PAPILLARY THYROID CARCINOMA WITH COEXISTENCE OF HASHIMOTO AND TUMOR-ASSOCIATED LYMPHOCYTES
Abstract
https://doi.org/10.31386/dmj.2025.19.2.4
Background: Papillary thyroid carcinoma represents the most common thyroid cancer. The
co-existence of Hashimoto thyroiditis and papillary thyroid carcinoma has long been described
in clinical research; however, the relationship is still debatable. This study aimed to estimate
the coexistence of Hashimoto's thyroiditis and papillary thyroid carcinoma and to correlate
these two conditions with the expression of immunological markers, including CD19 and IgG4,
and with clinicopathological factors.
Methods: The research conducted a retrospective investigation evaluating thyroid tissue
obtained from papillary thyroid carcinoma patients with Hashimoto thyroiditis or tumor-
associated lymphocytes coexistence. The examination determined B-cell and plasma cell
infiltration using CD19 and immunoglobulin G4 markers to correlate them statistically with
demographic and clinicopathological variables.
Results: Showed coexistence of Hashimoto thyroiditis and tumor-associated lymphocytes with
papillary thyroid carcinoma in 74%. A significant association between immunoglobulin G4-
related disease and age was detected in patients below 45 years, particularly among those with
Hashimoto thyroiditis (P=0.039), and with the histological subtypes in patients with classic
variant (66.7% in Hashimoto thyroiditis and 20% in tumor-associated lymphocytes) (P=0.049).
In contrast, other clinicopathological findings showed no correlation to Hashimoto thyroiditis
and immunological markers.
Conclusions: The high percentage of the coexistence of Hashimoto thyroiditis with papillary
thyroid carcinoma, together with the predominance of immunoglobulin G4-related disease in
young age patients, draws attention to immunobiological mechanisms behind this cancer,
which might help in the development of modern-immune-based diagnostic and therapeutic
approaches.
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References
1. Batool, S., Das, B., Arif, M., Islam, N.: Frequency of Hashimoto thyroiditis in papillary thyroid cancer patients and its impact on their outcome. (2022)
2. Harahap, A.S., Jung, C.K.: Cytologic hallmarks and differential diagnosis of papillary thyroid carcinoma subtypes. J Pathol Transl Med. 58, 265–282 (2024). https://doi.org/10.4132/jptm.2024.10.11
3. Fakhri, I., Al-Zughaibi, A., Kamal, M.S.: The Part Immunohistochemical Markers (CK19 AND CD56) Play in Distinguishing Papillary Thyroid Carcinoma from Other Pathological Imitators. (2023)
4. Tang, Q., Pan, W., Peng, L.: Association between Hashimoto thyroiditis and clinical outcomes of papillary thyroid carcinoma: A meta-analysis. PLoS One. 17, (2022). https://doi.org/10.1371/journal.pone.0269995
5. Molnár, C., Molnár, S., Bedekovics, J., Mokánszki, A., Győry, F., Nagy, E., Méhes, G.: Thyroid Carcinoma Coexisting with Hashimoto’s Thyreoiditis: Clinicopathological and Molecular Characteristics Clue up Pathogenesis. Pathology and Oncology Research. 25, 1191–1197 (2019). https://doi.org/10.1007/s12253-019-00580-w
6. Lee, J.-H., Kim, Y., Choi, J.-W., Kim, Y.-S.: The association between papillary thyroid carcinoma and histologically-2 proven Hashimoto’s thyroiditis: a meta-analysis Corresponding author: Young-Sik. (2012)
7. Caturegli, P., De Remigis, A., Rose, N.R.: Hashimoto thyroiditis: Clinical and diagnostic criteria, (2014)
8. Li, Y., Inomata, K., Nishihara, E., Kakudo, K.: IgG4 thyroiditis in the Asian population. Gland Surg. 9, 1838–1846 (2020). https://doi.org/10.21037/gs-20-417
