Morphological features of thyroid benign focal neoplasms in Graves’ disease

Background. The morphology of the thyroid in Graves’ disease (GD) can be quite diverse: in most cases there is a diffuse enlargement of the thyroid gland (diffuse goiter), in some cases it is not increased, and in some patients there are focal neoplasms (single and multiple), including thyroid cancer. According to some studies, in patients with Graves’ disease, focal formations are observed in 10–31% of cases, and in half of the patients, they appear against the background of treatment with thionamides. The purpose of this paper was a retrospective study of the morphological features of benign thyroid neoplasms due to GD based on the results of cytological and pathomorphological studies. Materials and methods. The study was performed at the clinic of the State Institution “V.P. Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine”. All patients with GD who were operated in the Department of Endocrine Surgery from 2008 to 2019 (1854 patients) were first selected, and then those who had benign focal formations according to the pathohistological examination were selected among them. Results. The frequency of benign thyroid neoplasms in GD is 22.06 % in women aged 26 to 55 years. Cytological studies of thyroid neoplasm punctures in GD made it possible to clearly establish their benign nature (BSRTC-2) in 94.3 % of cases. In 5.7 % of cases, cytological categories BSRTC-3 and BSRTC-4 were established. Positive immunocytochemical reactions to thyroid peroxidase and thyroglobulin, and the absence of CK17 allow avoiding cytological overdiagnosis, characteristic of benign neoplasms of the thyroid gland in GD. Conclusions. Among pathohistologically confirmed benign neoplasms of the thyroid gland in GD, in 63.82 % of cases a histological diagnosis was adenomatous or colloid goiter, in 34.47 % — signs of nodular hyperplasia, in 1.71 % — the presence of thyroiditis.