Yılmaz Akçay Eda, Tepeoğlu Merih, Özdemir Binnaz Handan, Özgün Gonca, Kazancı Semih, Haberal Mehmet
From the Department of Pathology, Faculty of Medicine, Baskent University, Ankara, Turkey.
Exp Clin Transplant. 2016 Nov;14(Suppl 3):67-70.
Patients with end-stage renal diseases can display abnormal thyroid gland function due to altered hormone excretion and transport. In this study, we aimed to evaluate the incidence of thyroid diseases by fine-needle aspiration cytology in kidney transplant candidates and to estimate the outcomes of these patients.
We reevaluated thyroid fineneedle aspiration biopsies, which were performed between January 2000 and December 2015, of 181 candidates for kidney transplant. Patient demographics and thyroid ultrasonography and biopsy findings were recorded.
The fine-needle aspiration biopsy findings of 181 patients were as follows: 162 were benign 5 were thyroiditis, 9 were atypia of undetermined significance/follicular lesion of undetermined significance, and 5 were malignant. Only 13 patients (7.1%) underwent thyroid operation after fine-needle aspiration, with 5 of these patients receiving a benign diagnosis, 3 receiving diagnosis of atypia of undetermined significance/follicular lesion of undetermined significance, and 5 patients showing malignancy. In the 5 patients with benign cytology, histopathologic findings were also benign. In the 3 patients with atypia of undetermined significance/follicular lesion of undetermined significance, the final diagnosis was adenomatous hyperplasia. Finally, in the 5 patients (2.8%) showing malignancy, results after fine-needle aspiration showed papillary thyroid carcinoma. In the 5 patients with papillary thyroid carcinoma, 4 underwent renal transplant. Survival of these 4 patients was 92 ± 42 months without tumor recurrence.
Fine-needle aspiration is a useful diagnostic modality in evaluation of thyroid nodules in kidney transplant candidates. Early detection and treatment of thyroid nodules are essential to decrease the morbidity and mortality of these patients.
终末期肾病患者由于激素排泄和转运改变,可出现甲状腺功能异常。在本研究中,我们旨在通过细针穿刺细胞学检查评估肾移植候选者甲状腺疾病的发生率,并估计这些患者的预后。
我们重新评估了2000年1月至2015年12月期间对181例肾移植候选者进行的甲状腺细针穿刺活检。记录患者的人口统计学资料、甲状腺超声检查及活检结果。
181例患者的细针穿刺活检结果如下:162例为良性,5例为甲状腺炎,9例为意义不明确的非典型性/意义不明确的滤泡性病变,5例为恶性。细针穿刺后仅13例患者(7.1%)接受了甲状腺手术,其中5例诊断为良性,3例诊断为意义不明确的非典型性/意义不明确的滤泡性病变,5例显示为恶性。在5例细胞学检查为良性的患者中,组织病理学检查结果也为良性。在3例意义不明确的非典型性/意义不明确的滤泡性病变患者中,最终诊断为腺瘤样增生。最后,在5例(2.8%)显示为恶性的患者中,细针穿刺结果显示为甲状腺乳头状癌。在5例甲状腺乳头状癌患者中,4例接受了肾移植。这4例患者的生存期为92±42个月,无肿瘤复发。
细针穿刺是评估肾移植候选者甲状腺结节的一种有用的诊断方法。早期发现和治疗甲状腺结节对于降低这些患者的发病率和死亡率至关重要。