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Clinical differences between IgG4 Hashimoto’s thyroiditis and primary thyroid lymphoma
BACKGROUND: Hashimoto’s thyroiditis (HT) can be divided into IgG4 HT and non-IgG4 HT based on IgG4 and IgG immunohistochemical staining. In clinical practice, it is often necessary to identify diseases such as primary thyroid lymphoma (PTL) and IgG4 HT when a patient presents with a rapidly enlarged...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Bioscientifica Ltd
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9175605/ https://www.ncbi.nlm.nih.gov/pubmed/35521776 http://dx.doi.org/10.1530/ETJ-21-0144 |
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author | Liu, Liyuan Yu, Yang Chen, Lei Zhang, Yang Lu, Guizhi Gao, Ying Zhang, Junqing |
author_facet | Liu, Liyuan Yu, Yang Chen, Lei Zhang, Yang Lu, Guizhi Gao, Ying Zhang, Junqing |
author_sort | Liu, Liyuan |
collection | PubMed |
description | BACKGROUND: Hashimoto’s thyroiditis (HT) can be divided into IgG4 HT and non-IgG4 HT based on IgG4 and IgG immunohistochemical staining. In clinical practice, it is often necessary to identify diseases such as primary thyroid lymphoma (PTL) and IgG4 HT when a patient presents with a rapidly enlarged thyroid. The aim of our study was to uncover the differential points between the two diseases. METHODS: Clinical information from 19 IgG4 HT and 10 PTL patients was obtained from the patients’ medical records, including age, sex, main clinical manifestation, thyroid functional status, the presence of serum anti-thyroid peroxidase antibodies, anti-thyroglobulin antibodies, and thyroid ultrasonography results. Thyroid sections from all patients were collected to detect IgG4 and IgG expression by immunohistochemical staining. RESULTS: The IgG4 HT patients were significantly younger than those in the PTL group (39.68 ± 10.95 vs 66.20 ± 10.23 years, P < 0.001). There were no significant differences in the sex distribution or TgAb- or TPOAb-positive rates. The PTL group had a higher prevalence of clinical hypothyroidism than the IgG4 HT group (P = 0.016). In the PTL group, thyroid lesions were more likely to exhibit hypoechogenicity (6/6 vs 1/19, P < 0.001) on ultrasound images. In the PTL group, two patients met the immunohistochemical cut-off value of the criteria for IgG4 HT. CONCLUSIONS: Simply relying on immunohistochemistry for IgG4 cannot diagnose IgG4 HT correctly when a patient presents with rapid thyroid enlargement. A combination of clinical and pathological analyses will help distinguish IgG4 HT from PTL which may be with abundant IgG4-positive plasma cells. |
format | Online Article Text |
id | pubmed-9175605 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Bioscientifica Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-91756052022-06-14 Clinical differences between IgG4 Hashimoto’s thyroiditis and primary thyroid lymphoma Liu, Liyuan Yu, Yang Chen, Lei Zhang, Yang Lu, Guizhi Gao, Ying Zhang, Junqing Eur Thyroid J Research BACKGROUND: Hashimoto’s thyroiditis (HT) can be divided into IgG4 HT and non-IgG4 HT based on IgG4 and IgG immunohistochemical staining. In clinical practice, it is often necessary to identify diseases such as primary thyroid lymphoma (PTL) and IgG4 HT when a patient presents with a rapidly enlarged thyroid. The aim of our study was to uncover the differential points between the two diseases. METHODS: Clinical information from 19 IgG4 HT and 10 PTL patients was obtained from the patients’ medical records, including age, sex, main clinical manifestation, thyroid functional status, the presence of serum anti-thyroid peroxidase antibodies, anti-thyroglobulin antibodies, and thyroid ultrasonography results. Thyroid sections from all patients were collected to detect IgG4 and IgG expression by immunohistochemical staining. RESULTS: The IgG4 HT patients were significantly younger than those in the PTL group (39.68 ± 10.95 vs 66.20 ± 10.23 years, P < 0.001). There were no significant differences in the sex distribution or TgAb- or TPOAb-positive rates. The PTL group had a higher prevalence of clinical hypothyroidism than the IgG4 HT group (P = 0.016). In the PTL group, thyroid lesions were more likely to exhibit hypoechogenicity (6/6 vs 1/19, P < 0.001) on ultrasound images. In the PTL group, two patients met the immunohistochemical cut-off value of the criteria for IgG4 HT. CONCLUSIONS: Simply relying on immunohistochemistry for IgG4 cannot diagnose IgG4 HT correctly when a patient presents with rapid thyroid enlargement. A combination of clinical and pathological analyses will help distinguish IgG4 HT from PTL which may be with abundant IgG4-positive plasma cells. Bioscientifica Ltd 2022-04-22 /pmc/articles/PMC9175605/ /pubmed/35521776 http://dx.doi.org/10.1530/ETJ-21-0144 Text en © The authors https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. (https://creativecommons.org/licenses/by-nc-nd/4.0/) |
spellingShingle | Research Liu, Liyuan Yu, Yang Chen, Lei Zhang, Yang Lu, Guizhi Gao, Ying Zhang, Junqing Clinical differences between IgG4 Hashimoto’s thyroiditis and primary thyroid lymphoma |
title | Clinical differences between IgG4 Hashimoto’s thyroiditis and primary thyroid lymphoma |
title_full | Clinical differences between IgG4 Hashimoto’s thyroiditis and primary thyroid lymphoma |
title_fullStr | Clinical differences between IgG4 Hashimoto’s thyroiditis and primary thyroid lymphoma |
title_full_unstemmed | Clinical differences between IgG4 Hashimoto’s thyroiditis and primary thyroid lymphoma |
title_short | Clinical differences between IgG4 Hashimoto’s thyroiditis and primary thyroid lymphoma |
title_sort | clinical differences between igg4 hashimoto’s thyroiditis and primary thyroid lymphoma |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9175605/ https://www.ncbi.nlm.nih.gov/pubmed/35521776 http://dx.doi.org/10.1530/ETJ-21-0144 |
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