Güncel Patoloji Dergisi 2017 , Vol 1 , Num 3
Nuray Can1, Filiz Ozyilmaz1, Mehmet Celik2, Yavuz Atakan Sezer 3, Necdet Sut 4, Ebru Tastekin1, Semra Ayturk2, Funda Ustun5, Buket Yilmaz Bulbul2, Sibel Guldiken2
1Trakya University, Medical Faculty, Department Of Pathology, Edirne, Turkey
2Trakya University, Medical Faculty, Department Of Internal Medicine, Division Of Endocrinology And Metabolism, Edirne, Turkey
3Trakya University, Medical Faculty, Department Of General Surgery, Edirne, Turkey
4Trakya University, Medical Faculty, Department Of Biostatistics, Edirne, Turkey
5Trakya University, Medical Faculty, Department Of Nuclear Medicine Edirne, Turkey


Objectives: Incidental papillary thyroid carcinomas (IPTCs) consist of a significant portion of increasing incidence in papillary thyroid carcinomas. This study investigated clinicopathological features of IPTCs with different perspectives, and also, with comparisons of nonincidental PTCs (NIPTC) in patients with total thyroidectomy and lymph node dissection.

Materials and methods: 308 patients who had been diagnosed as PTC; who had been performed preoperative fine needle aspiration(FNA); who had been performed total thyroidectomy with central/cervical lymph node dissection were included in the study. The patients with inconsistent localisation of FNA and tumor localisation were grouped as “unsampled in FNA/IPTC” while patients with consistent localisation were grouped as “sampled in FNA/NIPTC”. Clinicopathological features were compared between IPTCs and NIPTCs, and also, were compared between IPTC group by tumor size (≤5mm vs >5mm).

Results: IPTC was present in 27.9% of 308 patients. The basic results (with p values≤0.005) may be underlined as in the following. IPTCs were significantly accompanied by lymphocytic thyroiditis (LT), and particularly, by multinodular hyperplasia (MNH). IPTCs were more common in older patients (51.3 years vs. 47.2 years) and in female patients. IPTCs significantly differed from NIPTCs in terms of smaller tumour size, lymphatic vessel invasion (2.6% vs. 97.4%), extrathyroidal extension (4.3% vs. 95.7%), lymph node metastasis (3.6% vs. 96.4%), multifocality (21.2% vs 78.8%), bilaterality (5.3% vs. 94.7%), and BRAFV600 mutation (6.7% vs. 93.3%). Older age, bilaterality, encapsulation, and requirement of radioactive iodine (RAI) therapy were significantly more common in IPTCs with tumor diameter >5mm than in those with tumor diameter ≤5mm.

Conclusions: IPTCs are more commonly associated with LT and MNH. IPTCs may have a more favourable prognosis than NIPTCs, and tumour size > 5 mm may predict bilaterality and need for RAI therapy. Nevertheless, the patient-based clinical approach in IPTCs may have benefits in the management of IPTCs.