scholarly journals Distribution of IgG4- and/or IgG-Positive Plasma Cells in Hashimoto’s Thyroiditis: An Immunohistochemical Study

Pathobiology ◽  
2010 ◽  
Vol 77 (5) ◽  
pp. 267-272 ◽  
Author(s):  
Masaru Kojima ◽  
Mitsuyoshi Hirokawa ◽  
Haruji Kuma ◽  
Eijun Nishihara ◽  
Nobuhide Masawa ◽  
...  

Grossly, thyroid enlargement in Hashimoto's thyroiditis (HT) is generally symmetrical, often with a characteristic conspicuous pyramidal lobe. The tissue involved by HT is pinkish-tan to frankly yellowish in color and tends to have a rubbery firmness. There is no necrosis or calcification. The capsule is intact and non-adherent to peri-thyroid structures. Microscopically, there is a diffuse process consisting of a combination of epithelial cell destruction, lymphoid cellular infiltration, and fibrosis. Lymphocytes are predominantly T-cells and plasma cells. Most infiltrating T-cells have α/β T-cell receptors. Gamma/delta T-cells are rare. Hashimoto's thyroiditis has been graded based on lymphocytic infiltration seen on cytology, into Grades 0-III, where Grade 0 means no lymphoid cells and Grade III severe lymphoid cell infiltration. Deposits of dense material representing IgG are found along the basement membrane on electron microscopy. This chapter explores the pathology of Hashimoto's disease.


2014 ◽  
Vol 58 (8) ◽  
pp. 862-868 ◽  
Author(s):  
Henrique Vara Luiz ◽  
Diogo Gonçalves ◽  
Tiago Nunes da Silva ◽  
Isabel Nascimento ◽  
Ana Ribeiro ◽  
...  

Hashimoto’s thyroiditis (HT) has been characterized for many years as a well-defined clinicopathologic entity, but is now considered a heterogeneous disease. IgG4-related HT is a new subtype characterized by thyroid inflammation rich in IgG4-positive plasma cells and marked fibrosis. It may be part of the systemic IgG4-related disease. We report a case of a 56-year-old Portuguese man who presented with a one-month history of progressive neck swelling and dysphagia. Laboratory testing revealed increased inflammatory parameters, subclinical hypothyroidism and very high levels of thyroid autoantibodies. Cervical ultrasound (US) demonstrated an enlarged and heterogeneous thyroid gland and two hypoechoic nodules. US-guided fine needle aspiration cytology was consistent with lymphocytic thyroiditis. The patient was submitted to total thyroidectomy and microscopic examination identified typical findings of HT, marked fibrosis limited within the thyroid capsule and lymphoplasmacytic infiltration, with >50 IgG4-positive plasma cells per high-power field and an IgG4/IgG ratio of >40%. After surgery, serum IgG4 concentration was high-normal. Symptoms relief and reduction in laboratory inflammatory parameters were noticed. Thyroid function is controlled with levothyroxine. To our knowledge we report the first case of IgG4-related HT in a non-Asian patient. We also perform a review of the literature regarding IgG4-related disease and IgG4-related HT. Our case highlights this new variant of the well known HT, and helps physicians in recognizing its main clinical features, allowing for proper diagnosis and treatment.


Thyroid ◽  
2020 ◽  
Vol 30 (2) ◽  
pp. 251-261 ◽  
Author(s):  
Yaqiong Li ◽  
Xinli Wang ◽  
Zhiyan Liu ◽  
Jiwei Ma ◽  
Xiaoyan Lin ◽  
...  

Apmis ◽  
2014 ◽  
Vol 122 (12) ◽  
pp. 1259-1265 ◽  
Author(s):  
Funda Taşli ◽  
Güliz Özkök ◽  
Asuman Argon ◽  
Didem Ersöz ◽  
Ayşe Yağci ◽  
...  

2010 ◽  
pp. P2-121-P2-121
Author(s):  
Y Li ◽  
K Hirayama ◽  
E Nishihara ◽  
Z Liu ◽  
T Ozaki ◽  
...  

