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Lymphocytic thyroiditis yields high prevalence of benign cervical lymph nodes
Fewer central neck compartment metastatic lymph nodes and more reactive benign cervical lymph nodes were found in patients with lymphocytic thyroiditis compared with those without the autoimmune disorder, according to recent study findings.
It is unclear whether the link indicates a protective role of thyroid autoimmunity on lymph node spreading, according to the researchers.
Ines Donangelo, MD, PhD, of the endocrinology division, Allegheny General Hospital, Allegheny Health Network in Pittsburgh, and colleagues at Cedars-Sinai Medical Center evaluated data from 357 patients with differentiated thyroid cancer (DTC) who underwent total thyroidectomy with therapeutic or prophylactic central compartment node dissection (CCND) and 303 patients who underwent surgery without CCND at Cedars-Sinai Medical Center between 2003 and November 2013. Researchers sought to determine associations between thyroglobulin antibody (TgAb), lymphocytic thyroiditis and DTC characteristics at thyroidectomy.
In the CCND group, metastases to one or more cervical nodes were found in 60% of participants; 55% had central compartment node metastases, and 22% had lateral neck node metastases. Of participants without CCND, cervical node metastases were found in 18%. The CCND group was younger (P = .0227) and tumors were larger (P < .0001) compared with the group that did not undergo CCND.
Researchers found that 30% of the CCND group and 18% of the non-CCND group were TgAb-positive (P = .0005). There was a higher frequency of lymphocytic thyroiditis in the TgAb-positive patients (78%) compared with the TgAb-negative patients (26%; P < .0001). Among the CCND group, more cervical lymph nodes were excised in the TgAb-positive patients (14.5 nodes) compared with the TgAb-negative patients (10.4 nodes; P < .0001); however, the prevalence of cervical lymph nodes with metastatic thyroid carcinoma was similar between the two antibody groups.
“Our findings suggest that among patients with DTC who underwent total thyroidectomy with CCND, thyroid autoimmunity is associated with excision of a larger number of benign cervical lymph nodes, possibly reflecting larger, more noticeable lymph nodes reactive to the thyroiditis,” the researchers wrote. “Neither serum TgAb-positivity nor lymphocytic thyroiditis was associated with aggressive histological characteristics in patients with DTC. We found that subjects with lymphocytic thyroiditis have a smaller number of central compartment metastatic lymph nodes. Whether this association indicates a protective role of thyroid autoimmunity in lymph node spreading remains unclear.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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