title: Possible association of CEA expression with oxyphilic change but not with C-cell hyperplasia in Hashimoto's thyroiditis.
abstract: Reactive C-cell hyperplasia (CCH) has been observed in cases of autoimmune Hashimoto's thyroiditis; however, its occurrence in Graves' disease, the other major autoimmune disorder, has not yet been investigated. On the other hand, although Carcinoembryonic Antigen (CEA) serum levels have been reported elevated in patients with autoimmune thyroid disease (ATD), the source of CEA production at the cellular level is not elucidated. The aim of this study was to evaluate CCH and CEA immunohistochemical expression and comparatively analyze them in 136 ATD cases (107 Hashimoto's and 29 Graves' disease cases) and 20 cases of nodular hyperplasia (NH). Immunohistochemistry using monoclonal antibodies to chromogranin and CEA was performed. A scoring system for CCH and semiquantitative evaluation for CEA expression were applied. C-cell hyperplasia was absent in NH cases. In contrast, it was detected in 11% of ATD cases being more frequently observed in Hashimoto's (12.1%) than Graves' disease (6.8%) CCH associated to male sex and older age of Hashimoto's patients. CEA was detected only in ATD cases (33.8%), in C-cells and in follicular cells as well, being more frequently detected in Graves' (44.8%) than Hashimoto's (30.8%) disease. An interesting finding was an emerging possible association of CEA expression with oxyphilic change but not with C-cell hyperplasia in Hashimoto's thyroiditis. No significant correlation was established between CCH and CEA follicular cell expression in neither disease. In conclusion, C-cell hyperplasia and CEA expression may be encountered in the setting of Hashimoto's thyroiditis and Graves' disease.
authors.affiliation: Department of Pathology, School of Medicine, The National & Kapodistrian University of Athens, Athens, Greece.
authors.forename: Hariklia
authors.initials: H
authors.lastname: Gakiopoulou
authors.forename: Eleni
authors.initials: E
authors.lastname: Litsiou
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Valaris
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Balafoutas
authors.forename: Efstratios
authors.initials: E
authors.lastname: Patsouris
authors.forename: Sofia
authors.initials: S
authors.lastname: Tseleni-Balafouta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000032:analysis*; D018278:Carcinoma, Neuroendocrine; D002864:Chromogranins / Q000032:analysis; D005260:Female; D006111:Graves Disease / Q000378:metabolism / Q000473:pathology; D050031:Hashimoto Disease / Q000378:metabolism* / Q000473:pathology*; D006801:Humans; D006965:Hyperplasia; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D024862:Oxyphil Cells / Q000737:chemistry* / Q000473:pathology; D013964:Thyroid Neoplasms / Q000473:pathology; D016606:Thyroid Nodule / Q000473:pathology
chemical_list: D002272:Carcinoembryonic Antigen; D002864:Chromogranins