Iacconi Pietro, Giusti Laura, Da Valle Ylenia, Ciregia Federica, Giannaccini Gino, Torregrossa Liborio, Proietti Agnese, Donatini Gianluca, Mazzeo Salvatore, Basolo Fulvio, Lucacchini Antonio
Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, Via Bonanno 6, University of Pisa, 56126 Pisa, Italy.
J Med Case Rep. 2012 Apr 5;6:103. doi: 10.1186/1752-1947-6-103.
Riedel's thyroiditis, a rare thyroid disease, can be difficult to diagnose prior to surgical removal and can be confused with malignancy both clinically and cytologically.
We report the case of a 72-year-old Caucasian woman who presented with a goiter, which showed a rapid increase in size at ultrasound check, suggesting malignancy. Because of inconclusive cytology, a total thyroidectomy was performed. Fine-needle aspiration of the removed thyroid was processed by two-dimensional electrophoresis, and the proteome was compared with both anaplastic cancer and control samples. Significant differentially expressed protein spots were identified by Western blot analysis by using specific antibodies.
The protein pattern of Riedel's fine-needle aspiration revealed a superimposition with that of the control samples. The comparison of the protein pattern of Riedel's thyroiditis fine-needle aspiration with that of anaplastic cancer showed evidence of a different expression of ferritin heavy chains, ferritin light chains, and haptoglobins, as previously reported in thyroid cancers. Therefore, we performed Western blot analysis of these proteins and validated that their expression levels were low or absent in Riedel's thyroiditis and control samples despite the high concentrations present in fine-needle aspiration anaplastic samples. The concurrent absent or low expression levels of haptoglobin, ferritin light chain, and ferritin heavy chain in Riedel's thyroiditis fine-needle aspiration samples strongly indicate the benign nature of the thyroid lesion. These results suggest the potential applicability of fine-needle aspiration proteome analysis for Riedel's thyroiditis diagnosis.
里德尔甲状腺炎是一种罕见的甲状腺疾病，在手术切除前可能难以诊断，在临床和细胞学上都可能与恶性肿瘤混淆。
我们报告了一例72岁的白种女性患者，她因甲状腺肿就诊，超声检查显示其大小迅速增加，提示为恶性肿瘤。由于细胞学检查结果不明确，遂进行了全甲状腺切除术。对切除的甲状腺进行细针穿刺，并通过二维电泳对蛋白质组进行分析，然后将其与间变性癌和对照样本进行比较。使用特异性抗体通过蛋白质印迹分析鉴定出显著差异表达的蛋白斑点。
里德尔甲状腺炎细针穿刺的蛋白质图谱显示与对照样本重叠。将里德尔甲状腺炎细针穿刺的蛋白质图谱与间变性癌的图谱进行比较，结果显示铁蛋白重链、铁蛋白轻链和触珠蛋白的表达存在差异，这与甲状腺癌中先前报道的情况一致。因此，我们对这些蛋白质进行了蛋白质印迹分析，并证实尽管在间变性癌细针穿刺样本中这些蛋白质浓度较高，但在里德尔甲状腺炎和对照样本中其表达水平较低或不存在。里德尔甲状腺炎细针穿刺样本中触珠蛋白、铁蛋白轻链和铁蛋白重链同时缺乏或低表达，强烈表明甲状腺病变的良性性质。这些结果提示细针穿刺蛋白质组分析在里德尔甲状腺炎诊断中的潜在适用性。
