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NDRG1 protein overexpression in malignant thyroid neoplasms  

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Full Text Available OBJECTIVES: The aim of this study was to examine the expression of the N-myc downstream-regulated gene 1 protein in benign and malignant lesions of the thyroid gland by immunohistochemistry. INTRODUCTION: N-myc downstream-regulated gene 1 encodes a protein whose expression is induced by various stimuli, including cell differentiation, exposure to heavy metals, hypoxia, and DNA damage. Increased N-myc downstream-regulated gene 1 expression has been detected in various types of tumors, but the role of N-myc downstream-regulated gene 1 expression in thyroid lesions remains to be determined. METHODS: A tissue microarray paraffin block containing 265 tissue fragments corresponding to normal thyroid, nodular goiter, follicular adenoma, papillary thyroid carcinoma (classical pattern and follicular variant), follicular carcinoma, and metastases of papillary and follicular thyroid carcinomas were analyzed by immunohistochemistry using a polyclonal anti- N-myc downstream-regulated gene 1 antibody. RESULTS: The immunohistochemical expression of N-myc downstream-regulated gene 1 was higher in carcinomas compared to normal thyroid glands and nodular goiters, with higher expression in classical papillary thyroid carcinomas and metastases of thyroid carcinomas (P < 0.001). A combined analysis showed higher immunohistochemical expression of NDRG1 in malignant lesions (classical pattern and follicular variant of papillary thyroid carcinomas, follicular carcinomas, and metastases of thyroid carcinomas) compared to benign thyroid lesions (goiter and follicular adenomas) (P = 0.043). In thyroid carcinomas, N-myc downstream-regulated gene 1 expression was significantly correlated with a more advanced TNM stage (P = 0.007) and age, metastasis, tumor extent, and size (AMES) high-risk group (P = 0.012). CONCLUSIONS: Thyroid carcinomas showed increased immunohistochemical N-myc downstream-regulated gene 1 expression compared to normal and benign thyroid lesions and is correlated with more advanced tumor stages.

Renê Gerhard; Suely Nonogaki; José Humberto Tavares Guerreiro Fregnani; Fernando Augusto Soares; Maria Aparecida Nagai

2010-01-01

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NDRG1 protein overexpression in malignant thyroid neoplasms  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english OBJECTIVES: The aim of this study was to examine the expression of the N-myc downstream-regulated gene 1 protein in benign and malignant lesions of the thyroid gland by immunohistochemistry. INTRODUCTION: N-myc downstream-regulated gene 1 encodes a protein whose expression is induced by various stimuli, including cell differentiation, exposure to heavy metals, hypoxia, and DNA damage. Increased N-myc downstream-regulated gene 1 expression has been detected in various type (more) s of tumors, but the role of N-myc downstream-regulated gene 1 expression in thyroid lesions remains to be determined. METHODS: A tissue microarray paraffin block containing 265 tissue fragments corresponding to normal thyroid, nodular goiter, follicular adenoma, papillary thyroid carcinoma (classical pattern and follicular variant), follicular carcinoma, and metastases of papillary and follicular thyroid carcinomas were analyzed by immunohistochemistry using a polyclonal anti- N-myc downstream-regulated gene 1 antibody. RESULTS: The immunohistochemical expression of N-myc downstream-regulated gene 1 was higher in carcinomas compared to normal thyroid glands and nodular goiters, with higher expression in classical papillary thyroid carcinomas and metastases of thyroid carcinomas (P

Gerhard, Renê; Nonogaki, Suely; Fregnani, José Humberto Tavares Guerreiro; Soares, Fernando Augusto; Nagai, Maria Aparecida

2010-06-01

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Predictive Factors of Malignancy in Thyroid Nodules with a Cytological Diagnosis of Follicular Neoplasm.  

UK PubMed Central (United Kingdom)

In cases of follicular neoplasm identified by thyroid fine-needle aspiration (FNA), surgery is required to achieve a precise diagnosis. We investigated potential clinical factors for the preoperative prediction of malignancy in thyroid nodules with a cytological diagnosis of follicular neoplasm. We retrospectively reviewed the data of 97 patients who were diagnosed with follicular neoplasm by FNA and had undergone surgery at the Korea Cancer Center Hospital between April 2010 and April 2012. Age, sex, laboratory data (such as thyroid-stimulating hormone, free T4, thyroglobulin (Tg), and Tg antibody), and ultrasonographic findings were reviewed from the electronic medical records. Of 97 patients, 50 (51.5 %) were diagnosed with benign nodules, 16 (16.5 %) with follicular thyroid carcinoma (FTC), and 31 (32.0 %) with papillary thyroid carcinoma (PTC). In comparison with the features of benign nodules, FTC presented with a large nodule size, high serum Tg level, isoechogenicity, calcifications, and peripheral halo, whereas PTC exhibited traits similar to those of benign nodules, except for high serum Tg level and the presence of calcifications on ultrasonography. Therefore, a high serum Tg level (?75 ng/mL) and calcification were the only significant predictive factors for malignancy in case of follicular neoplasm (p?malignancy in thyroid nodules with cytological diagnosis of follicular neoplasm.

Lee SH; Baek JS; Lee JY; Lim JA; Cho SY; Lee TH; Ku YH; Kim HI; Kim MJ

2013-09-01

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Surgeon-performed ultrasound predictors of malignancy in patients with Hurthle cell neoplasms of the thyroid.  

UK PubMed Central (United Kingdom)

BACKGROUND: Fine-needle aspiration cannot reliably determine malignancy in patients with Hürthle cell neoplasms (HCNs) of the thyroid. Thyroid nodule size and characteristics determined by surgeon-performed ultrasound (SUS) may be useful for predicting malignancy in HCN preoperatively. This study examined whether tumor size and features by SUS can reliably predict malignancy in patients with HCN. MATERIALS AND METHODS: We performed a retrospective review of 84 patients with HCN by fine-needle aspiration, who underwent SUS and thyroidectomy from 2002 to 2010. All patients underwent thyroid lobectomy with isthmusectomy unless there was a history of radiation exposure, familial thyroid cancer, obstructive symptoms, bilateral nodules, and/or patient preference, in which case total thyroidectomy was performed. Tumor size and malignant features by SUS were correlated with final histopathology using multivariate regression analysis. RESULTS: On final histopathology, 29 patients had malignant thyroid nodules and 55 patients had benign ones. There were no statistically significant differences in terms of age, race, ethnicity, or gender between HCN patients who revealed malignant or benign nodules on final pathology. Tumor size ? 4 cm measured by SUS did not predict malignancy in HCN. Hypoechogenicity and hyperechogenicity were significantly associated with malignancy, whereas isoechogenicity was predictive of benignity (P = 0.044). No other ultrasonographic features were predictive for thyroid carcinoma by multivariate analysis. CONCLUSIONS: Tumor size and features determined by SUS do not reliably predict malignancy in patients with HCN. Such patients at risk for malignancy should initially undergo thyroid lobectomy for definitive diagnosis.

Parikh PP; Allan BJ; Lew JI

2013-09-01

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FNA of misclassified primary malignant neoplasms of the thyroid: Impact on clinical management  

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Full Text Available Background: Fine needle aspiration (FNA) cytology is a popular, reliable and cost effective technique for the diagnosis of thyroid lesions. The aim of our study was to review cases of misclassified primary malignant neoplasms of the thyroid by FNA, and assess the causes of cytologic misdiagnosis and their impact on clinical management. Methods: Clinical data, FNA smears and follow-up surgical specimens of cases diagnosed with primary thyroid carcinoma were reviewed. Results: Of the 365 cases with a malignant diagnosis by FNA over a period of 11 years, nine (2.4 %) were identified with discrepant histologic diagnosis with regard to the type of primary thyroid malignancy. In addition, four cases were added from the consultation files of the Massachusetts General Hospital. Areas of difficulty contributing to misclassification included overlapping cytologic features (n = 6), rarity of tumors (n = 3), and sampling limitations (n = 4). Of the 13 cases, 12 underwent total or near total thyroidectomy and one patient had concurrent surgical biopsy. Measurement of serum calcitonin levels in one case, with an initial cytologic diagnosis of medullary carcinoma, prevented unnecessary lymph node dissection. Misclassification of medullary carcinoma as papillary carcinoma precluded lymph node dissection in one case. Further management decisions were based on the final histologic diagnosis and did not require additional surgery. Two cases of undifferentiated (anaplastic) thyroid carcinoma were misdiagnosed as papillary thyroid carcinoma. Both patients received total thyroidectomies, which may not otherwise have been performed. Conclusions: A small subset of primary malignant neoplasms of the thyroid may be misclassified with regard to the type of malignancy on FNA. The majority of primary malignant neoplasms diagnosed on FNA require thyroidectomy. However, initial cytologic misclassification of medullary carcinoma or undifferentiated carcinoma as other malignant neoplasms or vice versa may have an impact on clinical management.

Shah Sejal; Faquin William; Izquierdo Roberto; Khurana Kamal

2009-01-01

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Risk of malignancy in follicular thyroid neoplasm: predictive value of thyrotropin.  

UK PubMed Central (United Kingdom)

UNLABELLED: The cytological diagnosis of follicular neoplasm is a common finding in fine needle aspiration cytology (FNAC) of thyroid nodules and includes benign disease as well as differentiated thyroid cancer. The aim of the study is to determine if thyrotropin is a predictive factor for a malignant nature of follicular neoplasm. PATIENTS, METHODS: The records of 119 patients with follicular neoplasm on FNAC, who underwent surgery for final diagnosis, were reviewed retrospectively. The predictive value of serum parameters including thyrotropin, thyroglobulin, and anti-thyroid antibodies, ultrasonographic criteria and clinical variables was evaluated by univariate analysis and logistic regression analysis. RESULTS, DISCUSSION: Patients with malignant nodules showed a higher thyrotropin concentration compared to patients with benign nodules (median 1.6 mU/l, interquartile range 1.4-3.0 mU/l vs. median 1.2 mU/l, interquartile range 0.8-1.6 mU/l, p < 0.01). ROC-analysis of thyrotropin revealed an optimal cut off value to differentiate benign and malignant nodules of 1.34 mU/l. The incidence of malignancy was 30.3% for a thyrotropin concentration higher than 1.34 mU/l compared to 6.4% for a thyrotropin concentration lower than or equal to 1.34 mU/l. On univariate analysis thyroglobulin higher than 300 ng/ml, positive anti-thyroid antibodies, hypoechogenicity, and ill-defined margins, respectively, were also significantly associated with malignancy. On logistic regression analysis higher thyrotropin concentrations, ill-defined margins, and thyroglobulin higher than 300 ng/ml, respectively, were independent predictive factors for malignancy (OR 20.0, 10.7, and 22.7, respectively). CONCLUSION: Higher thyrotropin concentrations are predictive for a malignant nature of follicular neoplasm.

Zimny M; Selkinski I; Blasius S; Rink T; Schroth HJ; Grünwald F

2012-01-01

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Predictive factors of malignancy in patients with cytologically suspicious for Hurthle cell neoplasm of thyroid nodules.  

UK PubMed Central (United Kingdom)

BACKGROUND: Our aim was to evaluate predictive factors of malignancy in patients with cytologically suspicious for Hurthle cell neoplasm (HCN) of thyroid nodules. MATERIALS AND METHODS: We searched cases with cytologically suspicious for HCN from 11,569 ultrasound-guided fine-needle aspirations (US-FNA) performed at our institution. Nodules that were confirmed surgically or followed-up for at least 2 years were compared with respect to age, gender, tumor size, US diagnosis, and US findings to predict malignancy. RESULTS: The incidence of cases with cytologically suspicious for HCN was 1.2% (143 of 11,569). Of 75 nodules that underwent sufficient follow-up or surgery, malignancies were found in 11 (14.7%). Malignant histological examination revealed oncocytic variants of papillary thyroid carcinoma (PTC) in 3 cases, classic PTC in 1, Hurthle cell carcinoma in 3, follicular carcinoma in 3 and an unclassified carcinoma in 1. In univariate analysis, tumor size was significantly larger in malignant nodules compared to benign nodules (p = 0.026). The best cut-off value of tumor size in predicting malignancy was 2.5 cm. (p = 0.006, sensitivity: 63.6%, specificity: 79.7%). The incidences of hypoechogenicity and malignant US diagnoses were higher in malignant nodules than in benign nodules (p < 0.001). In multivariate analysis, tumor size was an independent factor in predicting malignancies. (p = 0.037, odd ratio: 2.09, confidence interval: 1.046-4.161). CONCLUSION: Preoperative US provides predictive factors of malignancy in thyroid nodules with cytologically suspicious for HCN. Predictive factors include tumor size of 2.5 cm or greater, hypoechoic nodule and malignant US diagnosis.

Lee KH; Shin JH; Ko ES; Hahn SY; Kim JS; Kim JH; Oh YL

2013-07-01

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Expression of matrix metalloproteinase-2, but not caspase-3, facilitates distinction between benign and malignant thyroid follicular neoplasms.  

UK PubMed Central (United Kingdom)

PURPOSE: Definite diagnosis of follicular thyroid carcinoma (FTC) is based on the presence of capsular or vascular invasion. To date, no reliable and practical method has been introduced to discriminate this malignant neoplasm from follicular thyroid adenoma (FTA) in fine needle aspiration biopsy material. Matrix metalloproteinase-2 (MMP-2), by degrading extracellular matrix, and caspase-3, by induction of apoptosis, have been shown to play important roles in carcinogenesis and aggressive behavior in many tumor types. The aim of this study was to examine expression of MMP-2 and caspase-3 in thyroid follicular neoplasms and to determine their usefulness for differential diagnosis. METHOD: Sixty FTAs and 41 FTCs were analysed immunohistochemically for MMP-2 and caspase-3. RESULT: MMP-2 was positive in 4 FTCs (9.8%), but in none of FTAs, with statistical significance (p=0.025). Caspase-3 was positive in 30 (50%) of FTAs and in 27 (65.9%) of FTCs. CONCLUSION: Our results show MMP-2 expression only in FTCs and suggest that this protein may be a useful marker to confirm diagnosis of FTC versus FTA with 100% specificity and 100% predictive value of a positive test. We failed to show any differential diagnostic value for caspase-3 in thyroid follicular neoplasms.

Sanii S; Saffar H; Tabriz HM; Qorbani M; Haghpanah V; Tavangar SM

2012-01-01

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Horner's syndrome and thyroid neoplasms.  

UK PubMed Central (United Kingdom)

Although thyroid goiter is a common condition, it rarely results in Horner's syndrome. We report a case of a patient with an intrathoracic multinodular goiter complicated by Horner's syndrome. Benign thyroid disease was confirmed pathologically, and the patient's symptoms improved after surgery. In the literature, the major cause of Horner's syndrome is neoplasia, with malignant lesions being twice as frequent as benign tumors. An extensive review of the literature demonstrates a different repartition for thyroid neoplasia: including our case, 38 cases of Horner's syndrome secondary to a benign thyroid tumor are described, against only 8 cases caused by a thyroid carcinoma. We conclude that contrary to the commonly held opinion, Horner's syndrome is more often due to benign thyroid diseases than to thyroid malignancies.

Leuchter I; Becker M; Mickel R; Dulguerov P

2002-01-01

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Horner's syndrome and thyroid neoplasms.  

Science.gov (United States)

Although thyroid goiter is a common condition, it rarely results in Horner's syndrome. We report a case of a patient with an intrathoracic multinodular goiter complicated by Horner's syndrome. Benign thyroid disease was confirmed pathologically, and the patient's symptoms improved after surgery. In the literature, the major cause of Horner's syndrome is neoplasia, with malignant lesions being twice as frequent as benign tumors. An extensive review of the literature demonstrates a different repartition for thyroid neoplasia: including our case, 38 cases of Horner's syndrome secondary to a benign thyroid tumor are described, against only 8 cases caused by a thyroid carcinoma. We conclude that contrary to the commonly held opinion, Horner's syndrome is more often due to benign thyroid diseases than to thyroid malignancies. PMID:11891400

Leuchter, Igor; Becker, Minerva; Mickel, Robert; Dulguerov, Pavel

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Lobectomy in follicular thyroid neoplasms' treatment.  

UK PubMed Central (United Kingdom)

BACKGROUND: The purpose of this study is to evaluate the suitability of lobectomy with isthmectomy (LwI) in treatment of Follicular Thyroid Neoplasms (FTN), considering malignancy incidence and postoperative complications. METHODS: 192 patients (165 females; 27 males) who underwent LwI for FTN from 01/2005 to 12/2007 were retrospectively evaluated: clinical and pathological features, surgical complications and five year outcome. Inclusion criteria were cytological Bethesda category III and IV or histological follicular adenoma/carcinoma or follicular variant of papillary carcinoma). Metastatic disease or previous thyroidal surgery patients were excluded. RESULTS: Mean age was 48.68±14.93yrs. Overall malignancy occurred in 88 patients (45.83%) and 80 (41.67%) underwent thyroidectomy completion (TC), mainly by index lesion's malignancy. Forty-one (21.35%) in LwI and 31 (38.75%) in TC specimens had associated malignancy, mainly papillary microcarcinomas. High preoperative Thyroid-Stimulating Hormone (TSH), histological multinodularity and, in cytology category IV, younger age, were significantly associated to malignancy. Permanent recurrent laryngeal nerve lesion occurred in 0.58% in Lwl and 1.52% in TC, and temporary dysphonia occurred in 9.25% and 6.06% (LwI and TC respectively). No LwI patients presented hypoparathyroidism whereas 3.03% in TC had temporary symptoms. In LwI, 36.70% developed hypothyroidism. Higher preoperative TSH was associated with hypothyroidism development. CONCLUSIONS: LwI was inappropriate in 40.10% patients with malignancy who required TC and 23.12% had no functional benefit because post-LwI hypothyroidism. Nodular relapse was reported in at least 23/113 LwI patients (20.35%). We propose total thyroidectomy for patients with FTN preoperative TSH higher than 2.16 mU/L and, in Bethesda category IV, less than 39.5yrs.

Antunes CM; Taveira-Gomes A

2013-07-01

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Second Malignant Neoplasms Following Radiotherapy  

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Full Text Available More than half of all cancer patients receive radiotherapy as a part of their treatment. With the increasing number of long-term cancer survivors, there is a growing concern about the risk of radiation induced second malignant neoplasm [SMN]. This risk appears to be highest for survivors of childhood cancers. The exact mechanism and dose-response relationship for radiation induced malignancy is not well understood, however, there have been growing efforts to develop strategies for the prevention and mitigation of radiation induced cancers. This review article focuses on the incidence, etiology, and risk factors for SMN in various organs after radiotherapy.

Sanath Kumar

2012-01-01

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Juvenile thyroid malignancy  

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Full Text Available Thyroid malignancy is an uncommon tumor of the pediatric population. Patients can present with asymptomatic thyroid nodule and it requires thorough work up to rule out the malignancy. Radiological and pathological procedures are a standard part of the management. A 10-year-old girl had asymptomatic thyroid nodule; the cytological examination and the frozen section and final histology of the nodule was different each time. The girl had to undergo total thyroidectomy on the basis of histology of the nodule which was well differentiated papillary carcinoma of thyroid and is under regular follow-up for last two years on thyroid supplementation.

Parelkar Sandesh; Joshi Milind

2009-01-01

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Juvenile thyroid malignancy  

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Thyroid malignancy is an uncommon tumor of the pediatric population. Patients can present with asymptomatic thyroid nodule and it requires thorough work up to rule out the malignancy. Radiological and pathological procedures are a standard part of the management. A 10-year-old girl had asymptomatic ...

Parelkar Sandesh; Joshi Milind

15

[Uncommon variants of malignant melanocytic neoplasms].  

Science.gov (United States)

Benign and malignant melanocytic neoplasms are relatively frequent and show a broad morphological heterogeneity. The spectrum of malignant melanomas comprises the four main types, superficial spreading malignant melanoma, nodular malignant melanoma, lentigo-maligna melanoma and acrolentiginous malignant melanoma. In addition the rare spitzoid malignant melanoma, desmoplastic malignant melanoma as well as some unusual variants of malignant melanoma can be distinguished. The latter include nevoid malignant melanoma, a form of malignant melanoma resembling benign melanocytic nevi, animal type malignant melanoma, an atypical melanocytic neoplasm with numerous melanophages and prominent melanosis resembling an atypical epithelioid blue naevus as well as regressive malignant melanoma, and representing a questionably distinct entity, balloon cell and signet-ring malignant melanomas, melanoma types with degenerative clear cell changes, as well as myxoid and osteogenic malignant melanomas that are characterized by unusual stromal changes. PMID:17846776

Mentzel, T

2007-11-01

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[Uncommon variants of malignant melanocytic neoplasms  

UK PubMed Central (United Kingdom)

Benign and malignant melanocytic neoplasms are relatively frequent and show a broad morphological heterogeneity. The spectrum of malignant melanomas comprises the four main types, superficial spreading malignant melanoma, nodular malignant melanoma, lentigo-maligna melanoma and acrolentiginous malignant melanoma. In addition the rare spitzoid malignant melanoma, desmoplastic malignant melanoma as well as some unusual variants of malignant melanoma can be distinguished. The latter include nevoid malignant melanoma, a form of malignant melanoma resembling benign melanocytic nevi, animal type malignant melanoma, an atypical melanocytic neoplasm with numerous melanophages and prominent melanosis resembling an atypical epithelioid blue naevus as well as regressive malignant melanoma, and representing a questionably distinct entity, balloon cell and signet-ring malignant melanomas, melanoma types with degenerative clear cell changes, as well as myxoid and osteogenic malignant melanomas that are characterized by unusual stromal changes.

Mentzel T

2007-11-01

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Metastases of renal cell carcinoma to the thyroid gland with synchronous benign and malignant follicular cell-derived neoplasms.  

UK PubMed Central (United Kingdom)

Clear cell renal cell carcinoma (CCRCC) is the most common origin for metastasis in the thyroid. A 51-year-old woman was referred to our hospital for a subcarinal lesion. Ten years before, the patient had undergone a nephrectomy for CCRCC. Whole-body fluorodeoxyglucose positron emission tomography revealed elevated values in the thyroid gland, while the mediastinum was normal. An endoscopic ultrasonography-guided fine-needle aspiration biopsy of the mediastinal mass was consistent with CCRCC, and this was confirmed after resection. The thyroidectomy specimen also revealed lymphocytic thyroiditis, nodular hyperplasia, one follicular adenoma, two papillary microcarcinomas, and six foci of metastatic CCRCC involving both thyroid lobes. Curiously two of the six metastatic foci were located inside two adenomatoid nodules (tumor-in-tumor). The metastatic cells were positive for cytokeratins, CD10, epidermal growth factor receptor, and vascular endothelial growth factor receptor 2. No BRAF gene mutations were found in any of the primary and metastatic lesions. The patient was treated with sunitinib and finally died due to CCRCC distant metastases 6 years after the thyroidectomy. In CCRCC patients, a particularly prolonged survival rate may be achieved with the appropriate therapy, in contrast to the ominous prognosis typically found in patients with thyroid metastases from other origins.

Zamarrón C; Abdulkader I; Areses MC; García-Paz V; León L; Cameselle-Teijeiro J

2013-01-01

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A rare neoplasm of the thyroid gland.  

UK PubMed Central (United Kingdom)

Burkitt's lymphoma of the thyroid gland is a rare malignancy. We present a case of a 58-year-old female who developed a rapid enlargement of her thyroid gland. Core biopsy confirmed the diagnosis of Burkitt's lymphoma. The tumour resolved after three cycles of chemotherapy. This case report emphasises the importance of considering lymphoma when dealing with thyroid nodules and goitres, as its management is different from that of other thyroid pathologies and delaying treatment has an impact on prognosis.

Mweempwa A; Prasad J; Islam S

2013-02-01

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Treatment of thyroid malignancies  

International Nuclear Information System (INIS)

Clinically significant thyroid malignancies are relatively uncommon, although their prevalence in autopsy series ranges up to 11%. New data confirm an increased incidence of carcinoma in solitary thyroid nodules in younger patients and a greater likelihood for younger patients to present with metastatic disease. Treatment of differentiated thyroid carcinoma is controversial, although many series indicate excellent results with total thyroidectomy. Although iodine-131 ablation has been standard in most centers after total thyroidectomy when residual thyroid tissues are present, new data indicate that selective use of this therapy may be appropriate. Prophylactic neck dissection dose not improve survival or lessen recurrence in differentiated thyroid cancers and may increase morbidity. It should, therefore, be reserved for the patient with clinically enlarged cervical nodes.141 references.

1991-01-01

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Is a thyroid follicular neoplasm a good indication for endoscopic surgery?  

UK PubMed Central (United Kingdom)

Endoscopic thyroidectomy is a safe and feasible alternative as compared with conventional open thyroidectomy in patients with a small thyroid cancer or a benign thyroid tumor. However, despite the many advantages of endoscopic surgery, it can result in unexpected complications. Recently, the authors experienced a case of follicular thyroid cancer recurrence that developed around the operative bed and along the port insertion site after endoscopic thyroidectomy for a large follicular neoplasm. The authors suggest that a smaller follicular neoplasm is a good indication for endoscopic thyroidectomy, but that a large follicular neoplasm should not be viewed as indicators for endoscopic surgery, because of the possibility of malignancy and rupture during manipulation.

Hur SM; Kim SH; Lee SK; Kim WW; Choi JH; Kim JH; Choe JH; Lee JE; Oh YL; Nam SJ; Yang JH; Kim JS

2011-06-01

 
 
 
 
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Is a thyroid follicular neoplasm a good indication for endoscopic surgery?  

Science.gov (United States)

Endoscopic thyroidectomy is a safe and feasible alternative as compared with conventional open thyroidectomy in patients with a small thyroid cancer or a benign thyroid tumor. However, despite the many advantages of endoscopic surgery, it can result in unexpected complications. Recently, the authors experienced a case of follicular thyroid cancer recurrence that developed around the operative bed and along the port insertion site after endoscopic thyroidectomy for a large follicular neoplasm. The authors suggest that a smaller follicular neoplasm is a good indication for endoscopic thyroidectomy, but that a large follicular neoplasm should not be viewed as indicators for endoscopic surgery, because of the possibility of malignancy and rupture during manipulation. PMID:21654291

Hur, Sung Mo; Kim, Sung Hoon; Lee, Se Kyung; Kim, Wan Wook; Choi, Jae Hyuck; Kim, Jung-Han; Choe, Jun-Ho; Lee, Jeong Eon; Oh, Young Lyun; Nam, Seok-Jin; Yang, Jung-Hyun; Kim, Jee Soo

2011-06-01

22

Adrenal Oncocytic Neoplasm with Uncertain Malignant Potential  

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Full Text Available Adrenal oncocytic neoplasms (AONs) are a rare group of tumours with a somewhat uncertain natural history and clinical behaviour. Out of 46 cases of AON reported to date, 6 cases were histologically classified as neoplasms with uncertain malignant potential. We report the case of a 35-year-old male with an incidentallydetected large AON with mostly benign morphology and some characteristics which would make its behaviour uncertain.

Mooyad A. Ahmed; SureshKannan K. S.; Zaid R. Raouf; Sreedharan V. Koliyadan; Christopher S. Grant; Ahmed H. Al-Habsi; P. A. M Saparamadu; Dhuha Al-Sajee

2013-01-01

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Adrenal Oncocytic Neoplasm with Uncertain Malignant Potential  

Science.gov (United States)

Adrenal oncocytic neoplasms (AONs) are a rare group of tumours with a somewhat uncertain natural history and clinical behaviour. Out of 46 cases of AON reported to date, 6 cases were histologically classified as neoplasms with uncertain malignant potential. We report the case of a 35-year-old male with an incidentally-detected large AON with mostly benign morphology and some characteristics which would make its behaviour uncertain.

Ahmed, Mooyad A.; SureshKannan, K. S.; Raouf, Zaid R.; Koliyadan, Sreedharan V.; Grant, Christopher S.; Al-Habsi, Ahmed H.; Saparamadu, P. A. M; Al-Sajee, Dhuha

2013-01-01

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Primary thyroid lymphoma: a rare thyroid malignancy  

International Nuclear Information System (INIS)

Incidence of thyroidal masses is very high with predominance in females. Most of these masses are benign. Malignancy can be of thyroid or non-thyroid origin. Surgery is treatment of choice in the former but not in latter. Primary thyroid lymphoma (PTL) is a rare cause of thyroid malignancy of non-thyroid origin which is highly treatable without surgery but early diagnosis is important requisite to have better outcome. Fine needle aspiration cytology (FNAC) is an important tool in early diagnosis of PTL, which enables doctors to treat patient better without major surgery and its morbidity. Two cases of primary thyroid lymphoma are hereby presented. The patient diagnosed on FNAC had better outcome than the one who had major surgery. (author)

2011-01-01

25

Unusual presentations of thyroid malignancies - a case series.  

UK PubMed Central (United Kingdom)

Unusual presentations of thyroid neoplasms have been reported from time to time. Four such cases of bizarre presentations of thyroid malignancies seen in the ENT Department of ESIC Hospital, K.K. Nagar, Chennai, India are presented. These cases highlight certain important issues concerning the diagnosis and management. A review of the literature on the subject is discussed.

Raju G; Kameswaran M

2009-09-01

26

Unusual presentations of thyroid malignancies - a case series.  

Science.gov (United States)

Unusual presentations of thyroid neoplasms have been reported from time to time. Four such cases of bizarre presentations of thyroid malignancies seen in the ENT Department of ESIC Hospital, K.K. Nagar, Chennai, India are presented. These cases highlight certain important issues concerning the diagnosis and management. A review of the literature on the subject is discussed. PMID:23120642

Raju, G; Kameswaran, Mohan

2009-09-27

27

Multiple primary malignant neoplasms in breast cancer patients in Israel  

Energy Technology Data Exchange (ETDEWEB)

The data of an epidemiologic study of multiple primary malignant neoplasms in breast cancer patients in Israel are presented. During the 18-year period of the study 12,302 cases of breast carcinoma were diagnosed, and, of these, 984 patients (8%) had multiple primary malignant tumors. Forty-seven of these patients developed two multiple primary cancers. A significantly higher than expected incidence of second primary cancers occurred at the following five sites: the opposite breast, salivary glands, uterine corpus, ovary, and thyroid. Cancers of the stomach and gallbladder were fewer than expected. Treatment of the breast cancer by irradiation was associated with an increased risk of subsequent cancers of lung and hematopoietic system. The prognosis was mainly influenced by the site and malignancy of the second primary cancer. The incidence of multiple primary malignancies justifies a high level of alertness to this possibility in the follow-up of breast cancer patients.

Schenker, J.G.; Levinsky, R.; Ohel, G.

1984-07-01

28

Recurrent malignant salivary gland neoplasms.  

UK PubMed Central (United Kingdom)

Recurrent salivary gland malignancies present difficult therapeutic decisions and poor prognosis in many instances, and treatment becomes of a palliative nature only. As many of the salivary gland malignancies we see are of the recurrent type, the following study was done to determine the efficacy of a vigorous attempt at retreatment. During the period January 1, 1960, through December 31, 1984, 352 patients with major and minor salivary gland tumors were evaluated at our institution. There were 149 benign lesions and 203 patients with malignant tumors. Of these, 99 patients had recurrent and metastatic tumors that had been treated initially elsewhere. Thirty-three of these patients were able to be treated with curative intent: surgery, 21; surgery plus radiation, 9; radiation therapy alone, 2; and radiation plus chemotherapy, 1. The 5 year survival with no evidence of disease was achieved in three patients with surgery alone and two patients with surgery plus radiation therapy. The group of five patients was comprised of two patients with adenoid cystic carcinomas of the parotid, one with intermediate grade mucoepidermoid carcinoma of the parotid, one, sebaceous cell carcinoma of the parotid, and one, adenoid cystic carcinoma of an accessory salivary gland. The results of this study serve to re-emphasize the relative poor yield of attempts at retreatment of loco-regional recurrence of salivary gland tumors.

Rodriguez-Bigas MA; Sako K; Razack MS; Shedd DP; Bakamjian VY; Castillo NB; Rao U

1989-10-01

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Recurrent malignant salivary gland neoplasms.  

Science.gov (United States)

Recurrent salivary gland malignancies present difficult therapeutic decisions and poor prognosis in many instances, and treatment becomes of a palliative nature only. As many of the salivary gland malignancies we see are of the recurrent type, the following study was done to determine the efficacy of a vigorous attempt at retreatment. During the period January 1, 1960, through December 31, 1984, 352 patients with major and minor salivary gland tumors were evaluated at our institution. There were 149 benign lesions and 203 patients with malignant tumors. Of these, 99 patients had recurrent and metastatic tumors that had been treated initially elsewhere. Thirty-three of these patients were able to be treated with curative intent: surgery, 21; surgery plus radiation, 9; radiation therapy alone, 2; and radiation plus chemotherapy, 1. The 5 year survival with no evidence of disease was achieved in three patients with surgery alone and two patients with surgery plus radiation therapy. The group of five patients was comprised of two patients with adenoid cystic carcinomas of the parotid, one with intermediate grade mucoepidermoid carcinoma of the parotid, one, sebaceous cell carcinoma of the parotid, and one, adenoid cystic carcinoma of an accessory salivary gland. The results of this study serve to re-emphasize the relative poor yield of attempts at retreatment of loco-regional recurrence of salivary gland tumors. PMID:2796352

Rodriguez-Bigas, M A; Sako, K; Razack, M S; Shedd, D P; Bakamjian, V Y; Castillo, N B; Rao, U

1989-10-01

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[Malignant gynecologic neoplasms during menopause. Authors' experience  

UK PubMed Central (United Kingdom)

From January 1991 to December 1993 409 post-menopausal women were observed at the Center for the Study of Climateric Disorders of the Department of Obstetrics and Gynecology of the University of L'Aquila. The aim of the study was to evaluate the incidence of gynecologic neoplasm among this group of women. A total of 48 women at risk for malignant tumors were detected. The relationship between the climateric age and the oncologic risk is discussed.

Patacchiola F; Carta G; Mascaretti G; Di Stefano L; Panella A; Facioni L; Porzio G

1995-06-01

31

The Role of CD56, HBME-1, and p63 in Follicular Neoplasms of the Thyroid  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: Carcinomas originating from thyroid follicular cells are the commonest of all endocrine system malignancies. In this study we evaluated the importance of the expressions of CD 56, HBME-1 and p63 in the differential diagnosis of the follicular variant of papillary carcinoma from other follicular neoplasms.Material and Method: We re-evaluated 80 cases of thyroid neoplasms, comprising 40 cases of follicular variant of papillary thyroid carcinoma and 40 cases of follicular neoplasm, diagnosed at Dicle University Medical School, Department of Pathology between 2005 and 2008. All neoplasms were stained with CD 56, HBME-1 and p 63 compared to each other. Statistical analysis was with Student's t test and the Yates corrected chi-square test.Result: There was no statistically significant difference in the expression of CD 56 between follicular neoplasms and papillary carcinomas, but HBME-1 and p63 expressions were statistically significantly different between these neoplasms (p=0.005, p=0.0001).Conclusion: The use of HBME-1 and p63 may be helpful in differentiating papillary carcinoma, particularly follicular variant, from follicular neoplasms.

Hülya ETEM; Selver ÖZEK?NC?; Bülent MIZRAK; Senem ?ENTÜRK

2010-01-01

32

Cholesteryl esters in human malignant neoplasms.  

Science.gov (United States)

Cholesteryl esters (CholE) were detected in human malignant neoplasms by means of in vitro nuclear magnetic resonance spectroscopy. Spectroscopic analysis of the total lipid extracts obtained from cerebral tumors revealed appreciable amount of esterified cholesterol in high grade gliomas such as glioblastomas and anaplastic oligodendrogliomas, characterized by prominent neovascularity. The finding that no CholE were detected in the healthy brain and in low grade and benign tumors supports a possible correlation between this class of lipids and histological vascular proliferation. Compared with high grade gliomas, renal cell carcinomas show higher levels of CholE, absent in the healthy renal parenchyma and in benign oncocytomas. In nefro-carcinomas, cytoplasmic lipid inclusions and prominent vascularization contribute to the increased levels of CholE present mainly as oleate. CholE are discussed as potential biochemical markers of cancer and as a target for new therapeutic strategies. PMID:12469226

Tosi, M R; Bottura, G; Lucchi, P; Reggiani, A; Trinchero, A; Tugnoli, V

2003-01-01

33

[Thyroid nodule: benign or malignant?].  

UK PubMed Central (United Kingdom)

A thyroid nodule is a frequent occurrence. Its prevalence in a general adult population is about 50% and can even reach 67% when a cervical echography is performed. Only 5% of these nodules are cancers, and it is therefore important to avoid an useless and riskful surgery. This presentation is based on the Medical Guidelines for Clinical Practice: American Association of Clinical Endocrinologists (AACE), Associazione Medici Endocrinologi (AME) and European Thyroid Association (ETA) in 2010 for the Diagnosis and Management of Thyroid Nodules. In the absence of prospective randomized studies, these recommendations are established on the best evidence level. The patient history and clinical signs give some informations about potential risks. Thyroid tests not only evaluate thyroid functional status but TSH value and the presence of antithyroglobuline antibody seem to be associated with a higher risk of malignancy. A thyroid scintigraphy detects the presence of hot thyroid nodules. The thyroid echography is a key element before fine needle aspiration cytology. Some echographic criteria in the TIRADS (Thyroid Imaging Reporting and Data System), classification can reach an 88% sensitivity, a 49% specificity, a 49% positive predictive value, an 88% negative predictive value and a 94% diagnostic accuracy. The fine needle aspiration cytology performed with echography will be crucial to decide if the patient is to be eligible for surgery. In 70 to 80% of the cases, nodules can be classified as benign or malignant with a 92% negative predictive value for a benign diagnosis and a 100% positive predictive value for a diagnosis of cancer. The discovery of a follicular proliferation (cancer incidence of 20-30%) is a grey zone. Follicular proliferation and definite cancer lead of course to a surgical option. A decisional tree summarizes the different steps leading to a therapeutic decision.

Liénart F

2012-09-01

34

[Thyroid nodule: benign or malignant?].  

Science.gov (United States)

A thyroid nodule is a frequent occurrence. Its prevalence in a general adult population is about 50% and can even reach 67% when a cervical echography is performed. Only 5% of these nodules are cancers, and it is therefore important to avoid an useless and riskful surgery. This presentation is based on the Medical Guidelines for Clinical Practice: American Association of Clinical Endocrinologists (AACE), Associazione Medici Endocrinologi (AME) and European Thyroid Association (ETA) in 2010 for the Diagnosis and Management of Thyroid Nodules. In the absence of prospective randomized studies, these recommendations are established on the best evidence level. The patient history and clinical signs give some informations about potential risks. Thyroid tests not only evaluate thyroid functional status but TSH value and the presence of antithyroglobuline antibody seem to be associated with a higher risk of malignancy. A thyroid scintigraphy detects the presence of hot thyroid nodules. The thyroid echography is a key element before fine needle aspiration cytology. Some echographic criteria in the TIRADS (Thyroid Imaging Reporting and Data System), classification can reach an 88% sensitivity, a 49% specificity, a 49% positive predictive value, an 88% negative predictive value and a 94% diagnostic accuracy. The fine needle aspiration cytology performed with echography will be crucial to decide if the patient is to be eligible for surgery. In 70 to 80% of the cases, nodules can be classified as benign or malignant with a 92% negative predictive value for a benign diagnosis and a 100% positive predictive value for a diagnosis of cancer. The discovery of a follicular proliferation (cancer incidence of 20-30%) is a grey zone. Follicular proliferation and definite cancer lead of course to a surgical option. A decisional tree summarizes the different steps leading to a therapeutic decision. PMID:23091929

Liénart, F

2012-09-01

35

The cost of home care for patients with malignant neoplasms.  

Science.gov (United States)

A microeconomic study evaluated the health sector cost of home care in Greece for patients with malignant neoplasms. A cost-identification analysis was performed from the home care service's perspective. According to the results of the study, the cost varies among the main categories of malignant neoplasms because of a fluctuation in the cost of drugs, whereas the main cost-driver factor is the cost of laboratory tests. In comparison with the corresponding cost of in-hospital care, the cost of home care for patients with malignant neoplasms is significantly lower, which also is confirmed by the results of other international studies. PMID:19001914

Kouli, Eugenia; Kaitelidou, Daphne; Kalokerinou-Anagnostopoulou, Athena; Siskou, Olga

36

The cost of home care for patients with malignant neoplasms.  

UK PubMed Central (United Kingdom)

A microeconomic study evaluated the health sector cost of home care in Greece for patients with malignant neoplasms. A cost-identification analysis was performed from the home care service's perspective. According to the results of the study, the cost varies among the main categories of malignant neoplasms because of a fluctuation in the cost of drugs, whereas the main cost-driver factor is the cost of laboratory tests. In comparison with the corresponding cost of in-hospital care, the cost of home care for patients with malignant neoplasms is significantly lower, which also is confirmed by the results of other international studies.

Kouli E; Kaitelidou D; Kalokerinou-Anagnostopoulou A; Siskou O

2008-11-01

37

Current trend of malignant neoplasms among atomic bomb survivors  

International Nuclear Information System (INIS)

A survey was made on 7,589 admitted patients and 1,965 autopsy cases. The overall incidence of malignant neoplasms tended to decrease in the group exposed to atomic bomb within 2 km in autopsy cases and to increase in admitted patients. The incidence of pulmonary cancer tended to increase in both autopsy cases and admitted patients. The incidence of gastric cancer tended to increase up to 1975, and thereafter tended to decrease. The incidence of liver cancer tended to increase in both autopsy cases and admitted patients, which was marked in males. The incidence of leukemia was high in the group exposed to atomic bomb within 2 km in autopsy cases, and in the group within 1 km and the group which entered the city after the explosion in admitted patients. The incidence of malignant lymphoma tended to decrease, and the incidence of carcinoma of the colon tended to gradually increase in both autopsy cases and admitted patients. The incidence of multiple carcinomas tended to increase in both atomic bomb exposed group and non-exposed group, being higher in atomic bomb group than in non-exposed group. The incidence of breast cancer became constant since 1970. The incidence of carcinoma of the thyroid gland tended to decrease, although it was high in the group exposed near the explosion. (Namekawa, K.).

1984-01-01

38

Molecular pathology of chondroid neoplasms: part 2, malignant lesions  

Energy Technology Data Exchange (ETDEWEB)

This is the second part of a two-part review presenting an overview of the molecular findings associated with both benign and malignant chondroid neoplasms. The first part presented a brief review of modern methods in molecular pathology, along with a review of the cytogenetic and molecular genetic findings in benign chondroid neoplasms. This second part reviews the cytogenetic and molecular genetic findings in malignant chondroid neoplasms. Clinical aspects of the various lesions are briefly discussed, and each tumor is illustrated with representative radiographic and pathologic images. (orig.)

Bell, W.C. [University of Alabama at Birmingham, Department of Pathology, Birmingham, AL (United States); University of Alabama at Birmingham, Center for Metabolic Bone Disease, Birmingham, AL (United States); Klein, M.J. [University of Alabama at Birmingham, Center for Metabolic Bone Disease, Birmingham, AL (United States); University of Alabama at Birmingham, Department of Pathology, Birmingham, AL (United States); Pitt, M.J. [University of Alabama at Birmingham, Department of Diagnostic Radiology, Birmingham, AL (United States); University of Alabama at Birmingham, Center for Metabolic Bone Disease, Birmingham, AL (United States); Siegal, G.P. [University of Alabama at Birmingham, Departments of Pathology, Cell Biology, and Surgery, Birmingham, AL (United States); University of Alabama at Birmingham, Center for Metabolic Bone Disease, Birmingham, AL (United States)

2006-12-15

39

Malignant neoplasm rate in inhabitants of the Kozloduy NPP area  

International Nuclear Information System (INIS)

Illness incidence of malignant formations in lungs, mammary gland, thyroid gland, lymph and blood producing tissues is investigated in the 30 km area around Kozloduy and compared to data from two other locations in Bulgaria. The number of malignant growth in the lungs, mammary or thyroid gland on 100 000 persons is lower than the average number for the country as a whole. The number of malignant formations in lymph and blood producing tissues is higher than the average number for the country but the difference is statistically insignificant. Thyroid gland diseases occur with very small frequency for the investigated period (1985-1990). 8 refs., 4 figs.

1995-01-01

40

Morphological and immunohistochemical characterization of spontaneous thyroid gland neoplasms in guinea pigs (Cavia porcellus).  

UK PubMed Central (United Kingdom)

Reports of thyroid gland neoplasms in guinea pigs (Cavia porcellus) are rare, but thyroid tumors are among the most common neoplasms seen in cases submitted to Northwest ZooPath. This report describes the histological and immunohistochemical characteristics of thyroid neoplasms and lists the concurrent conditions found in guinea pig cases submitted to Northwest ZooPath during 1998 to 2008. Of 526 guinea pig case submissions, 19 had thyroid neoplasms. The most common clinical findings included a palpable mass on the ventral neck and progressive weight loss. Neoplasms were removed as an excisional biopsy from 7 guinea pigs, and 3 of these animals died within a few days after surgery. Radiographic mineral density was detected in 2 masses. Five of the neoplasms were reported as cystic; 5 were black or a dark color. Histologically, the neoplasms were classified as macrofollicular thyroid adenoma (8), thyroid cystadenoma (1), papillary thyroid adenoma (3), follicular thyroid carcinoma (5), follicular-compact thyroid carcinoma (1), and small-cell thyroid carcinoma (1). Osseous metaplasia was present in 8 neoplasms, and myeloid hyperplasia was present in 1 neoplasm. All 19 neoplasms were positive for thyroid transcription factor 1 and thyroglobulin but negative for parathyroid hormone and calcitonin. Numerous concurrent diseases, including hepatopathies, cardiomyopathies, and nephropathies, were present and considered to be the cause of death in many cases. Research is needed to determine the appropriate modalities for antemortem diagnosis and treatment and whether thyroid disease plays a role in the pathogenesis of chronic degenerative diseases in guinea pigs.

Gibbons PM; Garner MM; Kiupel M

2013-03-01

 
 
 
 
41

[The morbidity of malignant neoplasms in industrial metropolis].  

UK PubMed Central (United Kingdom)

The territorial characteristics of malignant neoplasms propagation was analyzed to reveal the risk factors concerning the population oncological morbidity in the City of Ufa. The data of accounting reporting documentation of the Bashkir republican oncological dispenser from 2000 to 2008 was used for analysis. The study revealed that in males and females the level of morbidity of oncological neoplasms is higher as compared with indicator's national level and continues to increase steadily factually in all oncological forms of this pathology.

Askarova ZF; Askarov RA; Tchuyenkova GA

2013-01-01

42

Thyroid cancer: a lethal endocrine neoplasm  

International Nuclear Information System (INIS)

This conference focuses on the controversies about managing thyroid cancer, emphasizing the possibility that the treatment of patients with potentially fatal thyroid cancer may be improved. Although the mortality rate from thyroid cancer is low, it is the highest among cancers affecting the endocrine glands (excluding the ovary). Exposure to radiation during childhood in the 1930s and 1940s increased the incidence of but not the mortality from thyroid cancer, because these tumors are mainly papillary cancers developing in young adults. These rates may change as the exposed cohort ages. Risk factors that increase mortality include older patient age and the growth characteristics of the tumor at diagnosis, the presence of distant metastases, and cell type (for example, the tall-cell variants of papillary cancer, follicular cancer [to be distinguished from the more benign follicular variant of papillary cancer], medullary cancer, and anaplastic cancer). Local metastases in lymph nodes do not seem to increase the risk for death from papillary cancer, but they do increase the risk for death from follicular and medullary cancer. In the latter, mortality is decreased by the early detection and treatment of patients with the familial multiple endocrine neoplasia syndrome 2a. There are excellent tumor markers for differentiated cancer of the parafollicular and of the follicular cells. Measuring the calcitonin level allows early diagnosis of familial medullary cancer, whereas measuring the thyroglobulin level, although useful only after total thyroidectomy, allows early recognition of recurrence or metastases of papillary or follicular cancer. Initial surgery, protocols for follow-up, and the use of radioiodine for the ablation of any residual thyroid and the treatment of metastatic cancer are discussed.128 references

1991-07-15

43

Second malignant neoplasms after treatment of childhood acute lymphoblastic leukemia.  

