Original Articles
Pathology of the autonomously functioning (hot) thyroid nodule

https://doi.org/10.1053/adpa.2002.30605Get rights and content

Abstract

We describe the pathologic findings of 73 clinically and scintigraphically confirmed hot nodules. In general, hot nodules from an unselected group primarily treated by surgery were smaller and the sex ratio was closer to equality compared with the ample female predominance in the referral, pre-, and post-prophylaxis groups. Malignancy was observed in six cases (8.2%) (5 follicular, 1 papillary). Of the 67 benign tumors, 48 (71.6%) were adenomas which showed the cytoarchitectural features of hot nodules described previously, and 19 (28.3%) were less well-differentiated adenomas that included a few oxyphil tumors. Intracolloid oxalate crystals from background thyroid tissue were present in 59 assessable cases (83%) overall, the majority showed more than occasional crystals that had a tendency to increase in number with decreasing morphologic activity of the thyroid epithelium. Thyroglobulin protein and mRNA stainings tended to be more pronounced in cell cytoplasm of the tumors than in background thyroid. This study shows that hot nodules may show a wide morphologic spectrum of follicular neoplasms and can be occasionally malignant. It is inferred from the morphologic and other findings that it is likely that some, if not all, of the primary follicular cancers associated with hyperfunction arise by clonal progression from benign hot nodules. This progression is rare, probably because most hot nodules present with the symptoms of hyperfunction and receive early treatment. Ann Diagn Pathol 6: 10-19, 2002.

References (0)

Cited by (28)

  • Hyperfunctioning papillary thyroid carcinoma: A case report with literature review

    2016, International Journal of Surgery Case Reports
    Citation Excerpt :

    Other 2 studies found 1.1% and 2.1% of thyroid carcinoma associated with high level of thyroid hormone (TH) [10,11]. Harach and coworkers described the microscopical findings of 73 hot nodules in which carcinoma were observed in 6 patients (8.2%) [12]. According to De Rosa et al. only 18 patients of hyperfunctioning papillary thyroid carcinoma have been reported in last 25 years.

  • Incidental thyroid cancer in toxic and nontoxic goiter: Is TSH associated with malignany rate? results of a meta-analysis

    2013, Endocrine Practice
    Citation Excerpt :

    The search identified 796 publications, the majority of which (n = 758) were dismissed based on their abstracts, which clearly showed that they did not meet the inclusion criteria. Among the 38 publications that were retrieved in full, 8 were excluded because they reported on the characteristics of thyroid cancers series (9-16), 8 publications were excluded because necessary data were not extractable (17-24), 6 publications were excluded because they were based on histopathological reports (25-30), and 3 publications (31-33) were excluded for other reasons (special subgroup of the target population limiting to those after radio-iodine treatment or with subcentimeter nodules, cohort <10 patients). Thirteen studies were used to calculate the overall ITC rate in patients with TMNG or TA.

View all citing articles on Scopus

Supported in part by Quimica Montpellier, Buenos Aries, Argentina.

View full text