis
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| Author:
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HUSSAIN TAHER ALBAAJ, AWS RASSUL HUSSAIN AL-SALIH
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| Abstract:
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Background: Chronic lymphocytic thyroiditis (CLT) is the most common inflammatory disorder that affects the thyroid gland. It presents either as goitrous (Hashimoto thyroiditis) or atrophic thyroiditis (AT) and the only difference between them is the presence of goiter that detects by clinical examination. The diagnosis is confirmed by the hormonal profile of high TSH with normal or low T3, T4, high autoantibodies, or by FNCA preoperatively. Objectives: The current retrospective study aims to determine the malignant changes in CLT, especially the PTC by analysis of 900 thyroidectomy operations that were undertaken in Diwaniyai hospital from 2014 - 2019. Results: The study revealed 81 cases with HT, all of them were presented to the surgeons because of an un-diagnostic goiter that did not investigate by autoantibodies or by FNCA, and all cases are diagnosed postoperatively by histopathology. 21 patients of them (25%) show malignant changes. PTC has seen in 16 cases (20%) of HT, while 4 cases with lymphoma and only one case with follicular carcinoma. The study also includes an analysis of 156 cases with differentiated thyroid carcinoma (DTC), 142 of them are PTC. In the analysis of histopathology of 156 cases with DTC, HT is seen in 17 cases while no case shows the histopathology of atrophic thyroiditis. This is a big difference between two extremes (AT and HT) of the same disease (CLT). The already high incidence of PTC in HT is further increased when adjusted with age, to be one-third of patient with HT in early adult life (20-40 years) because most of PTC in HT occurs in early adult life. The PTC in HT has its own clinical –pathology feature in comparison with PTC in non HT which are its high incidence in female, earlier age. Smaller size and multiplicity are more frequent. 5 patients of 8 male patients with HT are complicated by malignancy, 3 of them are with lymphoma. Conclusion: all cases of HT must be followed carefully for malignant changes, especially in young adult life and in males.
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| Keyword:
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Thyroid tumor; chronic lymphocytic thyroiditis; follicular carcinoma
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2021.13.01.584
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| Download:
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