1
|
Vita R, Di Bari F, Capodicasa G, Perelli S, Bonanno AM, Ieni A, Moleti M, Vermiglio F, Tuccari G, Benvenga S. Rates of lymphocytic thyroiditis and ultrasound features of citologically-interrogated thyroid nodules based on the area of residence in a Sicily province. Endocrine 2021; 72:744-757. [PMID: 33063274 DOI: 10.1007/s12020-020-02521-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/03/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To verify the prevalence of autoimmune thyroiditis (AIT) and the ultrasound characteristics (composition and volume) of thyroid nodules with respect to the area of residence in the province of Messina, some areas having environmental issues. METHODS Fine-needle aspiration-interrogated nodules (n = 902) of 809 patients were evaluated upon stratification into 8 areas of residence. RESULTS Overall, women were younger than men (55.3 ± 14.0 vs. 58.6 ± 12.6 years, P = 0.0083). Patients residing in three areas (one hosting two garbage dumps, one hosting a petrochemical complex and a thermoelectrical power plant, and one hosting several ceramic factories [CFA]) were younger than those residing in the city of Messina (MEA) (52.9 ± 13.4 vs. 57.7 ± 13.6 years, P < 0.0001). Also, patients residing in those three areas had a greater rate of AIT, diagnosed either ultrasonographically/serologically (22.2% of patients) or cytologically (26.3% of nodules), compared with MEA (11.7% of patients, P = 0.0007 or 20.2% of nodules, P = 0.0815). Rates of AIT ranged 12.5-28.6% in the remaining four areas. Overall, nodules in women were smaller than in men (3.6 ± 5.7 vs. 6.1 ± 9.4 ml, P = 0.0006). Compared with the other seven areas, patients living in CFA had the largest nodules (6.8 ± 6.8 ml, P = 0.0040-0.0291), with the nodule volume being inversely correlated to patient's age (r = -0.4955, P = 0.0431). CONCLUSION Rates of AIT and associated ultrasound features of thyroid nodules vary in different areas of our province. Further studies correlating these rates and features with exposure to specific toxicants are warranted.
Collapse
Affiliation(s)
- Roberto Vita
- Department of Clinical and Experimental Medicine, University of Messina, Viale Gazzi, 98125, Messina, Italy.
| | - Flavia Di Bari
- Department of Clinical and Experimental Medicine, University of Messina, Viale Gazzi, 98125, Messina, Italy
| | - Giovanni Capodicasa
- Department of Clinical and Experimental Medicine, University of Messina, Viale Gazzi, 98125, Messina, Italy
| | - Sarah Perelli
- Department of Clinical and Experimental Medicine, University of Messina, Viale Gazzi, 98125, Messina, Italy
| | - Anna Maria Bonanno
- Department of Human Pathology of Adult and Evolutive Age Gaetano Barresi - Section of Pathological Anatomy, University of Messina, Viale Gazzi, 98125, Messina, Italy
| | - Antonio Ieni
- Department of Human Pathology of Adult and Evolutive Age Gaetano Barresi - Section of Pathological Anatomy, University of Messina, Viale Gazzi, 98125, Messina, Italy
| | - Mariacarla Moleti
- Department of Clinical and Experimental Medicine, University of Messina, Viale Gazzi, 98125, Messina, Italy
| | - Francesco Vermiglio
- Department of Clinical and Experimental Medicine, University of Messina, Viale Gazzi, 98125, Messina, Italy
- Interdepartmental Program on New Models of Multidisciplinary Management in Endocrinology, University Hospital, A.O.U. Policlinico G. Martino, Viale Gazzi, 98125, Messina, Italy
| | - Giovanni Tuccari
- Department of Human Pathology of Adult and Evolutive Age Gaetano Barresi - Section of Pathological Anatomy, University of Messina, Viale Gazzi, 98125, Messina, Italy
| | - Salvatore Benvenga
- Department of Clinical and Experimental Medicine, University of Messina, Viale Gazzi, 98125, Messina, Italy
- Master Program on Childhood, Adolescent and Women's Endocrine Health, University of Messina, Viale Gazzi, 98125, Messina, Italy
- Interdepartmental Program of Molecular & Clinical Endocrinology and Women's Endocrine Health, University Hospital, A.O.U. Policlinico G. Martino, Viale Gazzi, 98125, Messina, Italy
| |
Collapse
|
2
|
