Association of Lymphocytic Thyroiditis and Thyroid Papillary Cancer
DOI:
https://doi.org/10.12970/2310-9874.2015.03.03.2Keywords:
Lymphocytic thyroiditis, papillary carcinoma, thyroid, autoimmunity, Thyroid NeoplasmsAbstract
Introduction: The association between the papillary thyroid carcinoma (PTC) and the lymphocytic thyroiditis (LT) is common and remains controversial.
Objectives: Define the prevalence of the association of LT with PTC and the characteristics of patients who suffer from PTC with LT compared to those without LT.
Methods: This is a retrospective cross-sectional study of patients followed for PTC within the Department of Endocrinology of Casablanca between 1986 and 2015. The statistical analysis was performed using SPSS 16.
Results: Among 348 files of patients who suffer from PTC, 49 patients had associated LT, giving a frequency of about 14.1%. The patients were divided into two groups: group with PTC + LT and group with PTC without LT. A female predominance was noticed in both groups. The tumor size was lower in the group with PTC + LT: 0.6cm vs 1.4cm in patients without LT (p = 0.001). TNM1 class was predominant in the LT group (p = 0.004). There was no difference in recurrence rates in both groups.
Conclusions: The association of PTC with LT is common; patients with LT typically present with smaller tumor size and lower TNM stage and have a generally good prognosis.
References
Dailey ME, Lindsay S, Skahen R. Relation of thyroid neoplasms to Hashimoto disease of the thyroid gland. Arch Surg 1955; 70: 291-7. http://dx.doi.org/10.1001/archsurg.1955.01270080137023
Lee JH, Kim Y, Choi JW, Kim YS. The association between papillary thyroid carcinoma and histologically proven Hashimoto’s thyroiditis: a meta-analysis. Eur J Endocrinol 2013; 15; 168(3): 343-9
Takahashi M, Buma Y, Iwamoto T, Inaguma Y, Ikeda H, Hiai H. Cloning and expression of the ret proto-oncogene encoding a tyrosine kinase with two potential transmembrane domains. Oncogene 1988; 3(5): 571-8.
Nikiforova MN, Caudill CM, Biddinger P, Nikiforova YE. Prevalence of RET/PTC rearrangements in Hashimoto’s thyroiditis and papillary thyroid carcinomas. Int J Surg Pathol 2002; 10(1): 15-22. http://dx.doi.org/10.1177/106689690201000104
Sugg SL, Ezzat S, Rosen IB, Freeman JL, Asa SL. Distinct multiple RET/PTC gene rearrangements in multifocal papillary thyroid neoplasia. J Clin Endocrinol Metab 1998, 83(11): 4116-22. http://dx.doi.org/10.1210/jc.83.11.4116
Matsubayashi S, Kawai K, MatsumotoY, MukutaT, MoritaT, Hirai K, et al. The correlation between papillary thyroid carcinoma and lymphocytic infiltration in the thyroid gland. J Clin Endocrinol Metab 1995; 80(12): 3421-4.
Gomez Saez JM, Gomez Arnaiz N, Sahun de la Vega M, Soler Ramon J. Prevalence and significance of lymphocyte infiltration in papillary carcinoma of the thyroid gland. An Med Interna 1997; 14(8): 403-5
Asanuma K, Sugenoya A, Kasuga Y, Itoh N, Kobayashi S, Amano J. The relationship between multiple intrathyroidal involvement in papillary thyroid carcinoma and chronic non-specific thyroiditis. Cancer Lett 1998; 122(1-2): 177-80. http://dx.doi.org/10.1016/S0304-3835(97)00398-4
Singh B, Shaha AR, Trivedi H, Carew JF, Poluri A, Shah JP. Coexistent Hashimoto’s thyroiditis with papillary thyroid carcinoma: impact on presentation, management, and outcome. Surgery 1999; 126(6): 1070-6. http://dx.doi.org/10.1067/msy.2099.101431
Loh KC, Greenspan FS, Dong F, Miller TR, Yeo PP. Influence of lymphocytic thyroiditis on the prognostic outcome of patients with papillary thyroid carcinoma. J Clin Endocrinol Metab 1999; 84(2): 458-63. http://dx.doi.org/10.1210/jcem.84.2.5443
Neuhold N, Kaiser H, Kaserer K. Latent carcinoma of the thyroid in Austria: a systematic autopsy study. Endocr Pathol 2001; 12(1): 23-31. http://dx.doi.org/10.1385/EP:12:1:23
Tamimi DM. The association between chronic lymphocytic thyroiditis and thyroid tumors. Int J Surg Pathol 2002; 10(2): 141-6. http://dx.doi.org/10.1177/106689690201000207
Ohmori N, Miyakawa M, Ohmori K, Takano K. Ultrasonographic findings of papillary thyroid carcinoma with Hashimoto’s thyroiditis. Intern Med 2007; 46(9): 547-50. http://dx.doi.org/10.2169/internalmedicine.46.1901
Kurukahvecioglu O, Taneri F, Yuksel O, Aydin A, Tezel E, Onuk E. Total thyroidectomy for the treatment of Hashimoto’s thyroiditis coexisting with papillary thyroid carcinoma. Adv Ther 2007; 24(3): 510-6. http://dx.doi.org/10.1007/BF02848773
Del Rio P, Cataldo S, Sommaruga L, Concione L, Arcuri MF, Sianesi M. The association between papillary carcinoma and chronic lymphocytic thyroiditis: does it modify the prognosis of cancer? Minerva Endocrinol 2008; 33(1): 1-5.
