Objective To explore the expressions of galectin-3 （Gal-3） and cytokeratin-19 （CK-19） in different tissues of Hashimoto thyroiditis （HT） complicated with papillary thyroid microcarcinoma （PTMC）. Methods The tumor tissue， 0.5 cm near tumor tissue， and opposite lateral lobe thyroid tissue in 25 HT with benign nodus patients， 25 PTMC patients， and 25 HT with PTMC patients were collected. The expressions of Gal-3 and CK-19 in these tissues were detected by immunohistochemical methods. Results ①The positive rates of Gal-3 and CK-19 expressions in the tumor tissueof HT with PTMC patients and PTMC patients were significantly higher than those of HT with benign nodus patients （P＜0.05）.②The positive rates of Gal-3 and CK-19 expressions in the opposite lateral lobe thyroid tissue of HT with PTMC patients and HT with benign nodus patients were significantly higher than those of PTMC patients （P＜0.05）．③The positive rates of Gal-3 and CK-19 expressions in the 0.5 cm near tumor tissue of HT with PTMC patients and HT with benign nodus patients were significantly higher than those of PTMC patients （P＜0.05）. ④The middle and b positive rates of Gal-3 and CK-19 expressions in the 0.5 cm near tumor tissue of HT with PTMC patients were significantly higher than those of HT with benign nodus patients and the PTMC patients （P＜0.05）．Conclusions ①Gal-3 and CK-19 protein are helpful to differentiate the benign thyroid tumor and malignant one. ② The expressions of Gal-3 and CK-19 protein in patients with HT are clear higher than those in patients without HT that means the prognosis evaluation in HT canceration. ③ Gal-3 combined with CK-19 protein are help for early diagnosis， the pathogenesis and prognosis evaluation in thyroid cancer. The b positive means canceration. ④ In HT with PTMC， it needs an operation therapy and a larger one， which is appropriate for lateral and opposite lobe partial resection or total resection.
Objective To summarize the diagnosis and treatment of Hashimoto thyroiditis （HT） coexistence withthyroid cancer （TC）. Methods One hundred and eighty-four patients with HT treated in The Affiliated Hospital of Guiyang Medical College from Jan. 2008 to Dec. 2011 were collected， and clinical data of 32 patients with TC of them were analyzed retrospectively. Results Thirty two patients combined with TC of the 184 patients with HT， and the incidence rate was 17.4%. All of the 32 patients were treated surgically according to the principle of surgery treatment for TC. Of the 32 cases of HT coexistence with TC， 15 patients were diagnosed by preoperative fine needle aspiration cytology （FNAC）， and the sensitivity of FNAC was 46.9% （15/32）. Twenty seven patients were diagnosed by intraop-erative frozen section pathological examination， and the sensitivity of it was 84.4% （27/32）， which was significantly higher than those of FNAC （χ2=7.563，P=0.004）. Thirty patients were diagnosed as papillary thyroid carcinoma （PTC）， and 2 patients were diagnosed as follicular thyroid carcinoma （FTC） by postoperative paraffin section pathological exam-ination and （or） immunohistochemistry， respectively. All patients were treated with levothyroxine （L-T4） after operation，and 5 patients were treatment with 131I therapy in addition. One patient suffered convulsion， and 2 patients suffered mild hoarsenessthere after operation. Only 29 patients were followed up for 3-49 months （average 35 months）， and during the followed up， there were no tumor recurrence， metastasis， and death. Conclusions The rate of preoperative diagnosis of HT coexistence with TC is low， and auxiliary examinations play an important role in diagnosis and guiding treatment. Surgery is the preferred treatment， but auxiliary therapies after surgery are indispensable too.
Objective To summarize the relationship between IgG4 and IgG4 related thyroid diseases. Methods Domestic and international publications involving the pathological features of IgG4-related thyroid diseases and relationship with IgG4 were retrieved and reviewed. Results IgG4-related disease was a newly recognized class of chronic and systemic lymphocytes disease， which may be solitary or involving multiple body organs， as well as thyroid. The expression of IgG4 was found in leisons of Hashimoto thyroiditis， Riedel thyroiditis， and papillary thyroid carcinoma. Conclusions IgG4-related thyroid disease is a new concept of thyroiditis. The knowledge of this new disease will provide appropriate treatment for patients with thyroiditis.
