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Diagnostics
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Pathology and Diagnosis of Thyroid Disease
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Pathology and Diagnosis of Thyroid Disease

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 7086

Special Issue Editor

Prof. Dr. Zhiyan Liu

E-Mail Website
Guest Editor
Department of Pathology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai 200233, China
Interests: endocrine pathology; thyroid; environmental pollutants
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue presents the latest advancements in the pathology and diagnosis of thyroid disease, offering insights from leading experts. Covering a range of topics, from the histological features of thyroid cancer to molecular markers and advanced imaging techniques, this Special Issue is an essential resource for clinicians, researchers, and pathologists seeking to improve patient outcomes.

Prof. Dr. Zhiyan Liu
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pathology
  • clinical diagnosis
  • prognosis
  • thyroid disease
  • marker

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Published Papers (5 papers)

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Research

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12 pages, 704 KiB  
Article
A 6-Year Retrospective Study in Surgery Patients with Thyroid Diseases in Mureș County, Romania, Before and During the COVID-19 Pandemic
by Ramona Teodora Cătană, Adela Nechifor-Boila, Ancuța Zăhan, Andreea Deborah Militaru, Georgian-Nicolae Radu and Angela Borda
Diagnostics 2025, 15(3), 287; https://doi.org/10.3390/diagnostics15030287 - 26 Jan 2025
Viewed by 692
Abstract
Background/Objectives: In this study, we aimed to assess the impact of the COVID-19 (Coronavirus Disease 2019) pandemic period on the time trend prevalence of thyroid pathology in a university hospital in Romania. Methods: We performed a 6-year retrospective study (2017–2022) including all patients [...] Read more.
Background/Objectives: In this study, we aimed to assess the impact of the COVID-19 (Coronavirus Disease 2019) pandemic period on the time trend prevalence of thyroid pathology in a university hospital in Romania. Methods: We performed a 6-year retrospective study (2017–2022) including all patients who underwent thyroid surgery, registered in the Pathology Department, Emergency County Hospital, Târgu-Mureș, Romania (n = 971). Thyroid lesions were grouped into three major categories: (1) benign, non-tumoral; (2) benign, tumoral; and (3) malignant, tumoral. To assess the impact of the COVID-19 pandemic on the annual rate of thyroid surgeries and thyroid pathology, data were analyzed in comparison: before COVID-19 (2017–2019) versus the COVID-19 (2020–2022) period. Results: A significant decrease in the mean number of thyroid specimens per year was observed in the COVID-19 period compared to the previous period (131 versus 192 cases, p = 0.0023). Thyroid benign lesions were the most frequent, but their prevalence was significantly lower during the pandemic period (50.8%) compared to the previous period (58.6%) (p = 0.017). Benign tumors were rare, revealing similar occurrence rates in both periods. By contrast, the annual rate of malignant tumors increased significantly during the COVID-19 period (26.3% versus 35.4%, p = 0.002), the most common histopathological type being papillary thyroid carcinoma. Conclusions: Along with the COVID-19 pandemic (starting in the year 2020), due to reduced access to medical investigations, many thyroid cancers remained unoperated in our hospital. Consequently, this has led to an increased prevalence of malignant cases in the years that came after. Full article
(This article belongs to the Special Issue Pathology and Diagnosis of Thyroid Disease)
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10 pages, 243 KiB  
Article
Diagnosis of Thyroid Nodules in Children and Adolescents with Subclinical Hypothyroidism and Their Outcomes after Early Thyroxine Treatment—A Longitudinal Study
by Eirini Kostopoulou, Eleana Georgia Koliofoti, Diamantina X. Spilioti, Konstantinos Miliordos, Spyros Skiadopoulos, Andrea Paola Rojas Gil, Sotirios Fouzas, Xenophon Sinopidis and Bessie E. Spiliotis
Diagnostics 2024, 14(14), 1528; https://doi.org/10.3390/diagnostics14141528 - 15 Jul 2024
Cited by 1 | Viewed by 1372
Abstract
Pediatric thyroid nodules (TNs) present a higher malignancy rate compared to adults. We sought to diagnose the frequency and characteristics of TNs in children and adolescents with subclinical hypothyroidism (SH) and their outcomes after levothyroxine (LT4) therapy. A total of 256 children with [...] Read more.
Pediatric thyroid nodules (TNs) present a higher malignancy rate compared to adults. We sought to diagnose the frequency and characteristics of TNs in children and adolescents with subclinical hypothyroidism (SH) and their outcomes after levothyroxine (LT4) therapy. A total of 256 children with TNs and SH were followed every semester from 2006 to 2018. All patients were treated with LT4. Clinical and radiologic findings, such as the size and texture of the nodules, were documented. Analysis included one-way ANOVA, Kruskal–Wallis, Chi-square, and Fisher’s exact tests. After initial LT4 therapy, TNs disappeared in 85.5% and did not reappear throughout follow-up. In 14.5%, TNs remained the same or increased in size, but they decreased after subsequent LT4 administration with an increased dose. Thyroid disease family history (FHTD) was documented in 77.0%. In total, 64.5% developed a goiter, 46.0% exhibited thyroid heterogeneity on ultrasound, 23.4% had positive Anti-Tg, and 25.4% had positive anti-TPO autoantibodies. Our findings support the possible premise that early pharmacologic intervention with LT4 may be beneficial in children and adolescents with TNs and SH. The increased frequency of FHTD, goiter, thyroid heterogeneity, and Hashimoto in our patients emphasizes that thyroid ultrasounds may be warranted in children and adolescents with these characteristics in order to rule out the presence of TNs. Full article