UK PubMed Central (United Kingdom)

PURPOSE: Second malignant neoplasms (SMNs) after diagnosis of childhood acute lymphoblastic leukemia (ALL) are rare events. PATIENTS AND METHODS: We analyzed data on risk factors and outcomes of 642 children with SMNs occurring after treatment for ALL from 18 collaborative study groups between 1980 and 2007. RESULTS: Acute myeloid leukemia (AML; n = 186), myelodysplastic syndrome (MDS; n = 69), and nonmeningioma brain tumor (n = 116) were the most common types of SMNs and had the poorest outcome (5-year survival rate, 18.1% ± 2.9%, 31.1% ± 6.2%, and 18.3% ± 3.8%, respectively). Five-year survival estimates for AML were 11.2% ± 2.9% for 125 patients diagnosed before 2000 and 34.1% ± 6.3% for 61 patients diagnosed after 2000 (P < .001); 5-year survival estimates for MDS were 17.1% ± 6.4% (n = 36) and 48.2% ± 10.6% (n = 33; P = .005). Allogeneic stem-cell transplantation failed to improve outcome of secondary myeloid malignancies after adjusting for waiting time to transplantation. Five-year survival rates were above 90% for patients with meningioma, Hodgkin lymphoma, thyroid carcinoma, basal cell carcinoma, and parotid gland tumor, and 68.5% ± 6.4% for those with non-Hodgkin lymphoma. Eighty-nine percent of patients with brain tumors had received cranial irradiation. Solid tumors were associated with cyclophosphamide exposure, and myeloid malignancy was associated with topoisomerase II inhibitors and starting doses of methotrexate of at least 25 mg/m(2) per week and mercaptopurine of at least 75 mg/m(2) per day. Myeloid malignancies with monosomy 7/5q- were associated with high hyperdiploid ALL karyotypes, whereas 11q23/MLL-rearranged AML or MDS was associated with ALL harboring translocations of t(9;22), t(4;11), t(1;19), and t(12;21) (P = .03). CONCLUSION: SMNs, except for brain tumors, AML, and MDS, have outcomes similar to their primary counterparts.

Schmiegelow K; Levinsen MF; Attarbaschi A; Baruchel A; Devidas M; Escherich G; Gibson B; Heydrich C; Horibe K; Ishida Y; Liang DC; Locatelli F; Michel G; Pieters R; Piette C; Pui CH; Raimondi S; Silverman L; Stanulla M; Stark B; Winick N; Valsecchi MG

2013-07-01

44

Primary mucosa-associated lymphoid tissue thyroid lymphoma: a rare thyroid neoplasm of extrathyroid origin  

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Primary thyroid lymphoma is a rare malignancy, representing 2-8% of all thyroid malignancies and 1-2% of all extranodal lymphomas. The majority of cases concern non-Hodgkin`s lymphoma of B cell origin, following by Hodgkin’s disease, T cell lymphomas and rarely marginal zone B-cell mucosa-associated...

Melpomeni Peppa; Panagiotis Nikolopoulos; Penelope Korkolopoulou; Dimitrios Lapatsanis; George Dimitriadis; Dimitrios Hadjidakis

45

Malignant pulmonary neoplasms causing airspace consolidation : CT findings  

International Nuclear Information System (INIS)

To determine the CT findings of consolidative malignant neoplasms of the lung. Seventeen patients in whom pulmonary consolidation was seen on chest radiography were involved in this study. In all cases malignancy was subsequently proven;the neoplasms involved were bronchioloalveolar carcinoma (n=9), malignant lymphoma (n=4), mucoepidermoid tumor (n=1), metastasis from colon cancer (n=2), and metastasis from pancreatic mucinous adenocarcinoma (n=1). CT images were retrospectively analyzed in terms of enhancement pattern of the consolidation, morphologic appearance of an air-bronchogram, CT angiogram sign, pseudocavitation, and lymphadenopathy. Visually assessed enhancement pattern of the consolidation showed lower attenuation than adjacent muscles in bronchioloalveolar carcinoma (8/9) and metastasis (1/3);isoattenuation in malignant lymphoma (3/4), mucoepidermoid carcinoma (1/1), and metastasis (1/3); and higher attenuation in bronchioloalveolar carcinoma (1/9), malignant lymphoma (1/4), and metastasis (1/3). Among the 15 of 17 patients for whom an airbronchogram was available, a stretching and squeezing pattern was seen in bronchioloalveolar carcinoma (4/9), malignant lymphoma (3/4), and metastasis (1/3). CT angiogram sign was identified in bronchioloalveolar carcinoma (5/9), malignant lymphoma (2/4), and metastasis (3/3). Pseudocavitation was observed in two patients with bronchioloalveolar carcinoma, while lymphadenopathy was seen in bronchioloalveolar carcinoma (4/9), malignant lymphoma (3/4), and metastasis (1/3). Conglomerate and extrathoracic lymphadenopathy are commonly associated with malignant lymphoma. Malignant neoplasms which apper as consolidative lung lesions appear not only as bronchioloalveolar carcinoma, which is well known, but also in other forms. Although these lesions cannot be differentiated on the basis of air-bronchography and CT angiography, poor enhancement of consolidative lesion and pseudocavitation are characteristic findings of bronchioloalveolar carcinoma, and conglomerate or extrathoracic lymphadenopathy are also characteristic of malignant lymphoma

1999-01-01

46

Malignant pulmonary neoplasms causing airspace consolidation : CT findings  

Energy Technology Data Exchange (ETDEWEB)

To determine the CT findings of consolidative malignant neoplasms of the lung. Seventeen patients in whom pulmonary consolidation was seen on chest radiography were involved in this study. In all cases malignancy was subsequently proven;the neoplasms involved were bronchioloalveolar carcinoma (n=9), malignant lymphoma (n=4), mucoepidermoid tumor (n=1), metastasis from colon cancer (n=2), and metastasis from pancreatic mucinous adenocarcinoma (n=1). CT images were retrospectively analyzed in terms of enhancement pattern of the consolidation, morphologic appearance of an air-bronchogram, CT angiogram sign, pseudocavitation, and lymphadenopathy. Visually assessed enhancement pattern of the consolidation showed lower attenuation than adjacent muscles in bronchioloalveolar carcinoma (8/9) and metastasis (1/3);isoattenuation in malignant lymphoma (3/4), mucoepidermoid carcinoma (1/1), and metastasis (1/3); and higher attenuation in bronchioloalveolar carcinoma (1/9), malignant lymphoma (1/4), and metastasis (1/3). Among the 15 of 17 patients for whom an airbronchogram was available, a stretching and squeezing pattern was seen in bronchioloalveolar carcinoma (4/9), malignant lymphoma (3/4), and metastasis (1/3). CT angiogram sign was identified in bronchioloalveolar carcinoma (5/9), malignant lymphoma (2/4), and metastasis (3/3). Pseudocavitation was observed in two patients with bronchioloalveolar carcinoma, while lymphadenopathy was seen in bronchioloalveolar carcinoma (4/9), malignant lymphoma (3/4), and metastasis (1/3). Conglomerate and extrathoracic lymphadenopathy are commonly associated with malignant lymphoma. Malignant neoplasms which apper as consolidative lung lesions appear not only as bronchioloalveolar carcinoma, which is well known, but also in other forms. Although these lesions cannot be differentiated on the basis of air-bronchography and CT angiography, poor enhancement of consolidative lesion and pseudocavitation are characteristic findings of bronchioloalveolar carcinoma, and conglomerate or extrathoracic lymphadenopathy are also characteristic of malignant lymphoma.

Kim, Bong Soo; Park, Choong Ki; Kim, Kwon Hyung; Bae, Jae Ik; Park, Dong Woo; Kim, Yong Soo; Choi, Yo Won; Jeon, Seok Chol; Hahm, Chang Kok [Hanyang Univ. College of Medicine, Seoul (Korea, Republic of); Baek, Jung Hwan [Dae Rim St. Mary' s Hospital, Seoul (Korea, Republic of)

1999-11-01

47

Actinomycosis of the parotid masquerading as malignant neoplasm.  

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Abstract Background Primary actinomycosis of the parotid gland is of rare occurrence and can mimic a malignant neoplasm both clinically as well as radiologically. Case presentation We present here a case of primary actinomycosis of the parotid gland presenting with a p...

Varghese Bipin T; Sebastian Paul; Ramachandran K; Pandey Manoj

48

[DNA content analysis in thyroid neoplasms: diagnostic and prognostic interest].  

Science.gov (United States)

Thyroid nodules are frequent and sometimes they pose a diagnostic and prognostic problem. DNA ploidy study and cell cycle analysis could be of value in the distinction between benign tumors and malignant tumors. Formalin-fixed and paraffin-embedded tissues from 69 patients with different benign and neoplastic lesions were investigated. Nuclear DNA content in thyroid cells was measured after Feulgen staining using SAMBA 200 image analysis system. A diploid DNA stemline was revealed in 75% of histologically proven benign thyroid tumors (15/20) and aneuploidy was found in 57.2% of malignant tumors (28/49). There is a significant correlation between aneuploidy and extra-thyroid extension (p=0.007) and bilateral and/or mediastinal lymph node metastasis (p=0.02). In the majority of benign tumors (19/20), the proliferation index was lower than 3% (3%) in more than 83% of malignant tumors (41/49) (p<0.001). The S phase fraction analysis revealed that the threshold of 14% divide the near whole of benign and malignant tumors (p<0.001). Our findings show that in follicular lesions, proliferation index and S phase fraction study appears interesting and helpful in the distinction between benign and malignant tumors, and aneuploidy seems more interesting in prognosis evaluation of these tumors. PMID:16392183

Missaoui, N; Hmissa, S; Mokni, M; Trabelsi, A; Trimech, M; Lagueb, I; Yacoubi, M T; Sriha, B; Korbi, S

2005-09-01

49

Malignant thyroid bed mass after total thyroidectomy  

Science.gov (United States)

Purpose Ultrasonographic (US) criteria on malignant thyroid bed mass have been suggested, including taller than wide shape, loss of echogenic hilum, abnormal vascularity, and microcalcification. The relationship between fine-needle aspiration (FNA) cytology findings and US findings on thyroid bed mass is unknown. We have retrospectively assessed the malignant thyroid bed mass after total thyroidectomy due to papillary thyroid carcinoma (PTC). Methods We retrospectively evaluated 2,048 patients who underwent total thyroidectomy due to PTC. FNA was performed in 97 patients on the thyroid bed under US surveillance. The 97 suspicious thyroid bed masses were divided into two groups: metastatic thyroid bed group (n = 34) and nonmetastatic group (n = 63). The groups were evaluated according to various clinical, serologic, and US findings. Results Within a median 47.0 months of follow-up, the proportion of malignant thyroid bed mass was high in large tumor size (1.37 cm vs. 1.03 cm), isthmic position (10.3% vs. 3.9%), and previous N1a (55.9% vs. 34.9%). US findings revealed that the presence of microcalcification or macrocalcification (47.1% vs. 19.0%) and thyroid bed mass height (5.4 mm vs. 3.9 mm) were the only discriminable criteria for central compartment recurrence. But, degree of echogenicity, loss of hilum, and irregularity of margin failed to discriminate malignant thyroid bed mass. Conclusion US findings on malignant thyroid bed mass were different from previously reported general criteria on lateral metastatic nodes. Additional FNA cytology should be performed on patients, even low-risk patients, who present the above findings.

Park, Do Sung; Park, Min Ho; Ryu, Young Jae; Hwang, Min Jung; Shin, Sun Hyung; Kim, Hee Kyung; Lim, Hyo Soon; Lee, Ji Shin; Yoon, Jung Han

2013-01-01

50

Primary mucosa-associated lymphoid tissue thyroid lymphoma: a rare thyroid neoplasm of extrathyroid origin  

Directory of Open Access Journals (Sweden)

Full Text Available Primary thyroid lymphoma is a rare malignancy, representing 2-8% of all thyroid malignancies and 1-2% of all extranodal lymphomas. The majority of cases concern non-Hodgkin`s lymphoma of B cell origin, following by Hodgkin’s disease, T cell lymphomas and rarely marginal zone B-cell mucosa-associated lymphoid tissue (MALT) lymphomas. MALT lymphomas have been associated with long-standing autoimmune Hashimoto`s thyroiditis. We present the case of a 44-years-old woman with thyroid MALT lymphoma in the background of multinodular goiter of autoimmune origin.

Melpomeni Peppa; Panagiotis Nikolopoulos; Penelope Korkolopoulou; Dimitrios Lapatsanis; George Dimitriadis; Dimitrios Hadjidakis; Sotirios A. Raptis

2012-01-01

51

Unusual malignant tumors of the thyroid gland.  

UK PubMed Central (United Kingdom)

BACKGROUND: Although situated on the last places among the statistical hierarchy of human malignancies, thyroid cancers (TC) are the most common tumors of the endocrine system. Follicular epithelium neoplasms account for more than 90% of these lesions with a favourable prognosis, while resting tumors (medullary, anaplastic, lymphoma, sarcoma etc) generally present a rapid unfavorable evolution with a low rate of survival. PATIENTS AND METHODS: In a series of 464 thyropathies personally treated, 72 cases of TC (15.5%) were identified. Fifty-seven patients presented epithelial TC a 34 papillary variant, 20 follicular variant and 8 mixed forms. Alongside these there were two medullary TC, 9 anaplastic TC and insular TC, and primary lymphoma and metastasis to the thyroid of a lung carcinoma each single case. Four cases have been described in patients who were aged 2-6 years at the time of the Chernobyl disaster. Out of the common types, based on our own taxonomic criteria, we selected a group of 36 TC with unusual clinical, histological and behavioural characteristics or particular pathological associations. Results: Seven cases of occult TC, 7 cases with precessive adenopathy TC and 11 patients with TC associated with hyperthyroidism were registered. All of them underwent adapted thyroidectomies in which the presence of cancer was decisive for the extent of surgery. Medullary, insular and anaplastic TC were the most aggressive lesions and even extended surgery and complementary therapy failed to improve the prognosis of these patients. In the same category we included the cases presenting the coexistence of two TC types, pathologic dedifferentiation in recurrences and concurrent presence of another endocrine or nonendocrine cervical lesion. The a surgical dogma of total thyroidectomy cannot always be respected, so complementary therapeutic solutions must be applied. Results were complex, registering steady recoveries in occult, hyperfunctioning and even in coexisting pathological lesions, but many recurrences and reinterventions with poor survival rates (a few weeks up to 2 years) in cases with reduced or absent histologic differentiation were also noted. Some lesions were inoperable. Discussions and conclusions: Increasing clinician, surgeon and pathologist awareness of these distinct, but not rare anatomoclinical contingencies could contribute to their adequate diagnosis and treatment. Recent progress in knowledge of molecular carcinogenesis and promising successes of targeted chemotherapy trials with new drugs offer promising perspectives in the management of advanced or metastatic TC. Surgery still remains the cornerstone treatment for thyroid cancers.

Diaconescu MR; Costea I; Glod M; Grigorovici M; Diaconescu S

2013-07-01

52

Original paper Thyroid neoplasms – errors of the cytological diagnosis  

Directory of Open Access Journals (Sweden)

Full Text Available Objectives: the evaluation of the diagnostic value of a cytological examination and its limitations for the diagnosis of thyroid neoplasms.Material and methods: From 1995 to 2004 nine hundred ninety eight patients were operated on for nodular lesions of the thyroid gland in our department. Cytological and histopathologic diagnoses were compared retrospectively in all cases where a neoplasm was suspected (true positive, false negative and false positive diagnoses). The verification was carried out independently by two pathologists. It enabled the establishment of interpretation errors (IE). The cases where cytological and histopathologic diagnoses were incompatible were interpreted as a sampling error (SE).Results: As a result of the verification 45 cytological and histopathologic diagnoses were changed compared with the primary ones. In the analysed material the following diagnoses were put: true positive – 144, true negative – 824, false positive – 12, false negative – 18. The sensitivity of FNAB was 0.89, specificity 0.99, accuracy 0.97 and a positive predictive diagnostic value 0.92. False cytological diagnoses were found in 75 cases (7.5%). In 45 cases (4.5%) a diagnosis was changed compared with a primary one – interpretation error. In the remaining 30 cases (3%) a false diagnosis was caused by a sampling error. Conclusions: FNAB is an examination of high diagnostic value for the detection of thyroid neoplasms in the hands of an experienced pathologist. False cytological diagnoses comprised only a small part (7.5%) of their total number and were caused by interpretation error in 4.5% and by sampling error in 3.0%. The percentage of interpretation errors can be decreased by a multiple independent assessment of samples.

S?awomir Jab?o?ski; Jacek Kordiak; Mariusz Bella; Krzysztof W?odzimierz Zieli?ski; Zbigniew Jab?onowski; Edyta Santorek; Jacek Rysz

2005-01-01

53

Surveillance following head, neck, and chest radiotherapy: thyroid ultrasound monitoring for secondary thyroid malignancy.  

UK PubMed Central (United Kingdom)

Children who receive head, neck, or chest radiotherapy for various primary malignancies have increased risk for secondary thyroid malignancy. Thyroid nodules are difficult to identify by physical examination and/or laboratory tests. Thyroid ultrasound can detect non-palpable nodules without adverse side effects. We performed a retrospective chart review of 36 patients who received radiotherapy and underwent thyroid ultrasound. Forty-seven percent (n = 17) had ?1 nodule(s) detected. Seven patients underwent thyroidectomy; four of whom were diagnosed with thyroid malignancy. Our study suggests routine use of thyroid ultrasound in high-risk patients detects subclinical thyroid nodules and potential thyroid malignancy post-radiotherapy.

Kelly C; Rivard L; Salvi S; Hayani A; Hopkins W; O'Brien S; Martin L; Canner J

2013-01-01

54

Cost Effectiveness of Intraoperative Pathology Examination during Diagnostic Hemithyroidectomy for Unilateral Follicular Thyroid Neoplasms.  

UK PubMed Central (United Kingdom)

BACKGROUND: The use of intraoperative pathology examination (IPE) during diagnostic hemithyroidectomy for a follicular neoplasm is controversial. Although this service rarely alters intraoperative decision making, it does provide patients with the possibility of avoiding reoperation for completion thyroidectomy if malignancy is detected. We hypothesized diagnostic hemithyroidectomy with IPE for a unilateral follicular thyroid neoplasm diagnosed on fine-needle aspiration is not cost effective compared with diagnostic hemithyroidectomy alone. STUDY DESIGN: Cost-effectiveness analysis with a Markov decision model was performed comparing diagnostic hemithyroidectomy without IPE, diagnostic hemithyroidectomy with IPE, and total thyroidectomy. Treatment outcomes and their probabilities were identified based on literature review. Costs were estimated using data from Medicare, the US Bureau of Labor Statistics, and the Nationwide Inpatient Sample. Sensitivity analysis and a 1,000-iteration Monte Carlo simulation were used to examine the uncertainty of cost, probability, and utility estimates in the model. RESULTS: Diagnostic hemithyroidectomy without IPE had an expected cost of US$7,665 and an effectiveness of 23.95 quality-adjusted life years and dominated both the IPE and total thyroidectomy strategies. Intraoperative pathology examination became cost effective during one-way sensitivity analysis if the sensitivity of IPE increased from 14.3% to 34.4%, the specificity increased from 98.6% to 99.8%, or the pretest probability of malignancy increased from 25% to 43%. Monte Carlo simulation demonstrated that the intraoperative pathology strategy was not cost effective in 92.7% of iterations. CONCLUSIONS: Intraoperative pathology examination is not cost effective in the diagnosis of follicular thyroid neoplasms during diagnostic hemithyroidectomy. Improvements in both the sensitivity and specificity of this service would be needed to justify its use.

Zanocco K; Heller M; Elaraj D; Sturgeon C

2013-06-01

55

Actinomycosis of the parotid masquerading as malignant neoplasm.  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Primary actinomycosis of the parotid gland is of rare occurrence and can mimic a malignant neoplasm both clinically as well as radiologically. Case presentation We present here a case of primary actinomycosis of the parotid gland presenting with a parotid mass lesion with erosion of skull bones. Conclusions Clinical presentation of cervico-facial actinomycosis is characterized by the presence of a suppurative or indurative mass with discharging sinuses. The lesion demonstrates characteristic features on fine needle aspiration cytology and histology, however at times the findings are equivocal.

Varghese Bipin T; Sebastian Paul; Ramachandran K; Pandey Manoj

2004-01-01

56

Four primary malignant neoplasms in a single patient  

Energy Technology Data Exchange (ETDEWEB)

A 60-year-old Caucasian male, with a previous history of a 10-year occupational exposure to ionizing radiation, chemical carcinogens, and a long history of tobacco and alcohol abuse, developed synchronous squamous cell carcinoma of the floor of the mouth and adenocarcinoma of the lung. Four years later, squamous cell carcinoma of the larynx followed by squamous cell carcinoma of the tongue were diagnosed. In this case report, we suggest that increased exposure to multiple carcinogenic factors may result in an increased incidence of both synchronous and metachronous primary malignant neoplasms.

Craig, D.M.; Triedman, L.J.

1986-05-01

57

Malignant thymic neoplasms that may mimic benign conditions.  

UK PubMed Central (United Kingdom)

The thymus is a complex, highly specialized organ that is derived from the third and fourth pharyngeal pouches and contains elements that originate from all three germinal layers. As such, it shows certain specific and distinctive reaction patterns to injury that are frequently encountered in a variety of reactive and inflammatory conditions. These reaction patterns, however, can also often be associated with neoplastic diseases arising from this organ, and in some instances, their presence may contribute to obscure the malignant nature of the underlying process. We present a review of the main tumor entities that may be mistaken for benign conditions of the thymus, with emphasis on the three major reaction patterns to injury that may be associated with malignant neoplasms of this organ: prominent cystic changes, stromal fibrosis, and reactive and hyperplastic changes of thymic epithelium. Histologic clues helpful for diagnosis and the differential diagnosis of these lesions are discussed.

Suster S; Moran CA

1995-02-01

58

Pancreatic Cystic Neoplasms: Predictors of Malignant Behavior and Management  

Science.gov (United States)

Background/Aim: Pancreatic cystic neoplasms are being increasingly identified with the widespread use of advanced imaging techniques. In the absence of a good radiologic or pathologic test to preoperatively determine the dianosis, clinical characteristics might be helpful. The objectives of this analysis were to define the incidence and predictors of malignancy in pancreatic cysts. Patients and Methods: Patients with true pancreatic cysts who were treated at our institution were included. Patients with documented pseudocysts were excluded. Demographic data, clinical manifestations, radiological, surgical, and pathological records of those patients were reviewed. Results: Eighty-one patients had true pancreatic cyst. The mean age was 47 ± 15.5 years. There were 28.4% serous cystadenoma, 21% mucinous cystadenoma, 6.2% intraductal papillary tumors, 8.6% solid pseudopapillary tumors, 1.2% neuroendocrinal tumor, 3.7% ductal adenocarcinoma, and 30.9% mucinous cystadenocarcinoma. Malignancy was significantly associated with men (P = 0.04), older age (0.0001), cysts larger than 3 cm in diameter (P = 0.001), presence of solid component (P = 0.0001), and cyst wall thickening (P = 0.0001). The majority of patients with malignancy were symptomatic (26/28, 92.9%). The symptoms that correlated with malignancy included abdominal pain (P = 0.04) and weight loss (P = 0.0001). Surgical procedures were based on the location and extension of the lesion. Conclusion: The most common pancreatic cysts were serous and mucinous cysts. These tumors were more common in females. Old age, male gender, large tumor, presence of solid component, wall thickness, and presence of symptoms may predict malignancy in the cyst.

Atef, Ehab; El Nakeeb, Ayman; El Hanafy, Ehab; El Hemaly, Mohamed; Hamdy, Emad; El-Geidie, Ahmed

2013-01-01

59

Thallium 201 thyroid scan: differential diagnosis of benign and malignant nodules  

International Nuclear Information System (INIS)

[en] To evaluate useful findings and diagnostic value of TI-201 thyroid scan in differentiating benign from malignant nodules. We studied 77 cold thyroid nodules proven histologically(27 malignant and 50 benign). Early (5-15 min) and delayed images(3-5 hours) were obtained after intravenous injection of thallium 201. In these nodules, we retrospectively analyzed the degree of TI-201 uptake in early and delayed images, histopathologic type, size, and presence or absence of cystic change in the sonograms of 22 malignant nodules. Useful finding for diagnosis of malignant nodules was strong uptake of TI-201 in early and delayed images(specificity: 98%, sensitivity: 63%, positive predictive value: 94.4%). Useful finding for benign nodules was no uptake of TI-201 in delayed image(specificity: 88.9%, sensitivity: 68%, positive predictive value: 91.9%). The accuracy of TI-201 thyroid scan in differentiating benign from malignant nodules was 66.2%. The nodules with strong TI-201 uptake in early image and low TI-201 uptake in delayed image were malignant in 29.4%. Cystic changes were found in 40% of malignant nodules with atypical TI-201 uptake. TI-201 thyroid scan showed high specificity in follicular neoplasm and adenomatous goiter in which differentiation of benignancy and malignancy is difficult with only cytologic examination. We consider that TI-201 thyroid scan is valuable in differentiating benign from malignant nodules and when combined with fine needle aspiration and ultrasound examination, it will enable more accurate differential diagnosis between benign and malignant thyroid nodules

1995-01-01

60

Thallium 201 thyroid scan: differential diagnosis of benign and malignant nodules  

Energy Technology Data Exchange (ETDEWEB)

To evaluate useful findings and diagnostic value of TI-201 thyroid scan in differentiating benign from malignant nodules. We studied 77 cold thyroid nodules proven histologically(27 malignant and 50 benign). Early (5-15 min) and delayed images(3-5 hours) were obtained after intravenous injection of thallium 201. In these nodules, we retrospectively analyzed the degree of TI-201 uptake in early and delayed images, histopathologic type, size, and presence or absence of cystic change in the sonograms of 22 malignant nodules. Useful finding for diagnosis of malignant nodules was strong uptake of TI-201 in early and delayed images(specificity: 98%, sensitivity: 63%, positive predictive value: 94.4%). Useful finding for benign nodules was no uptake of TI-201 in delayed image(specificity: 88.9%, sensitivity: 68%, positive predictive value: 91.9%). The accuracy of TI-201 thyroid scan in differentiating benign from malignant nodules was 66.2%. The nodules with strong TI-201 uptake in early image and low TI-201 uptake in delayed image were malignant in 29.4%. Cystic changes were found in 40% of malignant nodules with atypical TI-201 uptake. TI-201 thyroid scan showed high specificity in follicular neoplasm and adenomatous goiter in which differentiation of benignancy and malignancy is difficult with only cytologic examination. We consider that TI-201 thyroid scan is valuable in differentiating benign from malignant nodules and when combined with fine needle aspiration and ultrasound examination, it will enable more accurate differential diagnosis between benign and malignant thyroid nodules.

Oh, Jong Sub; Kim, Byong Geun; Park, Byung Ran; Kim, Se Jong; Ko, Kang Seok; Kim, Min Joong; Ji, Joo Yun [Kwangju Chrastian Hospital, Kwangju (Korea, Republic of)

1995-07-15

 
 
 
 
61

Autopsy findings of malignant neoplasms treated with radiation  

Energy Technology Data Exchange (ETDEWEB)

Autopsy findings in 26 cases of malignant neoplasms treated with radiation were analysed and following results were obtained. 1. Causes of death except for neoplastic extension were 58% (15/26) and infection was the single predominant cause of death (73% : 11/15) with 50% (4/8) in lung cancer. 2. Distant metastases were found in 73% (19/26). In 7 cases, no obvious metastasis was found before and after autopsy. On the other hand, the patients with metastases over 2 organs before autopsy revealed metastases in 82% (9/11) to the other organs at autopsy. 3. Radiation therapy was effective and the primary tumor disappeared completely in 71% (10/14) with curative irradiation. In metastatic lesions, tumor cells were almost disappeared with dosage over 40 Gy.

Okazaki, Atsushi; Ito, Jun; Tatezawa, Takashi; Nishimura, Toshinobu; Niibe, Hideo

1984-11-01

62

Galectin-3 immunostaining in thyroid neoplasms Imunomarcação por galectina-3 em neoplasias de tireóide  

Directory of Open Access Journals (Sweden)

Full Text Available Although fine-needle aspiration biopsy (FNAB) of the thyroid gland is the most important presurgical proceeding in defining the malignancy of a nodular lesion, it has limitations such as shared cytological morphology between malignant and benign lesions. Galectin-3, a b-galactoside-binding lectin is expressed mainly by malignant thyroid neoplasms. Fifty-seven specimens, including 14 papillary carcinomas, 22 follicular carcinomas and 21 follicular adenomas were tested for immunohistochemical staining against galectin-3. Normal thyroid adjacent to neoplastic tissue was also examined in 48 cases. All cases of papillary carcinoma were cytoplasmic stained, 18 cases of follicular carcinoma were cytoplasmic stained, and one case of follicular adenoma showed nuclear staining. No case of normal thyroid showed immunoreactivity. Sensitivity, specificity, positive predictive value and negative predictive value were respective 88%, 98%, 96%, and 94%. Galectin-3 expression is a valuable evidence of malignancy in cases where cytomorphological features are not conclusive. This immunomediated method could increase diagnosis accuracy for FNAB, thus making surgery indication more precise.A punção aspirativa por agulha fina de tireóide é o método pré-cirúrgico mais importante na definição da malignidade de uma lesão nodular. Entretanto esse procedimento apresenta limitações, como características morfológicas comuns entre neoplasias malignas e benignas. A expressão de uma lectina ligante de b-galactosídeos chamada galectina-3, aumentada em neoplasias malignas de tireóide, poderia ser utilizada como marcador de malignidade para neoplasias de tireóide. Cinqüenta e sete casos, entre eles 14 carcinomas papilares, 22 carcinomas foliculares e 21 adenomas foliculares, foram estudados quanto à expressão da galectina-3 por métodos imuno-histoquímicos. O tecido tireoidiano normal, adjacente ao tecido neoplásico, também foi avaliado em 48 casos. Todos os casos de carcinoma papilar e 18 casos de carcinoma folicular apresentaram marcação citoplasmática; um caso de adenoma folicular apresentou marcação nuclear. Nenhum caso de tecido tireoidiano normal demonstrou imunomarcação. Sensibilidade, especificidade, valor preditivo positivo e negativo foram respectivamente 88%, 98%, 96% e 94%. A expressão da galectina-3 é uma evidência valiosa de malignidade nos casos em que as características citomorfológicas não forem conclusivas. A marcação por imunocitoquímica poderá aumentar a exatidão diagnóstica nos exames citológicos por aspiração de tireóide, tornando a indicação cirúrgica mais precisa.

Marcos Emanuel de Alcântara Segura; Albino Verçosa de Magalhães

2005-01-01

63

Galectin-3 immunostaining in thyroid neoplasms/ Imunomarcação por galectina-3 em neoplasias de tireóide  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese A punção aspirativa por agulha fina de tireóide é o método pré-cirúrgico mais importante na definição da malignidade de uma lesão nodular. Entretanto esse procedimento apresenta limitações, como características morfológicas comuns entre neoplasias malignas e benignas. A expressão de uma lectina ligante de b-galactosídeos chamada galectina-3, aumentada em neoplasias malignas de tireóide, poderia ser utilizada como marcador de malignidade para neoplasias de (more) tireóide. Cinqüenta e sete casos, entre eles 14 carcinomas papilares, 22 carcinomas foliculares e 21 adenomas foliculares, foram estudados quanto à expressão da galectina-3 por métodos imuno-histoquímicos. O tecido tireoidiano normal, adjacente ao tecido neoplásico, também foi avaliado em 48 casos. Todos os casos de carcinoma papilar e 18 casos de carcinoma folicular apresentaram marcação citoplasmática; um caso de adenoma folicular apresentou marcação nuclear. Nenhum caso de tecido tireoidiano normal demonstrou imunomarcação. Sensibilidade, especificidade, valor preditivo positivo e negativo foram respectivamente 88%, 98%, 96% e 94%. A expressão da galectina-3 é uma evidência valiosa de malignidade nos casos em que as características citomorfológicas não forem conclusivas. A marcação por imunocitoquímica poderá aumentar a exatidão diagnóstica nos exames citológicos por aspiração de tireóide, tornando a indicação cirúrgica mais precisa. Abstract in english Although fine-needle aspiration biopsy (FNAB) of the thyroid gland is the most important presurgical proceeding in defining the malignancy of a nodular lesion, it has limitations such as shared cytological morphology between malignant and benign lesions. Galectin-3, a b-galactoside-binding lectin is expressed mainly by malignant thyroid neoplasms. Fifty-seven specimens, including 14 papillary carcinomas, 22 follicular carcinomas and 21 follicular adenomas were tested for (more) immunohistochemical staining against galectin-3. Normal thyroid adjacent to neoplastic tissue was also examined in 48 cases. All cases of papillary carcinoma were cytoplasmic stained, 18 cases of follicular carcinoma were cytoplasmic stained, and one case of follicular adenoma showed nuclear staining. No case of normal thyroid showed immunoreactivity. Sensitivity, specificity, positive predictive value and negative predictive value were respective 88%, 98%, 96%, and 94%. Galectin-3 expression is a valuable evidence of malignancy in cases where cytomorphological features are not conclusive. This immunomediated method could increase diagnosis accuracy for FNAB, thus making surgery indication more precise.

Segura, Marcos Emanuel de Alcântara; Magalhães, Albino Verçosa de

2005-10-01

64

Malignant nerve-sheath neoplasms in neurofibromatosis: distinction from benign tumors by using imaging techniques  

Energy Technology Data Exchange (ETDEWEB)

Malignant peripheral nerve-sheath neoplasms frequently complicate neurofibromatosis causing pain, enlarging masses, or neurologic deficits. However, similar findings sometimes also occur with benign nerve neoplasms. Our study was done retrospectively to determine if imaging techniques can differentiate malignant from benign nerve tumors in neurofibromatosis. Eight patients with symptomatic neoplasms (three benign, five malignant) were studied by CT in eight, MR in six, and /sup 67/Ga-citrate scintigraphy in seven. Uptake of /sup 67/Ga occurred in all five malignant lesions but not in two benign neoplasms studied. On CT or MR, all eight lesions, including three benign neoplasms, showed inhomogeneities. Of five lesions with irregular, infiltrative margins on CT or MR, four were malignant and one was benign. Of three lesions with smooth margins, one was malignant and two were benign. One malignant neoplasm caused irregular bone destruction. Accordingly, CT and MR could not generally distinguish malignant from benign lesions with certainty. However, both CT and MR provided structural delineation to help surgical planning for both types of lesion. /sup 67/Ga scintigraphy appears promising as a screening technique to identify lesions with malignant degeneration in patients with neurofibromatosis. Any area of abnormal radiogallium uptake suggests malignancy warranting further evaluation by CT or MR. Biopsy of any questionable lesion is essential.

Levine, E.; Huntrakoon, M.; Wetzel, L.H.

1987-11-01

65

Malignant nerve-sheath neoplasms in neurofibromatosis: distinction from benign tumors by using imaging techniques  

International Nuclear Information System (INIS)

[en] Malignant peripheral nerve-sheath neoplasms frequently complicate neurofibromatosis causing pain, enlarging masses, or neurologic deficits. However, similar findings sometimes also occur with benign nerve neoplasms. Our study was done retrospectively to determine if imaging techniques can differentiate malignant from benign nerve tumors in neurofibromatosis. Eight patients with symptomatic neoplasms (three benign, five malignant) were studied by CT in eight, MR in six, and 67Ga-citrate scintigraphy in seven. Uptake of 67Ga occurred in all five malignant lesions but not in two benign neoplasms studied. On CT or MR, all eight lesions, including three benign neoplasms, showed inhomogeneities. Of five lesions with irregular, infiltrative margins on CT or MR, four were malignant and one was benign. Of three lesions with smooth margins, one was malignant and two were benign. One malignant neoplasm caused irregular bone destruction. Accordingly, CT and MR could not generally distinguish malignant from benign lesions with certainty. However, both CT and MR provided structural delineation to help surgical planning for both types of lesion. 67Ga scintigraphy appears promising as a screening technique to identify lesions with malignant degeneration in patients with neurofibromatosis. Any area of abnormal radiogallium uptake suggests malignancy warranting further evaluation by CT or MR. Biopsy of any questionable lesion is essential

1987-01-01

66

Differential expression of Galectin-3 in papillary projections of malignant and non-malignant hyperplastic thyroid lesions  

Directory of Open Access Journals (Sweden)

Full Text Available Galectin-3 is a a beta-galactoside binding protein recently proposed to be a promising presurgical molecular marker for distinguishing benign from malignant thyroid neoplasms. We analyzed galectin-3 expression immunohistochemically in papillary areas of hyperplastic lesions of benign thyroid tissue in comparison with malignant papillary projections of papillary thyroid carcinoma (PTC). A monoclonal antibody to galectin-3 and ABC immunohistochemical technique were used to evaluate galectin-3 expression in 26 cases of benign papillary hyperplasia (8 cases of hyperplastic adenoma, 8 cases of hyperplastic colloid goiter, 10 cases of Graves disease) in comparison with 25 cases of PTC. Immunohistochemical results showed no reactivity for galectin-3 in papillary areas of benign hyperplastic lesions. Strong cytoplasmic galectin-3 immunoreactivity was found in all 25 cases of PTC. These results show that galectin-3 expression is a feature of malignant papillary projections but not of benign papillary hyperplasia. Thus, the immunohistochemical evaluation of galectin-3 might contribute to differential diagnosis between malignant and benign thyroid lesions with papillary projections.

Cveji? Dubravka S.; Savin-Žegarac Svetlana B.; Petrovi? Ivana M.; Paunovi? Ivan R.; Tati? Svetislav B.; Havelka Marija J.

2003-01-01

67

Thyroidal malignancy and scintigraphy; Schilddrsenmalignitaet und Szintigrafie  

Energy Technology Data Exchange (ETDEWEB)

Thyroid hypofunctional ('scintigraphic cool or cold') nodules are detected frequently. Dependent on the clinical situation, on morbidity and on economic aspects it is necessary to select patients for surgery and to avoid unnecessary surgical treatment. Therefore it is necessary to develop appropriate diagnostic algorithm to manage hypofunctional thyroid nodules. The ultrasound guided fine-needle aspiration cytology (FNA) is on the one hand side a useful diagnostic tool, but on the other hand side there exist certain limitations. It is questionable if the nodule is correctly reached. In case of heterogeneous larger mixed nodules or multiple hypofunctional nodules, it is difficult to choose the correct location of punctation. Furthermore a certain number of FNA's is not diagnostic without any result or due to 'follicular neoplasia'. {sup 99m}Tc-MIBI-sctintigraphy (MIBI) and {sup 18}F-FDG-positron-emission-tomography (FDG-PET) are established methods in the follow-up of differentiated thyroid cancer after thyroidectomy with elevated thyroglobulin-levels without adequate 131-Iodine-uptake. Moreover in case of parafollicular medullary thyroid carcinomas after thyroidectomy with elevated calcitonin-concentrations the FDG-PET is a valuable diagnostic method in localizing tumor. However these tracers gain in importance in differentiating malignant from benign preoperative hypofunctional nodules. In conclusion MIBI-scintigraphy should be used routinely to plan the correct guide of FNA. The application of both methods (MIBI and FNA) improves the differentiation of dignity, whereas a negative MIBI-examination and a negative FNA is able to exclude malignancy nearly. In this way the number of unnecessary numbers of surgical treatments can be reduced. FDG-PET is not definitely superior compared to MIBI-scintigraphy. From the cost perspective MIBI is more attractive than FDG-PET. (orig.)

Brandt-Mainz, K.; Moka, D. [Gemeinschaftspraxis fuer Radiologie und Nuklearmedizin Radionuk, Essen (Germany)

2008-09-15

68

Galectin-3: A promising marker of thyroid malignancy  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Galectin-3 is an endogenous beta-galactoside binding lectin implicated in neoplastic transformation and tumor progression. High levels of this lectin have recently been found in malignant thyroid tumors, but not in normal or benign thyroid tissue, suggesting galectin-3 as a promising presurgical marker of thyroid malignancy. Methods: We analyzed immunohistochemically galectin-3 expression in thyroid tissue using a monoclonal antibody. The total of 108 tissue specimens included 55 cases of thyroid carcinoma (30 papillary, 15 follicular, and 10 anaplastic type), 15 samples of follicular adenoma, 15 samples of normal thyroid tissue, and 23 thyroid tissue specimens from human fetuses (16 to 37 weeks of intrauterine life). Results: The results showed galectin-3 expression in 20/30 papillary carcinomas, 11/15 follicular carcinomas, 10/10 anaplastic carcinomas, and 4/15 follicular adenomas. Thyroid follicular cells in normal adult and fetal tissue were negative. Conclusions: These results further confirm that galectin-3 expression is a feature of malignant thyroid cells, and that immunohistochemical detection of galectin-3 could be useful in thyroid carcinoma diagnostics. The absence of galectin-3 in thyroid cells during fetal development suggests that galectin-3 is expressed de novo during malignant transformation of thyroid epithelium, thus it should not be considered an oncofetal antigen.

Cveji? Dubravka S.; Savin-Žegarac Svetlana B.; Paunovi? Ivan R.; Tati? Svetislav B.; Havelka Marija J.

2003-01-01

69

Role of metallothioneins in benign and malignant thyroid lesions  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Recent findings in the past two decades have brought many insights into the biology of thyroid benign and malignant lesions, in particular the papillary and follicular thyroid cancers. Although, much progress have been made, thyroid cancers still pose diagnostic problems regarding differentiation of follicular lesions in relation to their aggressiveness and the treatment of advanced and undifferentiated thyroid cancers. Metallothioneins (MTs) were shown to induce cancer cells proliferation, mediate resistance to apoptosis, certain chemotherapeutics and radiotherapy. Therefore, MTs may be of utility in diagnosis and management of patients with benign and malignant lesions of the thyroid.

Pula Bartosz; Domoslawski Pawel; Podhorska-Okolow Marzena; Dziegiel Piotr

2012-01-01

70

Corticosteroid correction of leukopenia in radiotherapy for malignant neoplasms  

International Nuclear Information System (INIS)

In radiation therapy, depression of hematopoiesis, particularly leukopoiesis, is a common attendant phenomenon presenting a complex therapeutic problem that is not readily solved. On account of this and in connection with some reports in te literature, the Roentgenology and Radiology Chair at the Sofia Medical Faculty has undertaken a study of corticosteroid leukostimulating effects in 25 female patients with extinct ovarian function. These patients with carcinomas were distributed as follows. By site of carcinoma: 11, uterus; 8, breast; 5, ovarium; 1, larynx. By clinical stage: 3, first stage; 13, second stage; 8, third stage; 1, forth stage. By degree of leukopenia: 4, light (3000-4000); 20, intermediate (2000-3000); 1, severe (1000-2000). Five of the patients were given corticosteroids alone; the remaining 20, corticosteroids plus conventional leukostimulators (leukogen, leuko-4, folic acid, vitamin B6). The following results were obtained: averaged over the group, leukopenia correction time was of 5.96 days per patient; rise in leukocyte counts relative to initial levels, by 79%. For comparison, observations were made on a control group of 25 patients with the same pathologic entities, who were given no corticosteroids but only the above mentioned conventional leukostimulators. Findings in this group were as follows: average correction time, 9.16 days; rise in leukocyte counts, by 22%. These results give us reason to assume that corticosteroids may be a good means for obtaining a more rapid and effective correction of leukopenias in radiotherapy of malignant neoplasms. (author)

1975-10-27

71

METHOD OF TREATING HEMATOLOGICAL MALIGNANCIES AND HEMATOLOGICAL NEOPLASMS  

UK PubMed Central (United Kingdom)

The invention relates to a method of treating hematological malignancies or hematological neoplasms in a subject, which comprises administering to a subject an effective amount of a peptide agent having actin-sequestering, actin-binding or actin-modulating peptide having a peptide motif as described herein, including the preferred motifs LKKTET (SEQ ID NO:10), KLKKTET (SEQ ID NO:25), LKKTETQ (SEQ ID NO:26) and LKKTNT (SEQ ID NO:11). Preferred peptides include TB4, a TB4 isoform, a TB4 N-terminal fragment, a TB4 C-terminal fragment, TB4ala, TB9, TB10, TB11, TB12, TB13, TB14, TB15, gelsolin, vitamin D binding protein (DBP), profilin, cofilin, adsevertin, propomyosin, fincilin, depactin, DNaseI, vilin, fragmin, severin, capping protein, ss-actinin, acumentin, TB4 sulfoxide, lymphoid TB4 or a functional variant thereof, and others, and any combination thereof. The method optionally further comprises administering a second agent, which can be a stimulating agent that stimulates production of the peptide agent and/or at least one antineoplastic agent.

BOWES DEBRA K; GOLDSTEIN ALLAN L

72

Second malignant neoplasms in childhood malignant brain tumour: a long-term population-based study.  

UK PubMed Central (United Kingdom)

AIM: To provide a profile of second malignant neoplasms (SMN) in patients with childhood primary malignant brain tumour originating from neuroepithelial tissues with latest data in a population-based study. METHODS: Surveillance, Epidemiology, and End Results (SEER) database (1973-2007) was used to identify above-stated patients. SMN patients were further identified, and standardised incidence ratios (SIRs) and excess absolute risks (EARs) for risk-factor-decided subgroups were calculated. Univariate and multivariate analyses of the association between cumulative incidence of SMN and the risk factors were performed in the whole population. RESULTS: A total of 106 patients were identified as having SMNs. EARs peaked at age at primary diagnosis of 10-14. Males had higher SIRs and EARs than females. Both SIRs and EARs increased after 1990. Age was statistically significant in both univariable and multivariable analyses for cumulative incidence of SMN and RT was not significant in both the analyses, in the whole population of 9075 patients. After follow-up recalculation, matched patients in the ?1990 group had slightly shorter median interval between primary and secondary cancer than those in the <1990 group, but with no significance. CONCLUSION: The risk of SMN in children with primary malignant brain tumours in a more advanced treatment era might have changed. During making further advances in the treatment of these neoplasms, minimising toxicities while maintaining promising prognostic outcomes will keep being our goal.