ObjectiveTo investigate the structure, ligand, and tissue distribution of galectin-3, the relationship of galectin3 with tumor and the expression of galectin-3 in several thyroid diseases. MethodsRelated articles were reviewed. ResultsGalectin-3 was expressed in normal and tumor cell that regulated cell growth, differentiation, adhesion, apoptosis, and angiogenesis, which participated invasion and metastasis of tumor. ConclusionGalectin-3 may be used to discriminate benign and malignant thyroid tumor.
ObjectiveTo analyze clinical manifestation, diagnosis, therapy, and prognosis of primary thyroid lymphoma. MethodFrom April 2012 to September 2015, the clinical data of 9 patients with primary thyroid lymphoma admitted to The Affiliated Hospital of Xuzhou Medical College, including clinical manifestation, diagnosis procedure, treatment project, and prognosis, were reviewed retrospectively. ResultsThe thyroids or nodules of 4 patients increased rapidly in 1-3 months, with the surrounding tissues and organs oppression symptoms. The preoperative examination revealed that there were 5 patients with swollen lymph nodes. Eight patients were received preoperative thyroid function examination, there were 4 patients with subclinical hypothyroidism, 4 patients with rose TSH, 6 patients with rose thyroglobulin antibody. There were 5 cases of primary thyroid lymphoma associated with Hashimoto thyroiditis. Eight patients were underwent surgical treatment in our hospital, 1 patient was underwent surgery in the other hospital. The results of pathological histology showed that 5 patients with mucosa associated lymphadenoma were stageⅠE, 3 patients with diffuse large B cell lymphoma were stageⅠE, 1 patient with diffuse large B cell lymphoma was stageⅡE. Two patients with diffuse large B cell lymphoma were received chemotherapy, the scheme was CHOP and COP respectively. Seven patients were received follow-up, the follow-up time was 2-42 months, the median follow-up time was 20 months, all of them were survived. ConclusionsPrimary thyroid lymphoma should be considered for patients with rapid growth of thyroid mass in a short term, which relies on the histopathologic and immunohistochemical diagnosis finally. The individualized treatment should be performed for primary thyroid lymphoma according to pathological classification.
Objective To compare differences of characteristics of ultrasonic elasticity imaging for benign and malignant small thyroid nodules with or without Hashimoto thyroiditis (HT). Methods The thyroid nodules with ≤1 cm size and the category 4A, 4B, 4C, and 5 of Thyroid Imaging Reporting and Data System (TI-RADS) were included into this study, and a further examination of real-time elastography was performed. The final diagnosis was relied on the pathological diagnosis. The elasticity score and strain ratio (SR) were recorded and compared between these two groups, respectively. Results Of the 424 nodules, 103 nodules were accompanied with HT (thyroid nodule with HT group), 321 nodules were not accompanied with HT (thyroid nodule without HT group). In the thyroid nodule with HT group, the area under the receiver operator characteristic (ROC) curve (AUCs) of the elasticity score and the SR was 0.685 and 0.676, respectively; the optimal cut offs of the elasticity score and the SR was 3 points and 2.45 respectively, their corresponding sensitivity, specificity, and accuracy was 75.7%, 57.6%, 68.0% and 75.7%, 60.6%, 67.6%, respectively. In the thyroid nodule without HT group, the AUCs of the elasticity score and the SR was 0.692 and 0.692, respectively; the optimal cut offs of the elasticity score and the SR was 4 points and 2.84, respectively; their corresponding sensitivity, specificity, and accuracy was 57.5%, 74.2%, 69.2% and 76.1%, 59.7%, 67.7%, respectively. Conclusions Elastography is helpful in differential diagnosis of benign and malignant small thyroid nodules. While, standards of elasticity score and SR value in differential diagnosis are different between benign and malignant small thyroid nodules with HT and without HT, elasticity score and SR ratio decrease in benign and malignant small thyroid nodules with HT.
ObjectiveTo investigate the diagnosis and treatment of primary thyroid lymphoma.MethodThrough reading of relevant literatures at home and abroad in recent years, the diagnosis and treatment progress of primary thyroid lymphoma were summarized.ResultsThe pathogenesis of primary thyroid lymphoma was associated with chronic inflammatory stimuli such as Hashimoto’s thyroiditis. Its preoperative diagnosis mainly relied on ultrasound-guided biopsy. The treatment depended mainly on its pathological type and tumor stage. Surgical resection was mainly used for pathological biopsy and relieving compression symptoms, and radiotherapy and chemotherapy were the main treatments.ConclusionsPrimary thyroid lymphoma is a rare thyroid malignancy. Being familiar with and understands its clinicopathological features have important guiding significance for preoperative diagnosis, clearing pathological type and staging, and selection of reasonable treatment measures.