Cho YY, Chung YJ, Kim HS. Malignancy Rate of Bethesda Class III Thyroid Nodules Based on the Presence of Chronic Lymphocytic Thyroiditis in Surgical Patients. Front Endocrinol (Lausanne) 2021; 12:745395. [PMID: 34659127 PMCID: PMC8515134 DOI: 10.3389/fendo.2021.745395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/13/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Hashimoto's thyroiditis (HT), also known as chronic lymphocytic thyroiditis (CLT), may interfere with the accurate cytological diagnosis of thyroid nodules. Recently, HT has been considered a premalignant condition for thyroid cancer development. The diagnosis of atypia of undetermined significance/follicular lesions of undetermined significance (AUS/FLUS) thyroid nodules is challenging and evidence for the malignancy risk of AUS/FLUS thyroid nodules coexisting with CLT is scarce. Therefore, we assessed the malignancy risk of AUS/FLUS thyroid nodules according to the presence of background CLT. METHODS This study included 357 surgically resected thyroid nodules with AUS/FLUS cytology. Cases with concomitant malignant nodules were excluded. CLT was defined based on the pathologic report after thyroid surgery. RESULTS Among 357 tumors, 130 tumors (36%) were confirmed to have coexisting CLT, and 170 tumors (48%) were determined to be malignant after thyroidectomy. Malignancy rates were similar in both groups (48% in each) regardless of background CLT (62/130 with CLT vs. 108/227 without CLT). In the group with CLT, thyroiditis was more frequent in the final pathology (12% with CLT vs. 1% without CLT, P = 0.003). In multivariate analysis, positive BRAFV600E mutation, highly suspicious sonographic features (K-TIRADS 5), and smaller thyroid nodules were significant factors for thyroid malignancies. CONCLUSION The malignancy rate of thyroid nodules with AUS/FLUS cytology was comparable irrespective of the presence of underlying CLT.
Collapse
Affiliation(s)
- Yoon Young Cho
- Division of Endocrinology and Metabolism, Department of Medicine, Soonchunhyang University Bucheon Hospital, College of Medicine, Soonchunhyang University, Bucheon, South Korea
| | - Yun Jae Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Chung-Ang University, Seoul, South Korea
- *Correspondence: Yun Jae Chung,
| | - Hee Sung Kim
- Department of Pathology, College of Medicine, Chung-Ang University, Seoul, South Korea
| |
Collapse
|
3
|
Mettler J, Armefti S, Schmidt M, Faust M, Engels M, Chiapponi C. Benign Thyroid Diseases: Are There Gender-Specific Differences for Diagnosis and Treatment of Nontoxic Thyroid Nodules? Results from a 4-Year Retrospective Analysis of an Endocrine Tumor Board. Visc Med 2020; 36:28-33. [PMID: 32110654 DOI: 10.1159/000505499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 12/17/2019] [Indexed: 11/19/2022] Open
Abstract
Introduction Benign nodular goiters are endemic in Germany and diagnostic thyroidectomy is one of the most frequent surgical procedures. Less than 10% result in a malignant finding which is a poor ratio in comparison to other European countries. There is a female preponderance in almost all thyroid pathologies according to the current literature but not much is known concerning gender-specific differences in thyroid nodules. Objective We aimed at finding gender-specific differences in diagnosis and treatment of nontoxic thyroid nodules and focused on preoperative workup as well as cytological and histological findings of patients with solitary and multinodular nontoxic goiters. Methods We retrospectively analyzed 392 cases out of 693 thyroid cases managed interdisciplinarily by the endocrine board of a university center between January 2015 and December 2018 (4 years). Results The combination of fine needle biopsy and interdisciplinary case discussion resulted in a rate of malignancy of 28.9% in patients undergoing surgery for solitary and multinodular nontoxic goiter. Although there was no significant gender-specific difference in the distributions and malignancy rates of Bethesda categories, male patients had a significantly higher malignancy rate of 40% in our collective (p = 0.04). Conclusions Surgical treatment for male patients with suspicious hypofunctioning thyroid nodules should be favored. However, well-designed prospective studies are required to investigate gender-specific recommendations for the treatment of benign thyroid diseases in the future.
Collapse
Affiliation(s)
- Jasmin Mettler
- Department of Nuclear Medicine, Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - Stella Armefti
- Department of General, Visceral, Cancer and Transplantation Surgery, University of Cologne, Cologne, Germany
| | - Matthias Schmidt
- Department of Nuclear Medicine, Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - Michael Faust
- Department of Endocrinology, Diabetes and Preventive Medicine, University of Cologne, Cologne, Germany
| | - Marianne Engels
- Department of Pathology, University of Cologne, Cologne, Germany
| | - Costanza Chiapponi
- Department of General, Visceral, Cancer and Transplantation Surgery, University of Cologne, Cologne, Germany
| |
Collapse
|