Cai Y; Cao L; Bao X; Xie L

2012-11-01

73

Sonographic findings of benign and malignant thyroid nodules  

Energy Technology Data Exchange (ETDEWEB)

To assess the differential points of benign and malignant lesions, authors evaluated the sonographic findings of 45 cases of thyroid nodules, comprising 31 cases of benign nodules and 14 cases of malignant nodules. Sonographic findings were evaluated in terms of the echo patterns, margin, size and multiplicity of the thyroid nodules. There is no significant differences between the benign and malignant nodules in echo patterns and multilicity. A large(more than 4 cm in diameter) and clear marinated nodule is suggestive of benignancy. Differentiation of benign from malignant thyroid nodules on the basis of sonographic findings seems to be difficult

Ham, Soo Youn; Park, C. M.; Oh, Y. H.; Kim, J. H.; Cha, I. H.; Suh, W. H. [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1990-12-15

74

Sonographic findings of benign and malignant thyroid nodules  

International Nuclear Information System (INIS)

To assess the differential points of benign and malignant lesions, authors evaluated the sonographic findings of 45 cases of thyroid nodules, comprising 31 cases of benign nodules and 14 cases of malignant nodules. Sonographic findings were evaluated in terms of the echo patterns, margin, size and multiplicity of the thyroid nodules. There is no significant differences between the benign and malignant nodules in echo patterns and multilicity. A large(more than 4 cm in diameter) and clear marinated nodule is suggestive of benignancy. Differentiation of benign from malignant thyroid nodules on the basis of sonographic findings seems to be difficult

1990-01-01

75

Photoacoustic spectroscopic differences between normal and malignant thyroid tissues  

Science.gov (United States)

The thyroid is one of the main endocrine glands of human body, which plays a crucial role in the body's metabolism. Thyroid cancer mortality ranks only second to ovarian cancer in endocrine cancer. Routine diagnostic methods of thyroid diseases in present clinic exist misdiagnosis and missed diagnosis to varying degrees. Those lead to miss the best period of cancer treatment--early. Photoacoustic spectroscopy technology is a new tool, which provides an effective and noninvasive way for biomedical materials research, being highly sensitive and without sample pretreatment. In this paper, we use photoacoustic spectroscopy technology (PAST) to detect the absorption spectrum between normal and malignant thyroid tissues. The result shows that the photoacoustic spectroscopy technology (PAST) could differentiate malignant thyroid tissue from normal thyroid tissue very well. This technique combined with routine diagnostic methods has the potential to increase the diagnostic accuracy in clinical thyroid cancer diagnosis.

Li, Li; Xie, Wengming; Li, Hui

2012-12-01

76

Isolated Thyroid Metastasis of Malignant Melanoma with Unknown Primary Origin  

Directory of Open Access Journals (Sweden)

Full Text Available Clinically significant metastases to the thyroid gland are very rare; however, they can present as the initial malignancy. We report the case of a 70-year-old woman referred to our Endocrinology outpatient clinic for a thyroid nodule, which was in fact metastasis of malignant melanoma. Because fine-needle aspiration biopsy was not diagnostic and the nodule was considered malignant nodule according to the ultrasonographic examination, bilateral total thyroidectomy and modified radical neck dissection was performed. Histopathologic examination of the nodule was consistent with malignant melanoma. The message from this unusual case is that all thyroid nodules need to be taken seriously and a thyroid lesion may be the sentinel event in a patient with a malignant melanoma.

Feridun Karakurt; Nükhet Bavbek; Reyhan Bayrak; Ay?e Karg?l?; Benan Kasapo?lu

2008-01-01

77

The role of {sup 201}Tl scintigraphy in evaluating proliferative activity in thyroid neoplasms  

Energy Technology Data Exchange (ETDEWEB)

To identify the relationship between the uptake of {sup 201}Tl and the proliferative activity in thyroid neoplasms, {sup 201}Tl scintigraphy was performed in 57 patients with thyroid neoplasms. {sup 201}Tl uptake ratio was calculated in both the early and the delayed images and then compared with factors representing cellular or practical proliferative activity of the lesions. The labeling index (LI) for proliferating cell nuclear antigen (PCNA) was determined quantitatively by flow cytometry. There was a significant correlation between the uptake ratio and LI for PCNA. The correlation coefficient for the delayed ratio (DR) vs. LI was better than that for the early ratio (ER) vs. LI. As parameters for practical proliferation, the surgical stage in primary thyroid carcinoma or {sup 131}I uptake in recurrent thyroid carcinoma was focused on. DR was strongly related to these parameters, regardless of the histopathological features or size of the lesions. Our results suggest that {sup 201}Tl uptake in delayed thyroid scan is useful in assessing proliferative activity in thyroid neoplasms. (author).

Nakada, Kunihiro; Katoh, Chietsugu; Kanegae, Kakuko; Tsukamoto, Eriko; Itoh, Kazuo; Furudate, Masayori; Tamaki, Nagara [Hokkaido Univ., Sapporo (Japan). School of Medicine

1996-02-01

78

Activation of the Sonic Hedgehog pathway in thyroid neoplasms and its potential role in tumor cell proliferation.  

UK PubMed Central (United Kingdom)

The sonic hedgehog (SHH) pathway is activated in several types of malignancy and plays an important role in tumor cell proliferation and tumorigenesis. SHH binding to a 12-pass transmembrane receptor, Patched (PTCH), leads to freeing of Smoothened (SMO) and subsequent activation of GLI transcription factors. In the present study, we analyzed the expression of SHH, PTCH, SMO, and GLI1 in 31 follicular thyroid adenomas (FTA), 8 anaplastic thyroid carcinomas (ATC), and 51 papillary thyroid carcinomas (PTC) by immunohistochemical staining. More than 65% of FTA, PTC, and ATC specimens stained positive for SHH, PTCH, SMO, and GLI. However, the expression of the genes encoding these four molecules did not correlate with any clinicopathologic parameters, including the age, gender, the status of BRAF gene mutation, tumor stage, local invasion, and metastasis. Three thyroid tumor cell lines (KAT-18, WRO82, and SW1736) all expressed the genes encoding these four molecules. 5-Bromo-2-deoxyuridine labeling and MTT cell proliferation assays revealed that cyclopamine (CP), an inhibitor of the SHH pathway, was able to inhibit the proliferation of KAT-18 and WRO82 cells more effectively than SW1736 cells. CP led to the arrest of cell cycle or apoptosis. Knockdown of SHH and GLI expression by miRNA constructs that target SHH or GLI mRNA in KAT-18 and SW1736 cells led to the inhibition of cell proliferation. Our results suggest that the SHH pathway is widely activated in thyroid neoplasms and may have potential as an early marker of thyroid cancer or as a potential therapeutic target for thyroid cancer treatment.

Xu X; Ding H; Rao G; Arora S; Saclarides CP; Esparaz J; Gattuso P; Solorzano CC; Prinz RA

2012-04-01

79

Thyroid malignancies: diagnostic strategy; Primaerdiagnostik des Schilddruesenkarzinoms  

Energy Technology Data Exchange (ETDEWEB)

The degree of alimentary iodine deficiency and, hence, the prevalence of thyroid nodules influence the diagnostic strategy to be followed in order to - mostly - exclude malignancy. Besides clinical factors like patient age and gender, rapid growth and compressive signs it is primarily the finding of a hypoechoic nodule without radio-nuclide accumulation that makes fine-needle aspiration biopsy (FNAB) mandatory. The accuracy of up to 95% which can be obtained with sufficient skill and expertise leads to a reduction of surgical interventions by at least 80% and to an increase of malignancy found during surgery by a factor of 10. The use of FNAB in the case of a hypoechoic, cold nodule represents a sufficiently accurate and highly cost-effective management of this frequent finding in endemic goitre areas. (orig.) [German] Die Dignitaetsbestimmung von Schilddruesenknoten wird von deren Praevalenz und diese von der alimentaeren Iodversorgung beeinflusst. Neben klinischen Parametern, wie z.B. Patientenalter und -geschlecht, Wachstumsgeschwindigkeit und Verdraengungszeichen, kommen v.a. dem sonographischen Befund der Echoarmut und der fehlenden Radionuklidanreicherung im Szintigramm entscheidende Bedeutung fuer die Selektion zur Feinnadelaspirationsbiopsie zu. Bei einer Treffsicherheit von bis zu 95%, die bei entsprechender Erfahrung und ausreichender Praeparatqualitaet erzielbar ist, kann mit der Zytologie die Zahl unnoetiger Eingriffe um mindestens 80% gesenkt und die operative 'Ausbeute' an malignen Befunden um den Faktor 10 gesteigert werden. Der Beschriebene, diagnostische Ablauf liefert eine ausreichende Sicherheit fuer Arzt und Patient bei hoher Kosteneffizienz. (orig.)

Leisner, B. [Allgemeines Krankenhaus St. Georg, Hamburg (Germany). Abt. fuer Nuklearmedizin

1999-12-01

80

Autoimmune thyroiditis in benign and malignant thyroid nodules: 16-year results.  

UK PubMed Central (United Kingdom)

BACKGROUND: It is controversial whether autoimmune thyroiditis is associated with higher frequency of papillary thyroid carcinoma (PTC). METHODS: This was a cross-sectional, retrospective study. PTCs were compared to benign nodules regarding the prevalence of autoimmune thyroiditis over 16 years. RESULTS: A similar proportion of autoimmune thyroiditis was observed in both benign and/or malignant nodules. Mean nodule size in cases with autoimmune thyroiditis was smaller than those without autoimmune thyroiditis. Multivariate analysis showed a negative association between the coexistence of autoimmune thyroiditis and lymph node and/or distant metastases. Lymph nodes involvement and distant metastases were lower in the PTC with autoimmune thyroiditis compared to those without autoimmune thyroiditis. Capsular invasion was a strong predictor for distant metastases attenuated by the presence of autoimmune thyroiditis. CONCLUSION: Thyroid nodules with autoimmune thyroiditis are not more likely to be malignant than those without autoimmune thyroiditis. The coexistent autoimmune thyroiditis may be beneficial as a decreased incidence of lymph nodes involvement and distant metastasis was seen in those patients. © 2013 Wiley Periodicals, Inc. Head Neck, 2013.

Giagourta I; Evangelopoulou C; Papaioannou G; Kassi G; Zapanti E; Prokopiou M; Papapostolou K; Karga H

2013-06-01

 
 
 
 
81

Histologically benign but clinically malignant neoplasms in the thorax: CT–pathological overview  

International Nuclear Information System (INIS)

[en] The purpose of this article is to review the computed tomography (CT) and histopathological features of uncommon primary neoplasms of the thorax that can manifest clinically malignant features (multiplicity of pulmonary nodules, an invasive nature, and metastases or recurrence after surgery) with little evidence of histological malignancy.

2012-01-01

82

Circadian clock characteristics are altered in human thyroid malignant nodules.  

UK PubMed Central (United Kingdom)

Context:Circadian clock represents the body's molecular time-keeping system. Recent findings revealed strong changes of clock gene expression in various types of human cancers.Objective:Due to emerging evidence on the connection between circadian oscillator, cell cycle and oncogenic transformation, we aimed to characterize the circadian clockwork in human benign and malignant thyroid nodules.Design:Clock transcript levels were assessed by quantitative RT-PCR in thyroid tissues. To provide molecular characteristics of human thyroid clockwork, primary thyrocytes established from normal or nodular thyroid tissue biopsies were subjected to in vitro synchronization with subsequent clock gene expression analysis by circadian bioluminescence reporter assay, and by quantitative RT-PCR.Results:The expression levels of Bmal1 were up-regulated in tissue samples of Follicular Thyroid Carcinoma (FTC), and in Papillary Thyroid Carcinoma (PTC), as compared to normal thyroid and benign nodules, while Cry2 was down-regulated in FTC and PTC. Human thyrocytes derived from normal thyroid tissue exhibited high-amplitude circadian oscillations of Bmal1-luciferase reporter expression, and of endogenous clock transcripts. Thyrocytes established from FTC and PTC exhibited clock transcript oscillations similar to those of normal thyroid tissue and benign nodules (except for Per2 altered in PTC), while cells derived from Poorly Differentiated Thyroid Carcinoma (PDTC) exhibited altered circadian oscillations.Conclusions:This is the first study demonstrating a molecular makeup of human thyroid circadian clock. Characterization of the thyroid clock machinery alterations upon thyroid nodule malignant transformation contributes to understanding the connections between circadian clocks and oncogenic transformation. Moreover, it might help improving the thyroid nodule pre-operative diagnostics.

Mannic T; Meyer P; Triponez F; Pusztaszeri M; Le Martelot G; Mariani O; Schmitter D; Sage D; Philippe J; Dibner C

2013-08-01

83

Upregulation of HMGA2 in thyroid carcinomas: a novel molecular marker to distinguish between benign and malignant follicular neoplasias.  

Science.gov (United States)

The identification of molecular markers allowing to differentiate between benign and malignant thyroid tumors remains a diagnostic challenge. Herein, we have used the expression of the high mobility group protein gene HMGA2 and its protein, respectively, as a possible marker detecting malignant growth of thyroid tumors. HMGA2 belongs to the high mobility group proteins, i.e. small, highly charged DNA-binding proteins. While HMGA2 is highly expressed in most embryonic tissues, its expression in adult tissues is very low. However, a reactivation of HMGA2 expression has been described for various malignant tumors and often correlates with the aggressiveness of the tumors. The aim of this study was to investigate whether the HMGA2 expression can be used to detect malignant thyroid tumors. RNA from 64 formalin-fixed paraffin-embedded thyroid tissues including normal tissue (n = 3), thyroiditis (n = 2), and follicular adenomas (n = 19) as well as follicular (n = 9), papillary (n = 28), and anaplastic (n = 3) carcinomas was reverse transcribed. Finally, real-time quantitative RT-PCR was performed. Expression differences of up to 400-fold were detected between benign and malignant thyroid tumors. Based on HMGA2 expression alone, it was possible to distinguish between benign and malignant thyroid tissues with a sensitivity of 95.9% and a specificity of 93.9%. There was a highly significant (P < 0.001) difference with histology of the tumors being the gold standard between the benign lesions and malignant tumors. Our results show that even as a stand-alone marker HMGA2 expression has a high potential to improve diagnoses of follicular neoplasms of the thyroid. PMID:17943974

Belge, Gazanfer; Meyer, Anke; Klemke, Markus; Burchardt, Käte; Stern, Corinna; Wosniok, Werner; Loeschke, Siegfried; Bullerdiek, Jörn

2008-01-01

84

Reconsideration of the use of 99Tcm-MIBI thyroid imaging for detection of thyroid malignancy in thyroid nodules  

International Nuclear Information System (INIS)

Objective: To reconsider the use of 99Tcm-methoxyisobutylisonitrile (MIBI) thyroid imaging for detection of thyroid malignancy in thyroid nodules. Methods: One hundred and one of 106 thyroid nodules patients underwent routine 99TcmO4- scan first, then after injection of 370 MBq 99Tcm-MIBI dual-phase (15 min and 2 h) thyroid imaging was performed in all 106 patients within 1 week. After operation the result of thyroid imaging was compared with pathologic findings. Results: Among 5/13 cases of thyroid malignancy and 23/93 of benign nodules, 99Tcm-MIBI imaging showed positive result. The sensitivity, specificity, positive predictive value and negative predictive value of 99Tcm-MIBI scintigraphy were 38.5%, 75.3%, 17.9% and 89.7%, respectively. No statistics difference was found between benign and malignant thyroid nodules ?2=0.49, P > 0.05). Conclusions: 99Tcm-MIBI thyroid imaging is not specific for thyroid malignancy. Thereby its clinical value is limited. (authors)

2006-01-01

85

[Fine needle aspiration biopsy in the diagnosis of thyroid neoplasms  

UK PubMed Central (United Kingdom)

The clinical value of fine needle aspiration biopsy cytology is discussed with reference to 4514 histologically verified cases. A good sensitivity and specificity, together with high accuracy, make this technique a method of choice in the preoperative diagnosis of thyroid disease.

Ravetto C

1994-01-01

86

Fra-1 expression in malignant and benign thyroid tumor.  

UK PubMed Central (United Kingdom)

BACKGROUND: The differential diagnosis of thyroid nodules is very important in deciding the treatment modality and the fine needle aspiration is the best diagnostic method. But, there are some limitations in use because of inadequate test materials and difficulty in interpreting. According to the study of oncogene and tumor suppressor gene about the origin of thyroid tumor, expression of Fra-1, one of AP-1 complex, is increased in thyroid neoplasm, though not present in the normal tissue. So, there is a possibility that it will be used as a method for the differential diagnosis of thyroid nodules. We tried to know whether presence or absence of Fra-1 expression can be used as a diagnostic method in differential diagnosis of thyroid nodules using the immunohistochemical (IHC) staining method. METHODS: In 4 types of thyroid tumor that were confirmed by histologic diagnosis after operation (18 cases of adenomatous goiter, 16 cases of follicular adenoma, 30 cases of papillary cancer, 10 cases of follicular cancer), IHC staining method was performed to evaluate the expression of Fra-1. RESULTS: In papillary and follicular thyroid cancers, the expression of Fra-1 was stronger than in benign thyroid tumor, but there was no difference in Fra-1 expression between the two types of carcinoma. Weak expression of Fra-1 was observed in all cases of follicular adenoma, though it was weaker than in carcinoma, and it was also weakly expressed only in some cases (33%) of adenomatous goiter. CONCLUSION: The expression of Fra-1 was stronger in thyroid cancer than in benign thyroid tumor, but it was impossible to differentiate thyroid cancer from benign thyroid tumor by presence or absence of Fra-1 expression using IHC staining method.

Kim YH; Oh JH; Kim NH; Choi KM; Kim SJ; Baik SH; Choi DS; Lee ES

2001-06-01

87

Hypomethylation of DNA from Benign and Malignant Human Colon Neoplasms  

Science.gov (United States)

The methylation state of DNA from human colon tissue displaying neoplastic growth was determined by means of restriction endonuclease analysis. When compared to DNA from adjacent normal tissue, DNA from both benign colon polyps and malignant carcinomas was substantially hypomethylated. With the use of probes for growth hormone, ? -globin, ? -chorionic gonadotropin, and ? -crystallin, methylation changes were detected in all 23 neoplastic growths examined. Benign polyps were hypomethylated to a degree similar to that in malignant tissue. These results indicate that hypomethylation is a consistent biochemical characteristic of human colonic tumors and is an alteration in the DNA that precedes malignancy.

Goelz, Susan E.; Vogelstein, Bert; Hamilton, Stanley R.; Feinberg, Andrew P.

1985-04-01

88

[Most efficient methods of cryodestruction of malignant neoplasms  

UK PubMed Central (United Kingdom)

Some peculiarities of the procedure for cryodestruction of neoplasms of various sites developed by the authors are considered. The regularities of variation in the adhesion of cryoapplicator to tissues on gradual cooling are discussed. The report is concerned with cryogenic procedures designed to ensure destruction of tumor cells and to prevent tumor cell dissemination in the course of surgical intervention. The cryogenic installation Penguin was used. Such effects as applicator's adhesion to tissue and its freezing-induced fixation in tissue were employed. Thawing period was prolonged with cryoapplicator still in contact with tissue. Tumor tissue adjacent to normal one was allowed to thaw to 0 degrees C.

Shakhov VIu; Kochenov VI; Ovsianikov VIa; Rylkin AI; Konev VE

1983-01-01

89

[Treatment of thyroid neoplasms and proposed therapeutic plan].  

UK PubMed Central (United Kingdom)

Thirty-seven patients with thyroid cancer were treated at 1a Clinica Chirurgica of Parma between 1962 and 1970. Fourty-five per cent of tumors were papillary, 24 per cent follicular, 2 per cent medullary, 9 per cent anaplastic. Surgery combined with ormonal therapy formed the commonest treatment. Eighty-five per cent of the patients with papillary carcinoma 70 per cent with follicular and 33,3 per cent with anaplastic carcinoma survived for 10 years. This present series indicates that total thiroidectomy combined with ormonal therapy influences the survival time, confirms the prognostic value of histology and shows that papillary node metastases do not prejudice survival.

Paolucci R; La Torre P; Salcuni PF; Foggi E; Vitali M

1977-01-01

90

Risk factors associated with benign and malignant thyroid nodules in autoimmune thyroid diseases.  

UK PubMed Central (United Kingdom)

Objectives. Assess the prevalence of thyroid nodules and predictors of malignant origin in patients with autoimmune thyroid diseases. Patients and Methods. Retrospective study including 275 patients, 198 with Graves' disease and 77 with Hashimoto's thyroiditis. Clinical and demographical data, ultrasonographical nodule characteristics, total thyroid volume and histological characteristics were recorded. Results. Graves' disease: the prevalence of thyroid nodules and thyroid carcinoma were 27.78% and 5.05%, respectively. Older age (OR = 1.054; 95% CI = 1.029-1.080) and larger thyroid volumes (OR = 1.013; 95% CI = 1.003-1.022) increased the chance of nodules. Younger age (OR = 1.073; 95% CI = 1.020-1.128) and larger thyroid volume (OR = 1.018; 95% CI = 1.005-1.030) predicted thyroid carcinoma. Hashimoto's thyroiditis: the prevalence of thyroid nodules and carcinomas were 50.7% and 7.8%, respectively. Nodules were predicted by thyroid volume (OR = 1.030; 95% CI = 1.001-1.062). We found higher number of nodules in patients with thyroid carcinoma than in those with benign nodules (3 versus 2; P = 0.03). Patients with Hashimoto's thyroiditis presented nodules more frequently than patients with Graves' disease (50.65% versus 27.28%; P < 0.001), while the prevalence of carcinoma was similar (P = 0.751). Conclusions. Larger goiter was associated with carcinoma in Graves' disease and Hashimoto's thyroiditis. Younger patients presented higher risk of papillary thyroid carcinoma in Graves' disease. The prevalence of carcinoma was similar in both conditions.

Lima PC; Moura Neto A; Tambascia MA; Zantut Wittmann DE

2013-01-01

91

Risk Factors Associated with Benign and Malignant Thyroid Nodules in Autoimmune Thyroid Diseases  

Science.gov (United States)

Objectives. Assess the prevalence of thyroid nodules and predictors of malignant origin in patients with autoimmune thyroid diseases. Patients and Methods. Retrospective study including 275 patients, 198 with Graves' disease and 77 with Hashimoto's thyroiditis. Clinical and demographical data, ultrasonographical nodule characteristics, total thyroid volume and histological characteristics were recorded. Results. Graves' disease: the prevalence of thyroid nodules and thyroid carcinoma were 27.78% and 5.05%, respectively. Older age (OR = 1.054; 95% CI = 1.029–1.080) and larger thyroid volumes (OR = 1.013; 95% CI = 1.003–1.022) increased the chance of nodules. Younger age (OR = 1.073; 95% CI = 1.020–1.128) and larger thyroid volume (OR = 1.018; 95% CI = 1.005–1.030) predicted thyroid carcinoma. Hashimoto's thyroiditis: the prevalence of thyroid nodules and carcinomas were 50.7% and 7.8%, respectively. Nodules were predicted by thyroid volume (OR = 1.030; 95% CI = 1.001–1.062). We found higher number of nodules in patients with thyroid carcinoma than in those with benign nodules (3 versus 2; P = 0.03). Patients with Hashimoto's thyroiditis presented nodules more frequently than patients with Graves' disease (50.65% versus 27.28%; P < 0.001), while the prevalence of carcinoma was similar (P = 0.751). Conclusions. Larger goiter was associated with carcinoma in Graves' disease and Hashimoto's thyroiditis. Younger patients presented higher risk of papillary thyroid carcinoma in Graves' disease. The prevalence of carcinoma was similar in both conditions.

Lima, Priscila Carneiro Moreira; Tambascia, Marcos Antonio; Zantut Wittmann, Denise Engelbrecht

2013-01-01

92

Small-cell (basaloid) thyroid carcinoma: a neoplasm with a solid cell nest histogenesis?  

UK PubMed Central (United Kingdom)

In the past, undifferentiated (anaplastic) carcinoma of the thyroid included a small-cell variant with either a diffuse or a compact morphology. After the mid-1980s, with the advance of immunohistochemistry, almost all those rare tumors with the former characteristic were reclassified as low-grade lymphomas and those with the latter characteristic as small-cell variants of medullary carcinoma and poorly differentiated ("insular") carcinoma. Since then, no primary thyroid small-cell carcinoma has been reported in the literature, with the exception of a case of a small-cell (neuroendocrine) carcinoma, an exceedingly rare neoplasm akin to medullary carcinoma, with expression of neuroendocrine markers but lacking calcitonin immunoreactivity. Here, the authors report a primary small-cell carcinoma of the thyroid displaying a basaloid appearance and lacking any signs of neuroendocrine or C-cell differentiation.

Cruz J; Eloy C; Aragüés JM; Vinagre J; Sobrinho-Simões M

2011-10-01

93

Frequency of malignant neoplasms in 257 chronic leg ulcers.  

UK PubMed Central (United Kingdom)

BACKGROUND: Chronic leg ulcers are one of the most common medical conditions and are a substantial source of morbidity. OBJECTIVES: To investigate the prevalence of skin cancer mimicking leg ulcers. PATIENTS AND METHODS: This observational study included all patients with a clinical diagnosis of chronic leg ulcers (CLU) admitted to the Wound Care Unit, Division of Dermatology, University of Bologna, between March 2008 and February 2011. Patients' general health was assessed, and skin biopsy and vascular Doppler of the lower limbs were performed. RESULTS: Two hundred fifty-seven patients ages 45 to 98 with CLU were included. Skin biopsies were performed in all patients. Pathologic results showed that 10 patients had ulcerative lesions of neoplastic origin. Surgical excision was performed in all patients with neoplasms. After at least 1 year of follow-up, no recurrences were observed. DISCUSSION AND CONCLUSION: Our findings highlight the important role of systematic biopsies in diagnosing ulcerated tumors of the lower legs and indicate a high prevalence of large ulcerated basal cell carcinomas.

Misciali C; Dika E; Fanti PA; Vaccari S; Baraldi C; Sgubbi P; Patrizi A

2013-06-01

94

Small thyroid nodules: ultrasonographic differentiation between benign and malignant lesions  

Energy Technology Data Exchange (ETDEWEB)

To evaluate the usefulness of ultrasonography in the differentiation between benignity and malignancy in the evaluation of small thyroid nodules (the longest diameter <10 mm). Fine needle aspiration or surgery was performed for the evaluation of seventy two (44 benign and 28 malignant) small thyroid nodules from fifty eight patients. Ultrasonographic findings were retrospectively reviewed for the margin, echogenecity, presence of microcalcification, intranodular cystic change and peripheral hypoechoic halo. Ill-defined margin was more common in malignant nodules (61% vs 11%, p<0.05). In internal echogenecity, either iso- or hyperechogenicity was more common in benign nodules (45% vs 18%, p<0.05) while malignant nodules were often markedly hypoechoic (39% vs 18%, p<0.05). Malignant nodules contained more microcalcifications (36% vs 9%, p<0.05) whereas benign nodules often showed intranodular cystic change(39% vs 7%, p<0.05) and hypoechoic halo (41% vs 18%, p<0.05). Ultrasonography can be useful in the differentiation between benign and malignant small thyroid nodules.

Min, Seon Jeong; Kang, Ik Won; Lee, Gyung Kyu [Hankang Seong-Sim Hospital, Hallym University College of Medicine, Seoul (Korea, Republic of); Yoon, Dae Young; Choi, Chul Soon; Lim, Kyoung Ja; Moon, Jeung Hee; Seo, Young Lan; Park, Sang Joon; Yoon, Young Cheol; Yun, Eun Joo [Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul (Korea, Republic of)

2004-03-15

95

Frequent hypermethylation of DBC1 in malignant lymphoproliferative neoplasms  

DEFF Research Database (Denmark)

Allelic loss at chromosome 9q31-34 is a frequent event in many lymphoproliferative malignancies. Here, we examined DBC1 at 9q33.1 as a potential target in lymphomagenesis. DBC1 is a putative tumor suppressor that has been shown to be involved in the regulation of cell growth and programmed cell death. The methylation status of the DBC1 promoter CpG island was examined by methylation-specific PCR, bisulfite sequencing, and methylation-specific melting curve analysis. DBC1 was hypermethylated in 5 of 5 B-cell-derived lymphoma cell lines, 41 of 42 diffuse large B-cell lymphomas, 24 of 24 follicular lymphomas, 5 of 5 mantle cell lymphomas, 4 of 4 small lymphocytic lymphomas, 1 of 2 lymphoplasmacytoid lymphomas, and in 12 of 12 acute lymphoblastic leukemias, but was unmethylated in 1 case of splenic marginal zone lymphoma, in 12 of 12 multiple myelomas, in 24 of 24 reactive lymph nodes, and in 12 of 12 samples of blood lymphocytes from random donors. DBC1 hypermethylation was associated with transcriptional silencing in lymphoma cell lines, and reexpression of this gene could be induced by treatment with the demethylating agent, 5-aza-2'-deoxycytidine. Our data suggest that hypermethylation of the DBC1 promoter region is a frequent event during the development of lymphoproliferative malignancies, and that DBC1 hypermethylation may serve as a marker for these cancers Udgivelsesdato: 2008/5

GrØnbæk, Karin Elmegård; Ralfkiaer, U.

2008-01-01

96

Predictive value for malignancy of the thyroid nodule macroscopically  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction: The fine needle aspiration (FNA) is a method of high accuracy in the preoperative diagnosis of thyroid nodules, but the "follicular" remains a factor of failure. Furthermore, the usefulness of intraoperative examination of freezing is controversial. Macroscopic aspects of thyroid nodules may increase the diagnostic accuracy of preoperative and intraoperative FNA biopsy and freezing. Objective: To evaluate the macroscopic aspects of the surgical specimen in the decision facing the nodular disease of thyroid gland. Methods: During 2007, 85 patients underwent surgical treatment for thyroid nodular diseases were evaluated by prospective and macroscopic aspects of 125 nodules were compared with histopathological findings. Results: We found that the pattern of recent growth, the presence of adhesions of the thyroid, absence of hemorrhage, necrosis and poor demarcation of the nodule had statistical significance in the outcome of malignant disease. Conclusion:Pattern of growth, thyroid adhesions, necrosis and poor demarcation of the nodule are predictors of malignancy, while the presence of hemorrhage is a protective factor.

Dedivitis, Rogério Aparecido; Couto Netto, Sergio Dias do; Castro, Mario Augusto Ferrari de; Pfuetzenreiter Junior, Elio Gilberto; Nardi, Carlos Eduardo Molinari; Barbara, Emanuel Casotti Duque de

2010-01-01

97

Prevalence and prediction for malignancy of additional thyroid nodules coexisting with proven papillary thyroid microcarcinoma.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To investigate the clinical efficacy of ultrasonographic (US) classification of additional thyroid nodules coexisting with proven papillary thyroid microcarcinoma (PTMC). STUDY DESIGN: Historical cohort study. SETTING: Tertiary care institution. SUBJECTS AND METHODS: In addition to the prevalence of additional thyroid nodules based on an US classification, the diagnostic accuracy and predictive factors for malignancy were assessed in 300 nodules randomly selected from 300 patients with cytologically proven PTMC who underwent total thyroidectomy. RESULTS: The most common thyroid nodules were "indeterminate nodules," 68.0%, followed by "probably benign nodules," 20.7%, and "suspicious malignant nodules," 11.3%. For indeterminate nodules, the malignancy rate was 16.6% (34/204) with disregard to its location, either on the contralateral (15.1%, 16/106) or ipsilateral side (18.4%, 18/98) of the known PTMC (P = .53). According to univariate and multivariate analyses of clinical and US findings for predictive variables of malignancy in indeterminate nodules, hypoechogenicity was proven to be the sole predictive factor for malignancy (odds ratio 5.62, 95% CI, 2.29-13.72). CONCLUSION: US-based classification of additional thyroid nodules is a useful tool for decision making of the surgical extent in patients with a single PTMC.

Choi SY; Woo SH; Shin JH; Choi N; Son YI; Jeong HS; Baek CH; Chung MK

2013-07-01

98

[Electroglottography in patients operated for thyroid gland malignancies].  

Science.gov (United States)

Electroglottography (EGG) was performed in 9 patients with vocal fold paresis (VFP) arisen after thyroid gland surgery performed for malignant tumours. Clinical symptoms, EGG waveforms and % Irregularity were analysed and correlation between dysphonia and % Irregularity computed. % Irregularity proved to be an effective measure of vocal fold dysfunction, significantly correlated with dysphonia. PMID:15518323

Zagólski, Olaf

2004-01-01

99

[Electroglottography in patients operated for thyroid gland malignancies].  

UK PubMed Central (United Kingdom)

Electroglottography (EGG) was performed in 9 patients with vocal fold paresis (VFP) arisen after thyroid gland surgery performed for malignant tumours. Clinical symptoms, EGG waveforms and % Irregularity were analysed and correlation between dysphonia and % Irregularity computed. % Irregularity proved to be an effective measure of vocal fold dysfunction, significantly correlated with dysphonia.

Zagólski O

2004-01-01

100

The thyroid malignancies at the Esslingen Radiation Institute  

International Nuclear Information System (INIS)

This work concerns itself with the results of the therapy of thyroid malignancies in the years 1968-1979. The frequency of differentiated/undifferentiated tumors was 90.9/9.1%, follicular/papillary carcinomas 71.4/19.5%. Three times as many women suffer from thyroid cancer as men. Differentiated carcinomas appear preferably in middle age (50 a), undifferentiated around 60 to 70 years. Papillary carcinomas metastasise in 26.7% of the cases in the neck region and 6.7% in the lungs, follicular in 34.5%, the most frequent, in the lungs. The therapy method used was I 131 and/or telecobalt. The 3-year survival rate with undifferentiated tumors was 27%, the 5-year survival rate of papillary carcinoma was 40%, of follicular carcinoma 33%. Clearly papillary carcinomas have the best prognosis of all thyroid malignancies, especially when they appear in younger patients. (orig./TRV)

1982-01-01

 
 
 
 
101

Benign and malignant thyroid nodules after neck irradiation  

International Nuclear Information System (INIS)

[en] A total of 444 persons were examined for the presence of thyroid nodules on average of 43 years after having been treated with x-rays for cervical tuberculous adenitis. Of this total, 101 subjects had undergone surgery for thyroid nodules: 25 for carcinoma (6%) and 76 for benign nodules (17%). Carcinoma occurred with the same frequency in multinodular and uninodular glands. Because of the uneven age distribution in the current series, it could not be decided whether there was a higher susceptibility of the young thyroid to the induction of thyroid carcinoma or benign nodules. The dosage range for the whole series was 0.40 to 50.90 Gy (40-5090 rad). There was a positive correlation between the absorbed radiation dose and the probability of developing benign and malignant thyroid nodules, even after doses of 20 Gy or more. The risk of developing thyroid carcinoma was equal for men and women, while the female-to-male ratio for benign nodules was 2.9:1, indicating that risk factors associated with females are of less importance in irradiated than in nonirradiated populations. The median latency for carcinoma was 40 years, suggesting that the increased risk of thyroid carcinoma after irradiation remains for the rest of the patient's life

1986-09-15

102

Benign and malignant thyroid nodules after neck irradiation  

Energy Technology Data Exchange (ETDEWEB)

A total of 444 persons were examined for the presence of thyroid nodules on average of 43 years after having been treated with x-rays for cervical tuberculous adenitis. Of this total, 101 subjects had undergone surgery for thyroid nodules: 25 for carcinoma (6%) and 76 for benign nodules (17%). Carcinoma occurred with the same frequency in multinodular and uninodular glands. Because of the uneven age distribution in the current series, it could not be decided whether there was a higher susceptibility of the young thyroid to the induction of thyroid carcinoma or benign nodules. The dosage range for the whole series was 0.40 to 50.90 Gy (40-5090 rad). There was a positive correlation between the absorbed radiation dose and the probability of developing benign and malignant thyroid nodules, even after doses of 20 Gy or more. The risk of developing thyroid carcinoma was equal for men and women, while the female-to-male ratio for benign nodules was 2.9:1, indicating that risk factors associated with females are of less importance in irradiated than in nonirradiated populations. The median latency for carcinoma was 40 years, suggesting that the increased risk of thyroid carcinoma after irradiation remains for the rest of the patient's life.

Fjaelling, M.T.; Tisell, L.E.; Carlsson, S.; Hansson, G.; Lundberg, L.M.; Oden, A.

1986-09-15

103

Ga-67 scintigram in evaluation of malignant lymphoma of the thyroid originated from chronic thyroiditis  

Energy Technology Data Exchange (ETDEWEB)

At the Itoh Hospitall, 27 patients with primary malignant lymphoma of the thyroid gland have been diagnosed from April 1985 to April 1988. Within the 27 patients, 8 patients were treated with a diagnosis of chronic thyroiditis during 1 year to 7 years at Itoh Hospital. Ga-67 scintigraphy was performed in the 8 patients as suspected malignant lymphoma. Of the 8 patients, 6 were very strong positive, 1 was strong positive and 1 was weak positive. All patients with Ga-67 strong positive scans should have a biopsy and the scans are helpful to direct the biopsy. Ga-67 scintigraphy is useful in the diagnosis of malignant lymphoma of the thyroid gland. (author).

Higashi, Tomomitsu (Kanagawa Dental College (Japan)); Itoh, Kunihiko; Ozaki, Osamu; Yashiro, Takashi; Momotani, Naoko; Mimura, Takashi

1989-09-01

104

Ga-67 scintigram in evaluation of malignant lymphoma of the thyroid originated from chronic thyroiditis  

International Nuclear Information System (INIS)

[en] At the Itoh Hospitall, 27 patients with primary malignant lymphoma of the thyroid gland have been diagnosed from April 1985 to April 1988. Within the 27 patients, 8 patients were treated with a diagnosis of chronic thyroiditis during 1 year to 7 years at Itoh Hospital. Ga-67 scintigraphy was performed in the 8 patients as suspected malignant lymphoma. Of the 8 patients, 6 were very strong positive, 1 was strong positive and 1 was weak positive. All patients with Ga-67 strong positive scans should have a biopsy and the scans are helpful to direct the biopsy. Ga-67 scintigraphy is useful in the diagnosis of malignant lymphoma of the thyroid gland. (author)

1989-01-01

105

'Suspicious for a Follicular Neoplasm' before and after the Bethesda System for Reporting Thyroid Cytopathology: Impact of Standardized Terminology.  

UK PubMed Central (United Kingdom)

Background: The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) standardized the terminology for indeterminate diagnoses, but the performance of the indeterminate categories before and after TBSRTC has not been compared. This study evaluates the 'suspicious for a follicular or Hürthle cell neoplasm' (SFN/HCN) category before and after the introduction of TBSRTC at a single institution and in a meta-analysis of the literature. Methods: A meta-analysis compiled findings from publications on SFN/HCN or similar diagnoses before and after the introduction of TBSRTC. The pathology database at our institution identified all SFN/HCN or similar diagnoses in the 8 years surrounding the introduction of TBSRTC, and those cases were correlated with the surgical follow-up. Results: In the meta-analysis, the fraction of cases called SFN/HCN or the equivalent increased from 6.1 to 7.4% (p = 0.0002); the surgical follow-up rate increased from 55 to 61% (p < 0.00001), and the histological malignancy rate among the cases that were resected increased from 22 to 28% (p = 0.03) after TBSRTC. In our institutional experience, the introduction of TBSRTC did not coincide with any significant changes. Conclusion: Standardized terminology clearly coincided with increases in follow-up and the malignancy rate of SFN/HCN. A change in the same statistics was not seen in our institutional experience. © 2013 S. Karger AG, Basel.

Boonyaarunnate T; Olson MT; Ali SZ

2013-01-01

106

Malignant neoplasm related mortality and morbidity of hypertensive outpatients in Japanese men and women.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To investigate the cause of reduced malignant neoplasm-related mortality in hypertensive outpatients. BACKGROUND: In previous studies, hypertensive outpatients have had modest improvement in overall mortality rate as compared with standard risk groups. While excessive mortality rates for cardiovascular disease and stroke were evident in hypertensive outpatients, the mortality rate of malignant neoplasm was greatly reduced. METHODS: Using database systems of Sumitomo Life Insurance Co, Japan, standard life tables were generated, and ratios or rates for mortality and morbidity of hypertensive outpatients were extrapolated and analyzed. RESULTS: The mortality ratio of all cancers was significantly low, 85% (95% CI: 77%-93%), and the morbidity ratio was significantly increased, 121% (95% CI: 109%-133%). The mortality ratio of each of categorized malignant neoplasm was below 100% except for colorectal cancer (111%, 95% CI: 83%-138%). The mortality ratios of stomach cancer (56%, 95% CI: 41%-72%) and liver cancer (52%, 95% CI: 32%-80%) were significantly decreased. The morbidity ratios of colorectal cancer, breast cancer, esophageal cancer, and others were over 100%, and was statistically significant in colorectal cancer (140%, 95% CI: 112%-167%) and others (139%, 95% CI: 113%-165%). The differences between the mortality ratio and the morbidity ratio of stomach cancer and others were statistically significant. The relative lethality of all but pancreatic cancer and leukemia were less than 1.0, and there was a positive correlation between the general prognosis of each cancer and the relative lethality. CONCLUSIONS: The decreased malignant neoplasm-related mortality ratio in hypertensive outpatients was indicative of an improved prognosis and likely benefited from close medical surveillance.

Kato S; Takamoto N; Matsumoto K; Kudo M; Hanaoka K

2013-01-01

107

Multiple primary malignant neoplasms in patients treated with definitive chemoradiotherapy for esophageal cancer  

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We reviewed our clinical experiences of chemoradiotherapy (CRT) for esophageal cancer (EC) in 44 patients with multiple primary malignant neoplasms. Among them, 34 were accompanied with synchronous tumors, 8 were accompanied with antecedent tumors and 8 with subsequent tumors. The sites of primary malignant neoplasms were as follows; stomach 24 (43.6%), head and neck 17 (30.9%), colon and rectum 4 (7.3%). Among the 19 patients with synchronous cancer in the stomach, 6 patients underwent gastrectomy or endoscopic mucosal resection before CRT, and the others received definitive CRT as initial treatment. While 5 patients were alive without recurrence of EC and gastric cancer, more than half of the patients died of EC. Among 11 patients with head and neck cancer (HNC), 9 patients underwent surgery for HNC before CRT, because the clinical stages of the HNC was more progressive than that of EC. Only 3 patients achieved complete cure of both EC and HNC. The number of patients who developed subsequent tumors after CRT for EC was too small for us to draw definitive conclusions from our discussion, so further long-term follow-up and analysis based on large-scale surveys are required. Although CRT has become one of the standard treatments for EC, there is no treatment strategy for patients with both EC and other malignant primary neoplasms. Our results suggest that we should consider the curability of EC by CRT when we treat such patients. (author)

Yamashita, Keishi; Muto, Manabu; Ohtsu, Atsushi; Mera, Kiyomi; Doi, Toshihiko; Sano, Yasushi; Yoshida, Shigeaki [National Cancer Center, Kashiwa, Chiba (Japan). Hospital East

2003-03-01

108

Multiple primary malignant neoplasms in patients treated with definitive chemoradiotherapy for esophageal cancer  

International Nuclear Information System (INIS)

[en] We reviewed our clinical experiences of chemoradiotherapy (CRT) for esophageal cancer (EC) in 44 patients with multiple primary malignant neoplasms. Among them, 34 were accompanied with synchronous tumors, 8 were accompanied with antecedent tumors and 8 with subsequent tumors. The sites of primary malignant neoplasms were as follows; stomach 24 (43.6%), head and neck 17 (30.9%), colon and rectum 4 (7.3%). Among the 19 patients with synchronous cancer in the stomach, 6 patients underwent gastrectomy or endoscopic mucosal resection before CRT, and the others received definitive CRT as initial treatment. While 5 patients were alive without recurrence of EC and gastric cancer, more than half of the patients died of EC. Among 11 patients with head and neck cancer (HNC), 9 patients underwent surgery for HNC before CRT, because the clinical stages of the HNC was more progressive than that of EC. Only 3 patients achieved complete cure of both EC and HNC. The number of patients who developed subsequent tumors after CRT for EC was too small for us to draw definitive conclusions from our discussion, so further long-term follow-up and analysis based on large-scale surveys are required. Although CRT has become one of the standard treatments for EC, there is no treatment strategy for patients with both EC and other malignant primary neoplasms. Our results suggest that we should consider the curability of EC by CRT when we treat such patients. (author)

2003-01-01

109

Glioneuronal Neoplasms with Malignant Histological Features: A Study of 36 Cases  

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Full Text Available Objective: Malignant glioneuronal tumors show considerable morphological diversity. Their biological behavior and clinicopathological characteristics are incompletely understood. With the exception of anaplastic ganglioglioma, they are not assigned to a specific entity in the current WHO classification. It is also not clear whether histological features of these neoplasms influence prognosis.Material and Method: We identified 36 glioneuronal tumors with malignant histological features among the departmental archives and neuropathology consultation files of the authors. We reviewed the pathological and radiological features of these tumors to construct a preliminary histological categorization.Results: Based on their pathological features, we divided the study group into three histologically distinct categories: 1) glioneuronal tumors with a malignant glial component (anaplastic gangliogliomas); 2) glioneuronal tumors with a malignant neuronal/neuroblastic component; 3) glioneuronal tumors with both malignant neuronal and glial components. All tumors occurred in a younger age group compared to glioblastomas and appeared radiologically well-defined, cystic and solid with variable contrast enhancement. There was a high rate of local recurrence (29 of 36 patients) and 12 patients died during follow-up period. Median progression-free survival was less than 12 months, and did not differ among categories. Cerebrospinal tumor spread was seen in only one patient. Concurrent WHO grade I ganglioglioma and the presence of a malignant neuronal component did not appear to influence prognosisConclusion: MGNTs were considered in three simple categories based on their malignant component(s). Tumors in all categories exhibited a high rate of local recurrence and aggressive behavior akin to malignant gliomas as opposed to classical PNET. Nevertheless, MGNT demonstrated clinicopathological features that distinguish them from typical glioblastoma. The exact nosology of MGNTs is unresolved and our study underscores the need for a more comprehensive classification of these neoplasms within the WHO scheme.

Tar?k T?HAN; Hümayun GÜLTEK?N; Nil ÇOMUNO?LU

2010-01-01

110

Partially Cystic Thyroid Nodules: Ultrasound Findings of Malignancy  

International Nuclear Information System (INIS)

To seek for the ultrasound (US) findings of partially cystic thyroid nodules that are associated with malignancy. We reviewed the US characteristics of 22 surgically confirmed partially cystic papillary carcinomas, and compared them with those of 80 benign partially cystic nodules. The review cases were selected in a random order from a total of 1029 partially cystic nodules that were diagnosed with an US-guided fine needle aspiration biopsy over a period of 8 years (June 2003 to October 2010) at our institution. In partially cystic thyroid nodules, a taller-than-wide shape (100%, p

2012-01-01

111

Follicular thyroid neoplasms can be classified as low- and high-risk according to HBME-1 and Galectin-3 expression on liquid-based fine-needle cytology.  

UK PubMed Central (United Kingdom)

DESIGN: Fine-needle aspiration biopsy (FNAB) is the most reliable diagnostic tool in the diagnosis of thyroid nodules. A cytologic diagnosis of follicular neoplasm with atypical cells of undetermined significance (FN/AUS) implies that the selection of patients between surgery and follow-up is difficult. In this setting immunocytochemical stainings might be helpful. The efficacy of a panel made up of HBME-1 and Galectin-3 antibodies is evaluated in cases processed by liquid-based cytology (LBC). METHODS: Out of 7091 thyroid FNAB processed by LBC method, 120 cases undergoing surgery successively were selected. These cases were classified as benign lesion (BL, eight cases), FN, including the ACUS category of the Bethesda classification (FN/AUS, 50 cases), suspicious for malignancy (SM, 59 cases), and malignant neoplasm (MN, three cases). Immunostains for HBME-1 and Galectin-3 were carried out on the LBC slides. RESULTS: All MN and BL were histologically confirmed. FN/AUS and SM showed a malignancy risk of 24 and 72.9% respectively. The complete immunocytochemical panel was positive in 83.3% of the cases resulting in malignancy and negative in 87.5% of cases resulting in benign histology. Among the FN/AUS, the complete positive immunocytochemical panel was detected in 76.9% of cases resulting as malignant and the complete negative immunocytochemical panel was observed in 96.8% of cases resulting as benign at histology. CONCLUSIONS: The expression of HBME-1 and Galectin-3 in cases classified as FN/AUS on LBC-processed FNABs can effectively distinguish lesions, which need immediate surgery (high risk or FNH or Thy 3h) from those which can be followed-up (low risk or FNL or Thy 3l).

