The impact of concurrent Hashimoto thyroiditis on thyroid nodule cytopathology assessed by ultrasound-guided fine-needle aspiration cytology

Hu, Fengqiu; Yan, Zhe; Ma, Buyun; Jiang, Yong; Huang, Hui

doi:10.1080/00325481.2020.1739462

Cited by 9 publications

(6 citation statements)

References 26 publications

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“…Our results are in agreement with those reported by Hu et al (16), that retrospectively evaluated more than 1.000 thyroid nodules subjected to FNAC, reporting no differences in the rate of indeterminate cytological results between patients with or without CAT. It should be highlighted that, at variance with the present study, in the series by Hu et al, histological confirmation was available in only a minority of investigated nodules (i.e.…”

Section: Discussionsupporting

confidence: 94%

“…Some evidence would support the notion that the diagnostic accuracy of fine-needle aspiration cytology (FNAC) for thyroid nodules might be reduced by a concomitant chronic autoimmune thyroiditis (CAT) (14,15) due to the thyroiditis-related cell atypia. The possibility that CAT might represent a confounding factor by increasing the rate of indeterminate cytology results was investigated by several studies, but the results were discrepant (15,16,17). The aim of the present study was to evaluate, in a single-center series, whether a coexistent CAT might reduce the diagnostic accuracy of fine-needle aspiration cytology for thyroid nodules.…”

Section: Introductionmentioning

confidence: 93%

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The diagnostic accuracy of fine-needle aspiration cytology for thyroid nodules is not affected by coexistent chronic autoimmune thyroiditis: results from a cyto-histological series of patients with indeterminate cytology

Rotondi

Molteni

Cappelli

et al. 2021

European Journal of Endocrinology

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Objective Indeterminate cytological result at Fine-needle-aspiration-cytology (FNAC) remains a clinical challenge for endocrinologists. Aim of the present study was to evaluate whether a coexistent Chronic-Autoimmune-Thyroiditis (CAT) might affect the diagnostic accuracy of fine-needle aspiration cytology for thyroid nodules. Design and Methods A retrospective cohort study was designed including all nodules receiving an indeterminate cytology result (TIR3A or TIR3B) undergoing thyroid surgery and subsequent histological confirmation. Patients were stratified in two groups according to the presence or absence of CAT. The hypothesis to be tested was whether follicular cell alterations induced by CAT might increase the rate of indeterminate cytological results in histologically benign thyroid nodules. Additional control groups were represented by nodules with determinate cytology, either benign (TIR 2) or malignant (TIR5). Results: One-hundred-eighty-nine indeterminate thyroid nodules were included (67 TIR3A and 122 TIR3B). At post-surgical histology 46 nodules (24.3%) were malignant. No significant differences were observed in the rate of histologically proven malignancy between patients without CAT and patients with CAT in the TIR3B (29.4% vs 32.4%; p=0.843) nor TIR3A (13.0% vs 11.4%; p=1.000) nodules. The rate of coexistent CAT was similar between TIR3B and TIR5 nodules harboring PTC at histology (30.4% vs 39.4%, p=0.491) and between indeterminate nodules and a control group of TIR2 nodules (39.2% vs 37.0%; p=0.720). Conclusions: The similar rates of histologically proven malignancy found in cytologically indeterminate nodules in the presence or absence of concomitant CAT, would not support that CAT itself affects the diagnostic accuracy of fine-needle aspiration cytology.

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Section: Discussionsupporting

confidence: 94%

Section: Introductionmentioning

confidence: 93%

The diagnostic accuracy of fine-needle aspiration cytology for thyroid nodules is not affected by coexistent chronic autoimmune thyroiditis: results from a cyto-histological series of patients with indeterminate cytology

Rotondi

Molteni

Cappelli

et al. 2021

European Journal of Endocrinology

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“…The fasting blood samples were collected at 6-7 a.m. of the second day after admission, including hemoglobin (Hb) levels, neutrophil-to-lymphocyte ratio (NLR), total cholesterol, uric acid, and plasma fibrinogen. In addition, the testing for serum thyroid function levels during the first admission (before immunotherapy) included serum free triiodothyronine (fT3, reference range, 3.60-7.50 pmol/l), free thyroxine (fT4, reference range, 12.0-22.0 pmol/l), thyrotropin (TSH, reference range, 0.27-4.20 mU/l), TPOAb (reference range, 0-34 U/ml), and TgAb (reference range, 0-115 U/ml), and these were tested by a Roche immunoanalyzer (Moduler EE, E170D) [19].…”

Section: Laboratory Testingmentioning

confidence: 99%

The detection of up-regulated anti-thyroid antibodies and autoimmune thyroid diseases in patients with autoimmune encephalitis: a retrospective study of 221 patients

