Diagnostic value of cytology, thyroglobulin, and combination of them in fine-needle aspiration of metastatic lymph nodes in patients with differentiated thyroid cancer

Xu, Yixin; Wu, Dapeng; Wu, Wenting; Jiang, Jian; Cheng, Xi; Ye, Nianyuan; Wang, Yibo; Xu, Xuezhong

doi:10.1097/md.0000000000017859

Cited by 20 publications

(14 citation statements)

References 53 publications

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“…However, several studies have reported that detection of Tg in fine-needle aspiration (FNA) biopsy washout fluid from lymph nodes identifies recurrences/metastases of differentiated TC [ 38 , 39 ]. The combination of fine-needle lymph node aspiration for cytology and for thyroglobulin measurement further increases diagnostic accuracy [ 40 – 42 ]. Thus, in future studies ultrasound or CT guided FNA for thyroglobulin measurement and for cytology should be examined in this selected patient group.…”

Section: Discussionmentioning

confidence: 99%

The diagnostic challenge of coexistent sarcoidosis and thyroid cancer – a retrospective study

et al. 2021

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Background Sarcoid lesions may mimic metastatic disease or recurrence in thyroid cancer (TC) patients as both diseases may affect the lungs and lymph nodes. We present the first study to systematically evaluate the clinical course of patients with (TC) after adjuvant radioactive iodine therapy (RIT) and concomitant sarcoidosis of the lung or the lymph nodes. Methods We screened 3285 patients and retrospectively identified 16 patients with TC (11 papillary thyroid cancer (PTC), 3 follicular thyroid cancer (FTC), 1 oncocytic PTC, 1 oncocytic FTC) and coexisting sarcoidosis of the lung and/or the lymph nodes treated at our institute. All patients had undergone thyroidectomy and initial adjuvant RIT. Challenges in diagnosing and the management of these patients were evaluated during long term follow-up (median 4.9 years (0.8–15.0 years)). Results Median age at first diagnosis of TC was 50.1 years (33.0–71.5 years) and of sarcoidosis 39.4 years (18.0–63.9 years). During follow-up, physicians were able to differentiate between SA and persistent or recurrent TC in 10 of 16 patients (63%). Diagnosis was complicated by initial negative thyroglobulin (Tg), positive Tg antibodies and non-specific imaging findings. Histopathology can reliably distinguish between SA and TC in patients with one suspicious lesion. Conclusion Physicians should be aware of the rare coexistence of sarcoidosis and TC. Lymphadenopathy and pulmonary lesions could be metastases, sarcoidosis or even a mix of both. Therefore, this rare patient group should receive a thorough work up including histopathological clarification and, if necessary, separately for each lesion.

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Section: Discussionmentioning

confidence: 99%

The diagnostic challenge of coexistent sarcoidosis and thyroid cancer – a retrospective study

et al. 2021

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“…Thyroid follicular cells are important functional units of the thyroid gland and the place of thyroid hormone synthesis and secretion; the stability of its structure directly affects the ability of thyroid hormone synthesis and secretion [ 32 , 33 ]. We, therefore, investigated the ultrastructure changes in thyroid follicular cells under the preeclamptic status.…”

Section: Discussionmentioning

confidence: 99%

“…Most of the T 4 and T 3 are carried by thyroxine-binding globulin (TBG) in blood, resulting in less than 0.05% of them remaining free [ 33 ]. FT 4 and FT 3 are hormones that enter target cells and bind to receptors to elicit biological effect.…”

Section: Discussionmentioning

confidence: 99%

“…FT 4 and FT 3 are hormones that enter target cells and bind to receptors to elicit biological effect. 5 BioMed Research International Moreover, in pregnant status, the TBG is stimulated by human chorionic gonadotropin (HCG), which can affect the levels of total T 4 and total T 3 ; however, serum FT 4 and FT 3 are less affected [33,40]. In addition, TSH is a hormone that can promote the release and synthesis of T 4 and T 3 , also a key role in the thyroid function negative-feedback loop [41].…”

Section: Discussionmentioning

confidence: 99%

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Effect of Preeclampsia on Ultrastructure of Thyroid Gland, Hepatic Type 1 Iodothyronine Deiodinase, and Thyroid Hormone Levels in Rats

