February 28, 2020
2 min read
Save

Microcarcinomas more likely found in chronic lymphocytic thyroiditis vs. other thyroid disorders

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Juan Carlos Jaume 2020
Juan Carlos Jaume

Adults who undergo thyroid surgery for noncancerous indications are more likely to have incidental findings of papillary thyroid cancer if they have chronic lymphocytic thyroiditis than either multinodular goiter or Graves’ disease, according to findings published in Thyroid.

“Incidentally discovered thyroid microcarcinomas are more common in patients with Hashimoto thyroiditis — also known as chronic lymphocytic thyroiditis — than in patients with multinodular goiters, while patients with Graves’ disease present with a lower incidence compared with both groups,” Juan Carlos Jaume, MD, professor of medicine, chief of the division of endocrinology, diabetes and metabolism, and director of the Center for Diabetes and Endocrine Research at the University of Toledo in Ohio, told Healio. “These data support previously published findings that euthyroid Hashimoto thyroiditis favors carcinogenesis, while Graves’ disease may have a protective role.”

Jaume and colleagues determined the percentage of patients with multinodular goiter (n = 2,933), chronic lymphocytic thyroiditis (n = 617) or Graves’ disease (n = 359) who had papillary thyroid microcarcinomas in a cohort of 3,909 adults who were not diagnosed with thyroid cancer prior to thyroid surgery (mean age, 49.1 years; 79.3% women). The researchers used surgical pathology results to determine the presence of papillary thyroid microcarcinomas.

Among the entire cohort, 14.6% had a papillary thyroid microcarcinoma, including 23.2% of those with chronic lymphocytic thyroiditis, 13.3% of those with multinodular goiter and 10.3% of those with Graves’ disease.

Thyroid ultrasound female 2019 
Adults who undergo thyroid surgery for noncancerous indications are more likely to have incidental findings of papillary thyroid cancer if they have chronic lymphocytic thyroiditis than either multinodular goiter or Graves’ disease.
Source: Adobe Stock

“No one expected microcarcinomas to be found in the background of chronic lymphocytic thyroiditis at such a rate,” Jaume said.

Participants with chronic lymphocytic thyroiditis had greater odds of having a papillary thyroid microcarcinoma than those with multinodular goiter (OR = 1.75; 95% CI, 1.42-2.16). In addition, participants with chronic lymphocytic thyroiditis had more than double the odds of papillary thyroid microcarcinoma than those with Graves’ disease (OR = 2.25; 95% CI, 1.53-3.3).

“These findings suggest that the various forms of autoimmune responses could have different effects on their ability to promote or suppress tumorigenesis,” the researchers wrote. “Some studies have identified an imbalance between cytotoxic and regulatory T lymphocytes in the peritumoral microenvironment in patients with chronic lymphocytic thyroiditis, which may affect the tumor-specific immune response. Therefore, the specific type of inflammatory cells ... could determine the fate of a thyroid cancer.” – by Phil Neuffer 

For more information:

Juan Carlos Jaume, MD, can be reached at juan.jaume@utoledo.edu.

Disclosures: The authors report no relevant financial disclosures.