Malignancy Rate of Bethesda Class III Thyroid Nodules Based on the Presence of Chronic Lymphocytic Thyroiditis in Surgical Patientsopen access
- Authors
- Cho, Yoon Young; Chung, Yun Jae; Kim, Hee Sung
- Issue Date
- Sep-2021
- Publisher
- Frontiers Media S.A.
- Keywords
- atypia of undetermined significance; fine-needle aspiration; chronic lymphocytic thyroiditis; Hashimoto's thyroiditis; thyroid malignancy
- Citation
- Frontiers in Endocrinology, v.12, no.0, pp 1 - 7
- Pages
- 7
- Journal Title
- Frontiers in Endocrinology
- Volume
- 12
- Number
- 0
- Start Page
- 1
- End Page
- 7
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/20919
- DOI
- 10.3389/fendo.2021.745395
- ISSN
- 1664-2392
- Abstract
- Background Hashimoto's thyroiditis (HT), also known as chronic lymphocytic thyroiditis (CLT), may interfere with the accurate cytological diagnosis of thyroid nodules. Recently, HT has been considered a premalignant condition for thyroid cancer development. The diagnosis of atypia of undetermined significance/follicular lesions of undetermined significance (AUS/FLUS) thyroid nodules is challenging and evidence for the malignancy risk of AUS/FLUS thyroid nodules coexisting with CLT is scarce. Therefore, we assessed the malignancy risk of AUS/FLUS thyroid nodules according to the presence of background CLT.</p> Methods This study included 357 surgically resected thyroid nodules with AUS/FLUS cytology. Cases with concomitant malignant nodules were excluded. CLT was defined based on the pathologic report after thyroid surgery.</p> Results Among 357 tumors, 130 tumors (36%) were confirmed to have coexisting CLT, and 170 tumors (48%) were determined to be malignant after thyroidectomy. Malignancy rates were similar in both groups (48% in each) regardless of background CLT (62/130 with CLT vs. 108/227 without CLT). In the group with CLT, thyroiditis was more frequent in the final pathology (12% with CLT vs. 1% without CLT, P = 0.003). In multivariate analysis, positive BRAF (V600E) mutation, highly suspicious sonographic features (K-TIRADS 5), and smaller thyroid nodules were significant factors for thyroid malignancies.</p> Conclusion The malignancy rate of thyroid nodules with AUS/FLUS cytology was comparable irrespective of the presence of underlying CLT.</p>
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