Repplinger D, Bargren A, Zhang YW, Adler JT, Haymart M, Chen H. Is Hashimoto’s thyroiditis a risk factor for papillary thyroid cancer? J Surg Res. 2008; 150(1): 49-52. http://dx.doi.org/10.1016/j.jss.2007.09.020
Fiore E, Rago T, Scutari M, Ugolini C, Proietti A, Di Coscio G, et al. Papillary thyroid cancer, although strongly associated with lymphocytic infiltration on histology, is only weakly predicted by serum thyroid autoantibodies in patients with nodular thyroid diseases. J Endocrinol Invest 2009; 32(4): 344-51. http://dx.doi.org/10.1007/BF03345725
Kim EY, Kim WG, Kim WB, Kim TY, Kim JM, Ryu JS, et al. Coexistence of chronic lymphocytic thyroiditis is associated with lower recurrence rates in patients with papillary thyroid carcinoma. Clin Endocrinol (Oxf) 2009; 71(4): 581-6. http://dx.doi.org/10.1111/j.1365-2265.2009.03537.x
Bruland O, Fluge O, Akslen LA, Eiken HG, Lillehaug JR, Varhaug JE, et al. Inverse correlation between PDGFC expression and lymphocyte infiltration in human papillary thyroid carcinomas. BMC Cancer 2009; 9: 425. http://dx.doi.org/10.1186/1471-2407-9-425
Kim HS, Choi YJ, Yun JS. Features of papillary thyroid microcarcinoma in the presence and absence of lymphocytic thyroiditis. Endocr Pathol 2010; 21(3): 149-53. http://dx.doi.org/10.1007/s12022-010-9124-9
French JD,Weber ZJ, Fretwell DL, Said S, Klopper JP, Haugen BR. Tumor-associated lymphocytes and increased FoxP3+ regulatory T cell frequency correlate with more aggressive papillary thyroid cancer. J Clin Endocrinol Metab 2010; 95(5): 2325-33. http://dx.doi.org/10.1210/jc.2009-2564
Mazokopakis EE, Tzortzinis AA, Dalieraki-Ott EI, Tsartsalis AN, Syros PK, Karefilakis CM, et al. Coexistence of Hashimoto’s thyroiditis with papillary thyroid carcinoma. A retrospective study. Hormones (Athens) 2010; 9(4): 312-7. http://dx.doi.org/10.14310/horm.2002.1282
Consorti F, Loponte M, Milazzo F, Potasso L, Antonaci A. Risk of malignancy from thyroid nodular disease as an element of clinical management of patients with Hashimoto’s thyroiditis. Eur Surg Res 2010; 45(3-4): 333-7. http://dx.doi.org/10.1159/000320954
Gul K, Dirikoc A, Kiyak G, Ersoy PE, Ugras NS, Ersoy R, et al. The association between thyroid carcinoma and Hashimoto’s thyroiditis: the ultrasonographic and histopathologic characteristics of malignant nodules. Thyroid 2010; 20(8): 873-8. http://dx.doi.org/10.1089/thy.2009.0118
Kim KW, Park YJ, Kim EH, Park SY, Park do J, Ahn SH, et al. Elevated risk of papillary thyroid cancer in Korean patients with Hashimoto’s thyroiditis. Head Neck 2011; 33(5): 691-5. http://dx.doi.org/10.1002/hed.21518
Ahn D, Heo SJ, Park JH, Kim JH, Sohn JH, Park JY, et al. Clinical relationship between Hashimoto ’s thyroiditis and papillary thyroid cancer. Acta Oncol 2011; 50(8): 1228-34. http://dx.doi.org/10.3109/0284186X.2011.602109
Huang BY, Hseuh C, Chao TC, Lin KJ, Lin JD. Well-differentiated thyroid carcinoma with concomitant Hashimoto’s thyroiditis present with less aggressive clinical stage and low recurrence. Endocr Pathol 2011; 22(3): 144-9. http://dx.doi.org/10.1007/s12022-011-9164-9
Yoon YH, Kim HJ, Lee JW, Kim JM, Koo BS. The clinicopathologic differences in papillary thyroid carcinoma with or without co-existing chronic lymphocytic thyroiditis. Eur Arch Otorhinolaryngol 2012; 269(3): 1013-7. http://dx.doi.org/10.1007/s00405-011-1732-6
Zhang L, Li H, Ji QH, Zhu YX, Wang ZY, Wang Y, et al. The clinical features of papillary thyroid cancer in Hashimoto’s thyroiditis patients from an area with a high prevalence of Hashimoto’s disease. BMC Cancer 2012; 12: 610. http://dx.doi.org/10.1186/1471-2407-12-610