Fadda G; Rossi ED; Raffaelli M; Pontecorvi A; Sioletic S; Morassi F; Lombardi CP; Zannoni GF; Rindi G

2011-09-01

112

Tl-201 thyroid imaging in differentiating benign from malignant thyroid nodules  

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To evaluate the value of Tl-201 thyroid imaging in differentiating benign from malignant thyroid nodules, 58 patients with histologically proven thyroid masses were studied. The nature of the thyroid tumor was initially assessed by Tc-99m scans. Early and delayed Tl-201 thyroid imaging were performed in all patients, and thallium uptake and clearance in the cold nodules were assessed visually. Of the 20 patients with histologically proven malignant nodules, 19 showed increased Tl-201 activity in both the early and delayed images, indicating a sensitivity of 95%. On the other hand, 35 out of the 38 patients with benign nodules showed no increased thallium activity in the nodules on the delayed images, indicating a specificity of 92%. When early thallium images were analyzed separately, the sensitivity was 100% but the specificity was only 37%. By combining early and delayed Tl-201 images, differentiation between benign and malignant cold nodules is feasible. False-positive and false-negative cases will be discussed.

el-Desouki, M. (College of Medicine, King Khalid University Hospital, King Saud University, Riyadh (Saudi Arabia))

1991-06-01

113

Tl-201 thyroid imaging in differentiating benign from malignant thyroid nodules  

International Nuclear Information System (INIS)

[en] To evaluate the value of Tl-201 thyroid imaging in differentiating benign from malignant thyroid nodules, 58 patients with histologically proven thyroid masses were studied. The nature of the thyroid tumor was initially assessed by Tc-99m scans. Early and delayed Tl-201 thyroid imaging were performed in all patients, and thallium uptake and clearance in the cold nodules were assessed visually. Of the 20 patients with histologically proven malignant nodules, 19 showed increased Tl-201 activity in both the early and delayed images, indicating a sensitivity of 95%. On the other hand, 35 out of the 38 patients with benign nodules showed no increased thallium activity in the nodules on the delayed images, indicating a specificity of 92%. When early thallium images were analyzed separately, the sensitivity was 100% but the specificity was only 37%. By combining early and delayed Tl-201 images, differentiation between benign and malignant cold nodules is feasible. False-positive and false-negative cases will be discussed

1991-01-01

114

The sonographic appearance of benign and malignant thyroid diseases and their histopathology correlate: demystifying the thyroid nodule.  

Science.gov (United States)

The thyroid gland is one of the largest endocrine glands in the human body. It functions as a regulator of metabolism. Diseases involving the thyroid range from benign to malignant and can be associated with major morbidity and mortality. Ultrasound (US) imaging of the thyroid gland is prompted because of a palpable mass on clinical examination; abnormality of thyroid function tests; incidental finding on other imaging modalities, that is, nuclear scintigraphy or computed tomography scan; screening for patients with risk factors for malignancy, such as multiple endocrine neoplasia type II; or prior neck radiation treatment.Ultrasound is an excellent, noninvasive, and cost-effective diagnostic tool in the detection and characterization of thyroid disease. Most thyroid diseases have pathognomonic features on US, which are of diagnostic importance and lead to appropriate clinical management. Ultrasound plays an important role in differentiating benign from malignant thyroid disease, thereby triaging patients for US-guided fine-needle aspiration. Ultimately, thyroid US, in conjunction with thyroid function tests, can aid in characterizing various thyroid diseases.The main objective of this pictorial essay is to illustrate the sonographic appearance of various benign and malignant diseases of the thyroid with their histopathology correlations. Management of thyroid nodules using US-guided fine-needle aspiration is also briefly discussed. PMID:23867569

Oyedeji, Francisca; Giampoli, Ellen; Ginat, Daniel; Dogra, Vikram

2013-09-01

115

The sonographic appearance of benign and malignant thyroid diseases and their histopathology correlate: demystifying the thyroid nodule.  

UK PubMed Central (United Kingdom)

The thyroid gland is one of the largest endocrine glands in the human body. It functions as a regulator of metabolism. Diseases involving the thyroid range from benign to malignant and can be associated with major morbidity and mortality. Ultrasound (US) imaging of the thyroid gland is prompted because of a palpable mass on clinical examination; abnormality of thyroid function tests; incidental finding on other imaging modalities, that is, nuclear scintigraphy or computed tomography scan; screening for patients with risk factors for malignancy, such as multiple endocrine neoplasia type II; or prior neck radiation treatment.Ultrasound is an excellent, noninvasive, and cost-effective diagnostic tool in the detection and characterization of thyroid disease. Most thyroid diseases have pathognomonic features on US, which are of diagnostic importance and lead to appropriate clinical management. Ultrasound plays an important role in differentiating benign from malignant thyroid disease, thereby triaging patients for US-guided fine-needle aspiration. Ultimately, thyroid US, in conjunction with thyroid function tests, can aid in characterizing various thyroid diseases.The main objective of this pictorial essay is to illustrate the sonographic appearance of various benign and malignant diseases of the thyroid with their histopathology correlations. Management of thyroid nodules using US-guided fine-needle aspiration is also briefly discussed.

Oyedeji F; Giampoli E; Ginat D; Dogra V

2013-09-01

116

"MONOCLONAL ANTIBODY HBME-1 USEFULNESS IN DIFFERENTIATION OF BENIGN NEOPLASM AND DIFFERENTIATED THYROID CARCINOMA"  

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Full Text Available HBME-l is an antimesothelial monoclonal antibody that recognizes an unknown antigen on microvilli of mesothelial cells. The antibody is only relatively specific for mesothelium and is used in the differential diagnosis of mesothelioma and adenocarcinoma within the context of an appropriate immuno-histochemical panel. HBME-l has also been reported to strongly and uniformly stain papillary and follicular carcinoma of the thyroid while benign disorders have been usually negative. We studied the immunoreactivity of HBME-l in 90 cases of benign and malignant thyroid lesions. We found strong positive staining in the majority of papillary carcinomas (28/31), in some of follicular carcinomas (4/6),and in a few follicular adenomas (2/17). Negative staining was found in oxyphilic cell adenoma (0/4), nodular goiter (0/13) and undifferentiated carcinoma. The results suggest that monoclonal antibody HBME-l is useful in differentiating papillary and follicular carcinoma of the thyroid from benign lesions, especially in more differentiated lesions. Strong and generalized immunoreactivity for HBME-l in a follicular lesion should raise the suspicion of malignancy, but negative staining specially in poorly differentiated lesion does not rule out malignancy.

M. Mokhtari; M. Sadeghi; A. Talebi

2005-01-01

117

Clinical, ultrasonographical and histopathological aspects in Hashimoto's thyroiditis associated with malignant and benign thyroid nodules.  

UK PubMed Central (United Kingdom)

INTRIDUCTION: The reported prevalence of chronic autoimmune thyroiditis associated with differentiated thyroid cancer (DTC) is heterogeneous.The aim of this study was to evaluate some epidemiological, clinical, sonographical and histological features of operated thyroidnodules with background diffuse autoimmune thyroiditis. MATERIAL AND METHODS: The study included 411 cases with Hashimoto's thyroiditis (HT), of which 118 presented thyroid nodular disease(TND). Thyroidectomy was performed in 76 cases. Of these patients, 24 presented histologically confirmed DTC and 52 benign lesions.DTC types were as follows: papillary thyroid cancer (PTC) (n = 6), follicular variant of PTC (FVPTC) (n = 6), papillary microcarcinomas(n = 8), follicular thyroid carcinoma (n = 1) and the mixed form (classic PTC and FVPTC) (n = 3). The benign nodules were dominatedby: follicular adenoma (48%), and colloid goitre (40.3%). RESULTS: The sonographic features with predictive risk for malignancy in cases with HT associated with TND were represented by: solidcomposition, hypoechogenicity and microcalcifications. The characters of margins, the nodular shape and the type of vascularity do notseem to be as useful for identification of malignant nodules in HT. Fine needle-aspiration biopsy (FNAB) showed in DTC cases differentcytological smears: malignant (ten), indeterminate (eight), benign (two), and non-diagnostic (four). In the group of benign nodules, theindeterminate smears represented also a significant percentage (n = 12). CONCLUSIONS: The incidence of TND associated with HT was 28.7%. Among 76 operated cases, 31.5% presented DTC. The accuracyof FNAB in the preoperative diagnosis showed higher sensitivity (90.0%) and specificity (61.5%) compared to sonographic criteria.

Zosin I; Bala? M

2013-01-01

118

Does bethesda category predict aggressive features in malignant thyroid nodules?  

UK PubMed Central (United Kingdom)

BACKGROUND: It has been speculated that the Bethesda Classification System for thyroid fine-needle aspirate (FNA) may be used to predict aggressive features among histologically proven malignancies. We sought to evaluate whether malignancies that were characterized as Bethesda category V or VI have more aggressive features than malignancies that were category III or IV. METHODS: A prospectively maintained database was reviewed to identify thyroid malignancies treated at a single center from 2004 to 2009. Only cancers that could be definitively matched to a preoperative FNA were included. Associations between Bethesda category, patient demographics, histopathologic findings, and outcomes were examined. RESULTS: A total of 360 cancers were analyzed: 73 (20 %) were Bethesda category III or IV and 287 (80 %) were category V or VI. The majority of Bethesda III and IV cancers were follicular variants of papillary thyroid carcinoma (fvPTC), whereas the majority of Bethesda V and VI cancers were classic PTC (52 and 67 %, respectively, p < 0.01). Extrathyroidal extension (30 vs. 16 %, p = 0.02), lymph node metastases (50 vs. 31 %, p = 0.05), and multifocality (51 vs. 37 %, p = 0.03) were more common among Bethesda V and VI nodules. However, when Bethesda III or IV classic PTC and fvPTC were compared to Bethesda V or VI cancers of the same histologic subtype, there were no differences in any features. Recurrence and overall survival were the same in all groups. CONCLUSIONS: Bethesda category may help to predict the most likely histologic subtype of thyroid cancer, but it does not have any prognostic significance once the histologic diagnosis is known.

Kleiman DA; Beninato T; Soni A; Shou Y; Zarnegar R; Fahey TJ 3rd

2013-10-01

119

Utility of immunohistochemical markers in differentiating benign from malignant follicular-derived thyroid nodules  

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Abstract Background Thyroid nodules are common among adults though only a small percentage is malignant, which can histologically mimic benign nodules. Accurate diagnosis of these thyroid nodules is critical for the proper clinical management. Methods We investigated i...

Saleh Husain A; Jin Bo; Barnwell John; Alzohaili Opada

120

Hematological follow-up studies on patients with thyroid neoplasms after 131I therapy  

International Nuclear Information System (INIS)

Based on 391 thyroid neoplasms diagnostic hematological follow-up studies were registered in 34 patients with an overall J-131-dose of more than 500 mCi including the following parameters: 1. Peripheral blood control. 2. Bone marrow aspiration. 3. Cell volume distribution size of leukocytes after preparative enrichment. If in doubt a bone marrow scintigraphy was added. The adjunctive diagnostic procedure was correlated with histological criteria of thyroid carcinoma and J-131 retention after therapeutic application of radioiodine. In particular, a case report is given regarding a patient of 66 years with follicular thyroid carcinoma receiving 990 mCi J-131 during a period of 11 years after having had total thyroidectomy twice. The development of acute leucemia followed by death happened 16 years later. The moment of bone marrow transformation was determined exactly. The value of blood parameters can be calculated as follows: 1. Peripheral blood controls are limited by lack of efficiency. 2. Biopsy of bone marrow can detect hypoplastic alteration being latent in circulating blood for some years, even of J-131 cumulation dose below 500 mCi. 3. The analysis of distribution size of leukocytes represents a functional aspect after radiation induced in injury of bone marrow. (author)

1978-01-01

 
 
 
 
121

SENSITIZER FOR AN ERYTHROCYTIC DIAGNOSTIC AGENT FOR DIAGNOSING MALIGNANT NEOPLASMS AND METHOD FOR PRODUCING SAME, ERYTHROCYTIC DIAGNOSTIC AGENT FOR DIAGNOSING MALIGNANT NEOPLASMS AND METHOD FOR PRODUCING SAME AND METHOD FOR DIAGNOSING THE PRESENCE OF  

UK PubMed Central (United Kingdom)

The invention relates to medicine and concerns the diagnosis of oncological diseases, in particular the diagnosis of the presence of malignant neoplasms. A sensitizer is proposed for an erythrocytic diagnostic agent for diagnosing the presence of malignant neoplasms, said sensitizer comprising a mixture of fractions of low-molecular protein compounds with a molecular mass of 3000-15000 Da, which are extracted from the blood serum of a pregnant mare in the early stage of pregnancy and exhibit a stimulating effect on the proliferation of malignant cells. A method is also proposed for producing the aforesaid sensitizer from pregnant mare blood serum. An erythrocytic diagnostic agent sensitized with the aforesaid sensitizer is proposed as well as a method for producing same. Furthermore, a method for diagnosing the presence of malignant neoplasms using the aforesaid erythrocytic diagnostic agent is proposed. The claimed invention makes it possible to determine with a high degree of reliability whether a patient has malignant neoplasms and to conduct relatively rapid screening of large population groups in order to identify individuals who might have malignant neoplasms.

BALYURA ALEXANDR VLADIMIROVICH; MOLODYK ALVINA ALFREDOVNA; SAVLUCHYNSKAYA LYUDMILA ALEXANDROVNA; TARASOV SERGEY GENNADEVICH

122

Incidentally detected thyroid papillary carcinoma on positron emission tomography in a patient with malignant melanoma  

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Full Text Available Focal or diffusely increased 18F-fluorodeoxyglucose (18FDG) uptake in thyroid gland are occasionally seen during 18FDG positron emission tomography (PET) scanning. Increased 18FDG uptake in thyroid nodules may be associated with benign or malignant tumours. In our case who was diagnosed as malignant melanoma, focally increased 18FDG uptake in a thyroid nodule was noticed. Thus, fine needle aspiration biopsy of the thyroid nodule was performed. On suspicious findings for the thyroid papillary cancer were reported, total thyroidectomy was performed. Histopathological evaluation revealed the thyroid papillary carcinoma. So, therapy for the incidental thyroid papillary carcinoma was commenced in this case who was under the follow-up for the malignant melanoma.J Clin Exp Invest 2012; 3 (3): 430-432Key words: Thyroid, papillary carcinoma, FDG-PET, thyroid incidentaloma

Zeki Dostbil; Bu?ra Kaya; Oktay Sar?; Erhan Varo?lu; Murat ?smailo?lu

2012-01-01

123

Predictive factors associated with malignancy of intraductal papillary mucinous pancreatic neoplasms  

Directory of Open Access Journals (Sweden)

Full Text Available AIM: To identify preoperative predictive factors associated with malignancy of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas.METHODS: Between April 1995 and April 2010, 129 patients underwent surgical resection for IPMNs at our institute and had confirmed pathologic diagnoses. The medical records were retrospectively reviewed and immunohistochemical staining for mucin (MUC) in pancreatic tissues was performed.RESULTS: Univariate analysis showed that the following five variables were closely associated with malignant IPMNs preoperatively: absence of extrapancreatic malignancy; symptoms; tumor size > 4 cm; main pancreatic duct (MPD) size > 7 mm; and lymph node enlargement on preoperative computed tomography (CT). Multivariate analysis revealed that the following two factors were significantly associated with malignant IPMNs preoperatively: MPD size > 7 mm [odds ratio (OR) = 2.50]; and lymph node enlargement on preoperative CT (OR = 3.57). No significant differences in the expression of MUC1, MUC2 and MUC5AC were observed between benign and malignant IPMNs.CONCLUSION: MPD size > 7 mm and preoperative lymph node enlargement on CT are useful predictive factors associated with malignancy of IPMNs.

Jin Hee Lee, Kyu Taek Lee, Jongwook Park, Sun Youn Bae, Kwang Hyuck Lee, Jong Kyun Lee, Kee-Taek Jang, Jin Seok Heo, Seong Ho Choi, Dong Wook Choi, Jong Chul Rhee

2010-01-01

124

Cystic Change of Thyroid Mass: A Useful Sign in Differentiating Benign from Malignant Thyroid Lesions?  

International Nuclear Information System (INIS)

To examine the usefulness of the cystic change of the thyroid mass in the diagnostic differentiation of benign from malignant thyroid lesions. We retrospectively analyzed the ultrasonographic (US) findings of 65 benign (30 follicular adenomas and 35 nodular hyperplasias) and 206 malignant (202 papillary carcinomas and 4 follicular carcinomas) lesions that had been confirmed by surgery. The cystic change was graded as 0 (mass without cystic change), 1, 2, 3 and 4 (cystic change less than 25%, 25-50%, 51-75%, and more than 75% of the volume of the mass, respectively). The incidence and grades of the cystic change of the benign thyroid lesions were compared with those of the malignant lesions. We also evaluated the US features of the cystic change to evaluate any differences between benign and malignant lesions. Statistical significance was assessed by Chi-square test. Cystic change was present in 47/65 (72.3%) of benign thyroid lesions (21/30 [70%] of follicular adenomas and 26/35 [74.3%] of nodular hyperplasias) and 16/206 (7.8%) of malignant lesions (14/202 [6.9%] of papillary carcinomas and 2/4 [50%] of follicular carcinomas). The grades of cystic change were grade 1 in 29/47 (61.7%), 2 in 2/47 (4.3%), 3 in 2/47 (4.3%), and 4 in 14/47 (29.8%) for benign thyroid lesions, and grade 1 in 14/16 (87.5%) and 3 in 2/16 (12.5%) for malignant lesions. In regard to the US features of cystic change, a large cyst with polypoid projection less than 1 cm in size and a large cyst with a peripheral rind of solid component were exclusively found in the benign thyroid lesions. In contrast, malignant lesions frequently presented as a mass with irregularly mixed, solid and cystic components, a solid mass with multiple cystic components, or a solid mass with one or two cystic components. Cystic change was more common (p

2007-01-01

125

Thyroid nodularity in children.  

Science.gov (United States)

Of 5,179 school children surveyed in Utah, Nevada, and Arizona for thyroid abnormalities because of possible exposure to radiation from fallout, nodularity of the thyroid was found in 98 (1.8%). In 34, the nodularity represented lobulation associated with adolescent goiter, and in 31, thyroiditis. Two malignant neoplasms were found. In a normal childhood population in which nodularity is incidentally discovered on physical examination, the risk of nodularity being malignant is approximately 2%. Factors that favor exploration of thyroid nodules in children are discreteness, growth of the mass, singleness, and absence of other thyroid disease. PMID:1174152

Rallison, M L; Dobyns, B M; Keating, F R; Rall, J E; Tyler, F H

1975-09-01

126

Thyroid nodularity in children.  

UK PubMed Central (United Kingdom)

Of 5,179 school children surveyed in Utah, Nevada, and Arizona for thyroid abnormalities because of possible exposure to radiation from fallout, nodularity of the thyroid was found in 98 (1.8%). In 34, the nodularity represented lobulation associated with adolescent goiter, and in 31, thyroiditis. Two malignant neoplasms were found. In a normal childhood population in which nodularity is incidentally discovered on physical examination, the risk of nodularity being malignant is approximately 2%. Factors that favor exploration of thyroid nodules in children are discreteness, growth of the mass, singleness, and absence of other thyroid disease.

Rallison ML; Dobyns BM; Keating FR Jr; Rall JE; Tyler FH

1975-09-01

127

Endoscopic groin lymph node dissection as a preferable technique for malignant skin neoplasms.  

UK PubMed Central (United Kingdom)

Groin lymph node dissection (GLND) remains an effective treatment for malignant neoplasms of the skin arising on the lower extremities and perineum. However, complications such as seroma, flap necrosis, and infections have been encountered. It is thought that a conventional operation using a long inguinal incision can result in those complications. To minimise the risk of such complications, endoscopic GLND (EGLND) was performed in five patients. No severe complications were found. Although EGLND is still in the developmental stage, this technique is suggested as a possible surgical option for reducing morbidity and improving aesthetic results.

Ichimiya M; Goishi K; Muto M

2013-09-01

128

Endoscopic groin lymph node dissection as a preferable technique for malignant skin neoplasms.  

Science.gov (United States)

Groin lymph node dissection (GLND) remains an effective treatment for malignant neoplasms of the skin arising on the lower extremities and perineum. However, complications such as seroma, flap necrosis, and infections have been encountered. It is thought that a conventional operation using a long inguinal incision can result in those complications. To minimise the risk of such complications, endoscopic GLND (EGLND) was performed in five patients. No severe complications were found. Although EGLND is still in the developmental stage, this technique is suggested as a possible surgical option for reducing morbidity and improving aesthetic results. PMID:23627646

Ichimiya, Makoto; Goishi, Keiichi; Muto, Masahiko

2013-04-30

129

Low malignancy risk of thyroid follicular lesion of undetermined significance in patients from post-endemic areas.  

UK PubMed Central (United Kingdom)

OBJECTIVE: New classification of the thyroid fine-needle aspiration biopsy (FNAB) results tries to stratify the risk of malignancy of thyroid follicular lesions using 'follicular lesion of undetermined significance' (FLUS) subcategory. Clinical significance of this category in the endemic (or post-endemic) areas has not been clearly established. DESIGN: The aim of the study was to determine the risk of malignancy for FLUS as well as to evaluate ultrasound (US) malignancy risk features (MRF) in such nodules in comparison with 'suspicious for neoplasm' (SFN) and 'benign lesions' (BL). METHODS: The US images and cytological diagnoses of 589 thyroid follicular lesions were analysed from January 2010 to July 2012. Cytological follow-up was assessed in 110 cases and surgical one in 100 cases. RESULTS: FLUS was diagnosed in 340 cases (3.8% of all cytological diagnoses and 57% of thyroid follicular lesions). Altogether, clinical and/or surgical follow-up revealed thyroid cancer in 3.2% patients with FLUS nodules. Repeat FNAB led to more specific diagnosis in 74.4% of FLUS (3.5%, papillary cancers or their suspicion; 2.3%, SFN; 68.6%, BL). The histopathological examination showed thyroid cancer in 6.4% cases of FLUS and 7.0% of SFN and follicular adenoma in 8.5% of FLUS and 11.6% of SFN (NS, FLUS vs SFN). FLUS showed MRF of intermediate values between BL and SFN; SFN more often than FLUS showed at least two MRF (53 vs 30%, P<0.0001). CONCLUSIONS: The risk of cancer in FLUS in areas with recently corrected iodine supply is low. In such areas, repeated biopsy leads to more precise cytological diagnosis in about 3/4 cases.

S?owi?ska-Klencka D; Wo?niak E; Wojtaszek M; Popowicz B; Sporny S; Klencki M

2013-04-01

130

Intensity modulated radiotherapy (IMRT) for pediatric cancer patients: the advantage and fear of second malignant neoplasm.  

UK PubMed Central (United Kingdom)

Intensity-modulated radiotherapy is used for delivering more efficient homogenous dose to the target and lowering of dose to the surrounding normal tissues. However, a second malignant neoplasm may develop after prolonged latent period. The use of modern precise radiotherapy techniques in the pediatric age group has many controversial issues in spite of its proven dosimetric distribution advantages and the considerable decrease of normal tissue complication probability (NTCP). This concern is due to many factors; mainly the exposure of a larger volume of normal tissues to low dose radiotherapy. Children have more proliferating tissues compared to the adults. However, the epidemiological data did not detect an increase in the incidence of radiation-induced second malignancy. This issue is still controversial as IMRT and other precise radiotherapy techniques were not widely used except recently. This may entail a thorough careful follow up for children treated with these techniques to detect any incidence increase.

Zaghloul MS

2013-03-01

131

[Malignant neoplasms and intestinal obstruction in children 3 to 15 years old  

UK PubMed Central (United Kingdom)

Observations on one of the rare complications in children presenting malignant neoplasms of the abdominal cavity and retroperitoneal space are described. Over a 7-year period, operative treatment is undertaken in 42 children aged 3 to 15 years. In eleven of them (26.42 per cent) it is a matter of mechanical ileus. The type of bowel obstruction in the series of children under study is a follows: obturation-in three and adhesion-in five cases. The obturation involves the large intestine, and is due to pressure of a neoplastic process in advanced stage of development on the colon. Ileus due to adhesions occurs after operative removal of the neoplastic formation. The essential differences in type of intestinal obstruction in children with malignant neoformation in the abdominal region from the one in adult patients justify the report on the observations.

Trifonov G; Mikhova M; Khristozova I; Dumanov K

1996-01-01

132

Malignant lymphoma of the thyroid gland. [/sup 60/Co  

Energy Technology Data Exchange (ETDEWEB)

We reviewed the records of 20 patients with malignant lymphoma present in the thyroid gland who were seen at The Princess Margaret Hospital between 1958 and 1977. The disease predominantly affected females of an older age group and clinically was characterized by a rapidly enlarging neck mass associated with obstructive symptoms. All patients were treated with radiotherapy. Adjuvant chemotherapy was used in only three patients. Overall survival rate at 5 years was 35%. Survival rate at 5 years from time of recurrence was 7%. Postmortem examination of eight patients showed widespread lymphoma in all; the lung, G.I. tract, liver and kidney were the most frequently affected distant sites. We conclude that radiotherapy to the neck and mediastinum is an adequate form of treatment in patients with lymphoma of the thyroid gland with Stage I or localized Stage II disease. More advanced disease should be managed with radiation and chemotherapy.

Souhami, L.; Simpson, W.J.; Carruthers, J.S.

1980-09-01

133

Fatores preditores de malignidade em neoplasias de células de Hurthle/ Predictor factors of malignancy in Hürthle cell neoplasms  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese OBJETIVO: neoplasias de células de Hurthle são tumores da glândula tireóide de baixa incidência que apresentam muitas controvérsias quanto à distinção entre carcinomas e adenomas. O objetivo deste estudo foi identificar fatores preditores de malignidade neste tipo específico de neoplasia. MÉTODOS: entre janeiro de 1999 e junho de 2006, 56 casos de neoplasia de células de Hurthle foram diagnosticados em nossa instituição e foram estudados retrospectivamente. (more) RESULTADOS: trinta e sete pacientes apresentaram diagnóstico patológico de adenoma de células de Hurthle (ACH), enquanto 19 casos foram diagnosticados como carcinoma de células de Hurthle (CCH). No grupo de pacientes com adenomas a idade média foi de 47,8 anos, sendo que trinta e cinco (94%) eram do sexo feminino e apenas dois (5,5%) casos do sexo masculino. O tamanho médio dos adenomas foi de 2,1 cm variando de 0,3 a 6,0 cm. Entre os 19 casos de carcinomas a média de idade foi de 51,1 anos, sendo quatorze casos em mulheres (73%) e cinco em homens (26,4%). O tamanho médio dos nódulos neste grupo foi de 3,8 cm, variando de 2,0 cm a 7,5 cm. CONCLUSÃO: Pacientes com neoplasias de células de Hurthle apresentando nódulos maiores que três centímetros, principalmente em homens, apresentam maior risco de malignidade. Abstract in english BACKGROUND: Hürthle cell neoplasms are uncommon thyroid gland tumors that present a diagnostic challenge due to difficulties to differentiate between adenomas and carcinomas. The purpose of this study is to identify preoperative predictor factors of malignancy. METHODS: A retrospective study of patients and tumor characteristics of 56 Hürthle cell tumors cases diagnosed in our institution between January 1999 and June 2006 was done. RESULTS: Thirty-seven patients presen (more) ted with adenoma, 35 women (94.5%) and 2 men (4.5%) with average age of 47.8 years. Medium tumor size in this group was 2.1 cm (ranging from 0.3 to 6.0 cm). Nineteen patients with Hürthle cell carcinoma were found in this series with 14 (73%) female and 5 male patients with average age of 51.1 years. Tumor size in this group ranged between 2.0 and 7.5 cm (medium of 3.8 cm). CONCLUSION: Patients with Hürthle cell neoplasm nodules larger than 3.0 cm, in the greatest diameter, especially in male patients, are predictor factors of having malignancy.

Fischer, Carlos Augusto; Graciano, Agnaldo José; Ferreira, Sérgio José; Daudt, Carlos Antônio; Fiorini, Cleber Antonio; Silvestri, Karina

2008-08-01

134

Methylation of the thyroid stimulating hormone receptor: diagnostic marker of malignity in thyroid cancer  

International Nuclear Information System (INIS)

The methylation state of the gene promoter for the receptor of the thyroid stimulating hormone (TSH) in the diagnosis of thyroid tumors of epithelial origin was analyzed. The study was conducted in thyroid tissue obtained from paraffin blocks of different thyroid pathologies (papillary, follicular and undifferentiated carcinoma and follicular adenomas). The work was done by using the DNA modification technique with sodium bisulfite, and polymerase chain reaction was applied to analyze the gene methylation state. Methylation of the promoter for the gene of the TSH receptor was found in the papillary carcinomas (33 of 40; 82.5 %), in 10 undifferentiated carcinomas (100 %), and in 10 of the 15 follicular carcinomas analyzed (66.6 %). No methylation was observed in the 8 follicular adenomas under study. The methylation of the gene for the TSH receptor was proposed as a new diagnostic marker of malignity and as a basis for using demethylating agents together with radioiodine therapy in patients with thyroid cancer of epithelial origin that do not respond to therapy. (Author)

2007-01-01

135

Primary osteosarcoma of the thyroid gland: report of a rare neoplasm/ Osteossarcoma primário da glândula tireoide: relato de uma neoplasia rara  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Tumores mesenquimais da glândula tireoide são extremamente raros. Os autores relatam um caso de osteossarcoma primário de tireoide em um paciente masculino que apresentou massa tumoral na região cervical. A tomografia computadorizada demonstrou um grande tumor no lobo tireoideano direito, com zonas de calcificação. A peça cirúrgica consistia de um tumor marrom-acinzentado e firme, medindo 13 × 11 × 7,5 cm. À microscopia, foi encontrada neoplasia maligna de alto (more) grau composta por células poligonais de tamanho intermédio, com um padrão condroide em algumas áreas e formação de osteoide. O processo revelou imunoexpressão negativa para AE1/AE3, proteína glial fibrilar ácida (GFAP), antígeno da membrana epitelial (EMA), p53 e fator de transcrição da tireoide (TTF-1) e imunopositividade para CD99 e S100. O diagnóstico de osteossarcoma primário da glândula tireoide foi, então, estabelecido. Abstract in english Primary mesenchymal tumors of the thyroid gland are extremely rare. The authors report a case of primary thyroid osteosarcoma in a male patient presenting a tumoral mass in the neck. CT scan demonstrated a large tumor in the right thyroid lobe with areas of calcification. The surgical specimen consisted of a hard brown-gray tumor, measuring 13 × 11 × 7.5 cm. Microscopy revealed a high-grade malignant neoplasm composed of polygonal cells of intermediate size, chondroid p (more) attern in some areas and osteoid formation. The process was immunonegative for AE1/AE3, glial fibrillary acidic protein (GFAP), epithelial membrane antigen (EMA), p53 and thyroid transcription factor-1 (TTF-1), and immunopositive for CD99 and S100. Thus the diagnosis of primary osteosarcoma of the thyroid gland was established.

Cambruzzi, Eduardo; Scholl, João Grigoleti; Molinari, Alberto Salgueiro; Pêgas, Karla Lais

2013-02-01

136

Primary osteosarcoma of the thyroid gland: report of a rare neoplasm Osteossarcoma primário da glândula tireoide: relato de uma neoplasia rara  

Directory of Open Access Journals (Sweden)

Full Text Available Primary mesenchymal tumors of the thyroid gland are extremely rare. The authors report a case of primary thyroid osteosarcoma in a male patient presenting a tumoral mass in the neck. CT scan demonstrated a large tumor in the right thyroid lobe with areas of calcification. The surgical specimen consisted of a hard brown-gray tumor, measuring 13 × 11 × 7.5 cm. Microscopy revealed a high-grade malignant neoplasm composed of polygonal cells of intermediate size, chondroid pattern in some areas and osteoid formation. The process was immunonegative for AE1/AE3, glial fibrillary acidic protein (GFAP), epithelial membrane antigen (EMA), p53 and thyroid transcription factor-1 (TTF-1), and immunopositive for CD99 and S100. Thus the diagnosis of primary osteosarcoma of the thyroid gland was established.Tumores mesenquimais da glândula tireoide são extremamente raros. Os autores relatam um caso de osteossarcoma primário de tireoide em um paciente masculino que apresentou massa tumoral na região cervical. A tomografia computadorizada demonstrou um grande tumor no lobo tireoideano direito, com zonas de calcificação. A peça cirúrgica consistia de um tumor marrom-acinzentado e firme, medindo 13 × 11 × 7,5 cm. À microscopia, foi encontrada neoplasia maligna de alto grau composta por células poligonais de tamanho intermédio, com um padrão condroide em algumas áreas e formação de osteoide. O processo revelou imunoexpressão negativa para AE1/AE3, proteína glial fibrilar ácida (GFAP), antígeno da membrana epitelial (EMA), p53 e fator de transcrição da tireoide (TTF-1) e imunopositividade para CD99 e S100. O diagnóstico de osteossarcoma primário da glândula tireoide foi, então, estabelecido.

Eduardo Cambruzzi; João Grigoleti Scholl; Alberto Salgueiro Molinari; Karla Lais Pêgas

2013-01-01

137

Sporadic ret-rearranged papillary carcinoma of the thyroid: a subset of slow growing, less aggressive thyroid neoplasms?  

UK PubMed Central (United Kingdom)

Despite the large amount of information accumulated on the role played by ret activation in the oncogenesis of papillary thyroid carcinoma (PTC), the biological and clinical significance of such activation 'in vivo' remains controversial. The aim of this study was to address some of the existing controversies by comparing two groups of unselected PTCs, one with and the other without ret rearrangement, with regard to several clinicopathological and biological features. Thirty-three PTCs were selected at random. ret rearrangement was found in eight cases (24.2 per cent) using Southern blot analysis. The mean age of the patients with tumours displaying ret rearrangement (28 +/- 3.1 years) was significantly lower than that of the patients harbouring cases that did not present rearrangement (45 +/- 2.9 years). The large majority of the tumours with ret rearrangement displayed a papillary or mixed follicular-papillary pattern and very low proliferative activity. ret rearrangement correlated significantly with decreased cytoplasmic expression of E-cadherin. No significant differences were found regarding the gender of the patients, tumour size, multicentricity, extrathyroidal growth, vascular invasion, lymphocytic infiltration, lymph node involvement or the expression of E-cadherin (membrane), c-erb-B2, c-met, Bcl-2, and vimentin. It is proposed that sporadic PTCs harbouring a ret rearrangement occur frequently as slow growing, papillary, or predominantly papillary tumours that do not usually progress towards less differentiated neoplasms representing what might be described as a Bonsai phenotype.

Soares P; Fonseca E; Wynford-Thomas D; Sobrinho-Simões M

1998-05-01

138

Sporadic ret-rearranged papillary carcinoma of the thyroid: a subset of slow growing, less aggressive thyroid neoplasms?  

Science.gov (United States)

Despite the large amount of information accumulated on the role played by ret activation in the oncogenesis of papillary thyroid carcinoma (PTC), the biological and clinical significance of such activation 'in vivo' remains controversial. The aim of this study was to address some of the existing controversies by comparing two groups of unselected PTCs, one with and the other without ret rearrangement, with regard to several clinicopathological and biological features. Thirty-three PTCs were selected at random. ret rearrangement was found in eight cases (24.2 per cent) using Southern blot analysis. The mean age of the patients with tumours displaying ret rearrangement (28 +/- 3.1 years) was significantly lower than that of the patients harbouring cases that did not present rearrangement (45 +/- 2.9 years). The large majority of the tumours with ret rearrangement displayed a papillary or mixed follicular-papillary pattern and very low proliferative activity. ret rearrangement correlated significantly with decreased cytoplasmic expression of E-cadherin. No significant differences were found regarding the gender of the patients, tumour size, multicentricity, extrathyroidal growth, vascular invasion, lymphocytic infiltration, lymph node involvement or the expression of E-cadherin (membrane), c-erb-B2, c-met, Bcl-2, and vimentin. It is proposed that sporadic PTCs harbouring a ret rearrangement occur frequently as slow growing, papillary, or predominantly papillary tumours that do not usually progress towards less differentiated neoplasms representing what might be described as a Bonsai phenotype. PMID:9713362

Soares, P; Fonseca, E; Wynford-Thomas, D; Sobrinho-Simões, M

1998-05-01

139

Inflammatory pseudotumor of the occipital condyle imitating a malignant neoplasm - a case report  

International Nuclear Information System (INIS)

[en] Inflammatory pseudotumor is a non-neoplastic process of unknown etiology characterized by proliferation of connective tissue with an inflammatory infiltrate. IPT most frequently arises in the orbit, but can also be found in the larynx, the paranasal sinus and rarely in the skull base. We present the case of a 20-year-old patient with a 4-month history of headache and insomnia. Neurological examination showed limited head mobility and hypoglossal nerve dysfunction. The patient was afebrile and no abnormalities in blood tests were found. CT revealed the presence of a tumor mass destructing the right occipital condyle. MRI was performed and the mass was surgically removed. The histological diagnosis was non-specific chronic inflammatory granulation tissue. Inflammatory pseudotumors can often mimic malignant neoplasms, especially in cases where bone destruction is observed. IPT of the occipital condyle is a rare but aggressive lesion that should be treated by surgical excision. (author)

2007-01-01

140

Vincristine sulfate as single-agent chemotherapy in a dog and a cat with malignant neoplasms.  

UK PubMed Central (United Kingdom)

A 12-year-old 4-kg spayed domestic shorthair cat with a poorly differentiated fibrosarcoma of the rostral aspect of the mandible and an 11-year-old 13-kg castrated dog of mixed breeding with pulmonary metastatic hemangiosarcoma were treated with 0.5 mg of vincristine sulfate/m2 of body surface, IV, weekly. Three months after beginning treatment, both animals had complete clinical remission. The role of this vinca alkaloid as a single agent for malignant neoplasms has seldom been discussed in the veterinary scientific literature. The results of these two cases indicate that single-agent vincristine sulfate chemotherapy is effective in the treatment of feline fibrosarcoma and canine hemangiosarcoma.

Hahn KA

1990-08-01

 
 
 
 
141

Concomitant chemo-radiotherapy and local dose of radiation as risk factors for second malignant neoplasms after cancer in childhood: a case control study  

International Nuclear Information System (INIS)

Radiotherapy and chemotherapy are associated with an increased risk of a second malignant neoplasm. after a cancer during childhood. This study specified the dose effect relationship between the local dose of radiation received at the site of the second malignant neoplasm and the risk of a second malignant neoplasm.It also investigated the effect of chemo radiotherapy on the risk of second malignant neoplasm. An European cohort of 4581 patients, treated for a solid cancer during childhood have been included in the study. 153 cases with a second malignant neoplasm, and 442 controls were matched according to sex, age at first cancer, calendar year, type of first cancer and follow-up. The local dose of radiation was estimated at the site of the second malignant neoplasm, for each case and at the same site, for his matched control. In conclusion, radiation was the foremost treatment related risk factor for the occurrence of a second malignant neoplasm. Compared to sequential treatment, concomitant chemo radiotherapy may lead to a higher risk of a second malignant neoplasm. (N.C.)

2006-01-01

142

Concomitant chemo-radiotherapy and local dose of radiation as risk factors for second malignant neoplasms after cancer in childhood: a case control study  

Energy Technology Data Exchange (ETDEWEB)

Radiotherapy and chemotherapy are associated with an increased risk of a second malignant neoplasm. after a cancer during childhood. This study specified the dose effect relationship between the local dose of radiation received at the site of the second malignant neoplasm and the risk of a second malignant neoplasm.It also investigated the effect of chemo radiotherapy on the risk of second malignant neoplasm. An European cohort of 4581 patients, treated for a solid cancer during childhood have been included in the study. 153 cases with a second malignant neoplasm, and 442 controls were matched according to sex, age at first cancer, calendar year, type of first cancer and follow-up. The local dose of radiation was estimated at the site of the second malignant neoplasm, for each case and at the same site, for his matched control. In conclusion, radiation was the foremost treatment related risk factor for the occurrence of a second malignant neoplasm. Compared to sequential treatment, concomitant chemo radiotherapy may lead to a higher risk of a second malignant neoplasm. (N.C.)

Guerin, S.; Guibout, C.; Vathaire, F. de [Institut National de la Sante et de la Recherche Medicale (INSERM), U605, 94 - Villejuif (France); Shamsaldin, A.; Diallo, I.; Oberlin, O.; Hartmann, O.; Le Deley, M.C. [Centre de Lutte Contre le Cancer Gustave-Roussy, 94 - Villejuif (France); Dondon, M.G. [Institut Curie, 75 - Paris (France); Hawkins, M. [Centre for Childhood Cancer Survivor Studies, Birmingham (United Kingdom)

2006-07-01

143

Renal cell carcinoma as a second malignant neoplasm in a patient with non-syndromic hemihypertrophy and previous Wilms tumor  

Energy Technology Data Exchange (ETDEWEB)

Survivors of childhood Wilms tumors are at an increased risk of second malignant neoplasms. Recently, it has been postulated that renal cell carcinoma is among the malignancies for which this population is at risk. We present the unique case of an adult Wilms tumor survivor with non-syndromic hemihypertrophy (NSHH) who developed renal cell carcinoma. This case highlights the need for close follow-up in two populations: adults who have survived Wilms tumor and those with NSHH. (orig.)

Kraushaar, Greg; Wiebe, Sheldon [Royal University Hospital, Department of Medical Imaging, Saskatoon (Canada)

2005-12-01

144

THYROID FUNCTION IN MALIGNANT PEDIATRIC PATIENTS AFTER RADIOTHERAPY  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction. Malignancy is seen in pediatrics, frequently. Radiotherapy as a common procedure in malignancy management may has many side effects and complications, especially about endocrine system. In this study, we evaluate the incidence of post radiotherapy hypothyroidism In malignant pediatric patients. Methods. In a cross sectional study one hundred and eighty children between 1 to 20 years old that survived of malignancy were selected. They have been treated in Sayyed-Alshohada hospital (affiliated to Isfahan University of Medical Sciences) from 1993 Sep. until 1998 Sep. by radiotherapy. Baseline characteristics (e.g. sex, age, dose, location and number of radiotherapy fraction, type of malignancy) were derived from medical records. Subjects were invited by letters to evaluate their thyroid functions in 1999. Serum T4 and FT4 concentrations assayed by RIA and TSH by IRMA methods. Results. The incidence of hypothyroidism was 13.3 percent (1.2 percent secondary hypothyroidism and 12.1 percent primary hypothyroidism). There was no statistical difference in age and sex distribution between patients with or without hypothyroidism. History of cervical region radiotherapy was taken in 45.8 percent of hypothyroid patients. There was no significant difference in dose and number of radiotherapy fraction between hypothyroid and euthyroid patients. Discussion. Radiotherapy may have a role in developing hypothyroidism in patients who received radiotherapy. This role has no relation to age and sex, dose and number of radiation fraction in development of hypothyroidism. Region of radiotherapy is important. It is suggested that this study continues and data will be collected during several years in future. Of course, many of hypothyroid patients will become euthyroid spontaneously.

M HASHEMI POUR; F GOLPAIEGANI; SH BABA ZADEH; A.R MAAFI; GH.A JAVANMARD

2000-01-01

145

`Cold` thyroid nodules: What does it mean? Association of `hot thyroid nodules with {sup 99m} Tc-tetrosfosmin` in previous `cold technetium thyroid nodules` and thyroid malignancies  

Energy Technology Data Exchange (ETDEWEB)

Full text. Tetrofosmin, a new lipophilic technetium-phosphine agent, proposed initially for myocardial perfusion imaging in which the precise mechanism of uptake into myocardial cells is likely to be similar to that of sestamibi, demonstrates in experimental data an accumulation in the mitochondria, a phenomenon dependent on the amount of proteins and energetic substrate (J Nucl Med, 35:48 P-47 P, 1994). Studies of biodistribution of Technetium-99 m-Tetrofosmin show early thyroid uptake which rapidly clears from normal thyroid tissue (tracer washout 4 h after injection), but it may be retained longer in malignant tumor lesion. Some reports have been describing localization of metastatic lesions of mixed thyroid cancer ( J Nucl Med, 36:2248-2251, 1995), follicular thyroid carcinoma (Eur J Nucl Med 22:1218-1220, 1995) and medullary thyroid carcinoma (J Nucl Med 38:227-230, 1997), utilizing Tc 99 m-Tetrofosmin and/or Sestamibi. We decided to use Tetrofosmin in our patients, since we hypothesized that its biological features and intracellular uptake mechanisms could justify its clinical applications in the differential of neoplastic diseases before surgery. We describe 2 patients, in a series of 6 who had no significant tracer uptake (cold nodules) with Technetium, that became `hot nodules` with Tc 99-Tetrofosmin, in which histologic findings after fine needle biopsy and thyroidectomy confirmed Hurthle cell Adenoma with Papillary Carcinoma nd the other a Papillary Multicentric Carcinoma. The other four patients are waiting for surgery. In conclusion, besides detecting metastatic lesions enabling us to better evaluation of the extended malignant disease, thyroid scintigraphic studies with Tc 99 m-Tetrofosmin seems to contribute for understanding and predicting of thyroid malignancies pre-surgically

Lima, Tadeu de Almeida; Pellini, Marcos P.; Almeida, Jose Carlos C.; Novaes, Luciene Targat; Pinto, Everton G.; Amarante Junior, Jose Luiz; Manhaes, Ricardo A. [MEDILABS Medicina Nuclear, Rio de Janeiro, RJ (Brazil)

1997-12-31

146

'Cold' thyroid nodules: What does it mean? Association of 'hot thyroid nodules with 99m Tc-tetrosfosmin' in previous 'cold technetium thyroid nodules' and thyroid malignancies  

International Nuclear Information System (INIS)

[en] Full text. Tetrofosmin, a new lipophilic technetium-phosphine agent, proposed initially for myocardial perfusion imaging in which the precise mechanism of uptake into myocardial cells is likely to be similar to that of sestamibi, demonstrates in experimental data an accumulation in the mitochondria, a phenomenon dependent on the amount of proteins and energetic substrate (J Nucl Med, 35:48 P-47 P, 1994). Studies of biodistribution of Technetium-99 m-Tetrofosmin show early thyroid uptake which rapidly clears from normal thyroid tissue (tracer washout 4 h after injection), but it may be retained longer in malignant tumor lesion. Some reports have been describing localization of metastatic lesions of mixed thyroid cancer ( J Nucl Med, 36:2248-2251, 1995), follicular thyroid carcinoma (Eur J Nucl Med 22:1218-1220, 1995) and medullary thyroid carcinoma (J Nucl Med 38:227-230, 1997), utilizing Tc 99 m-Tetrofosmin and/or Sestamibi. We decided to use Tetrofosmin in our patients, since we hypothesized that its biological features and intracellular uptake mechanisms could justify its clinical applications in the differential of neoplastic diseases before surgery. We describe 2 patients, in a series of 6 who had no significant tracer uptake (cold nodules) with Technetium, that became 'hot nodules' with Tc 99-Tetrofosmin, in which histologic findings after fine needle biopsy and thyroidectomy confirmed Hurthle cell Adenoma with Papillary Carcinoma nd the other a Papillary Multicentric Carcinoma. The other four patients are waiting for surgery. In conclusion, besides detecting metastatic lesions enabling us to better evaluation of the extended malignant disease, thyroid scintigraphic studies with Tc 99 m-Tetrofosmin seems to contribute for understanding and predicting of thyroid malignancies pre-surgically

1997-01-01

147

Differentiation between Benign and Malignant Solid Thyroid Nodules Using an US Classification System  

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To evaluate the diagnostic accuracy of a new ultrasound (US) classification system for differentiating between benign and malignant solid thyroid nodules. In this study, we enrolled 191 consecutive patients who received real-time US and subsequent US diagnoses for solid thyroid nodules, and underwent US-guided fine-needle aspiration. Each thyroid nodule was prospectively classified into 1 of 5 diagnostic categories by real-time US: 'malignant,' 'suspicious for malignancy,' 'borderline,' 'probably benign,' and 'benign'. We evaluated the diagnostic accuracy of thyroid US and the cut-off US criteria by comparing the US diagnoses of thyroid nodules with cytopathologic results. Of the 191 solid nodules, 103 were subjected to thyroid surgery. US categories for these 191 nodules were malignant (n = 52), suspicious for malignancy (n = 16), borderline (n = 23), probably benign (n 18), and benign (n = 82). A receiver-operating characteristic curve analysis revealed that the US diagnosis for solid thyroid nodules using the 5-category US classification system was very good. The sensitivity, specificity, positive and negative predictive values, and accuracy of US diagnosis were 86%, 95%, 91%, 92%, and 92%, respectively, when benign, probably benign, and borderline categories were collectively classified as benign (negative). The diagnostic accuracy of thyroid US for solid thyroid nodules is high when the above-mentioned US classification system is applied.

