{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:45:34Z","timestamp":1787755534565,"version":"build-2784847793"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T00:00:00Z","timestamp":1632960000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Hashimoto\u2019s thyroiditis (HT), also known as chronic lymphocytic thyroiditis (CLT), may interfere with the accurate cytological diagnosis of thyroid nodules. Recently, HT has been considered a premalignant condition for thyroid cancer development. The diagnosis of atypia of undetermined significance\/follicular lesions of undetermined significance (AUS\/FLUS) thyroid nodules is challenging and evidence for the malignancy risk of AUS\/FLUS thyroid nodules coexisting with CLT is scarce. Therefore, we assessed the malignancy risk of AUS\/FLUS thyroid nodules according to the presence of background CLT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study included 357 surgically resected thyroid nodules with AUS\/FLUS cytology. Cases with concomitant malignant nodules were excluded. CLT was defined based on the pathologic report after thyroid surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 357 tumors, 130 tumors (36%) were confirmed to have coexisting CLT, and 170 tumors (48%) were determined to be malignant after thyroidectomy. Malignancy rates were similar in both groups (48% in each) regardless of background CLT (62\/130 with CLT <jats:italic>vs.<\/jats:italic> 108\/227 without CLT). In the group with CLT, thyroiditis was more frequent in the final pathology (12% with CLT <jats:italic>vs.<\/jats:italic> 1% without CLT, P = 0.003). In multivariate analysis, positive <jats:italic>BRAF<\/jats:italic><jats:sup>V600E<\/jats:sup> mutation, highly suspicious sonographic features (K-TIRADS 5), and smaller thyroid nodules were significant factors for thyroid malignancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The malignancy rate of thyroid nodules with AUS\/FLUS cytology was comparable irrespective of the presence of underlying CLT.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2021.745395","type":"journal-article","created":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T22:00:21Z","timestamp":1633039221000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["Malignancy Rate of Bethesda Class III Thyroid Nodules Based on the Presence of Chronic Lymphocytic Thyroiditis in Surgical Patients"],"prefix":"10.3389","volume":"12","author":[{"given":"Yoon Young","family":"Cho","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun Jae","family":"Chung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hee Sung","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,9,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1111\/j.1365-2362.2009.02162.x","article-title":"Very High Prevalence of Thyroid Nodules Detected by High Frequency (13 MHz) Ultrasound Examination","volume":"39","author":"Guth","year":"2009","journal-title":"Eur J Clin Invest"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-126-3-199702010-00009","article-title":"Thyroid Incidentalomas: Management Approaches to Nonpalpable Nodules Discovered Incidentally on Thyroid Imaging","volume":"126","author":"Tan","year":"1997","journal-title":"Ann Intern Med"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2017.0500","article-title":"The 2017 Bethesda System for Reporting Thyroid Cytopathology","volume":"27","author":"Cibas","year":"2017","journal-title":"Thyroid"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1089\/thy.2015.0020","article-title":"American Thyroid Association Management Guidelines for Adult Patients With Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer","volume":"26","author":"Haugen","year":"2016","journal-title":"Thyroid"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24578","article-title":"Current Status and Diagnostic Values of the Bethesda System for Reporting Thyroid Cytopathology in a Papillary Thyroid Carcinoma-Prevalent Area","volume":"39","author":"Lee","year":"2017","journal-title":"Head Neck"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1111\/cyt.12438","article-title":"Thyroid Nodules Classified as Atypia or Follicular Lesions of Undetermined Significance Deserve Further Research: Analysis of 305 Surgically Confirmed Nodules","volume":"28","author":"Turkyilmaz","year":"2017","journal-title":"Cytopathology"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2021.05.016","article-title":"Fine Needle Aspiration and the Bethesda System: Correlation With Histopathology in 1,228 Surgical Patients","author":"Linhares","year":"2021","journal-title":"Surgery"},{"key":"B8","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.jcte.2018.10.003","article-title":"Gender-Specific Correlation of Intranodular Chronic Lymphocytic Thyroiditis With Thyroid Nodule Size, Echogenicity, and Histologically-Verified Cytological Class of Malignancy Risk","volume":"14","author":"Arena","year":"2018","journal-title":"J Clin Transl Endocrinol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1186\/1742-6413-4-10","article-title":"Lymphocytic Thyroiditis\u2013Is Cytological Grading Significant? 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