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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
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.
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.
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