Lin

Wang

et al. 2022

Neurol Sci

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Objective To investigate the potential detection rate of anti-thyroid antibodies' (ATAbs) positivity, thyroid dysfunctions, and autoimmune thyroid diseases (AITDs) in autoimmune encephalitis (AE) and to analyze whether thyroid autoimmunity/ dysfunction can affect the clinical course of AE. Methods Two hundred twenty-one AE patients and 229 age-and sex-matched controls were included in this study. We measured the levels of ATAbs (anti-thyroglobulin antibodies [TgAb], anti-thyroid peroxidase anti-bodies [TPOAb]) and thyroid hormones in all the individuals. In addition, the association of thyroid autoimmunity/dysfunctions with functional outcomes of AE was identified by using logistic regression and Kaplan-Meier analyses. ResultsThe prevalence of TPOAb-positive and TgAb-positive was significantly higher in AE patients (16.3% and 16.7%, respectively) as compared with controls (9.6% and 7.4%, respectively; P = 0.034 and P = 0.002, respectively). In addition, the free triiodothyronine (fT3) level was significantly lower in AE patients as compared to the controls (P < 0.001). However, the frequency of AITDs (Hashimoto's thyroiditis and Graves' disease) did not significantly differ between AE patients and control subjects. Importantly, low fT3 was found to be associated with poor functional outcomes at the 3-month follow-up in AE. Adjustment of potential confounders did not change the association. However, the presence of ATAbs did not significantly alert the disease course of AE. Conclusions ATAbs-positive and/or AITD patients with symptomatic encephalopathy should undergo proper surveillance for AE. Moreover, low fT3 could serve as a possible predictor of poor short-term outcome in AE, thereby suggesting that monitoring of thyroid function in AE may be necessary.

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“…It has been noted that when thyroiditis occurs, the echogenicity of the thyroid gland becomes uneven on US images and some inflammatory nodules appear hypo-echogenic, with poorly defined margins and even dystrophic microcalcifications ( 11 , 12 ). After FNA biopsy for thyroid nodules associated with Hashimoto’s thyroiditis, Hu et al ( 13 ) reported that the overall nondiagnostic and indeterminate cytology rates were 11.9% and 25%, respectively. The areas of necrosis and inflammatory cells within nodules may interfere with the FNA results, which usually leads to the need for more than one biopsy.…”

Section: Introductionmentioning

confidence: 99%

Comparison of contrast-enhanced ultrasound characteristics of inflammatory thyroid nodules and papillary thyroid carcinomas using a quantitative time-intensity curve: a propensity score matching analysis

Zhang¹,

Liu²,

Yang³

et al. 2022

Quant Imaging Med Surg

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Background: This study aims to compare the contrast-enhanced ultrasound (CEUS) characteristics of inflammatory thyroid nodules with those of papillary thyroid carcinomas using time-intensity curve (TIC) analysis.Methods: This was a retrospective cohort study. Among the thyroid nodules in 2161 patients who underwent CEUS from July 2014 to April 2018, 44 nodules in 44 patients ultimately diagnosed as inflammatory nodules and 44 nodules in 44 patients confirmed as papillary carcinomas (enrolled from July 2016 to April 2018) were included after propensity score matching analysis (1:1). The average diameters of lesions in the inflammatory and malignant groups (n=44 each) were 0.92±0.34 cm and 0.89±0.42 cm, respectively. CEUS patterns were evaluated and classified into four types, namely concentric hypo-enhancement, heterogeneous hypoenhancement, hypo-enhancement with a sharp margin, and homogeneous hyper/iso-enhancement. The measured TIC parameters included peak intensity (PI), rise time (RT), time to peak (TTP), maximum slope rate of the ascending curve (AS), and maximum slope rate of the descending curve (DS). The CEUS patterns and TIC parameters were compared between the inflammatory nodules and papillary carcinomas. Results:The heterogeneous hypo-enhancement CEUS pattern was predominantly present in the inflammatory nodules. The concentric hypo-enhancement pattern was identified as a valuable predictive pattern for papillary carcinomas. For the TIC, inflammatory nodules had a lower PI [55.42 (45.41, 76.91) vs. 84.43 (74.93, 90.92)] [median (interquartile range)] and a smaller AS [22.39 (13.37, 29.93) vs. 29.54 (19.37, 44.77)], compared with papillary carcinomas (P<0.05).Conclusions: CEUS patterns with TIC parameters could provide effective and quantitative information for characterizing microvascular perfusion of inflammatory thyroid nodules and papillary carcinomas.

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The impact of concurrent Hashimoto thyroiditis on thyroid nodule cytopathology assessed by ultrasound-guided fine-needle aspiration cytology

Cited by 9 publications

References 26 publications

The diagnostic accuracy of fine-needle aspiration cytology for thyroid nodules is not affected by coexistent chronic autoimmune thyroiditis: results from a cyto-histological series of patients with indeterminate cytology

The diagnostic accuracy of fine-needle aspiration cytology for thyroid nodules is not affected by coexistent chronic autoimmune thyroiditis: results from a cyto-histological series of patients with indeterminate cytology

The detection of up-regulated anti-thyroid antibodies and autoimmune thyroid diseases in patients with autoimmune encephalitis: a retrospective study of 221 patients

Comparison of contrast-enhanced ultrasound characteristics of inflammatory thyroid nodules and papillary thyroid carcinomas using a quantitative time-intensity curve: a propensity score matching analysis

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