Lee, Young Hun; Kim, Dong Wook; In, Hyun Sin; Park, Ji Sung; Kim, Sang Hyo; Eom, Jae Wook; Kim, Bomi [Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of); Lee, Eun Joo [Dongnam Institute of Radiological and Medical Science, Busan (Korea, Republic of); Rho, Myung Ho [Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2011-10-15

148

Differentiation between Benign and Malignant Solid Thyroid Nodules Using an US Classification System  

International Nuclear Information System (INIS)

[en] To evaluate the diagnostic accuracy of a new ultrasound (US) classification system for differentiating between benign and malignant solid thyroid nodules. In this study, we enrolled 191 consecutive patients who received real-time US and subsequent US diagnoses for solid thyroid nodules, and underwent US-guided fine-needle aspiration. Each thyroid nodule was prospectively classified into 1 of 5 diagnostic categories by real-time US: 'malignant,' 'suspicious for malignancy,' 'borderline,' 'probably benign,' and 'benign'. We evaluated the diagnostic accuracy of thyroid US and the cut-off US criteria by comparing the US diagnoses of thyroid nodules with cytopathologic results. Of the 191 solid nodules, 103 were subjected to thyroid surgery. US categories for these 191 nodules were malignant (n = 52), suspicious for malignancy (n = 16), borderline (n = 23), probably benign (n 18), and benign (n = 82). A receiver-operating characteristic curve analysis revealed that the US diagnosis for solid thyroid nodules using the 5-category US classification system was very good. The sensitivity, specificity, positive and negative predictive values, and accuracy of US diagnosis were 86%, 95%, 91%, 92%, and 92%, respectively, when benign, probably benign, and borderline categories were collectively classified as benign (negative). The diagnostic accuracy of thyroid US for solid thyroid nodules is high when the above-mentioned US classification system is applied.

2011-01-01

149

Sarcoma of the thyroid region mimicking Riedel's thyroiditis  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Because sarcomas of the anterior lower neck region occur so infrequently, they are not usually considered in the differential diagnosis of Riedel's thyroiditis. Riedel's thyroiditis itself may be confused on clinical grounds alone with malignant neoplasms because of its invasive features. Sarcomat...

Torres-Montaner, A; Beltran, M; d Romero,; Oliva, H

150

Mucinous cystic neoplasm of the pancreas with neuroendocrine cells and malignant stroma.  

UK PubMed Central (United Kingdom)

Mucinous cystic neoplasms (MCN) with malignant sarcomatous stroma are rare aggressive tumors and there are few recorded cases. We report a case of MCN that had adenocarcinoma in situ and invasive adenocarcinoma with foci of sarcomatous stroma in a 40-year-old woman. Clear transition from adenocarcinoma areas into sarcomatoid foci was noted. The stromal component showed immunoreactivity for CK7 and Cam 5.2 supporting epithelial origin of the sarcomatoid areas. Associated areas of cytologically benign MCN epithelium were present and were immunoreactive for positive staining with pan-cytokeratin (AE1/AE3), cytokeratin 7 (CK 7), cytokeratin 20 (CK 20), pan-cytokeratin (Cam 5.2), epithelial membrane antigen (EMA), muscle specific actin (MSA), and carcino-embryonic antigen (CEA). Interestingly, definite scattered pear-shaped neuroendocrine cells, as evidenced by strong immunoreactivity for chromogranin and synaptophysin, were identified in the cytologically benign MCN lining but not in the malignant epithelial component. We found that these tumor cells probably arise from a single precursor cell capable of divergent differentiation.

Asberry DE; Youngberg GA; Al-Abbadi MA

2013-01-01

151

Mucinous cystic neoplasm of the pancreas with neuroendocrine cells and malignant stroma  

Directory of Open Access Journals (Sweden)

Full Text Available Mucinous cystic neoplasms (MCN) with malignant sarcomatous stroma are rare aggressive tumors and there are few recorded cases. We report a case of MCN that had adenocarcinoma in situ and invasive adenocarcinoma with foci of sarcomatous stroma in a 40-year-old woman. Clear transition from adenocarcinoma areas into sarcomatoid foci was noted. The stromal component showed immunoreactivity for CK7 and Cam 5.2 supporting epithelial origin of the sarcomatoid areas. Associated areas of cytologically benign MCN epithelium were present and were immunoreactive for positive staining with pan-cytokeratin (AE1/AE3),  cytokeratin 7 (CK 7), cytokeratin 20 (CK 20), pan-cytokeratin (Cam 5.2), epithelial membrane antigen (EMA), muscle specific actin (MSA), and carcino-embryonic antigen (CEA). Interestingly, definite scattered pear-shaped neuroendocrine cells, as evidenced by strong immunoreactivity for chromogranin and synaptophysin, were identified in the cytologically benign MCN lining but not in the malignant epithelial component. We found that these tumor cells probably arise from a single precursor cell capable of divergent differentiation. 

Don E. Asberry; George A. Youngberg; Mousa A. Al-Abbadi

2013-01-01

152

Surgical treatment of malignant and benign colorectal neoplasms based on authors' clinical data.  

UK PubMed Central (United Kingdom)

BACKGROUND: Colorectal cancer remains a huge diagnostic and therapeutic issue in Poland and worldwide. World epidemiological data indicates a constant increase in morbidity in recent decades. OBJECTIVES: The aim of this research was to present surgical procedures in malignant and benign colorectal neoplasms based on authors' clinical data. MATERIAL AND METHODS: Between 2001 and 2010, in the 1st Department of General and Endocrinological Surgery in Bialystok, 754 patients with malignant colorectal cancer were hospitalized. Precancerous conditions which included polyps and non-specific bowel inflammations were observed in 491 and 52 patients, respectively. RESULTS: The most frequent location of a malignant colorectal tumor was the rectum - 271 (35%) cases and sigmoid colon - 235 (31%) cases. In 8 cases (1%), a multifocal location of colorectal neoplasm was observed. Similar locations were observed in the case of polyps. They were observed the most frequently in the sigmoid colon - 144 (29.3%) cases and rectum - 122 (24.8%) cases. In the cases of colorectal cancer located in the rectum (271), the most frequently applied procedure was abdomino-perineal amputation - 102 (37.6%) patients (T1-3 N1-2 M0). In sigmoid colon cancer (235 cases), sigmoid colon resection was performed most frequently - in 175 patients (74.5%) (T1-3 N0-2 M0-1). Right hemicolectomy was performed in 120 (T1-4 N0-2 M0-1) patients and left hemicolectomy in 52 (T1-4 N02 M0-1) patients. In 482 cases, endoscopic resection of polyps was performed and in 9 patients resection through laparotomy. The majority of operations were performed according to plan, however, many of them were performed in emergency. CONCLUSIONS: Colorectal cancers, irrespectively to their location, develop secretly without any symptoms in the early stages which is the reason why patients contact a doctor in the late stadium of the disease. It is also the cause for a majority of the procedures performed in emergency. The best prognosis and long-term results are obtained with treatment combined with radio- and chemotherapy.

Hady HR; So?datow M; Lukaszewicz J; Luba M; Pierko J; My?liwiec P; Ladny JR; Dadan J

2013-03-01

153

Use of immunohistochemistry in fine needle aspiration of thyroid nodules in patients with a history of malignancy. A report of two cases.  

UK PubMed Central (United Kingdom)

BACKGROUND: A history of a nonthyroid malignancy may present a diagnostic dilemma in the assessment of fine needle aspiration (FNA) of thyroid nodules. One reported series, on patients with prior malignancies and a thyroid nodule, indicated that in 17% of patients, the thyroid nodule represented metastatic malignancy, 6% were classified as primary thyroid cancers, and the remainder were benign or inconclusive lesions. The resolution of this problem is essential to patient management. CASES: We report two cases in which patients with a history of renal cell carcinoma presented with a thyroid nodule. The first patient was an 80-year-old female whose Papanicolaou-stained FNA demonstrated clusters of round to polygonal cells with round to ovoid, hyperchromatic nuclei and abundant, wispy cytoplasm. The second patient was a 55-year-old female with clusters and single cells with round to oval, eccentric nuclei and copious, granular, gray cytoplasm noted on Papanicolaou-stained material. In each case, the diagnosis was inconclusive on initial review of Papanicolaou-stained slides, and immunohistochemical staining was ordered to better characterize the lesions. Tumor cells from case 1 were positive for cytokeratin cocktail and vimentin and negative for thyroglobulin, epithelial membrane antigen and calcitonin, suggestive of metastatic renal cell carcinoma. In contrast, the tumor cells from case 2 expressed cytokeratin, thyroglobulin and vimentin, consistent with a primary thyroid neoplasm. In each case, the cytologic diagnoses were confirmed in the resected specimens. CONCLUSION: Immunohistochemistry is a helpful adjunct in the evaluation of thyroid nodules in patients with a past history of malignancy.

Porcell AI; Hitchcock CL; Keyhani-Rofagha S

2000-05-01

154

SOLITARY THYROID NODULE; FREQUENCY OF MALIGNANCY AT COMBINED MILITARY HOSPITAL RAWALPINDI  

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Full Text Available To determine frequency of malignancy in solitary thyroid nodule. Design: Case-series study. Place and Durationof Study: The study was conducted at Department of Surgery, Combined Military Hospital Rawalpindi, from April 2002 till April 2003. Patientsand Methods: Sixty patients with clinical solitary thyroid nodule fulfilled the selection criteria and were included in the study. Thyroid functiontests, ultrasonography and thyroid scanning was done. Finally FNAC and histopathology were done in all the operated cases and record wasevaluated. Results: Out of 60 cases studied, 8 (13.33%) were found to have malignant lesions. The remaining 52 (86.67%) cases had benignpathology. Male patients with solitary thyroid nodule showed a higher incidence of malignancy 17.65% as compared to females 11.63%.Maximum malignant cases (50%) were found between the ages of 31 to 40 years. Papillary carcinoma was the most common malignancy (50%)found in our study. Conclusions: The incidence of malignancy in solitary thyroid nodule is quite high (13.33%). So people should be educated toattend thyroid clinics for early diagnosis and adequate treatment.

AIMEL MUNIR TARRAR; MADIHA SAEED WAHLA

2010-01-01

155

Comparison of strain ratio with elastography score system in differentiating malignant from benign thyroid nodules.  

UK PubMed Central (United Kingdom)

BACKGROUND: To prospectively compare strain ratio to elastography score system in distinguishing between malignant and benign thyroid nodules. METHODS: The local institutional review board approved the study, and all patients provided written informed consent. We examined 168 thyroid nodules (52 malignant and 116 benign) with freehand elastography. The elastogram was performed with both the five-degree elastography score system and thyroid tissue-to-nodule strain ratio before core biopsies as standard reference. The area under the curve (AUC) and the best cut-off point were both obtained using receiver-operating characteristic (ROC) curve analysis. The sensitivity, specificity, and accuracy of both techniques were compared with the ?(2) test. Furthermore, strain ratio distribution was also compared with histopathological result. P<.05 was considered to indicate significance. RESULTS: The strain ratio distribution of malignant thyroid nodules significantly differed from that of benign nodules (all P<.001). The AUC of strain ratio was higher than that of the elastography score system (0.907 vs. 0.829; P<.05). By applying the best cut-off point of 3.855 for strain ratio and 3.5 for the elastography score system, strain ratio had significantly higher specificity (P<.05) in detecting malignant thyroid nodules. However, there was no significant difference in the sensitivity in distinguishing malignant thyroid nodules from benign ones between strain ratio and the elastography score system (P>.05). CONCLUSION: Strain ratio is more specific than conventional elastography score system in differentiating malignant from benign thyroid nodules.

Wang H; Brylka D; Sun LN; Lin YQ; Sui GQ; Gao J

2013-01-01

156

[Hurthle cell neoplasm: our experience].  

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Hurthle cell neoplasm is a rare form of thyroid tumors, comprising from 1.5% to 10% of all tumors. Hurthle cell nodules are clinically indistinguishable from other nodular thyroid diseases. The histologic features of Hurthle cell neoplasm don't allow us to exactly distinguish benign nodules from malignant ones. Accurate histologic valutation is possible and necessary for a correct diagnosis and therapy of Hurthle cell tumors. The adenomas usually exhibit a follicular pattern; the carcinomas include a subset of Hurthle cell tumors with different biological behavior, including malignant follicular variants and papillary ones. The authors are in favour of total thyroidectomy for carcinomas and lobectomy plus isthectomy for adenomas; in case of carcinomas, the lymphadenectomy reduces the incidence of local relapse and is necessary in case of lymphnode involvement. Adjuvant radiation therapy is successful in preventing recurrences, in symptomatic metastates as palliative therapy and control recurrence of advanced resected tumors. PMID:15960361

Cristofaro, M G; Vescio, G; Fava, M G; Aversa, C; Amantea, M; Giudice, M

157

Prevalence and risk factors of extrapancreatic malignancies in a large cohort of patients with intraductal papillary mucinous neoplasm (IPMN) of the pancreas.  

UK PubMed Central (United Kingdom)

BACKGROUND: The objectives of this study are to estimate prevalence and incidence of extrapancreatic malignancies (EPMs) among intraductal papillary mucinous neoplasms (IPMNs) of the pancreas, and to identify risk factors for their occurrence. PATIENTS AND METHODS: We conducted multicentric cohort study in Italy from January 2010 to January 2011 including 390 IPMN cases. EPMs were grouped as previous, synchronous (both prevalent) and metachronous (incident). We calculated the observed/expected (O/E) ratio of prevalent EPMs, and compared the distribution of demographic, medical history and lifestyle habits. RESULTS: Ninety-seven EPMs were diagnosed in 92 patients (23.6%), among them 78 (80.4%) were previous, 14 (14.4%) were synchronous and 5 (5.2%) were metachronous. O/E ratios for prevalent EPMs were significantly increased for colorectal carcinoma (2.26; CI 95% 1.17-3.96), renal cell carcinoma (6.00; CI 95% 2.74-11.39) and thyroid carcinoma (5.56; CI 95% 1.80-12.96). Increased age, heavy cigarette smoking, alcohol consumption and first-degree family history of gastric cancer are significant risk factors for EPMs, while first-degree family history of colorectal carcinoma was borderline. CONCLUSION: We report an increased prevalence of EPMs in Italian patients with IPMN, especially for colorectal carcinoma, renal cell and thyroid cancers. A systematic surveillance of IPMN cases for such cancer types would be advised.

Larghi A; Panic N; Capurso G; Leoncini E; Arzani D; Salvia R; Del Chiaro M; Frulloni L; Arcidiacono PG; Zerbi A; Manta R; Fabbri C; Ventrucci M; Tarantino I; Piciucchi M; Carnuccio A; Boggi U; Costamagna G; Delle Fave G; Pezzilli R; Bassi C; Bulajic M; Ricciardi W; Boccia S

2013-07-01

158

The efficacy of apparent diffusion coefficient value calculation in differentiation between malignant and benign thyroid nodules.  

UK PubMed Central (United Kingdom)

PURPOSE: To evaluate the efficacy of apparent diffusion coefficient (ADC) calculation in differentiation between malignant and benign thyroid nodules. METHODS AND MATERIALS: A prospective study was conducted in 52 patients. Diffusion-weighted echoplanar imaging was performed and b factors were taken as 0 and 400 s/mm(2). RESULTS: The mean ADC value for malignant thyroid nodules was 0.829±0.179×10(-3) mm(2)/s and that for benign thyroid nodules was 1.984±0.482×10(-3) mm(2)/s. The mean ADC value for malignant nodules was significantly lower than that for benign nodules (P=.0001). CONCLUSION: ADC value calculation is an effective method in differentiation of malignant thyroid nodules from benign ones.

Dilli A; Ayaz UY; Cakir E; Cakal E; Gultekin SS; Hekimoglu B

2012-07-01

159

[Diagnostic value of thallium 201 scintigraphy in the determination of malignancy of cold thyroid nodules  

UK PubMed Central (United Kingdom)

In this paper we discuss and quantify the respective values of Thallium 201 scintigraphy and cytologic punction in determining malignancy of the cold thyroid nodule. These two diagnostic tests are evaluated on the basis of their sensitivity and specificity while taking into consideration various therapeutic attitudes in the presence of a cold thyroid nodule.

Eeckhoudt L; Hermans J; Bauwens L; Lebrun T; Beauduin M; Pluygers E; Sailly JC

1987-01-01

160

Diagnostic value of Thallium 201 scintigraphy in determining malignancy of the cold thyroid nodule  

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In this paper we discuss and quantify the respective values of Thallium 201 scintigraphy and cytologic punction in determining malignancy of the cold thyroid nodule. These two diagnostic tests are evaluated on the basis of their sensitivity and specificity while taking into consideration various therapeutic attitudes in the presence of a cold thyroid nodule.

Eeckhoudt, L.; Bauwens, L.; Hermans, J.; Beauduin, M.; Pluygers, E.; Lebrun, TH.; Sailly, J.C.

1987-01-01

 
 
 
 
161

A Bayesian Classifier for Differentiating Benign versus Malignant Thyroid Nodules using Sonographic Features  

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Thyroid nodules are a common, yet challenging clinical problem. The vast majority of these nodules are benign; however, deciding which nodule should undergo biopsy is difficult because the imaging appearance of benign and malignant thyroid nodules overlap. High resolution ultrasound is the primary i...

Liu, Yueyi I.; Kamaya, Aya; Desser, Terry S.; Rubin, Daniel L.

162

Risk of second malignant neoplasm following proton versus intensity-modulated photon radiotherapies for hepatocellular carcinoma  

International Nuclear Information System (INIS)

Hepatocellular carcinoma (HCC), the sixth most common cancer in the world, is a global health concern. Radiotherapy for HCC is uncommon, largely because of the likelihood of radiation-induced liver disease, an acute side effect that is often fatal. Proton beam therapy (PBT) and intensity-modulated radiation therapy (IMRT) may offer HCC patients a better option for treating the diseased liver tissue while largely sparing the surrounding tissues, especially the non-tumor liver. However, even advanced radiotherapies carry a risk of late effects, including second malignant neoplasms (SMNs). It is unclear whether PBT or IMRT confers less risk of an SMN than the other. The purpose of this study was to compare the predicted risk of developing an SMN for a patient with HCC between PBT and IMRT. For both treatments, radiation doses in organs and tissues from primary radiation were determined using a treatment planning system; doses in organs and tissues from stray radiation from PBT were determined using Monte Carlo simulations and from IMRT using thermo-luminescent dosimeter measurements. Risk models of SMN incidence were taken from the literature. The predicted absolute lifetime attributable risks of SMN incidence were 11.4% after PBT and 19.2% after IMRT. The results of this study suggest that using proton beams instead of photon beams for radiotherapy may reduce the risk of SMN incidence for some HCC patients.

2010-12-07

163

Avoiding reoperation for indeterminate thyroid nodules identified as malignant after surgery  

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Thyroid nodules that are indeterminate as carcinoma by needle biopsy before surgery and by study of frozen sections at the time of surgery are occasionally identified to be malignant in later studies. If only a lobectomy has been performed, the advisability of reoperation to remove the remaining thyroid tissue to facilitate radioactive iodine therapy may cause concern. To obviate this difficulty as well as to reduce the occurrence of nodules later in a preserved contralateral thyroid lobe and to provide additional thyroid tissue for study, contralateral subtotal or near total lobectomy has been performed for indeterminate thyroid nodules. The small remnant of remaining thyroid tissue can later be ablated by radioactive iodine if desired. Of 37 patients with indeterminate thyroid nodules, none required reoperation, although the diagnosis of carcinoma was established after surgery for eight patients, three of whom were treated with radioactive iodine

1991-01-01

164

Avoiding reoperation for indeterminate thyroid nodules identified as malignant after surgery  

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Thyroid nodules that are indeterminate as carcinoma by needle biopsy before surgery and by study of frozen sections at the time of surgery are occasionally identified to be malignant in later studies. If only a lobectomy has been performed, the advisability of reoperation to remove the remaining thyroid tissue to facilitate radioactive iodine therapy may cause concern. To obviate this difficulty as well as to reduce the occurrence of nodules later in a preserved contralateral thyroid lobe and to provide additional thyroid tissue for study, contralateral subtotal or near total lobectomy has been performed for indeterminate thyroid nodules. The small remnant of remaining thyroid tissue can later be ablated by radioactive iodine if desired. Of 37 patients with indeterminate thyroid nodules, none required reoperation, although the diagnosis of carcinoma was established after surgery for eight patients, three of whom were treated with radioactive iodine.

Block, M.A.; Dailey, G.E. 3d.; Muchmore, D. (Scripps Clinic Medical Group Inc, La Jolla, CA (USA))

1991-05-01

165

Assessment of enzymatic activity of salinary glands in comprehensive radiotherapy of malignant neoplasms of head and neck  

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[en] It is shown that in the course of combined radiotherapy of patients with malignant tumour localization in the head and neck increase in the activity of alpha-amylase of saliva and decrease in enzymatic activity, depending on the absorbed isoeffective dose, take place. Suppression of enzymatic activity of saliva was more clearly pronounced in the patients subjected to neutron radiation, than those subjected to the standard conditions of gamma-therapy. Indices of saliva enzymatic activity in the process of combined radiotherapy were used as criterion of tolerance of salinary glands in the patients with malignant neoplasms in the head and neck. 6 refs.; 3 tabs

1992-01-01

166

Malignant thyroid teratoma: report of an aggressive tumor in a 64-year-old man.  

UK PubMed Central (United Kingdom)

Malignant teratoma of the thyroid is a rare and aggressive tumor, frequent in children than in adults. Histologically, thyroid teratomas usually show a predominance of a neuroectodermal component. Mature cartilage and bone may be present. We present the case of primary malignant teratoma of the thyroid in a 64-year-old man. Histologically, the tumor displayed a predominant neuroectodermal component. The diagnosis was confirmed by immunohistochemistry. The patient underwent a radical thyroidectomy with central neck dissection as primary treatment and radioiodine treatment afterwards. The patient had local and distant recurrence. A second surgery was performed with poor results and the patient died 3 months afterwards.

Vilallonga R; Zafon C; Ruiz-Marcellan C; Obiols G; Fort JM; Baena JA; Villanueva B; Garcia A; Sobrinho-Simões M

2013-09-01

167

Oral malignant melanomas and other head and neck neoplasms in Danish dogs - data from the Danish Veterinary Cancer Registry  

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Full Text Available Abstract Background Head and neck cancers (HNC) are relatively common and often very serious diseases in both dogs and humans. Neoplasms originating in the head and neck region are a heterogeneous group. HNC often has an unfavourable prognosis and the proximity of the tissue structures renders extirpation of tumours with sufficient margins almost incompatible with preservation of functionality. In humans oral malignant melanoma (OMM) is extremely rare, but represents a particular challenge since it is highly aggressive as is the canine counterpart, which thus may be of interest as a spontaneous animal model. Methods Canine cases entered in the Danish Veterinary Cancer Registry (DVCR) from May 15th 2005 through February 29th 2008 were included in this study. Fisher's exact test was used to compare proportions of HNC in dogs and humans as well as proportions of surgically treated cases of OMM and squamous cell carcinomas (SCC). Also the proportions of benign and malignant neoplasms of different locations in dogs were compared using Fisher's exact test. Results A total of 1768 cases of neoplasias (679 malignant, 826 benign, 263 unknown) were submitted. Of all neoplasias HNC accounted for 7.2% (n = 128). Of these, 64 (50%) were malignant and 44 (34%) benign. The most common types of malignant neoplasia were SCC (18; 28% of malignant), OMM (13; 20% of malignant), soft tissue sarcoma (11; 17% of malignant) and adenocarcinoma (5; 11% of malignant). The most common types of benign neoplasms were adenoma (7; 16% of benign), polyps (6; 14% of benign) and fibroma (5; 11% of benign). Conclusions In the current study, the proportion of neoplasia in the head and neck region in dogs in Denmark was similar to other canine studies and significantly more common than in humans with a large proportion of malignancies. Spontaneous HNC in dogs thus, may serve as a model for HNC in humans. Canine OMM is a spontaneous cancer in an outbred, immune-competent large mammal population and could be a clinical model for OMM in humans.

Brønden Louise B; Eriksen Thomas; Kristensen Annemarie T

2009-01-01

168

Subcellular distribution of the sodium-iodide-symporter (NIS) in benign and malignant thyroid tissues.  

UK PubMed Central (United Kingdom)

Introduction Membranous expression of the sodium iodide symporter (NIS) is a prerequisite for iodide uptake in thyrocytes. Previous studies reported heterogenous results on the relative frequency of staining in various pathological conditions of the thyroid. The present study aimed at determining membranous staining by using confocal laser microscopy in benign and malignant thyroid disease (complemented in a subgroup of patients with recurrent or metastatic disease with functional findings of radioiodine uptake (RIU) Methods 380 malignant thyroid tumors (145 papillary, 51 follicular, 87 Hurthle cell and 97 undifferentiated; UTC), 115 benign adenomas, 62 diffuse goitres, 89 inflammatory conditions (Graves', Hashimoto, Thyroiditis deQuervain, lymphocytic thyroiditis) and 179 normal tissues (NT, fetal and adult) were subjected to NIS (2 different antibodies) and thyroglobulin (Tg) staining and evaluated by confocal microscopy. In a subgroup of 50 samples from patients with recurrent or metastatic disease NIS staining was correlated to RIU. Results As compared to NT, Graves' patients showed significantly higher positive NIS membrane staining (> 97% vs. 69%) whereas patients with Hashimoto, lymphocytic thyroiditis but also benign adenomas scored lower than NT (56.7% and 55.8% vs 69%). Depending on their differentiation NIS staining was significantly lower in thyroid carcinomas in parallel to TG staining with only 1/97 UTCs being positive. RIU was more frequently positive than NIS staining. Discussion Confocal staining evaluating strictly only membranous expression of NIS was not used on a large scale before. We confirm the loss of membranous NIS in benign but more prominently in malignant thyroid tumors.

Kollecker I; von Wasielewski R; Langner C; Mueller JA; Spitzweg C; Kreipe H; Brabant G

2012-02-01

169

Squamous cell carcinoma of esophagus masquerading as solitary thyroid nodule  

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Full Text Available Secondary neoplasm of the thyroid mimicking a primary thyroid lesion is a rare finding, especially in an individual without a past history of malignancy. A case of squamous cell carcinoma metastatic to the thyroid (presenting as a solitary thyroid nodule), who had an unsuspected primary in the esophagus is described. Usually, multiple areas of the gland are involved in the secondary involvement of the thyroid. The clinical presentation of an apparently asymptomatic mass with neck lymphadenopathy, normal thyroid functions, and a cold nodule on 99mTcO4- thyroid scan can often lead to a misdiagnosis as primary thyroid neoplasm. The present case underscores the fact that due importance to the subtle signs and symptoms and a high degree of suspicion, whenever the histology is unusual for a thyroid primary, is needed and the workup should include ruling out other primary malignancies.

Basu S; Nair N; Borges A

2005-01-01

170

More Complete Removal of Malignant Brain Tumors by Fluorescence-Guided Surgery  

Science.gov (United States)

Benign Neoplasms, Brain; Brain Cancer; Brain Neoplasms, Benign; Brain Neoplasms, Malignant; Brain Tumor, Primary; Brain Tumor, Recurrent; Brain Tumors; Intracranial Neoplasms; Neoplasms, Brain; Neoplasms, Intracranial; Primary Brain Neoplasms; Primary Malignant Brain Neoplasms; Primary Malignant Brain Tumors; Gliomas; Glioblastoma

2013-05-14

171

Study on different imaging time of late 201Tl thyroid imaging to differentiate malignant from benign thyroid nodules  

International Nuclear Information System (INIS)

[en] This study was undertaken to clarify better time to initiate the late 201Tl thyroid imaging to differentiate malignant thyroid nodules from benign ones. Thyroid images were obtained at 5 min, 1 and 3 hr after i.v. injection of 74 MBq of 201Tl chloride. The early (5 min) and late (1 or 3 hr) 201Tl images were compared in pathologically proven 38 malignant and 48 benign nodules of 83 patients. The lesion activity (LA) on the early image was visually graded as no uptake (-), slight uptake less than the surrounding thyroid tissue uptake (SITU) (±), uptake equal to the STTU (+), and uptake more than the STTU (++). The change of LA relative to the STTU from the early image to the late image was visually graded as decreasing (D), unchanged (U) or increasing (I) pattern when the LA was (±) to (++). The benign or malignant possibility at 1 hr and 3 hr in each lesion pattern was as follows: When the LA was (-) or D, the benign possibility was 95% (35/37) and 85% (39/46). When the LA was I, the malignant possibility was 96% (27/28) and 91% (21/23). When the LA is U, the diagnosis was equivocal: malignancy; 43% (9/21) at 1 hr and 59% (10/17) at 3 hr. The positive LA had a tendency to decrease with time irrespective of tumor character. The 1 hr image was statistically better than the 3 hr image as a late image. Comparative diagnosis of 5 min and 1 hr images with the criteria of I and U lesions being malignant and others being benign seems to be the best not to overlook malignant nodules: negative predictive value of 95% and sensitivity 95%. (author)

1995-01-01

172

STAT3 mutations identified in human hematological neoplasms induce myeloid malignancies in a mouse bone marrow transplantation model.  

UK PubMed Central (United Kingdom)

STAT3 protein phosphorylation is a frequent event in various hematological malignancies and solid tumors. Acquired STAT3 mutations have been recently identified in 40% of patients with T large granular lymphocytic leukemia, a rare T-cell disorder. In this study we investigated the mutational status of STAT3 in a large series of patients with lymphoid and myeloid diseases. STAT3 mutations were identified in 1.6% (4/258) of patients with T-cell neoplasms, in 2.5% (2/79) of patients with diffuse large B-cell lymphoma but in no other B-cell lymphoma patients (0/104) or patients with myeloid malignancies (0/96). Functional in vitro assays indicated that the STAT3Y640F mutation leads to a constitutive phosphorylation of the protein. STA21, a STAT3 small molecule inhibitor, inhibited the proliferation of two distinct STAT3 mutated cell lines. Using a mouse bone marrow transplantation assay, we observed that STAT3Y640F expression leads to the development of myeloproliferative neoplasms with expansion of either myeloid cells or megakaryocytes. Together, these data indicate that the STAT3Y640F mutation leads to constitutive activation of STAT3, induces malignant hematopoiesis in vivo and may represent a novel therapeutic target in some lymphoid malignancies.

Couronné L; Scourzic L; Pilati C; Della Valle V; Duffourd Y; Solary E; Vainchenker W; Merlio JP; Beylot-Barry M; Damm F; Stern MH; Gaulard P; Lamant L; Delabesse E; Merle-Beral H; Nguyen-Khac F; Fontenay M; Tilly H; Bastard C; Zucman-Rossi J; Bernard OA; Mercher T

2013-07-01

173

Differentiation of benign and malignant thyroid nodules: sonographic analysis and a new scoring system  

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To analyze the synthetically created sonographic features of thyroid nodules, we present here a new scoring system for the sonographic features that are suggestive of malignant thyroid nodules. We also evaluated the accuracy and clinical significance of this system. In this study, we included 725 thyroid nodules of 405 patients that were pathologically proven by USG-guided percutaneous fine-needle aspiration biopsy (FNAB) or surgery. Two radiologists analyzed the sonographic features according to the internal content, margin, echogenecity, shape and calcification. We scored from 0 point to 2 point for each feature, and then we calculated the total scores and classified them as three groups according to the total score such as low risk (0-3), intermediate risk (4-6) or high risk (7-10). We demonstrated the difference of the frequency and the positive predictive value among the three groups by using the Chi-square test ({rho} < 0.005). For 725 nodules, 654 (90.2%) were benign and 71 (9.8%) were malignant. For 589 nodules classified as low risk, 10 (1.7%) were malignant. For 102 nodules classified as intermediate risk, 32 (31.4%) were malignant. For 34 nodules classified as high risk, 29 (85.8%) were malignant. There was a statistically significant difference in the frequency and positive predictive value of malignancy among the three groups ({rho} < 0.001). There was a statistically significant difference in the frequency and positive predictive value of malignancy among the three groups for the new scoring system presented in this study to analyze the synthetically sonographic features of thyroid nodules. So, we think that sonography can be helpful for making the differentiation between benign and malignant nodules. When we find thyroid nodules on sonography, we can reduce the unnecessary FNAB and we can diagnose malignant nodules at an earlier stage.

Lee, Seung Young; Bae, Il Hun; Han, Gi Seok; Cha, Sang Hoon; Kim, Sung Jin; Park, Kil Sun; Koong, Sung Soo [College of Medicine, Chungbuk National University, Cheongju (Korea, Republic of)

2006-01-15

174

Volume changes of thyroid nodules after thyroxine suppression therapy: the usefulness in predicting malignancy  

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To evaluate the usefulness of volume change after thyroxine suppression therapy in predicting the malignancy of thyroid nodules. We analyzed 28 cases of thyroid nodules diagnosed as benign by aspiration cytology or biopsy before thyroxine suppression therapy and which did not decrease more than 50 % in volume after therapy. Using Ultrasonography we measured the volume of nodules before and after thyroxine suppression therapy and then determined volume change by calculating nodule volume suppression rate (NVSR) and comparing this between benign and malignant nodules. All cases were surgically confirmed. NVSR(%) = nodule volume after treatment / nodule volume before treatment X100. Seventeen (60.7 %) of 28 thyroid nodules which showed less than 50% NVSR after thyroxine therapy were shown by surgical resection to be malignant, while 11(39.3%) were benign. The malignant cases were papillary carcinoma (n=9) and follicular carcinoma (n=8), while benign cases were either follicular adenoma (n=7) or adenomatous hyperplasia (n=4). The mean volume of malignant thyroid nodules was 5.2{+-}4.5cm{sup 3} before thyroxine suppression therapy and 5.9{+-}4.5cm{sup 3} after therapy, and that of benign nodules, 12.1{+-}10.3cm{sup 3} before therapy and 10.1{+-}9.9cm{sup 3} after. NVSR was 127.2{+-}46.2 % in malignant nodules and 79.4{+-}21.0 % in benign nodules, with no significant difference between the two groups (P < 0.05). Although further studies may be required, fine needle aspiration cytology or biopsy showed that among bening thyroid nodules which did not decrease more than 50 % in volume after thyroid therapy, the incidence of malignancy revealed by surgical resection was more than 60 %. Surgical exporation of these nodules is therefore highly recommended.

Kwon, Eun Joo; Hong, Hyun Sook; Lee, Hae Kyung; Kim, Kyung Suk; Choi, Jin Soo; Kim, Dae Ho; Kwon, Kui Hyang; Choi, Deuk Lin; Yoo, Myung Hee [Soonchunhyang Univ. Hospital, Seoul (Korea, Republic of)

1999-09-01

175

Multiple primary malignant neoplasms in patients with esophageal cancer treated with radiation therapy  

International Nuclear Information System (INIS)

Thirty-two of 178 patients with esophageal cancer treated with radiation therapy had multiple primary neoplasms (MPN). The outcomes of patients with MPN and those without did not differ significantly. Radiation therapy for second neoplasms was limited in some patients because they had received radiation for an earlier cancer. In a patient who underwent surgical resection for hypopharyngeal cancer, intraluminal radiation therapy for a esophageal cancer could not be performed owing to the narrow interposition of the jejunum. On the other hand, a patient treated with radiation for a first neoplasm died of pulmonary complications after surgical resection of a subsequent lung cancer. Because the outcome of treatment of early-stage second cancers was good, careful examination for additional cancers should be performed after treatment of a first neoplasm. (author)

1998-01-01

176

Multiple primary malignant neoplasms in patients with esophageal cancer treated with radiation therapy  

Energy Technology Data Exchange (ETDEWEB)

Thirty-two of 178 patients with esophageal cancer treated with radiation therapy had multiple primary neoplasms (MPN). The outcomes of patients with MPN and those without did not differ significantly. Radiation therapy for second neoplasms was limited in some patients because they had received radiation for an earlier cancer. In a patient who underwent surgical resection for hypopharyngeal cancer, intraluminal radiation therapy for a esophageal cancer could not be performed owing to the narrow interposition of the jejunum. On the other hand, a patient treated with radiation for a first neoplasm died of pulmonary complications after surgical resection of a subsequent lung cancer. Because the outcome of treatment of early-stage second cancers was good, careful examination for additional cancers should be performed after treatment of a first neoplasm. (author)

Soejima, Toshinori; Hirota, Saeko; Endo, Masahiro; Kozuma, Kyoko; Suzuki, Yasushi; Obayashi, Kayoko; Takada, Yoshiki [Hyogo Medical Center for Adults, Akashi (Japan); Hishikawa, Yoshio

1998-07-01

177

Volume changes of thyroid nodules after thyroxine suppression therapy: the usefulness in predicting malignancy  

International Nuclear Information System (INIS)

[en] To evaluate the usefulness of volume change after thyroxine suppression therapy in predicting the malignancy of thyroid nodules. We analyzed 28 cases of thyroid nodules diagnosed as benign by aspiration cytology or biopsy before thyroxine suppression therapy and which did not decrease more than 50 % in volume after therapy. Using Ultrasonography we measured the volume of nodules before and after thyroxine suppression therapy and then determined volume change by calculating nodule volume suppression rate (NVSR) and comparing this between benign and malignant nodules. All cases were surgically confirmed. NVSR(%) = nodule volume after treatment / nodule volume before treatment X100. Seventeen (60.7 %) of 28 thyroid nodules which showed less than 50% NVSR after thyroxine therapy were shown by surgical resection to be malignant, while 11(39.3%) were benign. The malignant cases were papillary carcinoma (n=9) and follicular carcinoma (n=8), while benign cases were either follicular adenoma (n=7) or adenomatous hyperplasia (n=4). The mean volume of malignant thyroid nodules was 5.2±4.5cm3 before thyroxine suppression therapy and 5.9±4.5cm3 after therapy, and that of benign nodules, 12.1±10.3cm3 before therapy and 10.1±9.9cm3 after. NVSR was 127.2±46.2 % in malignant nodules and 79.4±21.0 % in benign nodules, with no significant difference between the two groups (P

1999-01-01

178

Malignancy risk analysis in patients with inadequate fine needle aspiration cytology (FNAC) of the thyroid.  

UK PubMed Central (United Kingdom)

BACKGROUND: Thyroid fine needle aspiration cytology (FNAC) is the standard diagnostic modality for thyroid nodules. However, it has limitations among which is the incidence of non-diagnostic results (Thy1). Management of cases with repeatedly non-diagnostic FNAC ranges from simple observation to surgical intervention. We aim to evaluate the incidence of malignancy in non-diagnostic FNAC, and the success rate of repeated FNAC. We also aim to evaluate risk factors for malignancy in patients with non-diagnostic FNAC. MATERIALS AND METHODS: Retrospective analyses of consecutive cases with thyroid non diagnostic FNAC results were included. RESULTS: Out of total 1657 thyroid FNAC done during the study period, there were 264 (15.9%) non-diagnostic FNAC on the first attempt. On repeating those, the rate of a non-diagnostic result on second FNAC was 61.8% and on third FNAC was 47.2%. The overall malignancy rate in Thy1 FNAC was 4.5% (42% papillary, 42% follicular and 8% anaplastic), and the yield of malignancy decreased considerably with successive non-diagnostic FNAC. Ultrasound guidance by an experienced head neck radiologist produced the lowest non-diagnostic rate (38%) on repetition compared to US guidance by a generalist radiologist (65%) and by non US guidance (90%). CONCLUSIONS: There is a low risk of malignancy in patients with a non-diagnostic FNAC result, commensurate to the risk of any nodule. The yield of malignancy decreased considerably with successive non-diagnostic FNAC.

Al Maqbali T; Tedla M; Weickert MO; Mehanna H

2012-01-01

179

The expression of sialic fibronectin correlates with lymph node metastasis of thyroid malignant neoplasmas.  

UK PubMed Central (United Kingdom)

BACKGROUND: Papillary thyroid carcinoma (PTC) is often accompanied by lymph node metastasis (LNM), compared with follicular thyroid carcinoma (FTC). Sialic acid is carried by fibronectin (sFN) as the antigen of monoclonal antibody (MoAb) JT-95 detected in 90% of PTC, and a few cases of FTC. PATIENTS AND METHODS: JT-95 staining was performed in 9 PTC and 20 follicular type tumors to investigate the relationship between the expression of sFN and the frequency of LNM. RESULTS: There were 11 cases with LNM from 23 malignant tumors, and no cases of LNM from 6 benign follicular type tumors. The staining scores by JT-95 of the 11 tumors with LNM were 5+ in 4 cases, and 6+ in 7 cases. On the other hand, the scores of 12 malignant tumors without LNM were <4+ in all cases. CONCLUSION: An increase of sFN expression in thyroid malignancies is correlated with LNM.

Takeyama H; Kyoda S; Okamoto T; Manome Y; Watanabe M; Kinoshita S; Uchida K; Sakamoto A; Morikawa T

2011-04-01

180

Differentiation between Malignant and Benign Masses of Thyroid Gland Using Color Doppler Ultrasonogram  

Energy Technology Data Exchange (ETDEWEB)

To determine color Doppler ultrasound findings of malignant and benign thyroid nodules, and to identify differential points among them. 35 patients with palpable enlarged thyroid nodules were imaged by using with 7 MHz linear-array transducer. Color Doppler images were obtained in the transverse and longitudinal planes on the color setting for the thyroid gland. After setting receiver gain, velocity scale and filter were set to 6 cm / sec and 1, respectively. And we measured resistive index, pulsatility index, peak systolic velocity and end diastolic velocity from the fastest or next fast arterial signals in the thyroid nodules or in the margins of the thyroid nodules. Final diagnosis was confirmed by ultrasonography-guided or surgical biopsy. 25 cases of malignant nodule and 10 cases of benign nodule were confirmed histopathologically.On the color mapping, malignant nodules showed various internal flow signals from avascular to hyper vascular and no marginal flow signals in all cases, and benign nodules revealed 9 (36%) hypo vascular cases and 16 (64%)hyper vascular cases in the internal flow signals and increased marginal flow signals in all cases. On the spectral analysis, malignant nodules showed RI 0.7 (0.63{approx}0.83) in hyper vascular internal flow signals and RI 0.93(0.67{approx}1.00) in hypo vascular internal flow signals, and measured PI was 1.39 (1.03{approx}2.11), 2.71 (0.97{approx}4.81),respectively. and in benign nodules, measured RI was 0.65 (0.5{approx}0.88) and PI was 0.92 (0.59{approx}1.90). Color Doppler imaging can be helpful to differentiate benign and malignant thyroid masses by means of measuring marginal and internal flow signals of thyroid nodules

Son, Chang Woo; Kim, Chang Woo; Sin, Se Kwon; Jang, Kyeung Jae [Dae Dong Hospital, Busan (Korea, Republic of); Kim, Yi Tae [Dong A Hospital, Busan (Korea, Republic of)

1996-12-15

 
 
 
 
181

An antibody-like peptide that recognizes malignancy among thyroid nodules.  

UK PubMed Central (United Kingdom)

There is an urgent need for biomarkers to identify malignant thyroid nodules from indeterminate follicular lesions. We have used a subtractive proteomic strategy to identify novel biomarkers by selecting ligands to goiter tissue from a 12-mer random peptide phage-displayed library using the BRASIL method (Biopanning and Rapid Analysis of Selective Interactive Ligands). After three rounds of selection, two highly reactive clones to the papillary thyroid tumor cell line NPA were further evaluated, and their specific binding to tumor proteins was confirmed using phage-ELISA. The antibody-like peptide CaT12 was tumor-specific, which was further tested by immunohistochemistry against TMAs (tissue microarrays) comprised of 775 human benign and malignant tissues, including 232 thyroid nodular lesions: 15 normal thyroid tissues, 53 nodular goiters (NG), 54 follicular adenomas (FA); 69 papillary thyroid carcinomas (PTC); and 41 follicular carcinomas (FC). CaT12 was able to identify PTC among thyroid nodular lesions with 91.2% sensitivity and 85.1% specificity, despite its non-specificity for thyroid tissues. Additionally, the CaT12 peptide helped characterize follicular lesions distinguishing the follicular variant of PTC (FVPTC) from FA with 91.9% accuracy; FVPTC from NG with 83.1% accuracy; FVPTC from the classic PTC with 57.7% accuracy; and FVPTC from FC with 88.7% accuracy. In conclusion, our strategy to select differentially expressed ligands to thyroid tissue was highly effective and resulted in a useful antibody-like biomarker that recognizes malignancy among thyroid nodules and may help distinguish follicular patterned lesions.

Reis CF; Carneiro AP; Vieira CU; Fujimura PT; Morari EC; Silva SJ; Goulart LR; Ward LS

2013-07-01

182

Subcellular distribution of the sodium iodide symporter in benign and malignant thyroid tissues.  

UK PubMed Central (United Kingdom)

BACKGROUND: Membranous expression of the sodium iodide symporter (NIS) is a prerequisite for iodide uptake in thyrocytes. Previous studies reported heterogeneous results on the relative frequency of staining in various pathological conditions of the thyroid. The present study aimed at determining membranous staining by using confocal laser microscopy in benign and malignant thyroid diseases, complemented in a subgroup of patients with recurrent or metastatic disease with functional findings of radioiodine uptake (RIU). METHODS: There were 380 malignant thyroid tumors (145 papillary, 51 follicular, 87 Hurthle cell, and 97 undifferentiated thyroid carcinomas [UTC]), 115 benign adenomas, 62 diffuse goiters, 89 inflammatory conditions (Graves', Hashimoto, Thyroiditis deQuervain, and lymphocytic thyroiditis), and 179 normal tissues (NT, fetal, and adult). These were subjected to NIS (two different antibodies) and thyroglobulin (TG) staining and evaluated by confocal microscopy. RESULTS: In a subgroup of 50 samples from patients with recurrent or metastatic disease, NIS staining was correlated with the RIU. As compared with NT, Graves' patients had significantly higher positive NIS membrane staining (>97% vs. 69%) whereas patients with Hashimoto, lymphocytic thyroiditis but also benign adenomas scored lower than NT (56.7% and 55.8% vs. 69%). Depending on their differentiation NIS staining was significantly lower in thyroid carcinomas in parallel with TG staining with only 1/97 UTCs being positive. RIU was more frequently detectable than NIS staining. CONCLUSION: Confocal staining strictly evaluating only membranous expression of NIS has not used on a large scale before this study. We confirm the loss of membranous NIS in benign but more prominently in malignant thyroid tumors. NIS staining of diagnostic tissues cannot be used to predict RIU.

Kollecker I; von Wasielewski R; Langner C; Müller JA; Spitzweg C; Kreipe H; Brabant G

2012-05-01

183

Radiologic and clinical predictors of malignancy in the follicular lesion of undetermined significance of the thyroid.  

