TİROİD NEOPLAZİLERİ VE HASHİMOTO TİROİDİTİ BİRLİKTELİĞİ

AMAÇ: Hashimoto tiroiditi (HT) immünolojik, genetik ya da çevresel faktörlerle immun toleransın bozulması ile ortaya çıkan otoimmun bir hastalıktır. Otoimmun tiroid hastalıklarının en sık formudur. Kadınlarda erkeklerden 5-10 kat daha fazladır. Tiroid neoplazileri ve HT arasındaki ilişki ise hala tartışmalı bir konudur. HT'nin Papiller Tiroid Kanser (PTK) gelişiminde bir risk faktörü olduğu söylenmektedir. Buna ek olarak literatürde HT ile beraber izlenen PTK dışı tiroid tümörleri de tanımlanmıştır. Bu çalışmada HT ve tiroid tümör birlikteliği ve izlenen tümör subtipleri, HT ve tümör birlikteliğinin klinikopatolojik parametrelerle ilişkisi kaynaklar eşliğinde tartışılmıştır. GEREÇ ve YÖNTEM: Çalışmada 1990-2011 yılları arasında laboratuvarımıza gelen tiroidektomi materyelleri içinde histopatolojik olarak Hashimoto tiroiditi tanısı alan 382 olguya ait materyaller ışık mikroskobik olarak incelenmiştir. Olgularda yaş, cins, preoperatif klinik tanı, operasyon şekli, varsa eşlik eden malignite ve malignitenin tipi araştırılmıştır.BULGULAR: Olguların %13,6'sında (52 olgu) tiroid neoplazisi saptanmıştır. Bu tümörlerin %71,1'i papiller (37 olgu) karsinom, %13,5'u (7 olgu) folliküler karsinom ve %15,4'ü (8 olgu) folliküler adenom morfolojisindedir. İzlenen tüm papiller karsinomların %70,2'sinde tümör çapı 1 cm'nin altındadır.SONUÇ: Sunulan çalışmada HT olgularının PTK ile görece olarak sık birlikteliği ve bu birlikteliğe sıklıkla küçük tümör boyutunun eşlik ettiği saptanmıştır. HT ve tiroid neoplazisi birlikteliği de literatürle uyumlu bulunmuştur

Anahtar Kelimeler:

Hashimoto tiroiditi, tiroid papiller karsinom, tiroid neoplazm

Coexistence of Hashimoto Thyroiditis with Thyroid Neoplasm

OBJECTIVE: Hashimoto's thyroiditis (HT) is an autoimmune disease which becomes evident by impaired immune tolerance because of immunologic, genetic and environmental factors. HT is the most frequent form of autoimmune thyroid diseases. It occurs more frequently in women with prevalence ratios ranging from 5 to 10:1. Relationship between HT and thyroid tumors is still controversial. It's said that there is a higher risk in HT for growing papillary thyroid carcinoma. In addition, the non-papillary thyroid carcinomas that are analyzed with HT are defined in literature. In this study coexistence of HT and thyroid tumor and also tumor subtypes are analyzed. Furthermore relationship between this coexistence and clinicopathologic parameters are discussed with reference to the literature. MATERIAL and METHODS: In this study, the slides of 382 cases that were diagnosed as HT in the thyroidectomy specimens between 1990-2011 are analyzed by light microscopy. Age, sex, preoperative diagnosis and operation types are investigated in addition to the malignancy. RESULTS: In this study 382 cases of HT were analyzed retrospectively. In 13,6% of cases (52 cases) thyroid neoplasm was detected. Of these tumors 71,1% (37 cases) were papillary carcinoma, 13,5 % (7 cases) were follicular carcinoma and 15,4% (8 cases) were follicular adenoma. In 70,2% of cases tumor diameter is under 1 cm in all papillary carcinomas. CONCLUSION: In this study, relatively frequent coexistence of thyroid neoplasm and HT besides collocation of frequent small tumor diameter is determined. Coexistence of HT and thyroid neoplasm has been found consistent with literature.

Keywords:

Hashimoto thyroiditis, papillary thyroid carcinoma, thyroid neoplasm,

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