{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T23:48:46Z","timestamp":1789084126181,"version":"build-2803163510"},"reference-count":33,"publisher":"The Endocrine Society","issue":"4","license":[{"start":{"date-parts":[[2019,3,5]],"date-time":"2019-03-05T00:00:00Z","timestamp":1551744000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>The impact of Hashimoto thyroiditis (HT) on the risk of thyroid cancer and its accurate detection remains unclear. The presence of a chronic lymphocytic infiltration imparts a logical mechanism potentially altering neoplastic transformation, while also influencing the accuracy of diagnostic evaluation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a prospective, cohort analysis of 9851 consecutive patients with 21,397 nodules \u22651 cm who underwent nodule evaluation between 1995 and 2017. The definition of HT included (i) elevated thyroid peroxidase antibody (TPOAb) level and\/or (ii) findings of diffuse heterogeneity on ultrasound, and\/or (iii) the finding of diffuse lymphocytic thyroiditis on histopathology. The impact of HT on the distribution of cytology and, ultimately, on malignancy risk was determined.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 2651 patients (27%) were diagnosed with HT, and 3895 HT nodules and 10,168 non-HT nodules were biopsied. The prevalence of indeterminate and malignant cytology was higher in the HT vs non-HT group (indeterminate: 26.3% vs 21.8%, respectively, P &amp;lt; 0.001; malignant: 10.0% vs 6.4%, respectively, P &amp;lt; 0.001). Ultimately, the risk of any nodule proving malignant was significantly elevated in the setting of HT (relative risk, 1.6; 95% CI, 1.44 to 1.79; P &amp;lt; 0.001), and was maintained when patients with solitary or multiple nodules were analyzed separately (HT vs non-HT: 24.5% vs 16.3% solitary; 22.1% vs 15.4% multinodular; P &amp;lt; 0.01).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>HT increases the risk of thyroid malignancy in any patient presenting for nodule evaluation. Diffuse sonographic heterogeneity and\/or TPOAb positivity should be used for risk assessment at time of evaluation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/js.2018-00427","type":"journal-article","created":{"date-parts":[[2019,3,5]],"date-time":"2019-03-05T14:29:19Z","timestamp":1551796159000},"page":"791-800","source":"Crossref","is-referenced-by-count":67,"title":["The Impact of Hashimoto Thyroiditis on Thyroid Nodule Cytology and Risk of Thyroid Cancer"],"prefix":"10.1210","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7883-8175","authenticated-orcid":false,"given":"Nathalie","family":"Silva de Morais","sequence":"first","affiliation":[{"name":"Thyroid Interdisciplinary Team, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Massachusetts"},{"name":"Endocrinology Service, Instituto Nacional de C\u00e2ncer and Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil"},{"name":"Endocrinology Service, Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Stuart","sequence":"additional","affiliation":[{"name":"Thyroid Interdisciplinary Team, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haixia","family":"Guan","sequence":"additional","affiliation":[{"name":"Thyroid Interdisciplinary Team, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Endocrinology and Metabolism, The First Hospital of China Medical University, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihong","family":"Wang","sequence":"additional","affiliation":[{"name":"Thyroid Interdisciplinary Team, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1987-2004","authenticated-orcid":false,"given":"Edmund S","family":"Cibas","sequence":"additional","affiliation":[{"name":"Thyroid Interdisciplinary Team, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary C","family":"Frates","sequence":"additional","affiliation":[{"name":"Thyroid Interdisciplinary Team, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol B","family":"Benson","sequence":"additional","affiliation":[{"name":"Thyroid Interdisciplinary Team, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy L","family":"Cho","sequence":"additional","affiliation":[{"name":"Thyroid Interdisciplinary Team, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathew A","family":"Nehs","sequence":"additional","affiliation":[{"name":"Thyroid Interdisciplinary Team, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline A","family":"Alexander","sequence":"additional","affiliation":[{"name":"Thyroid Interdisciplinary Team, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Marqusee","sequence":"additional","affiliation":[{"name":"Thyroid Interdisciplinary Team, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathew I","family":"Kim","sequence":"additional","affiliation":[{"name":"Thyroid Interdisciplinary Team, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jochen H","family":"Lorch","sequence":"additional","affiliation":[{"name":"Thyroid Interdisciplinary Team, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justine A","family":"Barletta","sequence":"additional","affiliation":[{"name":"Thyroid Interdisciplinary Team, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9929-0188","authenticated-orcid":false,"given":"Trevor 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