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Related Experiment Video

Updated: Sep 24, 2025

Generation of a Mouse Spontaneous Autoimmune Thyroiditis Model
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Clinical differences between IgG4 Hashimoto's thyroiditis and primary thyroid lymphoma.

Liyuan Liu1, Yang Yu1, Lei Chen2

  • 1Department of Endocrinology, Peking University First Hospital, Beijing, People's Republic of China.

European Thyroid Journal
|May 6, 2022
PubMed
Summary

Distinguishing IgG4-related thyroiditis from primary thyroid lymphoma is crucial for rapid thyroid enlargement. Clinical and pathological analysis, not just IgG4 staining, aids accurate diagnosis.

Keywords:
IgG4 Hashimoto’s thyroiditisclinical differencegoitreprimary thyroid lymphoma

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Area of Science:

  • Endocrinology
  • Pathology
  • Immunology

Background:

  • Hashimoto's thyroiditis (HT) classification includes IgG4-HT and non-IgG4 HT based on IgG4/IgG staining.
  • Differentiating IgG4-related thyroiditis (IgG4-HT) from primary thyroid lymphoma (PTL) is clinically important for patients with rapidly enlarged thyroids.

Purpose of the Study:

  • To identify differential diagnostic points between IgG4-HT and PTL.

Main Methods:

  • Retrospective analysis of clinical data (age, sex, symptoms, thyroid function, antibodies, ultrasound) from 19 IgG4-HT and 10 PTL patients.
  • Immunohistochemical staining for IgG4 and IgG expression on thyroid tissue samples.

Main Results:

  • IgG4-HT patients were significantly younger (39.68 ± 10.95 years) than PTL patients (66.20 ± 10.23 years).
  • PTL group showed higher rates of hypothyroidism and hypoechoic lesions on ultrasound.
  • Two PTL patients met immunohistochemical criteria for IgG4-HT, highlighting diagnostic challenges.

Conclusions:

  • Immunohistochemistry alone is insufficient for diagnosing IgG4-HT in cases of rapid thyroid enlargement.
  • Combined clinical and pathological evaluations are essential to differentiate IgG4-HT from PTL, especially when IgG4-positive plasma cells are abundant.