Relationship between intrathyroid calcifications and thyroglobulin in endemic goiter

Intrathyroid calcifications represent a common finding within simple or nod ular goiters, but, as far as they can be found also inside papillary and me dullary thyroid carcinomas, an ultrasonographic detection of intrathyroid c alcifications stands as a different diagnosis problem. We have been looking for the presence of parameters associated with thyroid calcifications in patients affected by simple or nodular goiter, either sp oradic or endemic. We studied 284 euthyroid subjects, 250 females, ageing from 24 to 90 years, affected by a simple goiter, in the 9.51% of the cases, and by a nodular g oiter in the remaining part. 69.37% of the patients came from an endemic goiter area, while the others w ere affected by sporadic goiter. We tested fT3, fT4, TSH, hTG, Ab-TG, Ab-TP O and performed an ultrasonography in all the subjects. 57.75% of patients shown intrathyroid calcifications in the 57.75% of them. We applied a multistep discriminant analysis taking the presence/absence of calcifications as dependent variable and we tried to find which variable, by itself or in combination with others, could foretell its presence. We al so created a new variable (TG1) to differentiate normal from supraphysiolog ic concentrations of hTG (< 60 ng/ml). The variable with the highest signif icance F originated from endemic goiter area (F = 96.36), followed by TG1 ( F = 24.46) and age (F = 10.61). On the contrary hTG did not relate to calci fications, due to non-proportionally direct relationship between these two parameters, afterwards we used the multistep logistic regression that gave overlapping significances. This means that supraphysiologic hTG rates are s ufficient to predict the possible presence of intrathyroid calcifications. In conclusion, as far as a follicular hyperstimulation can be assumed, espe cially if long-lasting, the presence of intrathyroid calcifications should rise a clinical suspect toward an old goiter rather than a neoplastic lesio n.