UK PubMed Central (United Kingdom)

Various ultrasonographic characteristics of thyroid nodules have been associated with a higher likelihood of malignancy, and certain clinical features may also increase the likelihood of malignancy in patients. This study is designed to determine the ultrasonographic and clinical predictors of malignancy in the atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) category. A search through the cytology files at our institution was made for cases with diagnosis of AUS/FLUS. The clinical and radiologic findings were correlated with the final surgical pathology diagnosis. A total of 140 cases of AUS/FLUS with corresponding surgical intervention were identified (112 females and 28 males). There was a 79 % malignancy rate in nodules with irregular contours, compared to 51 % in nodules with regular outlines. Nodules demonstrating calcifications showed a 57 % malignancy rate, compared to 50 % in nodules without calcifications. Sixty-one percent of cases with an ultrasonographic diagnosis of indeterminate to suspicious were malignant following surgical resection. The rates of malignancy in patients with radiation exposure, symptomatic nodules, and positive family history of thyroid cancer were 22, 59, and 33 %, respectively. BRAF mutation was demonstrated in 57 % of malignant cases and in none of benign cases. No single clinical or ultrasonographic feature or combination of features is adequately sensitive or specific to identify all malignant nodules. However, a combination of solid nodules, nodules with irregular contours, symptomatic nodules, and positive BRAF mutation has high predictive value for malignancy in patients with a cytologic diagnosis of AUS/FLUS.

Carr R; Ustun B; Chhieng D; Schofield K; Theoharis C; Hammers L; Adeniran AJ

2013-06-01

184

Evaluating thyroid nodules: predicting and selecting malignant nodules for fine-needle aspiration (FNA) cytology.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To form and assess a set of diagnostic ultrasound criteria to select malignant nodules for fine-needle aspiration (FNA) cytology and reduce number of FNA biopsies. METHODS: In this prospective observational service evaluation study, 171 thyroid nodules that underwent FNA cytology were independently scored by two observers for established nodular sonographic characteristics for malignancy. The final diagnosis was confirmed by surgery or a 6-month follow-up in nodules with benign cytology. RESULTS: Logistic regression analysis and receiver operating characteristic curve analysis results indicate good and comparable predictive powers of certain ultrasound characteristics in predicting malignancy. The highest sensitivity in detecting malignancy was achieved when taking together the information of marked hypoechogenicity, microcalcification and mixed central/peripheral or central Doppler colour flow pattern. A sensitivity of 100 % and a specificity of 76 % were obtained in detecting malignant nodules using this criteria. CONCLUSIONS: Our study proposes a set of ultrasound and colour Doppler criteria to safely select malignant thyroid nodules for FNA cytology. MAIN MESSAGES: • There is a need to safely select malignant nodules for FNA cytology and reduce unnecessary FNA • Some ultrasound features are specific but none are independently/fully predictive of malignancy • We have prospectively tested a set of ultrasound criteria for selecting nodules for FNA cytology • Our ultrasound criteria detected malignant nodules with a 100 % sensitivity and 76 % specificity • A high sensitivity is clinically desirable as it selects many, if not all, malignant nodules for FNA.

Lingam RK; Qarib MH; Tolley NS

2013-10-01

185

Thyroid nodule management: clinical, ultrasound and cytopathological parameters for predicting malignancy  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english Although fine-needle aspiration cytology is considered to be the reference method for evaluating thyroid nodules, the results are inaccurate in approximately 10-30% of cases. Several studies have attempted to predict the risk of malignancy in thyroid nodules based on age, nodularity, thyrotropin values, thyroid autoimmune disease, hot/cold nodule status, and ultrasound parameters. However, no consensus has been found, and none of these parameters has significantly affecte (more) d patient management. The management of indeterminate thyroid nodules and re-biopsies of nodules with initially benign cytological results remain important and controversial topics of discussion. The Bethesda cytological system and several studies on the use of molecular markers to predict malignancy from cytological samples of thyroid nodules need further clarification. More in-depth discussions among and continuous education of the specialists involved in treating thyroid disease are necessary to improve the management of these patients. This review aims to examine the clinical, laboratory, ultrasound, and scintigraphic parameters that can be used for thyroid nodule management.

Maia, Frederico F. R.; Zantut-Wittmann, Denise Engelbrecht

2012-08-01

186

Thyroid nodule management: clinical, ultrasound and cytopathological parameters for predicting malignancy  

Directory of Open Access Journals (Sweden)

Full Text Available Although fine-needle aspiration cytology is considered to be the reference method for evaluating thyroid nodules, the results are inaccurate in approximately 10-30% of cases. Several studies have attempted to predict the risk of malignancy in thyroid nodules based on age, nodularity, thyrotropin values, thyroid autoimmune disease, hot/cold nodule status, and ultrasound parameters. However, no consensus has been found, and none of these parameters has significantly affected patient management. The management of indeterminate thyroid nodules and re-biopsies of nodules with initially benign cytological results remain important and controversial topics of discussion. The Bethesda cytological system and several studies on the use of molecular markers to predict malignancy from cytological samples of thyroid nodules need further clarification. More in-depth discussions among and continuous education of the specialists involved in treating thyroid disease are necessary to improve the management of these patients. This review aims to examine the clinical, laboratory, ultrasound, and scintigraphic parameters that can be used for thyroid nodule management.

Frederico F. R. Maia; Denise Engelbrecht Zantut-Wittmann

2012-01-01

187

Application of Real-time Ultrasound Elastography in Diagnosing Benign and Malignant Thyroid Solid Nodules  

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Full Text Available Objective Real-time ultrasound elastography (US-E) is a helpful tool in diagnosing thyroid nodules. This study aims to evaluate thyroid solid nodules, to establish the accuracy of US-E in providing information on the nature of these nodules, and to assess the clinical value of elasticity scores (ES) and strain ratio (SR) in differentiating thyroid solid nodules and to explore its distribution characteristics using pathological analysis as reference. Methods Traditional ultrasonography and US-E were performed on 131 thyroid solid nodules (99 benign ones and 32 malignant ones) in 120 patients (78 females and 41 males). Three radiologists evaluated the nodules based on a four-degree elasticity scoring system. The nodules were classi?ed according to the ES as soft (ES 1-2) or hard (ES 3-4). The SR was calculated online. Results The sensitivity and speci?city of the ES for thyroid cancer diagnosis were 78% and 80%, respectively. SR values ? 2.9 used as a standard to distinguish benign from malignant nodules had a sensitivity of 87% and a speci?city of 92%. The SR of the benign lesions was 1.64±1.37, which was signi?cantly different from that of malignant lesions, which was 4.96±2.13 (P<0.01). Conclusions Both the ES and SR were higher in malignant nodules than those in benign ones. Real-time US-E was a useful index in the differential diagnosis of thyroid solid nodules. It can provide quantitative information on thyroid nodule characterization and improve diagnostic con?dence.

Hai-ling Wang; Sheng Zhang; Xiao-jie Xin; Li-hui Zhao; Chun-xiang Li; Jia-li Mu; Xue-qing Wei

2012-01-01

188

Retarded cutaneous hypersensitivity reactions in patients treated with cytostatic drugs and Co60 because of genital malignant neoplasms  

International Nuclear Information System (INIS)

The effect of application of cytostatic drugs and telegammatherapy (Co60) was tested by means of cutaneous hyperactivity reactions in 89 women treated because of malignant neoplasms of the genital organs. The skin tests with 2,4-dinitrochlorobenzene (DNCB) and purified protein derivate (PPD) were used. The group 1 constituted of 36 women treated with cytostatic drugs through a period of 7 months to 4 years. The appearance of retarded cutaneous hypersensitivity to DNCB and PPD correlated with the clinical state of the subjects. In cases of improvement of the clinical state the skin reactions were more intensive, when the disease progreded the reactions became weak or disappeared. When the clinical state remained unchanged - the same was true with the skin reactions. In the group 253 women were treated by means of irradiation (Co60) because of similar diagnosis of malignant genital neoplasm. In all cases a regression of the retarded cutaneous hypersensitivity to DNCB and PPD was observed, together with a decrease of the number of white blood cells in the peripheric blood. Correlation of the individual skin reactions to DNCB and PPD demonstrated that the latter gave a smaller percent of positive reactions in comparison with the former agent, these reactions were also less sensitive. (author)

1978-01-01

189

Quantitative assessment of shear-wave ultrasound elastography in thyroid nodules: diagnostic performance for predicting malignancy.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To evaluate the predictability of shear-wave ultrasound elastography (SWE) for thyroid malignancy and to compare the diagnostic performances of SWE and B-mode US. METHODS: Retrospective review of 99 patients who underwent SWE before US-guided fine-needle aspiration of thyroid nodules was performed. SWE elasticity indices of the mean (Emean ), maximum (Emax), and minimum (Emin) of nodules were measured. Diagnostic performance of SWE was compared with that of B-mode US. RESULTS: Among a total of 99 nodules, 21 were papillary thyroid carcinoma (PTC) and 78 were benign. Emean, Emax, and Emin were significantly higher in PTCs than in benign nodules (P?malignancy were 76.1 %, 64.1 % with Emax (65 kPa), 61.9 %, 76.1 % with Emin (53 kPa), and 66.6 %, 71.6 % with Emean (62 kPa). Areas under the ROC curves (Az) of SWE values were not significantly different from those of US categories on B-mode US. However, combining Emean and Emin with B-mode US of probably benign lesions improved the specificity (P?=?0.02, 0.007) for predicting PTC. CONCLUSIONS: The quantitative parameter of SWE was significantly higher in PTC than in benign nodules, and combined use of quantitative SWE and B-mode US provided higher specificity for predicting malignancy. KEY POINTS: • Quantitative shear-wave elastography (SWE) helps differentiate benign from malignant nodules • SWE and conventional ultrasound have comparable diagnostic performance for predicting thyroid malignancy • Combined quantitative SWE and B-mode ultrasound is highly specific for thyroid malignancy.

Kim H; Kim JA; Son EJ; Youk JH

2013-09-01

190

Utility of immunohistochemical markers in differentiating benign from malignant follicular-derived thyroid nodules  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Thyroid nodules are common among adults though only a small percentage is malignant, which can histologically mimic benign nodules. Accurate diagnosis of these thyroid nodules is critical for the proper clinical management. Methods We investigated immunoexpression in 98 surgically removed benign thyroid nodules including 52 hyperplastic nodules (HN) and 46 follicular/Hurthle cell adenomas (FA), and 54 malignant tumors including 22 follicular carcinoma (FC), 20 classic papillary carcinoma (PTC), and 12 follicular variant papillary carcinoma (FVPC). Results The staining results showed that malignant tumors express galectin-3, HBME-1, CK19 and Ret oncoprotein significantly more than benign nodules. The sensitivity of these markers for the distinction between benign and malignant lesions ranged from 83.3% to 87%. The sensitivity of two-marker panels was not significantly different. Immunoexpression was usually diffuse and strong in malignant tumors, and focal and weak in the benign lesions. Conclusion Our findings indicate that these immunomarkers are significantly more expressed in malignant tumors compared to benign lesions and may be of additional diagnostic value when combined with routine histology.

Saleh Husain A; Jin Bo; Barnwell John; Alzohaili Opada

2010-01-01

191

Thyroid Malignancy Association with Cortical & Subcortical Brain SPECT Changes In Patients Presenting with a Myalgic Encephalomyelitis / Chronic Fatigue Syndrome.  

Directory of Open Access Journals (Sweden)

Full Text Available Thyroid malignancy in ME/CFS patients greatly exceeds the normal incidence of thyroid malignancy in any known subgroup. The thyroid malignancy incidence in the ME/CFS group may exceed 6,000 / 100,000. As part of their investigation, Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS) patients should be examined by thyroid ultrasound for evidence of thyroid pathology and malignancy. Thyroid pathology may be missed in this group of patients if investigation relies only upon serum testing for TSH, FT3, FT4, microsomal and thyroglobulin antibodies, which are usually normal. Thyroid uptake scans tend also to be normal and may also miss malignant lesions. A newly recognized syndrome may exist in ME/CFS patients characterized by: (a) thyroid malignancy, (b) persistent abnormal cortical and subcortical SPECT brain scans (NeuroSPECT), (c) failure of thyroidectomy surgery and hormone replacement to correct the fatigue syndrome, and (d) an unusual high incidence of cervical vertebrae osteoarthritic changes. ME/CFS patients with treated non-malignant thyroid disease and abnormal NeuroSPECT scans may also fail to improve despite adequate thyroid hormone replacement. A brief summary of the differences between ME and CFS is discussed.Lee, Hur and Ahn [1] stated that thyroid malignancy is said to be an infrequent occurrence found in 0.5 to 3 patients per 100,000 in the general population. They noted that in a subgroup of patients booked for mammography, a thyroid ultrasound was also performed. In this group, they found thyroid malignancy frequency was as high as 3 per 100,000. It is not known if their subgroup was at a higher risk for malignancy. Mittelstaedt [2] in the Globe and Mail states that thyroid malignancy was 15 per 100,000, In the past 100 patients whom I have investigated for (ME/CFS)[3], with or without associated Fibromyalgia Syndrome (FS), I have found that 6% of these patients had thyroid malignancy. In each of these patients the diagnosis was made by ultrasonography and needle biopsy under ultrasonography. This was followed by surgical removal of the thyroid, and each case the malignancy was confirmed. These findings would suggest that 6% of the ME/CFS patients seen, or 6,000 cases per 100,000, had a confirmed thyroid malignancy. Unfortunately, these figures may be conservative since we are in the process of obtaining needle biopsies on six further cases of these first 100 patients. In addition, we have not yet performed thyroid ultrasound on all 100 cases. We are in the process of further investigation of those patients who had not yet been investigated by thyroid ultrasound.Previously, it has been noted that the increased incidence of thyroid malignancy in the general population is only associated with increased radiation exposure. Patients presenting with symptoms of ME/CFS or Fibromyalgia may have significant higher thyroid malignancy incidence.NeuroSPECT was performed with the radiopharmaceutical NeuroliteTM and processed with the software Neurogam by Segami Corp.( Maryland USA.)

Byron, Hyde; MD; Jean, Leveille; MD; Sheila, Vaudrey; Tracy, Green

2007-01-01

192

Marcadores de riesgo de neoplasia folicular en nódulos tiroideos Risk markers of follicular neoplasms in thyroid nodules  

Directory of Open Access Journals (Sweden)

Full Text Available Los nódulos tiroideos de origen folicular abarcan procesos no neoplásicos y neoplásicos. No existen métodos de diagnóstico ni rasgos citológicos por punción con aguja fina (PAF) que los delimiten, constituyendo un dilema su diagnóstico diferencial. Analizamos la asociación existente entre variables clínicas y métodos de diagnóstico prequirúrgicos en nódulos tiroideos de estirpe folicular, con el objetivo de definir riesgo de neoplasia.Se estudiaron 92 pacientes con bocios nodulares de estirpe folicular por citología, tratados con tiroidectomía. Las variables analizadas fueron: sexo, edad, tamaño del nódulo, características ecográficas, diagnóstico citológico, nivel de TSH y resultados del centellograma. De los 92 casos, 74 fueron neoplásicos (56 adenomas y 18 carcinomas diferenciados) y 18 nódulos no neoplásicos, hiperplásicos o adenomatosos. Los marcadores que se relacionaron con alto riesgo de neoplasia folicular correspondieron al diagnóstico citológico de proliferación folicular de alto grado, en nódulos iso o hipoecogénicos, e hipocaptantes con I131. Los carcinomas presentaron citología de proliferación folicular de alto grado en nódulos hipoecogénicos, de bordes irregulares con microcalcificaciones e hipocaptantes, en pacientes varones o menores de 20 años. La presencia de macrocalcificaciones e hipercaptación estarían a favor de nódulo de origen benigno.La correlación de los métodos de diagnóstico y variables clínicas en nódulos tiroideos de estirpe folicular nos permitirían delimitar el riesgo de neoplasia y carcinoma para planificar un tratamiento quirúrgico selectivo.Thyroid nodules of follicular origin include neoplastic and non neoplastic processes. No methods of diagnosis or cytological features (obtained by fine-needle aspiration, FNA) may differentiate both types, and therefore differential diagnosis still constitutes a dilemma.We analyzed the existing association between clinical variables and methods of diagnosis in thyroid nodules of follicular type with the aim of defining risk of neoplasm. Ninety two patients with nodular goiters, of follicular origin by cytology, previously submitted to surgical treatment were analyzed. The studied variables were: sex, age, size of the nodule, ultrasound characteristics, cytological diagnosis, TSH level and results of the scintigraphy. Of 92 cases, 74 were neoplastic nodules (56 adenomas and 18 differentiated thyroid cancer) and 18 were non neoplastic nodules. Markers, that were related to high risk of follicular neoplasm corresponded to the cytological diagnosis of proliferation of high follicular degree, in iso or hypoechoic, and hypofunctioning nodules with I131. The carcinomas presented cytology of follicular proliferation of high degree, in hipoechoic nodules, of irregular edges with microcalcifications and hypofunctioning, in male patients or patients younger than 20 years. The presence of macrocalcifications and hypercaptation would be in favor of nodules of benign origin.The correlation of diagnostic methods and clinical variables in thyroid nodules of follicular type would allow us to differentiate the risk of neoplasm or carcinoma, and plan surgical selective treatments.

Marcelo Monteros Alvi; Nélida M. Romero; Sara Gonorazky; Vasco Gálvez; Mercedes Gálvez; Elvira Virgili; Graciela G. de Soler

2009-01-01

193

Color doppler image of thyroid nodule : differentiation between benign and malignant lesion  

Energy Technology Data Exchange (ETDEWEB)

To assess the utility of color Doppler sonography in the differential diagnosis of thyroid nodules. Fifty patients with thyroid nodules(10 cases of follicular adenoma, 12 of adenomatous hyperplasia, 21 of papillary adenocarcinoma, and 7 of follicular adenocarcinoma) were analyzed. Colour signal analysis was performed by inspecting the signals in and around the nodules, and these were graded from 0 to III according to the degree of vascularity in internal and marginal blood flow. Peak systoic velocity (PSV) and resisitive index (RI) in internal vascularity were used to analyse the flow signal. Internal color signals of malignant lesions tended to be high grade, whereas those of benign lesions tended to be low grade, with statistical significance(P<0.05). In spectral wave analysis, correlation between PSV and malignancy of thyroid nodules was statistically significant(P<0.05). The value of RI did not correlate with the malignancy of nodules, but tended to show a meaningful difference. Although further studies may be required, color Doppler sonography using color signal and flow signals analysis is a useful imaging modality for the differentiation of benign and malignant lesions of thyroid nodules.

Yoon, Jong Pil; Hong, Hyun Sook; Jeon, Young Tae; Kim, Seo Hee; Yoo, Myung Hee; Kim, Dae Ho; Lee, Hae Kyung; Kwon, Kui Hyang [Soonchunhyang College of Medicine, Asan (Korea, Republic of)

1996-11-01

194

[Methodology for evaluation of malignancy screening in surgical thyroid gland disease].  

UK PubMed Central (United Kingdom)

INTRODUCTION: We review a methodology for detection of malignancy in thyroid gland surgery, comparing clinical exploration, ultrasonography, gammagraphy, fine-needle aspiration (FNA) and extemporaneous biopsy with the definitive pathological results. MATERIAL AND METHODS: We carried out a retrospective study on a sample of 433 (N=433) patients who had been intervened due to thyroid gland disease at the same ENT centre between 1999 and 2004. We collected information focusing on the characteristics of cervical exploration, ultrasonography, gammagraphy, FNA, extemporaneous biopsy and definitive pathological results. RESULTS: With N=433, the male/female ratio was approximately 1/9 (m/f 1/9), the average age was 45.5 years, with a range between 13 and 87 years, and with 20.3% of referred family history of thyroid gland disease; the cervical exploration, ultrasonography ang gammagraphy were not good tests for the screening of malignancy; FNA and extemporaneous biopsy offered 74% and 81% of sensitivity (Se), and 73% and 92% of specificity (Sp) in the detection of malignancy. The specific sensitivities towards papillary carcinoma of FNA and extemporaneous biopsy were 81% and 88%, whilst for follicular carcinoma they were 66% and 62.5%, respectively. CONCLUSIONS: FNA has good sensitivity in clinical suspicion of thyroid papillary carcinoma, although it should be complemented by extemporaneous biopsy due to its better specificity. In the case of follicular carcinoma there is a tendency towards conservative treatment, without carrying out extemporaneous biopsy previously and with reintervention in case of definitive malignancy.

Rubio V; Tamarit JM; Baviera N; Fernández S; Estrems P; Seijas T; López C; Dalmau J

2009-11-01

195

Early diagnosis, therapy, follow-up and survival rate of the patients with thyroid malignancy  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The Aim of the paper was to give a reviw of an early diagnosis, therapy, follow-up and survival rate of patients with thyroid malignancy (TM). The paper presented the algorithm of early diagnosis: clinical, scintigraphic and ultrasonographic examination together with fine needle biopsy, cythologic a...

Maleševi? Milica ?.; Mihailovi? Jasna; Voji?i? Jelena V.; Popadi? Silvija M.

196

Thyroglobulin production by malignant thyroid tumors. An immunocytochemical and radioimmunoassay study.  

UK PubMed Central (United Kingdom)

Four hundred thirty surgical and biopsy specimens of malignant thyroid tumors of 323 patients were analyzed by histologic and immunocytochemical examination for their thyroglobulin (TG) content. Almost 95% of the differentiated thyroid carcinomas of follicular origin contained immunoreactive TG. The authors could not demonstrate TG in anaplastic carcinomas. Postoperative follow-up and serum TG determinations were available for 111 athyroid patients. Serum TG was elevated in five patients with metastatic or recurrent moderately differentiated follicular carcinoma, in two patients with metastasizing papillary, and in one patient with anaplastic carcinoma. Four patients had detectable serum TG levels without clinical and radiologic evidence of recurrence or metastases. In addition to conventional histologic examination, immunocytochemical demonstration of TG is a reliable and valuable aid in the diagnosis, classification, and determination of the grade of differentiation of malignant thyroid tumors. From this the pathologist can provide a pathologic basis for postoperative patient management.

Ryff-de Lèche A; Staub JJ; Kohler-Faden R; Müller-Brand J; Heitz PU

1986-03-01

197

THE THYROID NODULE  

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Full Text Available Nodular disease of the thyroid is common; however, malignancy of the thyroid occurs in only 0.004% of the American population annually (12,000 new cases per y). About 5% of thyroid nodules are malignant; the remainder represent a variety of benign diagnoses, including colloid nodules, degenerative cysts, hyperplasia, thyroiditis, or benign neoplasms. A rational approach to management of a thyroid nodule is based on the clinician's ability to distinguish the more common benign diagnoses from malignancy in a highly reliable and cost-effective manner. A comprehensive history and physical examination provides the foundation for decision making in the management of thyroid nodules. The diagnosis algorithm includes lab tests, ultasound exam, scintigraphy and fine-needle aspiration biopsy. This paper also presents the technique of thyroidectomy and the risks factors for recurrent nerve palsy. It is also discussed the indications of the total versus subtotal thyroidectomies in different thyroid pathology. Conclusions: Thyroid nodular is still a frequent disease. All “cold” nodules are potentially malignant. Unilateral isthmo-lobectomy or bilateral thyroidectomy are the treatments of choice. Careful search to identify recurrent nerve is adviseable, and mandatory in bilateral disease. Neuromonitoring may be promising tool to prevent the recurrent nerve palsy. Bloodless surgery reduces the risk of nerve lesion.

R. Van Hee

2008-01-01

198

The value of Tc-99m tetrofosmin scintigraphy in the differentiation of malignant from benign thyroid nodules  

International Nuclear Information System (INIS)

[en] Background: Previously, various radionuclides such as Ga-67, TI-201 and Tc-99m-sestamibi were used to differentiate benign from malignant thyroid nodules. Recently, it has been reported that malignant thyroid nodules concentrate Tc-99m-tetrofosmin (Tetrofosmin). In our study we evaluated the value of tetrofosmin scan in differentiation of malignant from benign thyroid nodules. Methods: Thirty nine patients with solitary nonfunctioning nodules in Tc-99M-04 scan and with solid thyroid nodules in thyroid sonography were included in the study. Fine needle aspiration biopsy and thyroidectomy were done in all patients within 2 weeks. After injection of 370 MBq of tetrofosmin, 30 min dynamic images and delayed static images at 1., 2., and 3. hours were acquired. After evaluation of images regions of interest were taken over nodule and contralateral normal thyroid tissue at 5., 15., 25., 60., 120. and 180. min. Average number of counts from tumor and contralateral normal thyroid tissue were taken. The mean malignant nodule/normal (M/N) and benign nodule/normal (B/N) thyroid tissue ratios were calculated. Results: Postop pathology of 19 nodules were malignant and 20 nodules were benign. The benign nodules showed more rapid washout as compared to malignant nodules. As a result of this significantly higher M/N ratios on delayed images are obtained (p

1994-01-01

199

Sonographic findings of thyroid cancer initially assessed as no suspicious malignancy  

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To review the retrospective imaging findings of thyroid cancer initially assessed as no suspicious malignancy. Of 338 nodules confirmed to be thyroid cancer, this study included 38 patients with 39 nodules assessed as no suspicious malignancy on initial sonography. (mean age:39 years, 36 females and 2 males). We evaluated sonographic findings by shape, margin, echogenecity, calcification, cystic degeneration and peripheral hypoechoic rim retrospectively. We analyzed whether sonographic findings were different according to the size (standard:1 cm). The most frequent sonographic findings were avoid to round shape 90%, well-defined smooth margin 64%, hypoechogenecity 54%, no calcification 92%, no cystic degeneration 77% and peripheral hypoechoic rim 56%. Suspicious malignancy findings were taller than wide shape 10%, well-defined spiculated margin 36%, markedly hypoechogenecity 10% and microcalcifications 8%. Isoechogenecity, cystic degeneration and peripheral hypoechoic rim were common in 1 cm more than nodules. Well-defined spiculated margin was common in 1 cm less than nodules. In retrospective, 56% showed no suspicious malignancy finding. Although nodules assessed as no suspicious malignancy on initial US had many retrospectively suspicious malignancy findings, still many nodules showed no suspicious malignancy finding. Suspicious findings were ignored due to equivocal finding in small size, isoechogenecity, cystic degeneration or peripheral hypoechoic rim. We need careful observation.

Kim, Do Youn; Kang, Seok Seon; Ji, Eun Kyung; Kwon, Tae Hee; Park, Hae Lin; Shim, Jeong Yun [CHA Hospital, Pochon CHA University College of Medicine, Seoul (Korea, Republic of)

2008-03-15

200

Nup88 (karyoporin) in human malignant neoplasms and dysplasias: correlations of immunostaining of tissue sections, cytologic smears, and immunoblot analysis.  

UK PubMed Central (United Kingdom)

Nuclear pore complexes (NPCs) are elaborate macromolecular structures that regulate the bidirectional nucleocytoplasmic traffic system. In vertebrate cells, NPCs include a family of 50 to 100 proteins termed nucleoporins (Nups). The 88-kD Nup has been found to be linked in a dynamic subcomplex with the oncogenic CAN/Nup214. Applying a polyclonal antiserum to Nup88 on paraffin sections, we found that it immunoreacts with numerous malignant neoplasms. All carcinomas reacted irrespective of site, type, or degree of differentiation; often, high-grade carcinomas stained more strongly and extensively. Some sarcomas (e.g., fibrosarcomas, leiomyosarcomas, liposarcomas, and rhabdomyosarcomas) reacted intensely; melanomas, gliomas, mesotheliomas, and malignant lymphomas also stained. In situ carcinomas of the colon, stomach, breast, and prostate stained convincingly, as did in situ melanomas; some samples of fetal tissues also reacted. Cytologic smears of some of the aforementioned tumors also stained. In selected samples, enhanced immunostaining of tissue sections and cytologic smears correlated strongly and consistently with immunoblot data. Immunoblots of the same tumors with antibodies to 2 other Nups (Nup214 and Nup153) showed no comparable enhancement. Therefore, it seems that in some malignant tumors, Nup88 overexpression is not parallelled by an overexpression of other Nups. Benign tumors, hyperplasias, and normal tissues showed weak and sporadic staining or absence of staining; immunoblots of the same samples yielded weak signals. Occasional highly proliferative hyperplastic-reactive processes showed focal staining. Thus, our correlative histologic, cytologic, and molecular data indicate that Nup88 may be viewed as a potentially useful, broadly based histodiagnostic and molecular marker of many malignancies and premalignant dysplasias, and further suggest that in some malignant tumors, Nup88 may be selectively overexpressed as compared with other Nups. Thus, we propose that Nup88 be designated as karyoporin.

Gould VE; Orucevic A; Zentgraf H; Gattuso P; Martinez N; Alonso A

2002-05-01

 
 
 
 
201

Nup88 (karyoporin) in human malignant neoplasms and dysplasias: correlations of immunostaining of tissue sections, cytologic smears, and immunoblot analysis.  

Science.gov (United States)

Nuclear pore complexes (NPCs) are elaborate macromolecular structures that regulate the bidirectional nucleocytoplasmic traffic system. In vertebrate cells, NPCs include a family of 50 to 100 proteins termed nucleoporins (Nups). The 88-kD Nup has been found to be linked in a dynamic subcomplex with the oncogenic CAN/Nup214. Applying a polyclonal antiserum to Nup88 on paraffin sections, we found that it immunoreacts with numerous malignant neoplasms. All carcinomas reacted irrespective of site, type, or degree of differentiation; often, high-grade carcinomas stained more strongly and extensively. Some sarcomas (e.g., fibrosarcomas, leiomyosarcomas, liposarcomas, and rhabdomyosarcomas) reacted intensely; melanomas, gliomas, mesotheliomas, and malignant lymphomas also stained. In situ carcinomas of the colon, stomach, breast, and prostate stained convincingly, as did in situ melanomas; some samples of fetal tissues also reacted. Cytologic smears of some of the aforementioned tumors also stained. In selected samples, enhanced immunostaining of tissue sections and cytologic smears correlated strongly and consistently with immunoblot data. Immunoblots of the same tumors with antibodies to 2 other Nups (Nup214 and Nup153) showed no comparable enhancement. Therefore, it seems that in some malignant tumors, Nup88 overexpression is not parallelled by an overexpression of other Nups. Benign tumors, hyperplasias, and normal tissues showed weak and sporadic staining or absence of staining; immunoblots of the same samples yielded weak signals. Occasional highly proliferative hyperplastic-reactive processes showed focal staining. Thus, our correlative histologic, cytologic, and molecular data indicate that Nup88 may be viewed as a potentially useful, broadly based histodiagnostic and molecular marker of many malignancies and premalignant dysplasias, and further suggest that in some malignant tumors, Nup88 may be selectively overexpressed as compared with other Nups. Thus, we propose that Nup88 be designated as karyoporin. PMID:12094380

Gould, Victor E; Orucevic, Amila; Zentgraf, Hanswalter; Gattuso, Paolo; Martinez, Nerea; Alonso, Angel

2002-05-01

202

Evaluation and development of a real-time predictive model for ultrasound investigation of malignant thyroid nodules.  

UK PubMed Central (United Kingdom)

Ultrasound investigations and correct identification of malignant thyroid nodules depend on the experience and qualifications of the investigators; thus, a model that provides better evaluation before needle aspiration is desired. Data from 687 patients with 726 thyroid nodules comprising 65 malignant nodules (61 papillary and 4 follicular carcinoma) and 661 benign nodules were used to construct a predictive model. Presence of micro-calcification, taller-than-wide shape, predominant solid echostructure, and irregular margins were shown to be good independent predictive parameters. A thyroid nodule was predicted as malignant with a score ?3.3. Internal validation of this predictive tool by the bootstrapping method showed excellent overall model performance.

Cheng PW; Chou HW; Wang CT; Lo WC; Liao LJ

2013-07-01

203

[Importance of exploratory thoracotomy in the diagnosis of malignant neoplasms of the lung  

UK PubMed Central (United Kingdom)

Role and importance of the explorative thoracotomy in diagnostics of malignant neoplasmas of the lung have great value. Among other diagnostic procedures explorative thoracotomy has an advantage because of visualization of process and possibility of the biopsy "extempore". As each diagnostic procedure, explorative thoracotomy has its own deficiencies because the procedure is aggressive, related to possibility of the postoperative complications, and because of these problems explorative thoracotomy is ultimative method in diagnosis of malignant neoplasmas of the lungs.

Hadzismajlovi? A; Budalica M; Guska S; Kacila M; Cerimagi? Z

1995-01-01

204

[Importance of exploratory thoracotomy in the diagnosis of malignant neoplasms of the lung].  

Science.gov (United States)

Role and importance of the explorative thoracotomy in diagnostics of malignant neoplasmas of the lung have great value. Among other diagnostic procedures explorative thoracotomy has an advantage because of visualization of process and possibility of the biopsy "extempore". As each diagnostic procedure, explorative thoracotomy has its own deficiencies because the procedure is aggressive, related to possibility of the postoperative complications, and because of these problems explorative thoracotomy is ultimative method in diagnosis of malignant neoplasmas of the lungs. PMID:9623071

Hadzismajlovi?, A; Budalica, M; Guska, S; Kacila, M; Cerimagi?, Z

1995-01-01

205

Nondiagnostic fine-needle aspirations of the thyroid: is the risk of malignancy higher?  

UK PubMed Central (United Kingdom)

BACKGROUND: Nondiagnostic fine-needle aspirations (FNAs) pose a dilemma in the management of patients with thyroid nodules. In most cases, these patients undergo either repeat FNA or surgical resection. However, a significant number of patients will only be observed, assuming that the risk of malignancy is low. Therefore, the purpose of this study was to determine whether the risk of malignancy is higher in patients with thyroid nodules and nondiagnostic FNAs. METHODS: We reviewed reports from 4286 consecutive FNA biopsies performed on patients with thyroid nodules at our institution between 2002 and 2010. We divided FNAs into two categories: diagnostic and nondiagnostic. We collected demographic, follow-up, and pathology data from both groups and then analyzed them with analysis of variance and chi-square tests. RESULTS: Of the 4286 FNAs, 259 were classified as nondiagnostic (6%). We saw no significant differences in age or gender between patients with diagnostic versus nondiagnostic FNAs. Of the patients with nondiagnostic FNAs, 62 underwent diagnostic thyroidectomy (24%), 74 had a repeat FNA (29%), and 123 had observation only (47%); thus, 136 patients had a cytologic or pathologic diagnosis. Patients with nondiagnostic FNAs had a significantly higher rate of all types of thyroid cancer, compared with those with diagnostic FNAs (12% versus 5%, respectively; P < 0.001). Impressively, the chance of papillary thyroid cancer was twofold higher in patients with nondiagnostic FNAs. CONCLUSIONS: The percentage of nondiagnostic FNA at our institution during this period (6%) was relatively low. However, the incidence of malignancy in these patients was significantly higher. Therefore, we recommend that patients with thyroid nodules and nondiagnostic FNAs undergo either repeat biopsy or diagnostic thyroidectomy.

Coorough N; Hudak K; Jaume JC; Buehler D; Selvaggi S; Rivas J; Sippel R; Chen H

2013-10-01

206

Importance of screening for synchronous malignant neoplasms in patients with hepatocellular carcinoma: impact of FDG PET/CT.  

UK PubMed Central (United Kingdom)

BACKGROUND & AIM: Synchronous neoplasms (SNs) are occasionally found in hepatocellular carcinoma (HCC). We examined such cases and the efficacy of 18-fluoro-2-deoxyglucose positron-emission tomography computed tomography (PET/CT), retrospectively. MATERIALS AND METHODS: We investigated 687 naïve HCC, who were admitted to our hospitals, encountered from October 2006 to December 2010 and evaluated the clinical backgrounds. All study protocols, was approved by our Institutional Ethics Committee. The usefulness of detecting SNs by PET/CT was evaluated in 234 patients who underwent PET/CT (PET group) and in 453 (non-PET group) examined in the same period. We noted the presence of SNs, defined as primary extrahepatic malignant neoplasms within 1 year of diagnosis of HCC. RESULTS: SNs were observed in 48 of 687 patients (54 tumours, 7.0%). SNs were detected by PET/CT in 18, which was 7.7% of PET group. The detection rate for SNs, were increased to 11.1% (26/234) in PET group by using together with upper gastrointestinal endoscopy and routine enhanced CT for HCC, which was greater than that of non-PET group (22/453, 4.9%) (P < 0.001). CONCLUSION: SNs were pointed out more frequently in PET group than non-PET group (11.1% vs. 4.9%). FDG PET/CT can enhance the detection ability for SNs in naïve HCC.

Hiraoka A; Hirooka M; Ochi H; Koizumi Y; Shimizu Y; Shiraishi A; Yamago H; Tanihira T; Miyata H; Ninomiya T; Kawasaki H; Ishimaru Y; Sogabe I; Inoue T; Abe M; Hiasa Y; Matsuura B; Onji M; Michitaka K

2013-08-01

207

Long-term health experience of jet engine manufacturing workers: III. Incidence of malignant central nervous system neoplasms.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To explore a perceived unusual occurrence of glioblastoma at one jet engine manufacturing facility located in North Haven (NH), Connecticut (CT). METHODS: Subjects were 212,513 workers ever employed in 1 of 8 manufacturing facilities from 1952 to 2001 and at risk from 1976 to 2004. We identified 722 cases of CNS neoplasms mainly by tracing through 19 state cancer registries. We computed standardized incidence ratios (SIRs) based on CT state and national rates and modeled internal relative risks (RRs). RESULTS: We found overall deficits in cases for glioblastoma (275 cases, SIR = 0.77, CI = 0.68-0.87) and most other histology categories examined. NH workers had a not statistically significant overall 8% excess in glioblastoma (43 cases, SIR = 1.08, CI = 0.78-1.46). Salaried NH workers had a statistically significant twofold risk of glioblastoma compared with hourly workers (17 cases, RR = 2.04, CI = 1.15-3.57). Other subgroups of NH workers revealed elevated but not statistically significant glioblastoma risks but little evidence of an association with duration of employment or time since first employment. CONCLUSIONS: Incidence rates for glioblastoma and other malignant CNS neoplasm histologies were not elevated in the total cohort. The glioblastoma excesses observed among NH workers may reflect external occupational factors, non-occupational factors or workplace factors unique to NH unmeasured in the current study.

Marsh GM; Buchanich JM; Youk AO; Cunningham MA; Lieberman FS; Kennedy KJ; Lacey SE; Hancock RP; Esmen NA; Fleissner ML

2010-08-01

208

Chromosome aberration observed in children with malignant neoplasms given antineoplastic agents and radiotherapy. With special reference to acute leukemia  

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Increased use of antineoplastic agents and radiotherapy in the pediatric field are producing the concern about chromosome aberration. Chromosome aberration was quantitatively examined in lymphocytes from peripheral blood and marrow cells. Forty one children with malignant neoplasms were classified into 2 groups, chemotherapy group (group Ch) and combined use group of chemotherapy and radiotherapy (group Ch + R). Blood samples were collected regularly 5 times at 6 month intervals. The results demonstrated significant difference in the incidence of aneupoid and structural abnormality of chromosomes compared with control or pretreatment samples, and showed a tendency to accumulate structural abnormality, especially in the peripheral blood. Influence of antineoplastic agents and radiotherapy was suspected. The incidences of abnormality in the peripheral blood and that of the marrow were not in good accordance, varying depending upon the disease or the therapy.

Baba, K. (Nagasaki Univ. (Japan). School of Medicine)

1981-06-01

209

Glutathione S-transferase T1 and M1 polymorphisms and risk of thyroid neoplasms  

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Full Text Available Background: In order to test the possibility of association between GSTT1 and M1 (glutathione S-transferase) null allele variant, in which the entire gene is absent, and the risk of TCO (thyroid carcinoma with cell oxyphilia), the case-control study was carried out. Methods: Genotypes for GSTT1 and GSTM1 were determined by multiplex PCR in the DNA from 108 healthy individuals and in DNA from samples of thyroid tumors from 130 patients of the same race and origin as the control group (Caucasian, Italian). The following types of NMTC were analyzed: oxyphilic adenoma (OA), oxyphilic carcinoma (OC) papillary thyroid carcinoma with oxyphilic features (PTCof), follicular adenoma (FA), follicular carcinoma (FC), follicular variant of PTC (fvPTC) and classical PTC. Associations between prevalence of particular genotypes and the occurrence of TCO (versus controls) and other subtypes of NMTC were tested. Associations were quantified by calculating OR (odds ratio) with 95% confidence interval. StatGraphics Plus v. 5 software (Manugistics) was used for statistical analysis. Results: In this study of the association between the GSTT1 and M1 null genotype and the increased risk of TCO, the frequency of GSTT1 null genotype of 19.2% in cases and 15.7% in controls was found with an adjusted odds ratio (OR) of 1.4 (95% confidence interval (CI) 0.70-2.81), and the frequency of GSTM1 null genotype of 59% in cases with oxyphilic tumors and of 55.6% in controls (OR 1.24; 95% CI, 0.62-2.48). Conclusion: These results indicate that the GSTT1 and M1 null genotypes do not increase the risk of development of oxyphilic tumors, as well as other types of NMTC that have been included in this study.

Stankov Karmen; Landi Stefano; Volante Marco; Papotti Mauro

2003-01-01

210

Evaluation of oncofetal protein-related mRNA transport activity as a potential early cancer marker in dogs with malignant neoplasms.  

Science.gov (United States)

A 55-kd protein with mRNA transport activity found in fetal rat liver cells and plasma from mice, rats, and human beings with malignant neoplasms has been designated oncofetal protein 55 (OFP55). Monoclonal antibody produced to rat OFP55 cross-reacts with human OFP55. Using this monoclonal antibody in a bioassay measuring mRNA transport stimulated by OFP55, we tested the plasma from 19 dogs with a variety of malignant neoplasms, including carcinomas, sarcomas, lymphomas, and melanomas, and compared the results with plasma from 20 clinically normal dogs without evidence of neoplasia. The mean mRNA transport activity from the group of dogs with malignant neoplasms was 0.43 +/- 0.28%/mg of protein. Mean transport activity from the group of control dogs was 0.04 +/- 0.02%/mg of protein. These means were significantly different (P < 0.0001). The degree of overlap between these 2 groups in their OFP55-related mRNA transport activity was minimal, and measurement of this protein appears to have potential for the early detection of malignant neoplasms in dogs. PMID:8599514

Stromberg, P C; Schumm, D E; Webb, T E; Ward, H; Couto, C G

1995-12-01

211

Preoperative Discrimination of Benign from Malignant Disease in Thyroid Nodules With Indeterminate Cytology Using Elastic Light-Scattering Spectroscopy.  

UK PubMed Central (United Kingdom)

Thyroid nodules are common and often require fine needle aspiration biopsy (FNAB) to determine the presence of malignancy to direct therapy. Unfortunately, approximately 15-30% of thyroid nodules evaluated by FNAB are not clearly benign or malignant by cytology alone. These patients require surgery for the purpose of diagnosis alone; most of these nodules ultimately prove to be benign. Elastic light scattering spectroscopy (ESS) that measures the spectral differences between benign and malignant thyroid nodules has shown promise in improving preoperative determination of benign status of thyroid nodules. We describe the results of a large, prospective, blinded study validating the ESS algorithm in patients with thyroid nodules. An ESS system was used to acquire spectra from human thyroid tissue. Spectroscopic results were compared to the histopathology of the biopsy samples. Sensitivity and specificity of the ESS system in the differentiation of benign from malignant thyroid nodules are 74% and 90% respectively, with a negative predictive value of 97%. These data suggest that ESS has the potential for use in real time diagnosis of thyroid nodules as an adjunct to FNAB cytology.

Rosen J; Suh H; Giordano N; A'amar O; Rodriguez-Diaz E; Bigio I; Lee S

2013-06-01

212

Differentiation of benign and malignant thyroid nodules: sonographic analysis and a new scoring system  

International Nuclear Information System (INIS)

[en] To analyze the synthetically created sonographic features of thyroid nodules, we present here a new scoring system for the sonographic features that are suggestive of malignant thyroid nodules. We also evaluated the accuracy and clinical significance of this system. In this study, we included 725 thyroid nodules of 405 patients that were pathologically proven by USG-guided percutaneous fine-needle aspiration biopsy (FNAB) or surgery. Two radiologists analyzed the sonographic features according to the internal content, margin, echogenecity, shape and calcification. We scored from 0 point to 2 point for each feature, and then we calculated the total scores and classified them as three groups according to the total score such as low risk (0-3), intermediate risk (4-6) or high risk (7-10). We demonstrated the difference of the frequency and the positive predictive value among the three groups by using the Chi-square test (?

2006-01-01

213

Early diagnosis, therapy, follow-up and survival rate of the patients with thyroid malignancy  

Directory of Open Access Journals (Sweden)

Full Text Available The Aim of the paper was to give a reviw of an early diagnosis, therapy, follow-up and survival rate of patients with thyroid malignancy (TM). The paper presented the algorithm of early diagnosis: clinical, scintigraphic and ultrasonographic examination together with fine needle biopsy, cythologic analysis of the smear and biopsy ex tempore of the clear and suspected thyroid node to malignancy. Therapy of all TM forms was mainly surgical; postsurgical treatment was dependent on the type of malignancy: radioiodine 131-I, radiologic treatment, chemotherapy and radioimmunotherapy, (the latest one being in the phase of a clinical research). Follow-up was in accordance with the protocole and it was necessary because it contributes to the survival rate. In the presentation of survival rate for differentiated and medullar carcinomas we gave our results and literature data, while for the other malignancies only data from literature were presented. Conclusion: only an early diagnosis of the nodular goiter together with an up-to-date treatment can cure TM patients in a high percentage and prevent development of a terminal stage of the desease which is extremely severe in all forms of this malignancy.

Maleševi? Milica ?.; Mihailovi? Jasna; Voji?i? Jelena V.; Popadi? Silvija M.

2003-01-01

214

The intestinal leiomyoblastoma and its classification as benign or malignant neoplasm  

International Nuclear Information System (INIS)

A symptom-causing duodenal stenosis diagnosed in a 47-year-old patient was found to be attributable to a malignant leiomyoblastoma. Ultrasonography, computerized tomography and MRI permitted a space-occupying process to be detected in the duodenum and a further tumour in the jejunum could be revealed by examinations of gastrointestinal transit. The presence of a total of three substantial tumours, one each in duodenum, jejunum and ileum, was however proven by angiography alone. (orig./MG).

1993-01-01

215

[Rare case of a malignant brain neoplasm in an 18-years old pregnant woman].  

UK PubMed Central (United Kingdom)

Authors presented rare case of anaplastic ependymoma diagnosed in the first trimester of pregnancy 18-years of age patient. Main symptoms of increased intracranial pressure and cerebral edema were vomits, severe headache and apathy. In the sixteen week of pregnancy performed craniotomy and evacuated malignant tumor of region IV ventricle trunk of the brain. Follow during pregnancy made brachytherapy (LDR). Cesarean section performed in the 30th week of pregnancy. Then indispensable radical radiotherapy was continued.

Kami?ski K; Bazowski P; Grzonka D; Adamowicz R; Muszer M

2003-06-01

216

Long-term health experience of jet engine manufacturing workers: V. Issues with the analysis of non-malignant central nervous system neoplasms.  