(This article belongs to the Special Issue Pathology and Diagnosis of Thyroid Disease)
21 pages, 26366 KiB  
Article
BRAF Detection in FNAC Combined with Semi-Quantitative 99mTc-MIBI Technique and AI Model, an Economic and Efficient Predicting Tool for Malignancy in Thyroid Nodules
by Laura Teodoriu, Maria-Christina Ungureanu, Mioara Matei, Irena Grierosu, Alexandra Iuliana Saviuc, Jalloul Wael, Iuliu Ivanov, Loredana Dragos, Radu Danila, Velicescu Cristian, Mihai-Andrei Costandache, Adrian Iftene, Cristina Preda and Cipriana Stefanescu
Diagnostics 2024, 14(13), 1398; https://doi.org/10.3390/diagnostics14131398 - 30 Jun 2024
Viewed by 1403
Abstract
Background: Technology allows us to predict a histopathological diagnosis, but the high costs prevent the large-scale use of these possibilities. The current liberal indication for surgery in benign thyroid conditions led to a rising frequency of incidental thyroid carcinoma, especially low-risk papillary micro-carcinomas. [...] Read more.
Background: Technology allows us to predict a histopathological diagnosis, but the high costs prevent the large-scale use of these possibilities. The current liberal indication for surgery in benign thyroid conditions led to a rising frequency of incidental thyroid carcinoma, especially low-risk papillary micro-carcinomas. Methods: We selected a cohort of 148 patients with thyroid nodules by ultrasound characteristics and investigated them by fine needle aspiration cytology (FNAC)and prospective BRAF collection for 70 patients. Also, we selected 44 patients with thyroid nodules using semi-quantitative functional imaging with an oncological, 99mTc-methoxy-isobutyl-isonitrile (99mTc-MIBI) radiotracer. Results: Following a correlation with final histopathological reports in patients who underwent thyroidectomy, we introduced the results in a machine learning program (AI) in order to obtain a pattern. For semi-quantitative functional visual pattern imaging, we found a sensitivity of 33%, a specificity of 66.67%, an accuracy of 60% and a negative predicting value (NPV) of 88.6%. For the wash-out index (WOind), we found a sensitivity of 57.14%, a specificity of 50%, an accuracy of 70% and an NPV of 90.06%.The results of BRAF in FNAC included 87.50% sensitivity, 75.00% specificity, 83.33% accuracy, 75.00% NPV and 87.50% PPV. The prevalence of malignancy in our small cohort was 11.4%. Conclusions: We intend to continue combining preoperative investigations such as molecular detection in FNAC, 99mTc-MIBI scanning and AI training with the obtained results on a larger cohort. The combination of these investigations may generate an efficient and cost-effective diagnostic tool, but confirmation of the results on a larger scale is necessary. Full article
(This article belongs to the Special Issue Pathology and Diagnosis of Thyroid Disease)
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14 pages, 3753 KiB  
Article
Comparison of Fine-Needle Aspiration Cytopathology with Histopathological Examination of the Thyroid Gland in Patients Undergoing Elective Thyroid Surgery: Do We Still Need Fine-Needle Aspiration Cytopathology?
by Oskar Gąsiorowski, Jerzy Leszczyński, Joanna Kaszczewska, Kamil Stępkowski, Piotr Kaszczewski, Maksymilian Baryła and Zbigniew Gałązka
Diagnostics 2024, 14(3), 236; https://doi.org/10.3390/diagnostics14030236 - 23 Jan 2024
Cited by 4 | Viewed by 2157
Abstract
Background: The thyroid gland is responsible for various functions, but it is susceptible to pathologies. The gold standard for preliminarily diagnosing thyroid abnormalities is fine-needle aspiration cytology (FNAC), although it has some limitations; thus, postoperative histopathological examination confirms the diagnosis. The aim of [...] Read more.
Background: The thyroid gland is responsible for various functions, but it is susceptible to pathologies. The gold standard for preliminarily diagnosing thyroid abnormalities is fine-needle aspiration cytology (FNAC), although it has some limitations; thus, postoperative histopathological examination confirms the diagnosis. The aim of the present study was to compare preoperative FNAC results with postoperative histopathological examination. Methods: This study is a retrospective study based on FNAC and postoperative histopathology examination, which were compared and analyzed. Results: This study included 344 patients between 18 and 86 years old (mean age: 53.06 ± 13.89), comprising 274 females and 70 males (mean ages 52.72 ± 13.86 and 54.39 ± 14.05, respectively) with a 3.9:1 female-to-male ratio. Statistical significance between the FNAC and histopathology results was observed (p = 0.0000), and 86 (25.00%) patients were found to have been diagnosed incorrectly based on FNAC. The sensitivity of FNAC was 92.31%, and its specificity was 82.08%, with positive and negative predictive values of 68.57% and 96.08%, respectively. Conclusions: Due to many factors, FNAC may lead to over- or under-diagnosis, increasing the chances of complications associated with the selected treatment. However, we do not have any other more accurate tools; therefore, FNAC should still remain as the gold standard of preliminary examination. Full article
(This article belongs to the Special Issue Pathology and Diagnosis of Thyroid Disease)
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Other

