Thyroiditis is known to associate with thyroid carcinoma. This study was aimed at analyzing a large series of patients underwent thyroidectomy and histologically proven thyroiditis, in a single hospital in Sri Lanka. Objectives are 1. To study epidemiology of thyroiditis patients diagnosed on thyroidectomy specimens 2. To investigate the association between chronic lymphocytic thyroiditis (CLT) and thyroid malignancy.
Patients underwent thyroidectomy at teaching hospital Kandy for 2 years from 2013 January to 2014 December were reviewed. The clinical and pathological characteristics of patients underwent thyroidectomy were analyzed. CLT was diagnosed by histopathologically.
Among 475 patients 49(11%) were male and 426(89%) were females. 142(30%) had thyroiditis. 115 were nonspecific chronic lymphocytic thyroiditis (without Hurthloid cell change) and 27 were Hashimoto thyroiditis. Malignancies were diagnosed in 66(14%) patients (Papillary-35(53%), Folicular-21(31%), lymphoma-4(6%) and other 6(9%). There was no significant association between the presence of thyroiditis and gender of the patient (P = 0.098). Percentage of Thyroid malignancies among patients underwent thyroidectomy was significantly higher in males compared to females (P = 0.002). Association of thyroiditis with thyroid malignancy was significant (P = 0 .035). Lymphovascular invasion was present in 40(61%) patients and 42(64%) had capsular invasion. The malignancy was unifocal in 48(73%) and 18(27%) were multifocal. There was no significant difference in multi focality of malignancy (P = 0.138), capsular (p = 0.256) and lymphovascular invasion (p = 0.226) amongst the patients with thyroiditis and without thyroiditis who had malignancies.
Patients presented with preexisting thyroiditis were more likely to have a malignancy than those who did not have thyroiditis. Malignancies in patients with thyroiditis were not always multifocal even though thyroiditis is diffusely affecting the gland. The influences of thyroiditis on the prognosis of the thyroid carcinoma with five year survival should still need to be investigated with a larger sample size.
Clinical trial identification
All authors have declared no conflicts of interest.