UK PubMed Central (United Kingdom)

OBJECTIVE: We attempted to examine non-malignant central nervous system (CNS) neoplasms incidence rates for workers at 8 jet engine manufacturing facilities in Connecticut. The objective of this manuscript is to describe difficulties encountered regarding these analyses to aid future studies. METHODS: We traced the cohort for incident cases of CNS neoplasms in states where 95% of deaths in the total cohort occurred. We used external and internal analyses in an attempt to obtain the true risk of non-malignant CNS in the cohort. Because these analyses were limited by data constraints, we conducted sensitivity analyses, including using state driver's license data to adjust person-year stop dates to help minimize underascertainment and more accurately determine cohort risk estimates. RESULTS: We identified 3 unanticipated challenges: case identification, determination of population-based cancer incidence rates, and handling of case underascertainment. These factors precluded an accurate assessment of non-malignant CNS neoplasm incidence risks in this occupational epidemiology study. CONCLUSIONS: The relatively recent (2004) mandate of capturing non-malignant CNS tumor data at the state level means that, in time, it may be possible to conduct external analyses of these data. Meanwhile, similar occupational epidemiology studies may be limited to descriptive analysis of the non-malignant CNS case characteristics.

Buchanich JM; Youk AO; Marsh GM; Kennedy KJ; Lacey SE; Hancock RP; Esmen NA; Cunningham MA; Leiberman FS; Fleissner ML

2011-01-01

217

Second Malignant Neoplasms in Digestive Organs After Childhood Cancer: A Cohort-Nested Case-Control Study  

International Nuclear Information System (INIS)

Purpose: Cancers of the digestive system constitute a major risk for childhood cancer survivors treated with radiotherapy once they reach adulthood. The aim of this study was to determine therapy-related risk factors for the development of a second malignancy in the digestive organs (SMDO) after a childhood cancer. Methods and Materials: Among 4,568 2-year survivors of a childhood solid cancer diagnosed before 17 years of age at eight French and British centers, and among 25,120 patients diagnosed as having a malignant neoplasm before the age of 20 years, whose data were extracted from the Nordic Cancer Registries, we matched 58 case patients (41 men and 17 women) of SMDO and 167 controls, in their respective cohort, for sex, age at first cancer, calendar year of occurrence of the first cancer, and duration of follow-up. The radiation dose received at the site of each second malignancy and at the corresponding site of its matched control was estimated. Results: The risk of developing a SMDO was 9.7-fold higher in relation to the general populations in France and the United Kingdom. In the case-control study, a strong dose–response relationship was estimated, compared with that in survivors who had not received radiotherapy; the odds ratio was 5.2 (95% CI, 1.7–16.0) for local radiation doses between 10 and 29 Gy and 9.6 (95% CI, 2.6–35.2) for doses equal to or greater than 30 Gy. Chemotherapy was also found to increase the risk of developing SMDO. Conclusions: This study confirms that childhood cancer treatments strongly increase the risk of SMDO, which occur only after a very long latency period.

2012-03-01

218

Second Malignant Neoplasms in Digestive Organs After Childhood Cancer: A Cohort-Nested Case-Control Study  

Energy Technology Data Exchange (ETDEWEB)

Purpose: Cancers of the digestive system constitute a major risk for childhood cancer survivors treated with radiotherapy once they reach adulthood. The aim of this study was to determine therapy-related risk factors for the development of a second malignancy in the digestive organs (SMDO) after a childhood cancer. Methods and Materials: Among 4,568 2-year survivors of a childhood solid cancer diagnosed before 17 years of age at eight French and British centers, and among 25,120 patients diagnosed as having a malignant neoplasm before the age of 20 years, whose data were extracted from the Nordic Cancer Registries, we matched 58 case patients (41 men and 17 women) of SMDO and 167 controls, in their respective cohort, for sex, age at first cancer, calendar year of occurrence of the first cancer, and duration of follow-up. The radiation dose received at the site of each second malignancy and at the corresponding site of its matched control was estimated. Results: The risk of developing a SMDO was 9.7-fold higher in relation to the general populations in France and the United Kingdom. In the case-control study, a strong dose-response relationship was estimated, compared with that in survivors who had not received radiotherapy; the odds ratio was 5.2 (95% CI, 1.7-16.0) for local radiation doses between 10 and 29 Gy and 9.6 (95% CI, 2.6-35.2) for doses equal to or greater than 30 Gy. Chemotherapy was also found to increase the risk of developing SMDO. Conclusions: This study confirms that childhood cancer treatments strongly increase the risk of SMDO, which occur only after a very long latency period.

Tukenova, Markhaba; Diallo, Ibrahima [Radiation Epidemiology Group, CESP Center for Research in Epidemiology and Population Health, INSERM, Villejuif (France); University Paris Sud 11, UMRS, Villejuif (France); Gustave Roussy Institute, Villejuif (France); Anderson, Harald [Department of Cancer Epidemiology, Lund University, Lund (Sweden); Hawkins, Mike [Center for Childhood Cancer Survivor Studies, Department of Public Health and Epidemiology, University of Birmingham, Birmingham (United Kingdom); Garwicz, Stanislaw [Childhood Cancer Research Center, University Children' s Hospital, Lund (Sweden); Sankila, Risto [Finnish Cancer Registry, Helsinki (Finland); El Fayech, Chiraz [Radiation Epidemiology Group, CESP Center for Research in Epidemiology and Population Health, INSERM, Villejuif (France); University Paris Sud 11, UMRS, Villejuif (France); Gustave Roussy Institute, Villejuif (France); Winter, Dave [Center for Childhood Cancer Survivor Studies, Department of Public Health and Epidemiology, University of Birmingham, Birmingham (United Kingdom); Rubino, Carole [Radiation Epidemiology Group, CESP Center for Research in Epidemiology and Population Health, INSERM, Villejuif (France); University Paris Sud 11, UMRS, Villejuif (France); Gustave Roussy Institute, Villejuif (France); Adjadj, Elisabeth [Radiation Epidemiology Group, CESP Center for Research in Epidemiology and Population Health, INSERM, Villejuif (France); University Paris Sud 11, UMRS, Villejuif (France); Gustave Roussy Institute, Villejuif (France); Curie Institute, Paris (France); Haddy, Nadia; Oberlin, Odile [Radiation Epidemiology Group, CESP Center for Research in Epidemiology and Population Health, INSERM, Villejuif (France); University Paris Sud 11, UMRS, Villejuif (France); Gustave Roussy Institute, Villejuif (France); Moller, Torgil [Department of Cancer Epidemiology, Lund University, Lund (Sweden); Langmark, Froydis [Finnish Cancer Registry, Helsinki (Finland); and others

2012-03-01

219

Are Radiation Therapy Oncology Group Para-aortic Contouring Guidelines for Pancreatic Neoplasm Applicable to Other Malignancies-Assessment of Nodal Distribution in Gynecological Malignancies.  

UK PubMed Central (United Kingdom)

PURPOSE: Intensity modulated radiation therapy is used to reduce dose to adjacent critical structures while maintaining adequate target coverage, but it requires precise target localization. We report the 3-dimensional distribution of para-aortic (PA) lymph nodes (LN) in pelvic malignancies. We propose a guideline to accurately define the PA LN by anatomic landmarks and compare our data with published guidelines for pancreatic cancer. METHODS AND MATERIALS: A retrospective analysis was performed on 46 patients with pelvic malignancies and positive PA LNs. Positive LNs were defined based on size and morphology or fluorodeoxyglucose avidity. All PA LNs were characterized into 3 groups based on location: left PA (between aorta and left psoas muscle), aortocaval (between aorta and inferior vena cava), and right paracaval (between inferior vena cava and right psoas muscle). Patients with retrocrural LNs were also analyzed. RESULTS: One hundred thirty-three positive PA LNs were evaluated. The majority of the PA LNs were in the left PA (59%) and aortocaval (35) regions, and only 8% were in the right paracaval region. All patients with positive right paracaval LNs also had involved left PA LNs, with only 1 exception. The highest PA LN involvement was at the level of the renal vessels and was seen in 28% of patients. Of these patients with disease extending to renal vessels, 38% had retrocrural LN involvement. CONCLUSIONS: The nodal contouring for the PA region should not be defined by a fixed circumferential margin around the vessels. The left PA and aortocaval spaces should be covered adequately because these are common locations of PA LNs. For microscopic disease superiorly, contouring should extend up to renal vessels rather than a fixed bony landmark. For patients who have nodal involvement at renal vessels, one can consider including retrocrural LNs. Radiation Therapy Oncology Group Para-aortic Contouring Guidelines for Pancreatic Neoplasm are not applicable to gynecological malignancies.

Kabolizadeh P; Fulay S; Beriwal S

2013-09-01

220

Overexpression of the anti-apoptotic protein AVEN contributes to increased malignancy in hematopoietic neoplasms.  

UK PubMed Central (United Kingdom)

AVEN has been identified as an inhibitor of apoptosis, which binds to the adaptor protein, APAF-1, and thereby prevents apoptosome formation and mitochondrial apoptosis. Recent data have demonstrated high expression levels of AVEN messenger RNA in acute leukemias as well as a positive correlation between AVEN mRNA overexpression and poor prognosis in childhood acute lymphoblastic leukemia. On the basis of these data, we investigated the potential involvement of AVEN in tumorigenesis. First, we confirmed the overexpression of AVEN in T-cell acute lymphoblastic leukemia/lymphoma (T-ALL) patient samples. We then established a transgenic mouse model with T-cell-specific overexpression of AVEN, with which we demonstrated the oncogenic cooperation of AVEN with heterozygous loss of p53. Finally, we used a subcutaneous xenograft mouse model to show that AVEN knockdown in the T-ALL cell lines, MOLT-4 and CCRF-CEM, and in the acute myeloblastic leukemia cell line, Kasumi-1, leads to a halt in tumor growth owing to the increased apoptosis and decreased proliferation of tumor cells. Collectively, our data demonstrate that the anti-apoptotic molecule, AVEN, functions as an oncoprotein in hematopoietic neoplasms.

Eißmann M; Melzer IM; Fernández SB; Michel G; Hrab? de Angelis M; Hoefler G; Finkenwirth P; Jauch A; Schoell B; Grez M; Schmidt M; Bartholomae CC; Newrzela S; Haetscher N; Rieger MA; Zachskorn C; Mittelbronn M; Zörnig M

2013-05-01

 
 
 
 
221

Thyroiditis  

Science.gov (United States)

... should. Symptoms What are the clinical symptoms of thyroiditis? There are no symptoms unique to thyroiditis. If ... in patients with subacute thyroiditis Causes What causes thyroiditis? Thyroiditis is caused by an attack on the ...

222

Malignant and benign ovarian neoplasms among atomic bomb survivors, Hiroshima and Nagasaki, 1950-80  

International Nuclear Information System (INIS)

For 1950-80, 194 ovarian cancer cases were ascertained among the 70,030 females of the Radiation Effects Research Foundation's Life-Span Study E-85 sample, and 106 autopsied cases with benign ovarian neoplasms were ascertained among all 3046 autopsies performed in the same sample. On the basis of microscopic review, 66% of the cancer and 84% of the benign tumor cases were classified by histologic type. The age-adjusted ovarian cancer incidence rates showed a statistically significant increase with increased exposure dose, both in the entire exposed group (P less than .01) and in the microscopically reviewed subset (P less than .01). This dose response was only significant (P less than .01) in the latter half of the study period, 1965-80. The radiation effect was higher in the younger age group at the time of the bomb (ATB) for the specific attained age or was adjusted for attained age. In general, relative risk (greater than or equal to 100 rad vs. 0 rad) did not differ by attained age, except for the youngest age group, less than 20 years old ATB, where the relative risk tended to decrease with increased attained age, although cases were few in number and follow-up study was necessary. Estimated minimum latent period for radiation-induced ovarian cancer seemed to be 15-20 years. The proportion of autopsied cases with benign ovarian tumor increased with increasing exposure dose, both in the entire series of cases (P less than .05) and in the microscopically reviewed subset. Statistical significance, however, was not achieved in the latter group. The distribution of histologic types of both cancer and benign tumor of the ovary did not vary significantly with radiation dose.

1987-01-01

223

Malignant and benign ovarian neoplasms among atomic bomb survivors, Hiroshima and Nagasaki, 1950-80  

Energy Technology Data Exchange (ETDEWEB)

For 1950-80, 194 ovarian cancer cases were ascertained among the 70,030 females of the Radiation Effects Research Foundation's Life-Span Study E-85 sample, and 106 autopsied cases with benign ovarian neoplasms were ascertained among all 3046 autopsies performed in the same sample. On the basis of microscopic review, 66% of the cancer and 84% of the benign tumor cases were classified by histologic type. The age-adjusted ovarian cancer incidence rates showed a statistically significant increase with increased exposure dose, both in the entire exposed group (P less than .01) and in the microscopically reviewed subset (P less than .01). This dose response was only significant (P less than .01) in the latter half of the study period, 1965-80. The radiation effect was higher in the younger age group at the time of the bomb (ATB) for the specific attained age or was adjusted for attained age. In general, relative risk (greater than or equal to 100 rad vs. 0 rad) did not differ by attained age, except for the youngest age group, less than 20 years old ATB, where the relative risk tended to decrease with increased attained age, although cases were few in number and follow-up study was necessary. Estimated minimum latent period for radiation-induced ovarian cancer seemed to be 15-20 years. The proportion of autopsied cases with benign ovarian tumor increased with increasing exposure dose, both in the entire series of cases (P less than .05) and in the microscopically reviewed subset. Statistical significance, however, was not achieved in the latter group. The distribution of histologic types of both cancer and benign tumor of the ovary did not vary significantly with radiation dose.

Tokuoka, S.; Kawai, K.; Shimizu, Y.; Inai, K.; Ohe, K.; Fujikura, T.; Kato, H.

1987-07-01

224

Malignancy Risk Assessment in Patients with Thyroid Nodules Using Classification and Regression Trees  

Science.gov (United States)

Purpose. We sought to investigate the utility of classification and regression trees (CART) classifier to differentiate benign from malignant nodules in patients referred for thyroid surgery. Methods. Clinical and demographic data of 271 patients referred to the Sadoughi Hospital during 2006–2011 were collected. In a two-step approach, a CART classifier was employed to differentiate patients with a high versus low risk of thyroid malignancy. The first step served as the screening procedure and was tailored to produce as few false negatives as possible. The second step identified those with the lowest risk of malignancy, chosen from a high risk population. Sensitivity, specificity, positive and negative predictive values (PPV and NPV) of the optimal tree were calculated. Results. In the first step, age, sex, and nodule size contributed to the optimal tree. Ultrasonographic features were employed in the second step with hypoechogenicity and/or microcalcifications yielding the highest discriminatory ability. The combined tree produced a sensitivity and specificity of 80.0% (95% CI: 29.9–98.9) and 94.1% (95% CI: 78.9–99.0), respectively. NPV and PPV were 66.7% (41.1–85.6) and 97.0% (82.5–99.8), respectively. Conclusion. CART classifier reliably identifies patients with a low risk of malignancy who can avoid unnecessary surgery.

Taghipour Zahir, Shokouh; Binesh, Fariba; Mirouliaei, Mehrdad; Khajeh, Elias

2013-01-01

225

The use of sonoelastographic elasticity index to differentiate benign and malignant thyroid nodules.  

UK PubMed Central (United Kingdom)

PURPOSE: The aim of this study is to evaluate the elasticity index of thyroid nodules by sonoelastographic imaging, and to determine the cut-off value to distinguish malignant nodules from benign nodules with optimum sensitivity and specificity. MATERIALS AND METHODS: Fine needle aspiration biopsy (FNAB) of 84 cases were evaluated with B-mode US and Sonoelastography (USE) preoperatively. The elasticity score (ELX 2/1) index of the nodules were calculated. Seventy-three patients with diagnostic biopsy results were included in this study. RESULTS: According to the FNAB results, 9 (12 %) nodules were malignant, 64 (88 %) nodules were benign. All malignant nodules were papillary carcinoma, and their diagnosis was confirmed with thyroidectomy. The ELX 2/1 index of all malignant nodules was higher than 1.65. The ELX 2/1 index of 45 (70.3 %) benign nodules was lower than 1.65 whereas the ELX 2/1 index of 19 (29.7 %) benign nodules was higher than 1.65. Using an ELX 2/1 index cut-off value of 1.65 led to a sensitivity of 100 % and a specificity of 71 % in detecting papillary thyroid carcinomas. CONCLUSIONS: Assessing the ELX 2/1 index as a screening test and deciding on FNAB accordingly, in addition to gray-scale ultrasound findings of the nodules, will be beneficial in order to prevent unnecessary biopsies.

Boyaci N; Karakas E; Sen Dokumaci D; Kocarslan S; Yildiz S; Cece H; Eren MA

2013-09-01

226

Malignancy risk assessment in patients with thyroid nodules using classification and regression trees.  

Science.gov (United States)

Purpose. We sought to investigate the utility of classification and regression trees (CART) classifier to differentiate benign from malignant nodules in patients referred for thyroid surgery. Methods. Clinical and demographic data of 271 patients referred to the Sadoughi Hospital during 2006-2011 were collected. In a two-step approach, a CART classifier was employed to differentiate patients with a high versus low risk of thyroid malignancy. The first step served as the screening procedure and was tailored to produce as few false negatives as possible. The second step identified those with the lowest risk of malignancy, chosen from a high risk population. Sensitivity, specificity, positive and negative predictive values (PPV and NPV) of the optimal tree were calculated. Results. In the first step, age, sex, and nodule size contributed to the optimal tree. Ultrasonographic features were employed in the second step with hypoechogenicity and/or microcalcifications yielding the highest discriminatory ability. The combined tree produced a sensitivity and specificity of 80.0% (95% CI: 29.9-98.9) and 94.1% (95% CI: 78.9-99.0), respectively. NPV and PPV were 66.7% (41.1-85.6) and 97.0% (82.5-99.8), respectively. Conclusion. CART classifier reliably identifies patients with a low risk of malignancy who can avoid unnecessary surgery. PMID:24102036

Taghipour Zahir, Shokouh; Binesh, Fariba; Mirouliaei, Mehrdad; Khajeh, Elias; Noshad, Sina

2013-09-11

227

Distribution of malignant neoplasms reported at different pathology centers and hospitals in Jaipur, Rajasthan  

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Full Text Available Background: Cancer data from Rajasthan are limited. Only two studies, one from Western Rajasthan, and the other from Eastern Rajasthan have been published by Sharma et al. in 1992 and 1996. Aims: To put the cancer profile from this region in proper perspective, we conducted the present study on the patterns of various malignancies in Jaipur region, i.e., Eastern Rajasthan. Setting and Design and Material and Methods: The study spans over one and half decade (1990-2004) and is based on a retrospective six-year sample analysis of approximately 200,000 histopathological and cytological reports for the years 1990, 1991, 1996, 1999, 2001 and 2004. Results: A total of 21,868 cancers were recorded in the six sample years. There were 59.11% (12,926) males and 40.89% (8942) females, with the male to female ratio being 1.45:1. Organ wise, lung (8.45%), prostate (7.12%), brain (6.04%), urinary bladder (5.31%), esophagus (4.67%) and tongue (4.60%) are most common sites involved in males with regard to frequency, whereas breast (20.44%), cervix (14.99%), ovary (4.35%), brain (3.80%), esophagus (3.67%), uterus (3.01%) and rectum (2.80%) are common sites for malignancies in females. Conclusions: Significant findings were a higher frequency of cancers of the prostate, urinary bladder, and brain in males along with gall bladder cancers in females. Our figures have been compared with the national data.

Sharma R; Kumar R; Jain S; Jhajhria S; Gupta N; Gupta S; Rawtani S; Kohli K; Prajapati L; Gupta R; Swamy N; Pathak D; Verma H; Ratnawat S

2009-01-01

228

The cytological grading of malignant neoplasms of the breast and its correlation with the histological grading.  

Science.gov (United States)

Background and Objectives: Breast carcinoma is one of the leading causes of malignancy in females. The diagnosis of breast carcinoma is often made by fine needle aspiration cytology. Nuclear grading is an important prognostic factor. It is important to grade breast carcinomas, which will provide valuable information to the treating oncologists to plan their management. The purpose of this study was to compare the cytological grading and typing with the histological grading and typing and the regional lymph node metastasis. Methodology: This retrospective and prospective study was done on 60 cases with malignant and suspicious diagnoses on FNAC, which had histopathological correlations, from January 2004 to December 2007. The cytological grading was done by Robinson's Method and the histopathological grading was done by the modified Scarff Bloom Richardson method. Cytological and histological typings were also done. The statistical analysis was done by using the SPSS software: The Chi square test was used and a contingency tale analysis (cross tabs procedure) was also done. Results: The cytohistological grading correlation was accurate in 7 cases (100%) of grade 1, 22 cases (71%) of grade 3 and 9 cases (42.9%) of grade 2 cancers. The accuracy was 62.7% (P < 0.001). A higher cytological grade was associated with a nodal metastasis. (cc : 0.399, P < .006) The cytological typing was accurate in 44 cases out of the 60 cases. Interpretation and Conclusion: The cytological grade correlated well with the histological grading accuracy (62.7%) and a higher grade was associated with a nodal metastasis (P < 0.006), Hence the cytological grading and typing should be routinely incorporated in the cytology reports and they can be of great value in guiding the choice of the treatment protocols. PMID:23905097

Vasudev, Vidya; R, Rangaswamy; V, Geethamani

2013-04-02

229

The cytological grading of malignant neoplasms of the breast and its correlation with the histological grading.  

UK PubMed Central (United Kingdom)

Background and Objectives: Breast carcinoma is one of the leading causes of malignancy in females. The diagnosis of breast carcinoma is often made by fine needle aspiration cytology. Nuclear grading is an important prognostic factor. It is important to grade breast carcinomas, which will provide valuable information to the treating oncologists to plan their management. The purpose of this study was to compare the cytological grading and typing with the histological grading and typing and the regional lymph node metastasis. Methodology: This retrospective and prospective study was done on 60 cases with malignant and suspicious diagnoses on FNAC, which had histopathological correlations, from January 2004 to December 2007. The cytological grading was done by Robinson's Method and the histopathological grading was done by the modified Scarff Bloom Richardson method. Cytological and histological typings were also done. The statistical analysis was done by using the SPSS software: The Chi square test was used and a contingency tale analysis (cross tabs procedure) was also done. Results: The cytohistological grading correlation was accurate in 7 cases (100%) of grade 1, 22 cases (71%) of grade 3 and 9 cases (42.9%) of grade 2 cancers. The accuracy was 62.7% (P < 0.001). A higher cytological grade was associated with a nodal metastasis. (cc : 0.399, P < .006) The cytological typing was accurate in 44 cases out of the 60 cases. Interpretation and Conclusion: The cytological grade correlated well with the histological grading accuracy (62.7%) and a higher grade was associated with a nodal metastasis (P < 0.006), Hence the cytological grading and typing should be routinely incorporated in the cytology reports and they can be of great value in guiding the choice of the treatment protocols.

Vasudev V; R R; V G

2013-06-01

230

Genetic markers to discriminate benign and malignant thyroid nodules with undetermined cytology in an area of borderline iodine deficiency.  

UK PubMed Central (United Kingdom)

BACKGROUND: Fine needle aspiration (FNA) with cytologic evaluation is the most reliable tool for malignancy prediction in thyroid nodules, but cytologic diagnosis remains undetermined for 20% of nodules. AIM: We investigated the diagnostic potential of a set of 6 marker genes to distinguish benign and malignant thyroid nodules. SUBJECTS AND METHODS: The prospective study included 153 thyroid samples obtained by FNA of thyroid nodules from 151 patients (56 benign, 43 malignant, and 54 nodules with undetermined cytology). Gene expression was evaluated by quantitative realtime PCR and statistical analysis of data was performed. All samples were analyzed for V600E BRAF mutation. RESULTS: A decrease in TTF3 and HGD1 expression was observed in malignant nodules with respect to benign ones, while an increase in PLAB expression was demonstrated in these nodules. The decision model was valid for 88 of 99 cases of benign and malignant nodules, with a total of 11 false positive or negative predictions. The obtained malignant/benign phenotype prediction was also valid for 37 of 54 cases of nodules with undetermined cytology with a total of 8 false positive and 9 false negative predictions. V600E BRAF gene mutation was demonstrated in 19/43 malignant nodules, in 0/56 benign nodules, and in 1/54 undetermined nodules. CONCLUSIONS: The expression profiles of genes (TFF3, HGD1, and PLAB) allowed a good prediction for the differentiation of benign thyroid lesions and thyroid cancer starting from cells of FNA; however, this assay showed limitations when applied to discriminate thyroid nodules with undetermined cytology.

Tonacchera M; Agretti P; Rago T; De Marco G; Niccolai F; Molinaro A; Scutari M; Candelieri A; Conforti D; Musmanno R; Di Coscio G; Basolo F; Iacconi P; Miccoli P; Pinchera A; Vitti P

2012-09-01

231

Atherogenicity and carcinogenicity of high-arsenic artesian well water. Multiple risk factors and related malignant neoplasms of blackfoot disease  

Energy Technology Data Exchange (ETDEWEB)

The objective of this study was to examine multiple risk factors and correlated malignant neoplasms of blackfoot disease (BFD), a unique peripheral vascular disease related to continuous exposure to high-arsenic artesian well water. A total of 241 BFD cases, including 169 with spontaneous or surgical amputations of affected extremities, and 759 age-sex-residence-matched healthy community controls were studied to explore the risk factors of BFD. Multiple logistic regression analysis showed that artesian well water consumption, arsenic poisoning, familial history of BFD, and undernourishment were significantly associated with the development of BFD. The life-table method used to analyze cancer mortality of 789 BFD patients followed for 15 years showed a significantly higher mortality from cardiovascular diseases, peripheral vascular diseases, and cancers of bladder, skin, lung, and liver among BFD patients as compared with the general population in Taiwan or residents in the BFD-endemic area. The results imply the atherogenicity and carcinogenicity of the artesian well water in the BFD-endemic area.

Chen, C.J.; Wu, M.M.; Lee, S.S.; Wang, J.D.; Cheng, S.H.; Wu, H.Y.

1988-09-01

232

[Mortality due to malignant neoplasms of the liver and intrahepatic bile ducts in Brazil, 1980-2010].  

Science.gov (United States)

This study aimed to analyze trends in mortality due to malignant neoplasms of the liver and intrahepatic bile ducts in Brazil from 1980 to 2010. This was a time series study using data provided by the Mortality Information System. Crude and standardized mortality rates were calculated according to age, area of residence, and gender. Trends were analyzed using polynomial regression models. An increasing trend in mortality was observed for both males and females in Brazil. Mean overall mortality was 3.59, with a linear increase of 0.020 (R² = 0.588; p < 0.001). The rate for males was 4.20 deaths per 100,000 inhabitants with a linear annual increase of 0.044 (R² = 0.81; p < 0,001), and for females, 2.98 per 100,000 inhabitants with a linear annual increase of 0.0194 (R² = 0.35; p = 0.008). The article discusses possible explanations for this increase, as well as potential information bias. PMID:23843009

de Amorim, Thiago Rodrigues; Merchán-Hamann, Edgar

2013-07-01

233

Risk of second malignant neoplasms after cyclophosphamide-based chemotherapy with or without radiotherapy for non-Hodgkin lymphoma.  

UK PubMed Central (United Kingdom)

Relatively little information is available on quantitative risks of therapy-induced second malignant neoplasm (SMN) in patients with non-Hodgkin lymphoma (NHL). A nested case-control study was conducted in a cohort of 3412 patients treated for NHL between 1990 and 2006, including 118 patients with SMN and 472 controls. Risks of leukemia/lung/breast/colorectal and bladder cancer were higher in NHL compared with the general population. A higher risk of leukemia was restricted to patients given a cumulative dose of cyclophosphamide more than 11 250 mg/m(2). However, no significant association was found between SMN risk with rituximab, fludarabine, anthracyclines, epipodophyllotoxins and platinum, respectively. In combined modality treatment, involved-?eld radiation therapy (IFRT) had a higher risk for second solid cancers as compared to involved-nodal radiation therapy (INRT). For patients receiving radiation doses exceeding 40 Gy, the risk of lung cancer and breast cancer was increased. In conclusion, we found that cyclophosphamide-based therapy increased the risk of SMN in NHL. Leukemia risk was linked with high-dose cyclophosphamide. A received larger radiation field or higher radiation dose also could be an important risk factor for the development of SMN.

Xu Y; Wang H; Zhou S; Yu M; Wang X; Fu K; Qian Z; Zhang H; Qiu L; Liu X; Wang P

2013-07-01

234

[Mortality due to malignant neoplasms of the liver and intrahepatic bile ducts in Brazil, 1980-2010].  

UK PubMed Central (United Kingdom)

This study aimed to analyze trends in mortality due to malignant neoplasms of the liver and intrahepatic bile ducts in Brazil from 1980 to 2010. This was a time series study using data provided by the Mortality Information System. Crude and standardized mortality rates were calculated according to age, area of residence, and gender. Trends were analyzed using polynomial regression models. An increasing trend in mortality was observed for both males and females in Brazil. Mean overall mortality was 3.59, with a linear increase of 0.020 (R² = 0.588; p < 0.001). The rate for males was 4.20 deaths per 100,000 inhabitants with a linear annual increase of 0.044 (R² = 0.81; p < 0,001), and for females, 2.98 per 100,000 inhabitants with a linear annual increase of 0.0194 (R² = 0.35; p = 0.008). The article discusses possible explanations for this increase, as well as potential information bias.

de Amorim TR; Merchán-Hamann E

2013-07-01

235

Clinical study of 89Sr therapy with radiosensitization by nicotinamide and carbogen in multiple bone metastasis of malignant neoplasms  

International Nuclear Information System (INIS)

Objective: To evaluate the curative effect and side effects of 89Sr therapy with radiosensitization by nicotinamide and carbogen in multiple bone metastasis of malignant neoplasms. Methods: Ninety-seven patients were divided into 4 groups respectively: group A, 89Sr + nicotinamide + carbogen (24 patients); group B, 89Sr + nicotinamide(22 patients); group C, 89Sr + carbogen (25 patients); group D, 89Sr, (26 patients). 89SrCl was intravenously injected at a dose of 1.48-2.22 MBq/kg. Nicotinamide was taken orally 1 hour before 89SrCl injection, 6 g/day, tid, d1-d5. Aspiration of carbogen(95%O2 + 5%CO2 ) gases, 6 L/min, 10 minutes, qd, d1-d5. Results: The effective rate of pain control and QOL improvement in A group were higher than in groups B, C and D (91.7% VS 77.3%, 76.0% and 69.2%, P=0.048). The lesions assessed by SPECT imaging in every group was not significantly different at three months after treatment. I to II degree toxic effect on bone marrow appeared in every group and there were no significantly inter-group differences. Conclusions: Combinative therapy using 89Sr + nicotinamide + carbogen is more effective to treat multiple metastatic bone pain and for improvement of QOL. The side effects are not increased. (authors)

2005-01-01

236

Automated benign & malignant thyroid lesion characterization and classification in 3D contrast-enhanced ultrasound.  

UK PubMed Central (United Kingdom)

In this work, we present a Computer Aided Diagnosis (CAD) based technique for automatic classification of benign and malignant thyroid lesions in 3D contrast-enhanced ultrasound images. The images were obtained from 20 patients. Fine needle aspiration biopsy and histology confirmed malignancy. Discrete Wavelet Transform (DWT) and texture based features were extracted from the thyroid images. The resulting feature vectors were used to train and test three different classifiers: K-Nearest Neighbor (K-NN), Probabilistic Neural Network (PNN), and Decision Tree (DeTr) using ten-fold cross validation technique. Our results show that combination of DWT and texture features in the K-NN classifier resulted in a classification accuracy of 98.9%, a sensitivity of 98%, and a specificity of 99.8%. Thus, the preliminary results of the proposed technique show that it could be adapted as an adjunct tool that can give valuable second opinions to the doctors regarding the nature of the thyroid nodule. The technique is cost-effective, non-invasive, fast, completely automated and gives more objective and reproducible results compared to manual analysis of the ultrasound images. We however intend to establish the clinical applicability of this technique by evaluating it with more data in the future.

Acharya UR; S VS; Molinari F; Garberoglio R; Witkowska A; Suri JS

2012-01-01

237

Diagnostic value of diffusion-weighted MR imaging in thyroid disease: application in differentiating benign from malignant disease.  

UK PubMed Central (United Kingdom)

BACKGROUND: Fine needle aspiration biopsy is usually performed to evaluate thyroid lesions. The purpose of this study was to evaluate the usefulness of diffusion weighted imaging to differentiate malignancy of thyroid lesions. METHODS: The study was approved by ethics committee of Shanghai Changzheng Hospital.Forty-two patients, 10 men and 32 women (range: 20--72 years, mean age 42.4 years) with thyroid lesions were included in the study. Routine neck MR and diffusion-weighted MR imaging was performed using multiple b-values. ADC values were computed for the different b-values. Histological results of the thyroidectomy samples were obtained for all the patients. ADC values of benign and malignant thyroid lesions were compared with the pathology results. Logistic regression analysis was used to detect independent parameters for differentiating benign and malignancy of lesions.Result: Based on the histology results there were 28 benign and 14 malignant cases. The difference of ADC value between benign and malignant thyroid lesions was significant for ADC values obtained using b-values of 0 and 300 s/mm2 (p < 0.001). The ADC values were significantly higher in benign lesions (benign ADC: 2.37 +/- 0.47 x 10-3 mm2/s vs. malignant: 1.49 +/- 0.60 x 10-3 mm2/s). ADC values obtained with b-values of 0 and 300 mm2/s and max nodular diameter was regarded as the two most discriminative parameters for differentiating malignancy. Using the pathology results as a standard reference, area under ROC curve was found to be 0.876 for an ADC cutoff value of 2.17 x 10-3 mm2/s that corresponded to an acquisition with b-values of 0 and 300 mm2/s. CONCLUSION: Diffusion-weighted MR imaging is a promising non-invasive method to differentiate malignancy in thyroid lesions.

Wu Y; Yue X; Shen W; Du Y; Yuan Y; Tao X; Tang CY

2013-07-01

238

Epidemiología descriptiva de las neoplasias malignas en niños Descriptive epidemiology of pediatric malignant neoplasms  

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Full Text Available El objetivo de este estudio es presentar la epidemiología descriptiva del cáncer en los niños menores de 15 años a nivel mundial y nacional. Se realizó una revisión de la literatura internacional y nacional de los artículos publicados sobre cáncer en los niños, seleccionando aquellos que trataran los aspectos epidemiológicos de tiempo, lugar y persona y analizándose tanto la incidencia como la mortalidad por cáncer en niños. La incidencia mundial es de 100 a 150 casos x 10(6) niños/año. La incidencia específica varía de acuerdo al tipo cáncer, el país o región que se estudie. El patrón latinoamericano de neoplasias lo constituyen las leucemias, los linfomas y los tumores del sistema nervioso central (TSNC); en el norteamericano y europeo los TSNC ocupan el segundo lugar; y en el africano predominan los linfomas. La incidencia es mayor en los menores de 5 años en el medio urbano y existe un incremento de 1% anual de cánceres en los niños de Estados Unidos de América. La mortalidad por cáncer en niños ha disminuido de forma importante principalmente en los países desarrollados, como Estados Unidos e Inglaterra; en los subdesarrollados permanece estable o hay una leve disminución. La incidencia es mayor en países desarrollados; sin embargo, en los países subdesarrollados puede estar subestimada. Aún hay muchos datos que se desconocen sobre la epidemiología del cáncer en el niño, por lo que son necesarios más estudios.The object of this study is to present the descriptive epidemiology of cancer in children at the world and national levels. The international and national literature published on cancer in children was comprehensively reviewed, with emphasis on reports treating epidemiological aspects of time, place and person. For practical reasons and with the aim of integrating the information, only the more relevant publications were included. Incidence and child mortality were analyzed. Overall incidence is between 100 and 150 (annual rates = cases x 10(6) children). Specific incidence varies according to the type of cancer, the region and the country. The Latin American pattern of neoplasms is constituted by leukemias, lymphomas, and central nervous system tumors (CNST); in the Northamerican/European pattern the CNST appear in second place and in the African pattern, lymphomas show predominance. Incidence is higher among the younger than 5 year olds, from urban environments, and there is a 1% annual increase of cancer in Northamerican children. Child mortality has diminished remarkably, mainly in developed countries, whereas in developing or underdeveloped countries, incidence remains stable or shows a slight fall. The incidence of cancer in children is greater in developed countries, but in underdeveloped countries it may be underestimated. These countries have not managed to reduce the incidence of child mortality caused by cancer, as have the United States or Great Britain. Further studies on the epidemiology of cancer in children are necessary, since many data remain unknown.

Arturo Fajardo-Gutiérrez; Juan Manuel Mejía-Aranguré; Leticia Hernández-Cruz; Hilda Francisca Mendoza-Sánchez; Juan Garduño-Espinosa; María del Carmen Martínez-García

1999-01-01

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Solid and isoechoic thyroid nodules without malignant sonographic features: comparison of malignancy rate according to nodule size, shape and color Doppler pattern.  

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This study aimed to assess the malignancy rate of solid and isoechoic thyroid nodules without malignant sonographic features (SITNs) and to compare the malignant and benign SITNs according to nodule size, shape and color Doppler pattern. Of 382 SITNs with the largest diameter ?10 mm, nodule size, nodule shape (i.e. spherical vs. ovoid) and color Doppler pattern (i.e. scant, peripheral, central, and mixed type) of each nodule were retrospectively evaluated. A total of 114 SITNs were histopathologically confirmed by surgery (called surgical SITN) and the malignancy rate of surgical SITNs was 8.8% (10/114). There was no statistical association between the incidence of malignancy of SITNs and nodule size but the malignancy rate of spherical SITNs was higher than that of ovoid SITNs. A significant relationship between peripheral vascularity of SITNs and benignity was found but the other vascularity patterns showed no significant association with malignancy or benignity of SITNs.

Kim DW; In HS; Choo HJ; Jung SJ; Kim YW

2013-02-01

240

Thyroid adenoma following treatment of acute lymphocytic leukemia  

International Nuclear Information System (INIS)

[en] Sequelae of the treatment of children with acute lymphocytic leukemia (ALL) include multiple effects on the endocrine system, especially as it relates to growth and puberty. Thyroid dysfunction, and in particular, the occurrence of thyroid neoplasia, has been only rarely described. We report the development of benign thyroid neoplasms in two patients 9 years following the diagnosis and treatment of ALL. Both patients were clinically and biochemically euthyroid with noncystic cold nodules found on thyroid scan. In light of these observations, and along with previous reports of malignant thyroid neoplasia in children with ALL, long-term careful observation of children successfully treated for ALL is indicated. 17 references

1990-01-01

 
 
 
 
241

Sex variability of fine-needle aspiration reliability in the diagnosis of malignancy in thyroid nodules ?4 cm.  

UK PubMed Central (United Kingdom)

BACKGROUND: The effect of sex on fine-needle aspiration (FNA) diagnosis of thyroid cancer remains unknown. This study determines the reliability of FNA when evaluating thyroid nodules ?4 cm in women and men. METHODS: Prospectively collected data of 1,068 patients who underwent FNA and thyroidectomy at a tertiary medical center were retrospectively reviewed. Data were stratified by sex and thyroid nodule size ?4 cm. RESULTS: The FNA false-negative rate for thyroid malignancy in women and men was 17% and 0%, respectively. FNA was less predictive of malignancy in women (odd ratio = 31.7; 95% confidence interval, 19.2 to 52.5; P < .0001) compared with men (odds ratio = 51.7; 95% confidence interval, 11.8 to 225.1; P < .0001) with thyroid nodules ?4 cm. CONCLUSIONS: For the diagnosis of malignancy in large thyroid nodules, FNA may be less reliable in women compared with men. This study advocates using a more aggressive approach that includes surgical resection for definitive diagnosis in women with thyroid nodules ?4 cm.

Parikh PP; Allan BJ; Lew JI

2013-06-01

242

Diagnostic performances of various gray-scale, color Doppler and contrast-enhanced ultrasound findings in predicting malignant thyroid nodules.  

UK PubMed Central (United Kingdom)

Background: Ultrasound is the most frequently used clinical tool for the identification, assessment and follow-up of thyroid nodules. The purpose of this research was to screen the valuable diagnostic ultrasound indicators, to obtain rankings of the most valuable indicators in the differential diagnosis of thyroid nodules, and analyze the optimal diagnostic points and clinical values. Methods: One hundred and forty-four patients with 172 thyroid nodules underwent preoperative ultrasound examinations including gray-scale ultrasound (GSUS), color Doppler ultrasound (CDUS) and contrast-enhanced ultrasound (CEUS). Fourteen indicators of thyroid nodules on GSUS, CDUS and CEUS were selected to evaluate all thyroid nodules. The differences between the benign and malignant thyroid nodules in all indicators and the diagnostic were analysed, and the optimal diagnostic points were explored. Results: Of the 172 thyroid nodules, 78 were benign and 94 were malignant. Ten indicators of GSUS and CEUS showed significant differences (P<0.05), whereas four CDUS indicators had no value. The rankings of the valuable indicators were obtained according to their odd ratios (ORs). The top four indicators were ring-enhancement and homogeneity of enhancement on CEUS and microcalcification and halo on GSUS. These indicators were the most valuable in the differential diagnosis of benign and malignant thyroid nodules. The other six indicators, including the relative arrival time of the nodule on CEUS, interior echogenicity on GSUS, peak interior echogenicity on CEUS, shape on GSUS, peak peripheral echogenicity on CEUS and orientation on GSUS, were also valuable. The areas under the ROC curves for GSUS, CEUS, and the combination of GSUS and CEUS in the diagnosis of thyroid nodules were 0.936, 0.910 and 0.966, respectively. Five positive features on GSUS and CEUS defined the cut-off for the diagnosis of malignant thyroid nodules, with a sensitivity of 89.4% (84/94), specificity of 93.6% (73/78) and accuracy of 91.3% (157/172). Conclusions: The ring-enhancement and homogeneity of enhancement of thyroid nodules on CEUS and the microcalcification and halo on GSUS were the four most valuable indicators in the differential diagnosis of thyroid nodules. Conjoint analysis of specific features of thyroid nodules on GSUS and CEUS could enhance the diagnostic value of thyroid nodules.

Ma JJ; Ding H; Xu BH; Xu C; Song LJ; Huang BJ; Wang WP

2013-08-01

243

Utility of diffusion-weighted imaging in differentiating malignant from benign thyroid nodules with magnetic resonance imaging and pathologic correlation.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The objective of this study was to evaluate the role of magnetic resonance diffusion-weighted imaging (DWI) in differentiating malignant from benign thyroid nodules. METHODS: The prospective study included 111 consecutive patients with solitary thyroid nodules (23 malignant and 88 benign nodules) who underwent DWI. The DWI signal and apparent diffusion coefficient (ADC) values of the nodules were determined and correlated with the histopathologic findings. RESULTS: The majority (65%) of malignant thyroid nodules showed slightly hyperintense, and the majority (69%) of benign nodules were hyperintense on DWI (P < 0.01). The ADC values were lower in the thyroid cancer than in the adenoma and nodular goiter (P < 0.05). When the b factor was 500 s/mm, an ADC value of 1.704 × 10 mm/s can be threshold differentiating malignant from benign nodules, with 92% sensitivity, 88% specificity, and 87% accuracy. The higher cell density and more severe desmoplastic response were the causes of the lower ADC value of thyroid cancer. CONCLUSION: Diffusion-weighted imaging can be a promising noninvasive imaging to discriminate malignant from benign nodules.

Shi HF; Feng Q; Qiang JW; Li RK; Wang L; Yu JP

2013-07-01

244

[Breast cancer in multiple primary malignant neoplasms, epidemiological and clinical analysis].  

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OBJECTIVE: To investigate the epidemiological and clinical characteristics of breast cancer associated with multiple primary malignant neoplasmas (MPMNs). METHODS: The data of 519 patients of breast cancer associated with MPMNs admitted to the Cancer Hospital, CAMS and diagnosed by operation and pathology in the period of 1958 to 2001 were studied retrospectively to analyze the morbity, age of onset, sex ratio, predilection site of tumor, and the interval time between sequential tumors. The 519 patients, all female, were divided into four groups: bilateral primary breast cancer (1st group), synchronic Paget's disease (PD) associated with breast cancer in the same breast (2nd group), breast cancer as the first tumor associated with MPMNs (3rd group), and breast cancer as the second or third tumour associated with MPMNs (4th group). RESULTS: The constituent rate of bilateral primary breast cancer, synchronic Paget's disease (PD) associated with breast cancer in the same breast, breast cancer as the first tumor associated with MPMNs, and breast cancer as the second or third primary tumour associated with MPMNs was 3.0%, 0.8%, 3.2%, and 2.5% respectively. The median age of onset was 42.5, 47.3, 51.4, and 51.8 years respectively for the four groups. The mean interval time between the appearance of the first tumor and the appearance of the second tumor was 5.4, 0, 8.6, and 7.6 years in the four groups respectively. The predilection sites of second and third primary cancers in the third group were lung, breast, esophageal, ovary, and large intestine. The predilection sites of first primary cancer in the 4th group were uterus, ovary, large intestine, lung, lymphatic tissue, and esophagus successively. The involvement rate of breast in breast cancer associated with MPMNs was 72.4%. CONCLUSION: (1) Breast is one of the predilection organs of MPMNs. (2) The predilection organs of breast associated with MPMNs are the target organs of female hormone (eg, breast, ovary and uterus) and the organs involved by radiotherapy for breast cancer (eg, lung and esophagus). (3) Early diagnosis and timely and proper treatment have satisfactory effect.

Wang C; Zhao P; Bai X; Wang H; Bai Y

2002-09-01

245

Diagnostic performance of (99m)Tc-MIBI scan in predicting the malignancy of thyroid nodules: a meta-analysis.  

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Several studies have investigated the diagnostic performance of (99m)Tc-MIBI scan in the evaluation of thyroid nodules suspicious for malignancy with conflicting results. The aim of our study is to meta-analyze published data on this topic. A comprehensive literature search of studies published through December 2012 regarding the diagnostic performance of (99m)Tc-MIBI scan in the evaluation of thyroid nodules suspicious for malignancy was carried out. Pooled sensitivity and specificity of (99m)Tc-MIBI scan on a per lesion-based analysis and the area under the ROC curve were calculated. Pathological reports of thyroid nodules were considered as reference standard. Twenty-one studies were included in the meta-analysis. Pooled sensitivity and specificity of (99m)Tc-MIBI scan in detecting malignant thyroid nodules were 85.1 % [95 % confidence interval (95 % CI): 81.1-88.5 %] and 45.7 % (95 % CI: 42.7-48.7 %), respectively, on a per lesion-based analysis, irrespective of eventual results of previous technetium pertechnetate ((99m)TcO4) or iodine-123 ((123)I) scan. The area under the ROC curve was 0.78. A sub-analysis restricted to data on hypofunctioning nodules on (99m)TcO4 or (123)I scans was performed: pooled sensitivity and specificity of (99m)Tc-MIBI scan in these nodules were 82.1 % (95 % CI: 77.2-86.3 %) and 62.8 % (95 % CI: 58.9-66.7 %), respectively, on a per lesion-based analysis. The area under the ROC curve was 0.81. (99m)Tc-MIBI scan is a sensitive diagnostic tool in predicting the malignancy of thyroid nodules. Therefore, this imaging method could be helpful in patients with thyroid nodules in which malignancy is suspected on the basis of conventional diagnostic techniques. Higher specificity can be reached when hypofunctioning thyroid nodules are considered.

Treglia G; Caldarella C; Saggiorato E; Ceriani L; Orlandi F; Salvatori M; Giovanella L

2013-08-01

246

Diagnostic performance of (99m)Tc-MIBI scan in predicting the malignancy of thyroid nodules: a meta-analysis.  