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11 pages, 21897 KiB  
Case Report
Regressed Papillary Thyroid Carcinoma with Anaplastic Transformation into Lymph Node Metastasis: Case Report with Review of the Literature
by Bozidar Kovacevic, Bojana Rancic, Sasa Jovic, Snezana Cerovic, Vesna Skuletic, Jelena Karajovic, Milka Gardasevic, Gordana Supic and Kennichi Kakudo
Diagnostics 2025, 15(5), 523; https://doi.org/10.3390/diagnostics15050523 - 21 Feb 2025
Viewed by 771
Abstract
Background: Small papillary thyroid carcinomas with the largest dimension of 10 mm are slow-growing and self-limiting tumors, most of which have no potential for progression, rarely becoming clinically evident carcinomas or undergoing regressive changes. Their anaplastic transformation, primarily in the thyroid gland [...] Read more.
Background: Small papillary thyroid carcinomas with the largest dimension of 10 mm are slow-growing and self-limiting tumors, most of which have no potential for progression, rarely becoming clinically evident carcinomas or undergoing regressive changes. Their anaplastic transformation, primarily in the thyroid gland or into lymph node metastasis, is extremely rare. Case Presentation: A 66-year-old female patient was admitted to our hospital for diagnostics and treatment of a large tumor on the left neck side. Preoperative imaging and cytological findings of the neck tumor suggested metastasis of papillary thyroid carcinoma. Total thyroidectomy and metastasectomy were performed. In the final diagnosis, anaplastic transformation of the papillary thyroid carcinoma’s metastasis in the neck was confirmed. Opposite to advanced dedifferentiation of metastasis, primary tumor foci in the thyroid were regressed and replaced with sclerosis and microcalcification. The synchronous co-occurrence of incidental primary thyroid carcinoma and anaplastic thyroid carcinoma originating from ectopic cervical thyroid tissue was considered diagnostically. Conclusions: The case highlights the necessity of regular monitoring of the thyroid and neck lymph nodes for patients under active surveillance, including those with small calcified tumor foci. This paper also comprehensively reviews the existing literature on this topic. Full article
(This article belongs to the Special Issue Pathology and Diagnosis of Thyroid Disease)
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