Jeong JS, Kim HK, Lee CR, Park S, Park JH, Kang SW, et al. Coexistence of Chronic Lymphocytic Thyroiditis with Papillary Thyroid Carcinoma: Clinical Manifestation and Prognostic Outcome. J Korean Med Sci 2012; 27(8): 883-9. http://dx.doi.org/10.3346/jkms.2012.27.8.883
Zhang Y, Ma XP, Deng FS, Liu ZR, Wei HQ, Wang XH, et al. The effect of chronic lymphocytic thyroiditis on patients with thyroid cancer. World J Surg Oncol 2014; 12: 277. http://dx.doi.org/10.1186/1477-7819-12-277
Konturek A, Barczyński M, Nowak W, Wierzchowski W. Risk of lymph node metastases in multifocal papillary thyroid cancer associated with Hashimoto's thyroiditis. Langenbecks Arch Surg 2014; 399(2): 229-36. http://dx.doi.org/10.1007/s00423-013-1158-2
Park JY, Kim DW, Park HK, Ha TK, Jung SJ, Kim do H, et al. Comparison of T stage, N stage, multifocality, and bilaterality in papillary thyroid carcinoma patients according to the presence of coexisting lymphocytic thyroiditis. Endocr Res 2015; 40(3): 151-5. http://dx.doi.org/10.3109/07435800.2014.977911
Girardi FM, Barra MB, Zettler CG. Papillary thyroid carcinoma: does the association with Hashimoto's thyroiditis affect the clinicopathological characteristics of the disease? Braz J Otorhinolaryngol. Braz J Otorhinolaryngol 2015; 81(3): 283-7. http://dx.doi.org/10.1016/j.bjorl.2014.04.006
Meier DW, Woolner IB, Beahrs OH, Mcconahey WM. Parenchymal findings in thyroidal carcinoma: Pathologic study of 256 cases. J Clin Endocrinol Metab 1959; 19(1): 162-71. http://dx.doi.org/10.1210/jcem-19-1-162
Crile G Jr, Hazard JB. Incidence of cancer in struma lymphomatosa. Surg Gynecol Obstet 1962; 115: 101-3.
Tallini G, Asa SL. RET oncogene activation in papillary thyroid carcinoma. Adv Anat Pathol 2001; 8(6): 345-54. http://dx.doi.org/10.1097/00125480-200111000-00005
Nakazawa T, Kondo T, Kobayashi Y, Takamura N, Murata S, Kameyama K et al. RET gene rearrangements (RET/ PTC1 and RET/PTC3) in papillary thyroid carcinomas from an iodine-rich country (Japan). Cancer 2005; 104(5): 943-51. http://dx.doi.org/10.1002/cncr.21270
Sheils OM, O'Eary JJ, Uhlmann V, Lattich K, Sweeney EC. Ret/PTC-1 activation in Hashimoto Thyroiditis. Int J Surg Pathol 2000; 8(3): 185-189. http://dx.doi.org/10.1177/106689690000800305
Unger P, Ewart M, Wang BY, Gan L, Kohtz DS, Burstein DE. Expression of p63 in papillary thyroid carcinoma and in Hashimoto's thyroiditis: a pathobiologic link? Hum Pathol 2003; 34(8): 764-9. http://dx.doi.org/10.1016/S0046-8177(03)00239-9
Kamma H, Fujii K, Ogata T. Lymphocytic infiltration in juvenile thyroid carcinoma. Cancer 1988; 1; 62(9): 1988-93.
Boelaert K, Horacek J, Holder RL, Wtkinson JC, Sheppard MC et al. Serum thyrotropin concentration as a novel predictor of malignancy in thyroid nodules investigated by fine-needle aspiration. J Clin Endocrinol Metab 2006; 91(11): 4295-301. http://dx.doi.org/10.1210/jc.2006-0527
Hovens GC, Stokkel MP, Kievit J, Corssmit EP, Pereira AM, Romijn JA, et al. Associations of serum thyrotropin concentrations with recurrence and death in differentiated thyroid cancer. J Clin Endocrinol Metab 2007; 92(7): 2610-5. http://dx.doi.org/10.1210/jc.2006-2566
Kim ES, Lim DJ, Baek KH, Lee JM, Kim MK, Kwon HS, et al. Thyroglobulin antibody is associated with increased cancer risk in thyroid nodules. Thyroid 2010; 20(8): 885-91. http://dx.doi.org/10.1089/thy.2009.0384
Azizi G, Keller JM, Lewis M, Piper K, Puett D, Rivenbark KM, et al. Association of Hashimoto’s thyroiditis with thyroid cancer. Endocr Relat Cancer 2014; 21(6): 845-52. http://dx.doi.org/10.1530/ERC-14-0258
Al-Omari AA, Haddad FH, Khushman HM, Malkawi OM. Graves disease and papillary thyroid cancer. An association that can be missed. Saudi Med J 2005; 26(8): 1280-2.