Incidence and Types of Thyroid Tumor in Chronic Lymphocytic Thyroiditis

Abstract

Author(s): Hussain Taher Abbas Al-baaj

The Chronic Lymphocytic Thyroiditis (CLT) is the most common
inflammatory disorder that affects the thyroid gland. It presents either
as goitrous (hashimoto thyroiditis) or Atrophic Thyroiditis (AT) and
the only difference between them is the presence of goiter that
detects by clinical examination. The diagnosis are confirmed by
hormonal profile of high TSH with normal or low T3, T4, high
autoantibodies or by FNCA preoperatively .The histopathology in HT
is diagnostic. The management is medical, but if the disease is
presented with goiter, the surgical interference is indicated in case of
the pressure effect or malignant changes. The commonest malignant
tumor of thyroid gland is the Papillary Thyroid Carcinoma (PTC) 80%.
Follicular carcinoma occurs in 10% of cases. Lymphoma is rare
malignancy of thyroid gland but certainly complicates CLT. The
association of HT and PTC is still topic of debate since first described
in 1955.
Material and Methods: Retrospective study aims to determine the
malignant changes in CLT, especially the PTC by analysis of 900
thyroidectomy operations that were undertaken in Diwaniyai
hospital from 2014 - 2019 . All the cases are diagnosed
postoperatively by histopathology. The patients are divided into two
age group, group A between 20-40 years and group B above 40
years
Results: The study revealed 81 cases with HT, all of them were
presented to the surgeons because of un-diagnostic goiter that did
not investigate by autoantibodies or by FNCA. 21(25%) patients of
them show malignant changes. PTC is seen 16 cases (20%) of HT,
while 4 cases with lymphoma and only one case with follicular
carcinoma. In group A that includes 38 patients, 13 of them are with
PTC. In group B that include 43 patients , 3 of them with PTC
The study also include analysis of 156 cases with differentiated
thyroid carcinoma (DTC), 142 of them are PTC. In the analysis of
histopathology of 156 cases with DTC, HT is seen in 17 cases while
no case shows the histopathology of atrophic thyroiditis. 7 cases of
PTC (44%) are microscopic . 8 cases (50%) are multifocal . 15 (88%)
of DTC are seen in females and 2 (12%) in males
5 patients of 8 male patients with HT are complicated by malignancy, 3
of them are with lymphoma.

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