Liu

Xu²,

et al. 2021

BioMed Research International

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Background. Although hypothyroidism during pregnancy may develop grave outcomes for both mothers and offspring, management of which is still a challenge due to the insufficient understanding of this disease. The close correlation between hypothyroidism and preeclampsia is well documented, suggesting that preeclampsia is a potential risk factor for the development of maternal hypothyroidism. However, the exact role of preeclampsia in gestational hypothyroidism is still obscure. Objective. In this study, we explored the possible mechanisms of the effect of preeclampsia on thyroid function of maternal rats. Methods. Thirty pregnant rats were randomly divided into normal pregnancy control (NOP), preeclampsia (PE), and preeclampsia supplemented with amlodipine besylate (PEAml). NG-Nitro-L-arginine-methyl ester was used to induce preeclamptic symptoms. On gestational day 21, rats were sacrificed, and then, the ultrastructure of the thyroid gland, type 1 iodothyronine deiodinase (Dio1) expression, and serum-free thyroxine (FT4), free triiodothyronine (FT3), and thyroid stimulation hormones (TSH) were assessed. Results. Compared to NOP rats, results of PE rats showed that thyroid follicular cells’ ultrastructure was damaged; both hepatic Dio1 mRNA and protein levels were decreased. Interestingly, these changes were ameliorated in PEAml rats. Additionally, FT4, FT3, and TSH levels have no significant differences among groups. Conclusion. These findings indicated that preeclampsia could disrupt synthesis, secretion, and metabolism function of thyroid hormones by damaging thyroid follicular cells and interfering Dio1 expression.

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“…Patients with higher risk of recurrence should undergo follow-up examinations more frequently than the patients unlikely to develop relapse of disease. Measurement of sTg, cervical US, and occasionally whole-body scintigraphy are commonly used in the detection of metastases in patients with DTC ( 8 , 24 ).…”

Section: Discussionmentioning

confidence: 99%

Thyroglobulin Measurement in Needle Aspiration for Detection of Recurrences and Neck Metastases in Patients with Differentiated Thyroid Carcinoma: Significance of Anti-Tg Antibodies

Blažeković

Romić

Butković

et al. 2020

ACC

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SUMMARY The worldwide incidence of differentiated thyroid cancer (DTC) has increased in recent decades, likely due to frequent use of cervical ultrasonography (US) and US-guided fine needle aspiration biopsy (FNA)., US is performed during follow-up after thyroidectomy, and US-guided FNA with cytology is used if suspicious cervical lymph nodes (LN) or thyroid bed masses are detected. Knowing that serum anti-Tg antibodies (sTgAb) affect the use of serum Tg (sTg) as a tumor marker, the aim of our study was to assess the usefulness of Tg determination in needle aspirates (FNA-Tg) in presence of sTgAb. This retrospective study included 149 patients with DTC and 159 aspirations of suspicious LN and thyroid bed masses. As expected, there was a negative correlation between sTg and sTgAb levels (p<0.05), while FNA-Tg levels had a positive correlation with FNA-TgAb levels (p<0.05). Furthermore, we found a positive correlation between sTg and FNA-Tg levels (p<0.05), but not between sTgAb and FNA-TgAb or sTgAb and FNA-Tg. In conclusion, these results show that FNA-Tg values were not affected by sTgAb and that FNA-Tg measurement were highly effective in detecting cervical DTC metastases. However, combined use with cytology is suggested for neck evaluation because cytology could reveal metastases from other tumor sites.

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Diagnostic value of cytology, thyroglobulin, and combination of them in fine-needle aspiration of metastatic lymph nodes in patients with differentiated thyroid cancer

Cited by 20 publications

References 53 publications

The diagnostic challenge of coexistent sarcoidosis and thyroid cancer – a retrospective study

The diagnostic challenge of coexistent sarcoidosis and thyroid cancer – a retrospective study

Effect of Preeclampsia on Ultrastructure of Thyroid Gland, Hepatic Type 1 Iodothyronine Deiodinase, and Thyroid Hormone Levels in Rats

Thyroglobulin Measurement in Needle Aspiration for Detection of Recurrences and Neck Metastases in Patients with Differentiated Thyroid Carcinoma: Significance of Anti-Tg Antibodies

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