Reviews in Endocrine and Metabolic Disorders

, Volume 19, Issue 4, pp 301–309 | Cite as

The increasing prevalence of chronic lymphocytic thyroiditis in papillary microcarcinoma

  • Roberto Vita
  • Antonio Ieni
  • Giovanni Tuccari
  • Salvatore BenvengaEmail author


Although the incidence of some malignancy has decreased over the recent years, this is not the case of papillary thyroid microcarcinoma (PTMC), whose incidence has increased worldwide. Most PTMC are found incidentally after histological examination of specimens from surgery for benign thyroid disease. Hashimoto’s thyroiditis, whose incidence has also increased, coexists in about one in three PTMC patients. Three different mechanisms have been proposed to clarify the association between chronic lymphocytic thyroiditis and PTMC, namely tumor development/growth by: (i) TSH stimulation, (ii) expression of certain proto-oncogenes, (iii) chemokines and other molecules produced by the lymphocytic infiltrate. Whether Hashimoto’s thyroiditis protects against lymph node metastasis is debated. Overall, autommune thyroiditis seems to contribute to the favorable prognosis of PTMC. Major limitations of the studies so far performed include: (i) retrospective design, (ii) limited statistical power, (iii) high risk of selection bias, (iv) and predominant Asian ethnicity of patients. Full genetic profiling of both diseases and identification of environmental factors capable to trigger them, as well as well-powered prospective studies on different ethnical groups, may help understand their causal association and why their frequencies are continuing raising.


Papillary thyroid cancer Microcarcinoma Papillary thyroid microcarcinoma Hashimoto’s thyroiditis Autoimmune thyroiditis Chronic lymphocytic thyroiditis 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Roberto Vita
    • 1
  • Antonio Ieni
    • 2
  • Giovanni Tuccari
    • 2
  • Salvatore Benvenga
    • 1
    • 3
    • 4
    Email author
  1. 1.Department of Clinical and Experimental MedicineUniversity of MessinaMessinaItaly
  2. 2.Department of Human Pathology of Adult and Evolutive Age “Gaetano Barresi”—Section of Pathological AnatomyUniversity of MessinaMessinaItaly
  3. 3.Master Program on Childhood, Adolescent and Women’s Endocrine HealthUniversity of MessinaMessinaItaly
  4. 4.Interdepartmental Program of Molecular & Clinical Endocrinology and Women’s Endocrine HealthUniversity HospitalMessinaItaly

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