2020 ◽  
Vol 4 (1) ◽  
pp. 6-16
Author(s):  
Matthew Crabtree ◽  
Ping Ji ◽  
Cai Jennifer Cindy ◽  
Xin Qing

Plasma cell neoplasms of the thyroid gland are uncommon. They may occur either as a primary extraosseous (extramedullary) plasmacytoma or as secondary involvement by multiple myeloma (MM). Here, we report the case of a 62-year-old female, presenting with goiter and Hashimoto’s thyroiditis, in whom the histologic diagnosis of extraosseous plasmacytoma was unexpected. Histology of the total thyroidectomy specimen showed a diffuse infiltration of well-differentiated plasma cells against a background of Hashimoto’s thyroiditis. By immunohistochemistry, the majority of the plasma cells are positive for IgG heavy chain and kappa light chain (kappa:lambda ratio was about 6-7:1). PCR analysis of the immunoglobulin heavy and kappa chain (IGH, IGK) gene rearrangements showed clonal IGH and IGK gene rearrangements. MM was ruled out by lack of MM-related end organ damage and negative serum protein electrophoresis, immunofixation, and bone marrow biopsy. Although rare, plasmacytoma should be considered in patients presenting with enlarging thyroid gland and autoimmune thyroiditis. Histologic diagnosis and differential diagnoses are comprehensively discussed.


2004 ◽  
Vol 89 (4) ◽  
pp. 1534-1537 ◽  
Author(s):  
Silvana Laurent ◽  
Luc Mouthon ◽  
Elisabeth Longchampt ◽  
Marie Roudaire ◽  
Sylvia Franc ◽  
...  

Abstract Plasma cell granuloma (PCG) is a rare, benign inflammatory tumor composed of myofibroblasts, abundant plasma cells, and lymphocytes combined with collagen. A thyroid localization of PCG is extremely rare, and surgical therapy is indicated. We report the case of a 35-yr-old woman with a thyroid PCG, associated with Hashimoto’s thyroiditis, that was responsible for tracheal compression. Surgery was performed, but the thyroid could not be removed because of the fibrotic process. The patient was treated with corticosteroids and immunosuppressive therapy. Dyspnea and dysphagia improved within 1 month, whereas thyroid volume returned to normal within 3 yr. We also review other reports of thyroid PCG in the literature and discuss the differential diagnosis and treatment. Although the use of immunosuppressive therapy has never been reported for thyroid PCG until now, this treatment may represent a good alternative to surgery in life-threatening, unresectable PCG.


2021 ◽  
Vol 14 (3) ◽  
pp. e238177
Author(s):  
Tânia Matos ◽  
Margarida Mendes de Almeida ◽  
Lucas Batista ◽  
Sónia do Vale

IgG4-thyroid-related disease (TRD) represents an uncommon spectrum of diseases, with four subcategories established so far, IgG4-related Hashimoto’s thyroiditis, fibrosing variant of Hashimoto’s thyroiditis, Riedel’s thyroiditis and Graves disease with elevated IgG4 levels. We report the case of a 59-year-old woman presenting with painless cervical swelling and hypothyroidism. Thyroid gland was enlarged and distinctively very hard, with reduced mobility. Neck ultrasonography showed multiple nodularity and diffuse thyroid enlargement, which on CT scan conditioned slight deviation of the airway. Fine-needle aspiration of the biggest nodule was suggestive of lymphocytic thyroiditis. She developed compressive symptoms and was submitted to total thyroidectomy. Histology of the thyroid revealed extensive areas of fibrosis, oncocytic cells and lymphoplasmacytic infiltrates. Immunohistochemistry confirmed the predominance of IgG4-secreting plasma cells. IgG4-TRD is characterised by a rapidly progressive and destructive thyroiditis process. Typical presentation can often mimic malignancy; hence, an opportune recognition of IgG4-TRD may avoid unnecessary burdens.


2018 ◽  
Vol 65 (2) ◽  
pp. 175-180 ◽  
Author(s):  
Mitsuyoshi Hirokawa ◽  
Eijun Nishihara ◽  
Nami Takada ◽  
Miyoko Higuchi ◽  
Masumi Kotakemori ◽  
...  

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