9. Han, X., Zhang, P., Li, J., Liu, Z., Lu, H., Luo, X., Pan, B., Lian, X., Zeng, X., Zhang, W., Zeng, X.: Clinical features and treatment efficacy for IgG4-related thyroiditis. Orphanet J Rare Dis. 16, (2021). https://doi.org/10.1186/s13023-021-01942-x
10. Xu, S., Huang, H., Qian, J., Liu, Y., Huang, Y., Wang, X., Liu, S., Xu, Z., Liu, J.: Prevalence of hashimoto thyroiditis in adults with papillary thyroid cancer and its association with cancer recurrence and outcomes. JAMA Netw Open. 4, E2118526 (2021). https://doi.org/10.1001/jamanetworkopen.2021.18526
11. Jie, Y., Ruan, J., Luo, M., Liu, R.: Ultrasonographic, clinical, and pathological features of papillary thyroid carcinoma in children and adolescents with or without Hashimoto’s thyroiditis. Front Oncol. 13, (2023). https://doi.org/10.3389/fonc.2023.1198468
12. Alvin W. Martin: Diagnostic Immunohistochemistry. (2011)
13. Tang, J., Cai, S., Ye, C., Dong, L.: Biomarkers in IgG4-related disease: A systematic review, (2020)
14. Deshpande, V., Zen, Y., Chan, J.K.C., Yi, E.E., Sato, Y., Yoshino, T., Klöppel, G., Godfrey Heathcote, J., Khosroshahi, A., Ferry, J.A., Aalberse, R.C., Bloch, D.B., Brugge, W.R., Bateman, A.C., Carruthers, M.N., Chari, S.T., Cheuk, W., Cornell, L.D., Fernandez-Del Castillo, C., Forcione, D.G., Hamilos, D.L., Kamisawa, T., Kasashima, S., Kawa, S., Kawano, M., Lauwers, G.Y., Masaki, Y., Nakanuma, Y., Notohara, K., Okazaki, K., Ryu, J.K., Saeki, T., Sahani, D. V., Smyrk, T.C., Stone, J.R., Takahira, M., Webster, G.J., Yamamoto, M., Zamboni, G., Umehara, H., Stone, J.H.: Consensus statement on the pathology of IgG4-related disease. Modern Pathology. 25, 1181–1192 (2012). https://doi.org/10.1038/modpathol.2012.72
15. Moghaddam, P.A., Virk, R., Sakhdari, A., Prasad, M.L., Cosar, E.F., Khan, A.: Five Top Stories in Thyroid Pathology, (2016)
16. Lun, Y., Wu, X., Xia, Q., Han, Y., Zhang, X., Liu, Z., Wang, F., Duan, Z., Xin, S., Zhang, J.: Hashimoto’s thyroiditis as a risk factor of papillary thyroid cancer may improve cancer prognosis. Otolaryngology - Head and Neck Surgery (United States). 148, 396–402 (2013). https://doi.org/10.1177/0194599812472426
17. Akoglu, H.: User’s guide to correlation coefficients, (2018)
18. Zheng, K., Mao, J.: Comparison and Analysis of Clinical Features of Papillary Thyroid Cancer Complicated With Hashimoto’s Thyroiditis. Clin Med Insights Oncol. 18, (2024). https://doi.org/10.1177/11795549241287085
19. Hussein, O., Abdelwahab, K., Hamdy, O., Awny, S., Megahed, N.A., Hafez, M.T., Elalfi, A.F., Abdelaziz, M., Gaballah, K., Abdelkhalek, M.: Thyroid cancer associated with Hashimoto thyroiditis: similarities and differences in an endemic area. J Egypt Natl Canc Inst. 32, (2020). https://doi.org/10.1186/s43046-020-0017-9
20. Ahn, D., Heo, S.J., Park, J.H., Kim, J.H., Sohn, J.H., Park, J.Y., Park, S.K., Park, J.: Clinical relationship between Hashimoto’s thyroiditis and papillary thyroid cancer. Acta Oncol (Madr). 50, 1228–1234 (2011). https://doi.org/10.3109/0284186X.2011.602109
21. Haq, F., Park, G., Jeon, S., Hirokawa, M., Jung, C.K.: Utilizing Immunoglobulin G4 Immunohistochemistry for Risk Stratification in Patients with Papillary Thyroid Carcinoma Associated with Hashimoto Thyroiditis. Endocrinology and Metabolism. 39, 468–478 (2024). https://doi.org/10.3803/EnM.2024.1923
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Duhok Medical Journal (DMJ)
College of Medicine, University of Duhok
Duhok, Iraq
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