Multiple Thyroid Cysts May Be a Cause of Hypothyroidism in Patients with Relatively High Iodine Intake

Kubota, Sumihisa; Fujiwara, Mako; Hagiwara, Hanae; Tsujimoto, Naoyuki; Takata, Kazuna; Kudo, Takumi; Nishihara, Eijun; M, Ito; Amino, Nobuyuki; Miyauchi, Akira

doi:10.1089/thy.2009.0264

Cited by 12 publications

(17 citation statements)

References 8 publications

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“…These pathological features were identified in all the presented cases with PCTD, and may be the cause of PCTD. We previously reported that the tissue between the cysts detected by ultrasound was hypo-echoic and had a sponge-like appearance in the PCTD patients [1]. The huge follicles seemed to be cysts and the area with moderately large follicles appeared as hypoechoic lesions on ultrasound.…”

Section: Comparison Of Normal-looking Thyroid Tissuementioning

confidence: 88%

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confidence: 99%

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Pathologic features of polycystic thyroid disease: Comparison with benign nodular goiter

et al. 2011

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Polycystic thyroid disease (PCTD) is characterized by multiple thyroid cysts detected by ultrasonography, the absence of thyroid autoantibodies, and susceptibility to the development of hypothyroidism due to a high iodine intake [1]. We previously reported that hypothyroidism induced by PCTD accounted for about 7% of all causes of hypothyroidism in a region with a high iodine intake [2]. We speculated that the development of hypothyroidism was due to a decreased volume of normal thyroid hormone-producing tissue because of multiple cysts in PCTD. From the previously published images of ultrasonography, PCTD may have been classified as multinodular goiter thus far. We have to obtain histopathological information on PCTD in order to clarify whether it is different from multinodular goiter. We retrospectively identified three patients with PCTD who underwent thyroidectomy because of Abstract. Polycystic thyroid disease (PCTD) is characterized by multiple thyroid cysts detected by ultrasonography, the absence of thyroid autoantibodies, and susceptibility to the development of hypothyroidism due to a high iodine intake. It is necessary to obtain histopathological information on PCTD in order to clarify the cause of hypothyroidism. We retrospectively reviewed three patients with PCTD and small papillary thyroid cancer who underwent thyroidectomy. We observed the thyroid tissues pathologically in areas with and without multiple cysts, and compared them with those of multinodular goiter with cysts. In the patients with PCTD, there were multiple enlarged follicles that resembled enlarged normal follicles and differed from those found in multinodular goiter in terms of their shape. Huge follicles corresponded to the cysts that were detected by ultrasonography. Each follicle contained colloid. Follicular cells in enlarged follicles comprised low cuboidal epithelium that appeared normal. These findings were common in the 3 patients with PCTD. In Conclusion the PCTD patients had multiple enlarged follicles that seemed to decrease the total number of follicular cells, and may be a cause of hypothyroidism. We believe that PCTD is a new entity of thyroid disease based on the pathological findings.Key words: Hypothyroidism, Thyroid cyst, Polycystic thyroid diseases, Pathology papillary thyroid carcinoma, and were able to obtain the PCTD tissues. We present the pathologic findings of PCTD in these patients and compare them with those of multinodular goiter with cysts in this report. subjects and MethodsThe subjects were three PCTD patients who underwent thyroidectomy because of papillary thyroid carcinoma. Since the carcinomas in these patients were small, we were able to observe the non-carcinomatous thyroid tissues. As control cases, we collected seven cases with multinodular goiter macroscopically containing multiple cystic lesions, which were resected from 2007 to 2010 in our hospital. Serum thyroid hormone levels were normal in all control cases. We observed the tissues of cystic lesions and normal-looking areas in both group...

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Section: Comparison Of Normal-looking Thyroid Tissuementioning

confidence: 88%

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mentioning

confidence: 99%

Pathologic features of polycystic thyroid disease: Comparison with benign nodular goiter

et al. 2011

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“…On the other hand, regardless of chronic thyroiditis, group C, which showed a higher titer of TSH before treatment than group D, showed a higher dose of LT4 before delivery than group D. Because this study was retrospective, the causes of SCH besides chronic thyroiditis could not be clarified adequately. However, we suspected that these subjects were probably suffering from mild chronic thyroiditis showing a negative titer of anti-thyroid antibody or polycystic thyroid disease, which is one of the causes of hypothyroidism associated with multiple thyroid cysts influenced by high iodine intake [16]. In addition, high iodine intake might influence their thyroid function because Japan is an area of high iodine intake.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Clinical Features of Infertile Women With Subclinical Hypothyroidism in Relatively High-Iodine-Intake Area

et al. 2015

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Background: It is well known that hypothyroidism may cause menstrual abnormalities, infertility, increased risk of miscarriage, obstetric complications, and adverse outcomes in offspring. On the other hand, some studies have reported the efficacy of supplementation of levothyroxine (LT4) for subclinical hypothyroidism (SCH) in infertile women. The aim of this study was to evaluate the clinical features of infertile SCH patients in Japan.

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“…Fine-needle aspiration biopsy is not necessary for such small cysts, even though such children present positive or negative for thyroid autoantibodies. Recently, it has been reported that multiple small cysts in the whole thyroid gland may be a cause of hypothyroidism in old patients with relatively high iodine intake [14]. Such patients presented negative for thyroid autoantibodies, and the disease was named polycystic thyroid disease [14].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, it has been reported that multiple small cysts in the whole thyroid gland may be a cause of hypothyroidism in old patients with relatively high iodine intake [14]. Such patients presented negative for thyroid autoantibodies, and the disease was named polycystic thyroid disease [14]. These multiple small cysts are diffusely located in the whole thyroid glands, not aggregated in some area.…”

Section: Discussionmentioning

confidence: 99%

Papillary Thyroid Carcinoma with Honeycomb-Like Multiple Small Cysts: Characteristic Features on Ultrasonography

et al. 2013

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Background: Thyroid nodules with cystic content or mixed sponge-like aspect on ultrasonography and a concordant cytology are strongly predictive of benignity. Objectives: We present 8 patients with honeycomb-like papillary thyroid carcinoma with multiple small cysts on ultrasonography. Methods: The patients were 6 women and 2 men aged between 30 and 57 years. The tumors of these patients showed honeycomb-like multiple small cysts that were aggregated in some area of the thyroid gland on ultrasonography. Histopathological examination indicated a well-differentiated type of papillary thyroid carcinoma with multiple small cysts and a small solid lesion. The cysts were lined with papillary carcinoma cells, and normal thyroid tissue lay between the cysts. Results: There is a peculiar type of papillary thyroid carcinoma that histopathologically shows honeycomb-like multiple small cysts in the thyroid gland. Ultrasonography can be used to identify characteristic features of honeycomb-like multiple small cysts in the thyroid gland in such patients. Conclusions: One should be aware of this peculiar type of papillary thyroid carcinoma with honeycomb-like multiple small cysts on ultrasonography, although thyroid nodules with cystic lesions are generally regarded as benign in clinical management.

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Multiple Thyroid Cysts May Be a Cause of Hypothyroidism in Patients with Relatively High Iodine Intake

Cited by 12 publications

References 8 publications

Pathologic features of polycystic thyroid disease: Comparison with benign nodular goiter

Pathologic features of polycystic thyroid disease: Comparison with benign nodular goiter

Evaluation of the Clinical Features of Infertile Women With Subclinical Hypothyroidism in Relatively High-Iodine-Intake Area

Papillary Thyroid Carcinoma with Honeycomb-Like Multiple Small Cysts: Characteristic Features on Ultrasonography

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