Coexistence of hashimoto thyroiditis with thyroid neoplasm

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.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

Medullary Thyroid Carcinoma Showing Melanocytic Differentiation: A Report of a Rare Case

Medullary thyroid carcinoma (MTC) accounts for 5-10% of all thyroid malignancies. These tumors show variable morphological features, however, to the best of our knowledge, melanocytic differentiation is rare with only 11 reported cases. We report a 44-year-old female who presented to our clinic with neck swelling of a few months. The thyroid fine needle aspiration biopsy results were suspicious, leading to a total thyroidectomy. On microscopic examination, a malignant tumor with melanocytic features was seen. There was no amyloid deposition in the stroma. Immunohistochemical analysis revealed that the tumor cells were positive for calcitonin, melan-A, HMB45, pancytokeratin, chromogranin, carcinoembriyonic antigen; focal positive for S-100; and negative for HBME-1 and thyroglobulin. This tumor was diagnosed as medullary carcinoma with melanocytic differentiation when evaluated with the morphological and immunohistochemical findings. Turk Jem 2015; 19: 72-7

ASSOCIATION OF AGE AT DIAGNOSIS OF BREAST CANCER WITH SURVIVAL AND MOLECULAR SUBTYPE. A SINGLE-CENTER EXPERIENCE

Introduction: In this study, we aimed to evaluate the relationship between age at diagnosis of breast cancer and molecular type and survival. Material and Method: The present study included operated breast cancer cases over the age of 18 who applied to our oncology outpatient clinic between 1998 and 2020. Results: A total of 849 operated stage I-III breast cancer patient s were included in the study. The median age of the patients was 52 (27-93). The patients were classified into 6 age groups: 44 patients were 35 years old, 70 patients were 36-40, 293 patients were 41-50, 217 patients were 51-60, 138 patients were 61-70 years old, and 87 patients were >70 years old. There was no significant relationship between age group and molecular subtypes. Of the patients, 167 (20%) were Stage I, 426 (50%) we re Stage II, 256 (30%) were Stage III, and no significant correlation was found between age and diagnosis stage. In terms of survival, the median survival could not be detected for the age groups of ≤35 years, 36-40 years, 41-50 years, and 51-60. The median survival of the 61-70 years group was 180 months, which was 125 months for the group of cases aged ≥71 years. The difference between the groups was statistically significant in terms of mean survival (p0.001). Tthe multivariate cox regression analysis revealed a significant correlation between histological grade, ER and PR status, tumor size, lymph node positivity, molecular type, presence of DCIS, presence of relapse, and survival. Conclusions: Our study supports the existence of a relationship between age at diagnosis and breast cancer- specific survival