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Several studies have investigated the diagnostic performance of (99m)Tc-MIBI scan in the evaluation of thyroid nodules suspicious for malignancy with conflicting results. The aim of our study is to meta-analyze published data on this topic. A comprehensive literature search of studies published through December 2012 regarding the diagnostic performance of (99m)Tc-MIBI scan in the evaluation of thyroid nodules suspicious for malignancy was carried out. Pooled sensitivity and specificity of (99m)Tc-MIBI scan on a per lesion-based analysis and the area under the ROC curve were calculated. Pathological reports of thyroid nodules were considered as reference standard. Twenty-one studies were included in the meta-analysis. Pooled sensitivity and specificity of (99m)Tc-MIBI scan in detecting malignant thyroid nodules were 85.1 % [95 % confidence interval (95 % CI): 81.1-88.5 %] and 45.7 % (95 % CI: 42.7-48.7 %), respectively, on a per lesion-based analysis, irrespective of eventual results of previous technetium pertechnetate ((99m)TcO4) or iodine-123 ((123)I) scan. The area under the ROC curve was 0.78. A sub-analysis restricted to data on hypofunctioning nodules on (99m)TcO4 or (123)I scans was performed: pooled sensitivity and specificity of (99m)Tc-MIBI scan in these nodules were 82.1 % (95 % CI: 77.2-86.3 %) and 62.8 % (95 % CI: 58.9-66.7 %), respectively, on a per lesion-based analysis. The area under the ROC curve was 0.81. (99m)Tc-MIBI scan is a sensitive diagnostic tool in predicting the malignancy of thyroid nodules. Therefore, this imaging method could be helpful in patients with thyroid nodules in which malignancy is suspected on the basis of conventional diagnostic techniques. Higher specificity can be reached when hypofunctioning thyroid nodules are considered. PMID:23529672

Treglia, Giorgio; Caldarella, Carmelo; Saggiorato, Enrico; Ceriani, Luca; Orlandi, Fabio; Salvatori, Massimo; Giovanella, Luca

2013-03-26

247

Treatment of Thyroid Cancer in Childhood.  

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Contents: Papillary Thyroid Cancer in Children; Pathology of Pediatric Thyroid Cancer; Radiation-induced Thyroid Cancer in Children; Natural History of Childhood Thyroid Neoplasms; Thyroid Nodule Pathology in Children of Belarus Following the Chernobyl Ac...

1995-01-01

248

Clinicopathologic characteristics of synchronous primary thyroid cancer detected by initial staging 18F-FDG PET-CT examination in patients with underlying malignancy.  

UK PubMed Central (United Kingdom)

Background: The objective of this study was to define clinicopathologic characteristics in concurrent primary thyroid cancer detected by initial 18F-FDG PET-CT scanning in patients with underlying malignancy. Patients and Methods: Among 155 patients with known underlying malignancy and with focal FDG uptake in the thyroid, 25 patients (22 females and 3 males; mean age ± SD, 54.40 ± 11.20 years, age range, 27-70 years) who were confirmed to have papillary thyroid cancer (PTC, synchronous thyroid cancer) by cytological examination were included. Another twenty five patients (24 females and 1 male; mean age ± SD, 48.80 ± 12.76 years) with focal uptake in preoperative 18F -FDG PET-CT due to PTC and no history of other malignancy (primary thyroid cancer) were also included. Immunohistochemical studies were performed for glucose transporter-1 (GLUT-1) and vascular endothelial growth factor (VEGF). Results: GLUT-1 expression was significantly lower in synchronous thyroid cancer (7 of 25 patients, 28.0%) compared with primary thyroid carcinoma (15 of 25 patients, 60.0%) (p = 0.045). However, age and tumor size of synchronous thyroid cancer were not significantly different from the patients with primary thyroid carcinomas. There was no significant difference in VEGF expression, SUVmax, extrathyroidal extension, LN metastasis, advanced stage and multifocality between both thyroid cancer groups. Conclusion: Clinicopathologic characteristics of synchronous thyroid cancer in patients with underlying malignancy were not different from those of patients with primary thyroid cancers except for GLUT-1 expression.

Kim BH; Lee CH; Kim SJ; Jeon YK; Kim SS; Kim YK; Kim IJ

2013-03-01

249

Conventional ultrasonography and real time ultrasound elastography in the differential diagnosis of degenerating cystic thyroid nodules mimicking malignancy and papillary thyroid carcinomas.  

UK PubMed Central (United Kingdom)

Background: To evaluate the diagnostic utility of conventional ultrasonography and real time ultrasound elastography in differentiating degenerating cystic thyroid nodules mimicking malignancy from papillary thyroid carcinoma. Methods: We retrospectively analyzed conventional ultrasonographic and elastographic characteristics of 19 degenerating cystic thyroid nodules mimicking malignancy in 19 patients, with 30 surgically confirmed PTCs as controls. Based on size, the nodules had been grouped into less than 10mm (group A) and greater than 10 mm (group B). We evaluated conventional parameters and elasticity pattern. Color-scaled elastograms were graded as to stiffness of nodules using an elasticity pattern from I (soft) to IV (stiff). Results: Degenerating cystic thyroid nodules were similar to PTCs in conventional ultrasonographic findings, but the former frequently showed oval to round in shape (group A, 69.2% vs 18.8%, P=0.017; group B, 66.7% vs 7.14%, P=0.017) and punctuate hyperechoic foci (group A, 61.5% vs 0, P<0.001; group B, 50% vs 0, P<0.001). On real time ultrasound elastography, 7 of 13 degenerating cystic thyroid nodules in group A were pattern I, 5 were pattern II, 1 was pattern III. One degenerating cystic thyroid nodule in group B was pattern II, 5 were pattern III. The area under the curve for elastography was 0.98 in group A (sensitivity 92.3%, specificity 100%, P = 0.002), and 0.88 in group B (sensitivity 16.7%, specificity 100%, P = 0.014). Conclusions: As a dependable imaging technique, elastography helps increase the performance in differential diagnosis of degenerating cystic thyroid nodule and malignancy.

Wu HX; Zhang BJ; Wang J; Zhu BL; Zang YP; Cao YL

2013-01-01

250

Thyroid neoplasia in long-term Segment III beagles  

International Nuclear Information System (INIS)

[en] Seventy-four (4.4%) of the 1680 Segment III beagles had one or more thyroid tumors as of December 31, 1979. Four sacrificed at 5 years of age and 13 sacrificed at 8 years of age had thyroid tumors. Ten malignant thyroid tumors have been removed surgically and 47 other dead dogs with thyroid neoplasms were found. Most tumors were of thyroid follicular cell origin and were near equally divided between benign and malignant varieties. Five dogs had tumors of the parafollicular cells (C-cells). To date, thyroid neoplasia does not appear to be associated with radiation exposure, but there does not appear to be an association with hypothyroidism. Forty-seven (68%) of the 69 dogs with thyroid follicular cell tumors were hypothyroid

1981-01-01

251

Adrenocortical oncocytic neoplasm presenting with Cushing's syndrome: a case report  

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Full Text Available Abstract Introduction Oncocytic neoplasms occur in several organs and are most commonly found in the thyroid, kidneys and salivary glands. Oncocytic neoplasms of the adrenal cortex are extremely rare and are usually non-functioning. Case presentation We report the case of an adrenocortical oncocytic neoplasm with uncertain malignant potential in a 31-year-old man with Cushing's syndrome. The patient had been operated on following diagnosis of a 7 cm adrenal mass. Following surgery, the Cushing's syndrome resolved. The patient is still alive with no metastases one year after the surgery. Conclusion Adrenocortical oncocytic neoplasms must be considered in the differential diagnosis of both functioning and non-functioning adrenal masses.

Kabayegit Ozlem; Soysal Dilek; Oruk Gonca; Ustaoglu Bahar; Kosan Umut; Solmaz Serife; Avci Arzu

2008-01-01

252

Differential expression of galectin-3, CK19, HBME1, and Ret oncoprotein in the diagnosis of thyroid neoplasms by fine needle aspiration biopsy  

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Full Text Available Background: Fine needle aspiration biopsy (FNAB) is a common and excellent procedure for the evaluation of thyroid lesions that require surgical resection. At times, the FNAB diagnosis can be difficult, particularly of follicular-patterned lesions. Previous studies have shown that some immunohistochemical (IHC) markers may be helpful in establishing more accurate diagnosis. In this study, our goal was to evaluate four of the recently investigated markers in differentiating benign from malignant thyroid nodules on FNABs. Materials and Methods: We performed IHC staining of galectin-3, Ret oncoprotein (Ret), HBME-1, and cytokeratin 19 (CK19), on cell block sections of thyroid FNAB cases that had corresponding surgical resections. They included 44 benign lesions (37 hyperplastic or cellular nodules, HN; and 7 follicular adenomas, FA) and 27 malignant tumors (6 follicular carcinoma, FC; 19 classic papillary carcinoma, PTC; and 2 follicular variant of papillary carcinoma, FVPC). The stains were done according to the standard avidin-biotin-peroxidase method. Results: Statistical analysis showed that immunoexpression was significantly higher in the malignant group for all four markers. The sensitivity for positive expression for all benign lesions versus malignant tumors was as follows: 10/44 (22.7%) versus 25/27 (92.6%) for galectin-3; 14/44 (31.8%) versus 23/27 (85%) for Ret; 12/44 (27.3%) versus 24/27 (88.8%) for HBME-1; and 13/44 (29.5%) versus 23/27 (85%) for CK19. The sensitivity and specificity was highest for galectin-3 (92.6% and 77.3%, respectively) followed by HMBE-1 (88.9% and 72.7%, respectively). When combining the markers? expressions, the panel of galectin-3 + HBME-1 showed the highest sensitivity and specificity (90.7% and 75%, respectively), but this was, however, lower than galectin-3 alone (92.3% and 77.3%, respectively). Conclusion: We conclude that galectin-3 is the best single marker in differentiating benign from malignant thyroid lesions with the highest sensitivity and specificity. The galectin-3 + HBME-1 was the best combination for distinguishing benign from malignant lesions. Because they were the best two independent and combined markers, we recommend the use of the galectin-3 + HBME-1 panel to enhance the diagnostic accuracy of follicular-patterned thyroid lesions on FNABs.

Saleh Husain; Feng Jining; Tabassum Farah; Al-Zohaili Opada; Husain Muji; Giorgadze Tamara

2009-01-01

253

The clinical significance and management of incidental focal FDG uptake in the thyroid gland on positron emission tomography/computed tomography (PET/CT) in patients with non-thyroidal malignancy  

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Background Incidental focal fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG) uptake in the thyroid is not uncommon. A significant proportion is due to intercurrent thyroid cancer on further evaluation. Purpose To investigate and discuss the clinical significance and management of incidental focal FDG uptake in the thyroid gland on positron emission tomography/computed tomography (PET/CT) in patients with non-thyroidal malignancy. Material and Methods We investigated 188/7896 (2.4%) patients who had incidental focal thyroid uptake on FDG PET/CT in an oncology population over a 45-month period. Diagnosis was confirmed in 63 patients of whom 59 patients had histopathological verification. Results Thirty-two percent of confirmed cases were malignant comprising intercurrent thyroid cancer in three-quarters of these patients. Maximum standardized uptake values of the thyroid lesions and SUV ratios compared with background thyroid and mediastinal uptake were not predictive of a benign or malignant etiology. In patients with incidental thyroid cancers, more than half had non-papillary and intermediate to high-risk pathology. Conclusion Focal FDG uptake in the thyroid gland on PET/CT showed a malignancy risk of 32%. The intensity of uptake does not predict histology and underpins the importance of further investigations to exclude intercurrent thyroid cancer in suitable patients

Wong, Christine (Univ. of New South Wales (Australia)); Lin, Michael (Univ. of New South Wales (Australia); Liverpool Hospital, Dept. of Nuclear Medicine and PET, Liverpool (Australia)), email: Michael.lin@swsahs.nsw.gov.au; Chicco, Andrew; Benson, Rhonda (Liverpool Hospital, Dept. of Nuclear Medicine and PET, Liverpool (Australia))

2011-10-15

254

Horner syndrome as a manifestation of thyroid carcinoma: a rare association.  

Science.gov (United States)

An 82-year-old patient presented a progressively growing hard thyroid nodule, and left ptosis. Additionally, ophthalmologic evaluation revealed ipsilateral miosis, diagnostic findings of Horner syndrome. Computerized tomography revealed a 7.5-cm thyroid mass infiltrating the main neck vessels. Although clinical and imaging data were suggestive of poorly differentiated thyroid carcinoma, fine-needle aspiration led to the diagnosis of papillary carcinoma. Paliative care was proposed to the patient due to the advanced stage of the neoplasm and to significant comorbidities. Horner syndrome is an infrequent manifestation of thyroid disorders and benign etiologies are more often implied. Malignant thyroid neoplasms represent a rare cause of Horner syndrome. However, an appropriate and prompt diagnosis is paramount for timely treatment of rare thyroid malignancies. PMID:24030189

Pereira, Bernardo; Silva, Tiago; Luiz, Henrique; Manita, Isabel; Raimundo, Luísa; Portugal, Jorge

2013-08-01

255

Intrathyroid epithelial thymoma (ITET) and carcinoma showing thymus-like differentiation (CASTLE): CD5-positive neoplasms mimicking squamous cell carcinoma of the thyroid.  

UK PubMed Central (United Kingdom)

Carcinoma of possible thymic epithelial origin may occur within the thyroid gland, which was first reported by Miyauchi et al. as intrathyroid epithelial thymoma (ITET). ITET is a rare tumor comprising about 0.08% of all primary thyroid malignancies. It is a low-grade thyroid carcinoma with squamous cell differentiation whose overall survival rate was found to be 71%. Lymph node metastasis at surgery was found in 40% and hematogenous metastases developed in bones, liver and lungs. This tumor grows within the thyroid gland and invades into the thyroid parenchyma as well as into the extrathyroid structures. It is a well-circumscribed solid tumor with a sharp tumor border, but is not capsulated. After fixation, the cut surface of the tumor is gray-white in color and is a solid tumor with lobulation. Tumor calcification was not detected in our 15 cases. The tumor cells show solid sheets of growth with occasional keratinization without follicular or papillary structures. Lymphocytic infiltration in the stroma is one of the most characteristic features of this tumor. The tumor cells are polygonal epithelial cells with distinct nucleoli and ill-defined cell border. Positive immunoreactivity for CD5 is a key feature to differentiate it from undifferentiated carcinoma, poorly differentiated carcinoma, medullary (C cell) carcinoma and high-grade squamous cell carcinoma (so-called primary squamous cell carcinoma) of the thyroid. Negative immunoreactivity for calcitonin, TTF1 and thyroglobulin, and positive immunoreactivity for p63 and KIT are also helpful for differential diagnosis. Nuclear atypia is mild and mitoses are less frequent, with an intermediate proliferation index (MIB-1 labeling index is usually less than 20%), which are also helpful to differentiate it from high-grade primary squamous cell carcinoma of the thyroid. The tumors in our 15 cases demonstrate 3 histological subtypes: keratinizing squamous cell carcinoma type, non-keratinizing basaloid cell carcinoma (lymphoepithelioma-like) type and neuroendocrine carcinoma type, which correspond to subtypes of the mediastinal thymic carcinomas.

Kakudo K; Bai Y; Ozaki T; Homma K; Ito Y; Miyauchi A

2013-05-01

256

A cutaneous adnexal neoplasm with features of adamantinoid trichoblastoma (lymphadenoma) in the benign component and lymphoepithelial-like carcinoma in the malignant component: a possible case of malignant transformation of a rare trichoblastoma variant.  

UK PubMed Central (United Kingdom)

The authors describe a case of cutaneous adnexal tumor with a component reminiscent of adamantinoid trichoblastoma (lymphadenoma) that shows gradual transition to a high-grade carcinoma resembling lymphoepithelial-like carcinoma. The tumor was located above the upper lip of a 57-year-old woman and metastasized in regional lymph nodes. This seems to be the first documented report of malignant transformation of adamantinoid trichoblastoma. We discuss also other possibilities of histogenesis of this unique neoplasm.

Kazakov DV; Banik M; Kacerovska D; Michal M

2011-10-01

257

A cutaneous adnexal neoplasm with features of adamantinoid trichoblastoma (lymphadenoma) in the benign component and lymphoepithelial-like carcinoma in the malignant component: a possible case of malignant transformation of a rare trichoblastoma variant.  

Science.gov (United States)

The authors describe a case of cutaneous adnexal tumor with a component reminiscent of adamantinoid trichoblastoma (lymphadenoma) that shows gradual transition to a high-grade carcinoma resembling lymphoepithelial-like carcinoma. The tumor was located above the upper lip of a 57-year-old woman and metastasized in regional lymph nodes. This seems to be the first documented report of malignant transformation of adamantinoid trichoblastoma. We discuss also other possibilities of histogenesis of this unique neoplasm. PMID:21915036

Kazakov, Dmitry V; Banik, Martin; Kacerovska, Denisa; Michal, Michal

2011-10-01

258

Clinical application of 99Tcm-HL91 hypoxic imaging in differential diagnoses of malignancy from benign thyroid nodules  

International Nuclear Information System (INIS)

Objective: Recent studies showed that 99Tcm-4, 9-diaza-3,3,10,10-tetramethyldode- can-2, 11-dizone dioxime (HL91) might be of potential in characterizing hypoxic areas within malignant tumors. The aims of this study were to use 99Tcm-HL91 in patients with thyroid nodules and also to explore its clinical utilities in differentiate benign and malignant thyroid nodules. Methods: Fifty-eight patients with thyroid nodules, detected either by ultrasound or physical palpation, were enrolled. 99Tcm-HL91 planar thyroid images were performed at early (10 min after injection) and delay (4 h after injection) phases. The radioactivity ratio of tumor to non-tumor (T/N) was calculated and compared with the pathological results. The t test and ?2 test were used for data analysis. Results: Of the 58 patients, 21 were thyroid cancer and 37 were benign nodules. The sensitivity, specificity and accuracy of 99Tcm-HL91 for thyroid cancer were 85.7%, 94.6% and 91.4% respectively. Moreover, the sensitivity was positively correlated with the tumor size and was unrelated to the histological types (?2=0.778, P>0.05). A significant higher uptake of 99Tcm-HL91 in malignant nodule was noted than benign at delay phase (1.25 ± 0.03 vs 0.91 ± 0.12, t= 3.885, P99Tcm-HL91 hypoxic imaging has potential in both detecting and differentiating malignancy from benign thyroid nodules, especially when delay phase was applied. (authors)

2008-01-01

259

The role of proton MR spectroscopy and apparent diffusion coefficient values in the diagnosis of malignant thyroid nodules: preliminary results.  

UK PubMed Central (United Kingdom)

PURPOSE: Performance of proton magnetic resonance spectroscopy (H-MRS) and apparent diffusion coefficient (ADC) values in the diagnosis of malignant thyroid nodules. METHOD: In a retrospective study with malignant nodules of 14 patients, H-MRS and diffusion-weighted MR imaging (DWI) were performed. Choline (Cho) peak, Cho/creatine (Cr) ratio, and ADC values of malignant nodules were correlated with the five benign nodules and four normal-appearing thyroid lobe parenchymata. The gold standard reference was fine needle aspiration biopsy and histopathology. RESULTS: At echo time 40-144-ms acquisitions, average Cho/Cr ratio for the malignant nodules was 2.95±1.54-5.30±2.38, cutoff values were >0.805 and >1.225, and ADC values were 0.06±0.02. CONCLUSION: H-MRS acquisitions, DWI, and ADC mapping give diagnostic data about the nature of the nodules.

Ayd?n H; K?z?lgöz V; Tatar ?; Damar Ç; Güzel H; Hekimo?lu B; Deliba?? T

2012-07-01

260

Differentiation between malignant and benign thyroid tumors by X-ray fluorescent analysis-comparison of cases from Russia and Albany, New York  

International Nuclear Information System (INIS)

[en] Intra thyroid iodine level in different types of thyroid neoplasms in Russia (126 cases) and USA (37 cases) were investigated by X-ray fluorescent analysis in vitro. A decrease in intra thyroid iodine concentration is associated with the stepwise loss of differentiation in thyroid tumors. In colloid goiter tissue from Russia, the intra thyroid iodine level is increased. The intra thyroid iodine level was markedly increased in micro follicular adenomas and colloid goiters from American patients which may reflect a higher iodine supply in the USA. X-ray fluorescent analysis together with careful clinical appraisal can be used for management of thyroid patients with suspicious nodules which should be treated by surgery

1996-01-01

 
 
 
 
261

Thyroid neoplasia following radiation therapy for Hodgkin's lymphoma  

International Nuclear Information System (INIS)

[en] The question of thyroid neoplasia following high-dose radiation treatment to the neck and mediastinum for malignant neoplasms such as Hodgkin's lymphoma in children and young adults has been raised recently. Five patients, 19 to 39 years old, were operated on for thyroid neoplasms that developed following cervical and mediastinal radiation therapy for Hodgkin's lymphoma. Three patients had papillary carcinomas and two had follicular adenomas. The latency period between radiation exposure and the diagnosis of thyroid neoplasm ranged from eight to 16 years. This limited series provided strong support for the recommendation that children and young adults who are to receive high-dose radiation therapy to the head, neck, and mediastinum should receive suppressive doses of thyroxine prior to radiation therapy in order to suppress thyrotropin (thyroid-stimulating hormone) and then be maintained on a regimen of suppression permanently

1987-01-01

262

Doxorubicin-induced myocardial failure in rats with malignant neoplasm: Protective role of fullerenol C60(OH)24  

Directory of Open Access Journals (Sweden)

Full Text Available The therapeutic utility of the anthracycline antibiotic doxorubicin is limited due to its cardiotoxicity. Our aim was to investigate the efficacy of fullerenol C60(OH)24 in preventing single, high-dose doxorubicin-induced cardiotoxicity in rats with malignant neoplasm. In vitro and in vivo studies have shown that fullerenol C60(OH)24, has strong antioxidative potential. Experiment was performed on adult female Sprague Dawley rats with chemically induced mammary carcinomas. All 32 rats (2-5 groups) received i.p. applications of 1-methyl-l-nitrosourea (MNU; 50 mg/kg body weight) on the 50th and 113th day of age. Animals were randomly divided into five groups as follows: (1) Untreated control group - rats received saline only; (2) Cancer control group - rats received MNU and saline; (3) Dox group - rats received MNU and Dox 8 mg/kg; (4) Full/Dox group -rats received MNU and Full 100 mg/kg 30 min before Dox 8 mg/kg; (5) Full group - rats received MNU and Full 100 mg/kg. Tumor incidence was 4.94 +- 0.576 per rat. The animals were sacrificed 2 days after the application of doxorubicin and/or fullerenol, and the serum activities of CK, LDH and ?-HBDH, as well as the levels of MDA, GSH, GSSG, GSH-Px, SOD, CAT, GR and TAS in the heart, were determined. The results obtained from the enzymatic activity in the serum show that the administration of a single dose of 8 mg/kg in all treated groups induces statistically significant damage. There are significant changes in the enzymes of LDH and CK (p < 0.05), after an i.p. administration of doxorubicin/fullerenol and fullerenol. Comparing all groups with untreated control group, point to the conclusion that in the case of a lower oc-HBDH/LDH ratio, results in more serious the liver parenchymal damage. The results revealed that doxorubicin induced oxidative damage and that the fullerenol antioxidative influence caused significant changes in MDA, GSH, GSSG, GSH-Px, SOD, CAT, GR and TAS level in the heart (p < 0.05). Ultra structural analysis of heart tissues from rats treated with doxorubicin and indicated that the hearts of the rats were protected from doxorubicin-induced subcellular damage. Doxorubicin/fullerenol rats did not appear to show significant cardiac damage although occasional focal loss of cristae in the mitochondria was observed. Therefore, it is suggested that fullerenol might be a potential cardioprotector in doxorubicin-treated individuals.

Injac Rade; ?or?evi? Aleksandar N.; Štrukelj Borut

2008-01-01

263

Role of AgNORs in thyroid lesions on fine needle aspiration cytology smears  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Fine needle aspiration has an important role in diagnosis of thyroid neoplasm. However, it is difficult to differentiate between follicular adenoma and follicular carcinoma by cytology alone. Recently, silver staining has been performed for nucleolar organizer regions (AgNORs) to differentiate various tumors. Aims: The present study was undertaken to see if the AgNOR technique could distinguish between benign and malignant lesions, particularly, follicular neoplasm. Materials and Methods: One hundred forty cases of thyroid lesions were examined, which included colloid goiter (n = 36), multinodular goiter (n = 38), subacute thyroiditis (n = 6), Hashimoto?s thyroiditis (n = 17), lymphocytic thyroiditis (n = 3), follicular neoplasm (n = 18), Hurthle cell neoplasm (n = 3), papillary carcinoma (n = 16), and medullary carcinoma (n = 3). Diagnosis was confirmed by histopathology in 80 cases. The usual one-step silver colloidal reaction was performed at room temperature for 35 minutes and intranuclear dots of silver deposits were counted in 100 cells. Results: AgNOR counts of benign and malignant lesions were compared and were found to be statistically significant (P Conclusions: AgNOR counting in fine needle aspiration smears is a simple, sensitive, and cost-effective method for differentiating benign from malignant thyroid follicular neoplasms.

Asotra Sarita; Sharma Jaishree

2008-01-01

264

Nulliparity enhances the risk of second primary malignancy of the breast in a cohort of women treated for thyroid cancer  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Many studies have reported an increased risk of developing a second primary malignancy (SPM) of the breast in women treated for thyroid cancer. In this study, we investigated several potential risk factors for this association. The aim of this retrospective cohor...

Consorti Fabrizio; Di Tanna Gianluca; Milazzo Francesca; Antonaci Alfredo

265

Comparative analysis of the prevalence of the glutathione S-transferase (GST) system in malignant and benign thyroid tumor cells.  

UK PubMed Central (United Kingdom)

CONTEXT AND OBJECTIVE: When null, the mu and theta genes of the glutathione S-transferase system (GSTM1 and GSTT1, respectively) are related to malignant tumors affecting the lungs, colon, prostate, bladder and head and neck. In the thyroid, the appearance of cancer has been correlated with deletion of these genes. The aim of this study was to compare the frequencies of these genes in patients with benign and malignant tumors of the thyroid gland. DESIGN AND SETTINGS: This was a cross-sectional clinical trial carried out in the Head and Neck Surgery Division, Faculdade de Medicina da Santa Casa de São Paulo. METHODS: Samples of thyroid tissue were collected from 32 patients and divided into two groups: benign tumor (A) and malignant tumor (B). After DNA extraction, the genes were amplified using PCR. RESULTS: The B group presented four cases of positive genotyping for both genes, seven positive for GSTT1 and negative for GSTM1, two negative for GSTT1 and positive for GSTM1, and only one case of double negative. The A group showed 11 cases with positive genotyping for both genes and none with the double negative genotype. CONCLUSION: In this study, there was no relationship between the presence of the GSTT1 and GSTM1 genes and the benign and malignant thyroid tumors.

Gonçalves AJ; Carvalho LH; Serdeira K; Nakai MY; Malavasi TR

2007-09-01

266

Malignancy Rate in Sonographically Suspicious Thyroid Nodules of Less than a Centimeter in Size Does Not Decrease with Decreasing Size  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We evaluated the malignancy and nondiagnostic rates using fine needle aspiration cytology (FNAC) results in thyroid nodules smaller than 1 cm according to the subdivided size. We retrospectively reviewed the medical records of all subjects underwent FNAC from 2003 to 2009 in our hospital, and 2,756 ...

Bo, Yul Hwang; Ahn, Hwa Young; Lee, Yun Hee; Lee, Ye Jin; Kim, Jung Hee; Ohn, Jung Hun; Hong, Eun Shil; Kim, Kyung Won

267

Diagnostic and prognostic value of immunocytochemistry and BRAF mutation analysis on liquid-based biopsies of thyroid neoplasms suspicious for carcinoma.  

UK PubMed Central (United Kingdom)

OBJECTIVE: In the field of fine-needle aspiration cytology, the category of suspicious for malignancy (SM) thyroid lesions, that bears 55-85% risk of malignant histology, is a challenging topic in which morphology alone is not always able to make a correct diagnosis. Recently, immunocytochemistry (ICC) has been referred to as helpful in differentiating low- and high-malignant risk lesions and BRAF activating mutations have been identified in a significant amount of papillary thyroid carcinomas (PTC). The introduction of the liquid-based cytology (LBC) may simplify the application of these techniques to thyroid cytology. DESIGN: Our aim is to evaluate the diagnostic and prognostic role of both ICC and BRAF mutation for the SM category on LBC. METHODS: From October 2010 through June 2011, 113 LBC cytological cases (including 37 SM and 76 PTC) underwent surgery. All cases were studied for BRAF mutation and ICC. RESULTS: ICC resulted positive in 26 (86.6%) histologically malignant SM with 15 of which (40.5%) expressing a BRAF mutation. Overall, 63 cases showed a BRAF mutation resulting in PTC. Concerning the prognostic role of BRAF mutation for the two categories, we reported a significant correlation with multifocality, nodal involvement and extra-capsular invasion (P<0.0001). CONCLUSIONS: Special techniques such as ICC and molecular markers might be successfully carried out on LBC-processed material. For both categories, ICC is more sensitive whereas BRAF analysis is an interesting support due to its high specificity adding a prognostic value in both SM and PTCs.

Rossi ED; Martini M; Capodimonti S; Straccia P; Cenci T; Lombardi CP; Pontecorvi A; Larocca LM; Fadda G

2013-06-01

268

Spatial autocorrelation analysis of 13 leading malignant neoplasms in Taiwan: a comparison between the 1995-1998 and 2005-2008 periods  

Directory of Open Access Journals (Sweden)

Full Text Available Spatial autocorrelation methodologies, including Global Moran’s I and Local Indicators of Spatial Association statistic (LISA), were used to describe and map spatial clusters of 13 leading malignant neoplasms in Taiwan. A logistic regression fit model was also used to identify similar characteristics over time. Two time periods (1995-1998 and 2005-2008) were compared in an attempt to formulate common spatio-temporal risks. Spatial cluster patterns were identified using local spatial autocorrelation analysis. We found a significant spatio-temporal variation between the leading malignant neoplasms and well-documented spatial risk factors. For instance, in Taiwan, cancer of the oral cavity in males was found to be clustered in locations in central Taiwan, with distinct differences between the two time periods. Stomach cancer morbidity clustered in aboriginal townships, where the prevalence of Helicobacter pylori is high and even quite marked differences between the two time periods were found. A method which combines LISA statistics and logistic regression is an effective tool for the detection of space-time patterns with discontinuous data. Spatio-temporal mapping comparison helps to clarify issues such as the spatial aspects of both two time periods for leading malignant neoplasms. This helps planners to assess spatio-temporal risk factors, and to ascertain what would be the most advantageous types of health care policies for the planning and implementation of health care services. These issues can greatly affect the performance and effectiveness of health care services and also provide a clear outline for helping us to better understand the results in depth.

Pui-Jen Tsai; Cheng-Hwang Perng

2011-01-01

269

Risk of malignancy in thyroid incidentalomas detected by (18)f-fluorodeoxyglucose positron emission tomography : a systematic review  

DEFF Research Database (Denmark)

Background: The expanding use of (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) has led to the identification of increasing numbers of patients with an incidentaloma in the thyroid gland. We aimed to review the proportion of incidental thyroid cancers found by (18)F-FDG PET or PET/computed tomography imaging. Methods: Studies evaluating thyroid carcinomas discovered incidentally in patients or healthy volunteers by (18)F-FDG PET were systematically searched in the PubMed database from 2000 to 2011. The main exclusion criteria were known thyroid disease, lack of assigned diagnoses, investigation of diffuse uptake only, or investigation of patients with head and neck cancer, or cancer in the upper part of the thorax. Results: Twenty-two studies met our criteria comprising a total of 125,754 subjects. Of these, 1994 (1.6%) had unexpected focal hypermetabolic activity, while 999 of 48,644 individuals (2.1%) had an unexpected diffuse hypermetabolic activity in the thyroid gland. A diagnosis was assigned in 1051 of the 1994 patients with a focal uptake, 366 of whom (34.8%) had thyroid malignancy. Likewise, a diagnosis was assigned in 168 of 999 patients with a diffuse uptake, 7 of whom (4.4%) had thyroid malignancy. In the eight studies reporting individual maximum standardized uptake values (SUV(max)), the mean SUV(max) was 4.8 (standard deviation [SD] 3.1) and 6.9 (SD 4.7) in benign and malignant lesions, respectively (p

Soelberg, Kerstin Kathrine; Bonnema, Steen Joop

2012-01-01

270

A distinctive colour associated with high iodine content in malignant pleural effusion from metastatic papillary thyroid cancer: a case report.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Pleural effusions are a common clinical problem and affect about one million people in the United States and United Kingdom each year. Over 60 causes of pleural effusion have been identified; establishing the definitive aetiology can be difficult, and often requires invasive procedures. Guidelines state that macroscopic examination of the fluid should be the first step in determining the aetiology of a pleural effusion. Papillary thyroid carcinoma is an uncommon cause of malignant pleural effusion, with only 10 cases reported in the literature, their physical characteristics and composition having been rarely described. We describe for the first time a distinctive brown colour of the malignant effusion (despite centrifugation) from a rare case of metastatic papillary thyroid cancer to the pleura, associated with a high pleural fluid iodine content. Such a characteristic may be useful in expediting diagnosis of a malignant pleural effusion in the appropriate clinical context. CASE PRESENTATION: We present the case of a 71-year-old Caucasian man with metastatic papillary thyroid cancer; a large, long-standing, right-sided pleural effusion and a 83-fold higher pleural thyroglobulin level compared to corresponding serum, supporting this malignancy as the cause of the patient's effusion. The pleural fluid had a distinctive pigmentation similar to iodine-containing antiseptic preparations. Biopsy during medical thoracoscopy confirmed metastatic papillary thyroid carcinoma. Analysis of pleural fluid showed a pleural thyroglobulin level over 80 times that of serum levels (29,000?g/L versus 350ug/L). Pleural fluid iodine content was 23,000ug/L and may account for the fluid's distinctive pigment, as iodine is an essential component in thyroglobulin and thyroid hormone synthesis. CONCLUSIONS: Pleural fluid pigmentation may aid diagnosis in the appropriate clinical setting. A distinctive iodine-like brown colour of pleural fluid may represent elevated iodine content and should raise consideration of metastatic thyroid cancer as a cause for a pleural effusion.

Rosenstengel A; Lim EM; Millward M; Lee YG

2013-01-01

271

Identificación molecular de helicobacter pylori en tejidos gástricos con neoplasias malignas embebidos en parafina/ Molecular identification of helicobacter pylori in paraffin embedded gastric tissues with malignant neoplasm  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Introducción: Helicobacter pylori es considerado uno de los principales agentes causales de gastritis crónica, úlcera péptica y neoplasias gástricas malignas en humanos. Objetivo: evaluar el uso de la reacción en cadena de la polimerasa para la identificación de H. pylori y sus genotipos en tejidos gástricos con neoplasias malignas embebidos en parafina. Material y Métodos: se estudiaron secciones de 5 bloques de parafina procedentes de 5 pacientes mexicanos con (more) neoplasias gástricas malignas. Se realizaron coloraciones de rutina y especiales de anatomía patológica, así como la técnica de la reacción en cadena de la polimerasa para la detección del microorganismo y sus genotipos. Resultados: la técnica de la reacción en cadena de la polimerasa identificó a este agente infeccioso en todos los bloques analizados en correspondencia con su detección a través de las técnicas histológicas. Esta metodología permitió demostrar una variabilidad genética del patógeno en las muestras analizadas según los genotipos vacA y cagA. Conclusiones: la reacción en cadena de la polimerasa podría ser un método eficaz en la identificación del H. pylori en tejidos gástricos con neoplasias malignas embebidos en parafina. Esta se perfila como una estrategia atractiva para realizar estudios de epidemiología molecular y permitirá establecer posibles asociaciones de genotipos/subtipos del microorganismo con variables clínicas, epidemiológicas y de manejo del paciente. Abstract in english Introduction: Helicobacter pylori is considered one of the main causal agents of chronic gastritis, peptic ulcer and gastric malignant neoplasms in humans. Objective: to evaluate polymerase chain reaction for identification of Helicobacter pylori and its genotypes in paraffin embedded gastric tissues with malignant neoplasms. Material and Methods: sections of five paraffin blocks from five patients with gastric malignant neoplasms were studied. They were analyzed through (more) routine and special stains of pathological anatomy, as well as the polymerase chain reaction technic for microorganism and genotypes detection. Results: the infectious agent was identified in all of the analyzed blocks through the polymerase chain reaction technic in correspondence with its detection through histologic techniques. This methodology showed a genetic variability of the pathogen in the analyzed samples in respect to vacA and cagA genotypes. Conclusions: the polymerase chain reaction could be an efficacious method for the identification of H. pylori in paraffin embedded gastric tissues with malignant neoplasms. It is projected as an attractive strategy for performing studies of molecular epidemiology and the establishment of possible associations between genotypes/subtypes of the microorganism and clinic or epidemiologic variables, and patient handling.

Escobar Habeica, Edmundo Dantés; de Armas Rodríguez, Yaxsier; Cantelar de Francisco, Nereyda; Capó de Paz, Virginia; Cathcart Roca, Fidel; Jiménez López, Marco Antonio

2013-06-01

272

Trends in the incidence and mortality rates of malignant neoplasms in regions with radio ecological problems (Seslavtsi, Eleshnitsa, Yana) during the period 1995-1999  

International Nuclear Information System (INIS)

[en] A retrospective study is carried out to examine incidence and mortality trends of some malignant neoplasms in regions at high radioecological risk (Seslavtsi, Eleshnitsa, Yana) during the period 1995-1999. The analysis is made according to sex and age groups. Information sources are official medical statistics data, original records and database of the Oncological Dispensary in Sofia. The analysis of incidence and mortality dynamics doesn't show an increase in the incidence/mortality rate of the selected radiation-related oncological diseases compared with the same indices for the country within that period. (author)

2001-01-01

273

Analysis of the Malignancy Rate for Thyroid Nodules based on the Use of a Fine Needle Aspiration Biopsy and Ultrasonography  

Energy Technology Data Exchange (ETDEWEB)

This study was designed to analyze the malignancy rate for thyroid nodules determined after a fine needle aspiration biopsy (FNAB) and ultrasonography (US) and to propose follow-up FNAB indications. A total of 287 patients (265 female, 22 male) who underwent repeated US-guided FNABs were included in the cohort study. The results of the FNABs were classified as inadequate, benign, indeterminate,suspicious for a malignancy and a malignancy. The US findings were assigned five grades according to the possibility of a malignancy present. The frequency of a malignant nodule was evaluated by the use of the Kaplan-Meier method and Cox proportional risk model. The malignancy rates of inadequate, benign, and indeterminate nodules were 12.8%, 8.2% and 37.5%, respectively, for the FNAB findings. The rates of grades 3, 4 and 5 were 38.6%, 50.0% and 53.8%, respectively,for the US findings. Inadequate and indeterminate nodules as determined by an FNAB and grades 3, 4 and 5 assigned after US showed a higher malignancy rate than other nodules and would be regarded as high risk lesions.The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 93.3%,38.4%, 22.0%, 96.9% and 47.0%, respectively, if the nodule was considered a high-risk lesion, based on the FNAB or US findings. Thyroid nodules should be evaluated based on an FNAB and US findings. If a thyroid nodule is classified as a high-risk lesion, a follow-up study is needed due to the high malignancy rate

Choi, Ju Wan; Park, Ji Won; Jeong, Han Young; Kim, Hye Jung; Kim, Gab Chul; Kim, Yong Sun; Park, Ji Young; Lee, Hui Joong [Kyungpook National University Hospital, Daegu (Korea, Republic of)

2008-12-15

274

Analysis of the Malignancy Rate for Thyroid Nodules based on the Use of a Fine Needle Aspiration Biopsy and Ultrasonography  

International Nuclear Information System (INIS)

This study was designed to analyze the malignancy rate for thyroid nodules determined after a fine needle aspiration biopsy (FNAB) and ultrasonography (US) and to propose follow-up FNAB indications. A total of 287 patients (265 female, 22 male) who underwent repeated US-guided FNABs were included in the cohort study. The results of the FNABs were classified as inadequate, benign, indeterminate,suspicious for a malignancy and a malignancy. The US findings were assigned five grades according to the possibility of a malignancy present. The frequency of a malignant nodule was evaluated by the use of the Kaplan-Meier method and Cox proportional risk model. The malignancy rates of inadequate, benign, and indeterminate nodules were 12.8%, 8.2% and 37.5%, respectively, for the FNAB findings. The rates of grades 3, 4 and 5 were 38.6%, 50.0% and 53.8%, respectively,for the US findings. Inadequate and indeterminate nodules as determined by an FNAB and grades 3, 4 and 5 assigned after US showed a higher malignancy rate than other nodules and would be regarded as high risk lesions.The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 93.3%,38.4%, 22.0%, 96.9% and 47.0%, respectively, if the nodule was considered a high-risk lesion, based on the FNAB or US findings. Thyroid nodules should be evaluated based on an FNAB and US findings. If a thyroid nodule is classified as a high-risk lesion, a follow-up study is needed due to the high malignancy rate

2008-01-01

275

Pediatric Thyroid Cancer  

Science.gov (United States)

... en Español About Otolaryngology ENT History Fact Sheet: Pediatric Thyroid Cancer The thyroid is a butterfly-shaped ... thyroid malignancies. Medullary thyroid carcinoma (MTC) in the pediatric population is usually associated with specific inherited genetic ...

276

Diagnostic performance of combined elastosonography scoring and high-resolution ultrasonography for the differentiation of benign and malignant thyroid nodules.  

UK PubMed Central (United Kingdom)

AIM: To evaluate the diagnostic performance of the combined use of elstosonography (USE) scoring and high-resolution ultrasonography (HRUS) for the differentiation of benign and malignant thyroid nodule. PATIENTS AND METHODS: Forty-seven consecutive patients with 66 thyroid nodules were enrolled in the present study. Thyroid surgery had been already planned for all the patients. All of them were submitted to high-resolution ultrasonography and elastography scoring at the same sitting. The latter was determined with 5-point scoring method. The examination results were compared against pathological findings as the gold standard of reference. RESULTS: The sensitivity, specificity, accuracy, positive predictive, and negative predictive values of HRUS in the differential diagnosis of thyroid nodules were 92.0%, 72.9%, 60.1%, 95.0%, and 63.1%, respectively, while that of ultrasound elastography scoring were 75.4%, 85.5%, 86.7%, 71.4%, and 90.5%, respectively. Combined use of both US techniques resulted in a higher diagnostic performance as it showed 95.4%, 94.8%, 95.2%, 82.3% and 98.8% sensitivity, specificity, accuracy, positive predictive, and negative predictive values, respectively. CONCLUSIONS: The use of combined USE and HRS for the differentiation of benign and malignant thyroid nodules resulted in a high diagnostic performance and a significant statistical difference as compared to HRUS or USE alone (P=0.003).

Shweel M; Mansour E

2013-06-01

277

[Current status of therapeutic approaches with targeted therapies in malignant thyroid cancer. Highlights from the 2011 ASCO Congress].  

UK PubMed Central (United Kingdom)

Increasing interest in the treatment of locally advanced and already metastasized thyroid cancer is reflected in the high number of submitted and accepted conference papers at the annual meeting of the American Society of Clinical Oncology (ASCO Congress) 2011. Many patients suffering from differentiated, undifferentiated and medullary thyroid cancer do not respond to established therapeutic procedures, so that new strategies have to be developed. Targeted biological agents are a new and promising therapeutic method that selectively affects complex signaling cascades, especially angiogenesis, of the malignant cells. Clinicians and researchers should understand the potential of these therapeutic strategies and be aware of the typical side effects.

Uecker FC; Laban S; Knecht R

2012-05-01

278

Radiation-induced thyroid disease  

Energy Technology Data Exchange (ETDEWEB)

Ionizing radiation has been demonstrated to result in a number of changes in the human thyroid gland. At lower radiation dose levels (between 10 and 1500 rads), benign and malignant neoplasms appear to be the dominant effect, whereas at higher dose levels functional changes and thyroiditis become more prevalent. In all instances, the likelihood of the effect is related to the amount and type of radiation exposure, time since exposure, and host factors such as age, sex, and heredity. The author's current approach to the evaluation of patients with past external radiation therapy to the thyroid is discussed. The use of prophylactic thyroxine (T4) therapy is controversial. While T4 therapy may not be useful in preventing carcinogenesis when instituted many years after radiation exposure, theoretically T4 may block TSH secretion and stimulation of damaged cells to undergo malignant transformation when instituted soon after radiation exposure.

Maxon, H.R.

1985-09-01

279

A preoperative diagnostic test that distinguishes benign from malignant thyroid carcinoma based on gene expression  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Accurate diagnosis of thyroid tumors is challenging. A particular problem is distinguishing between follicular thyroid carcinoma (FTC) and benign follicular thyroid adenoma (FTA), where histology of fine-needle aspirates is not conclusive. It is often necessary to remove healthy thyroid to rule out ...

Cerutti, Janete M.; Delcelo, Rosana; Amadei, Marcelo João; Nakabashi, Claudia; Maciel, Rui M.B.; Peterson, Bercedis

280

Epithelial cell adhesion molecule (EpCAM) overexpression is correlated with malignant potentials of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas.  

UK PubMed Central (United Kingdom)

Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas exhibit a wide range of histopathological variation. Epithelial cell adhesion molecule (EpCAM) is a 40 kDa type I membrane protein that is known to be highly expressed in epithelial carcinomas. In this study, we examined immunohistochemical expression of EpCAM in the pancreatic IPMNs in order to clarify its clinicopathological significance. We analyzed 51 cases of surgically resected IPMNs: 32 cases of adenoma; 6 cases of non-invasive carcinoma; 8 cases of minimally invasive carcinoma; and 5 cases of invasive carcinoma. Additionally, these 51 cases were classified into four phenotypes (gastric, intestinal, pancreatobiliary and oncocytic). EpCAM overexpression was found in 16 (31.4%) of the tumor samples. We found five predictive factors of malignancy using the univariate analysis as follows; serum CA19-9 level, main pancreatic duct diameter, presence of mural nodule, phenotype and EpCAM overexpression. In the multivariate analysis, only EpCAM overexpression was identified to be independently associated as a predictive factor for malignancy (odds ratio, 11.039; 95% confidence interval, 1.877-64.919; P-value, 0.008). Our study is the first report to demonstrate that EpCAM overexpression is an independent factor for malignancy; therefore, EpCAM overexpression is thought to be a novel predictor of malignant IPMNs.

Yonaiyama S; Toyoki Y; Morohashi S; Sakuraba S; Yoshizawa T; Suzuki T; Wu Y; Kijima H; Hakamada K

2013-04-01

 
 
 
 
281

Predictors of malignancy in intraductal papillary mucinous neoplasm of the pancreas: analysis of 310 pancreatic resection patients at multiple high-volume centers.  

UK PubMed Central (United Kingdom)

OBJECTIVES: The present study was a retrospective investigation of predictors of malignancy in intraductal papillary mucinous neoplasm (IPMN) of the pancreas. METHODS: The subjects were 310 patients who underwent pancreatic resection at 3 high-volume centers. Preoperative laboratory and imaging findings were analyzed in logistic regression analyses. Endoscopic ultrasonography measurements were essential for the size of mural nodules, and a central review was conducted for pathological diagnosis. RESULTS: Pathological diagnosis was benign IPMN in 150 cases and malignant in 160 (noninvasive carcinoma, n = 100; invasive, n = 60). In multivariate analysis, size of mural nodules, diameter of main pancreatic duct, and cyst size of branch pancreatic duct were independent predictors of malignancy, and areas under the receiver operating characteristic curve for these 3 factors were 0.798, 0.643, and 0.601, respectively. With 7 mm taken as the cutoff value for the size of mural nodules, the diagnosis of malignant IPMN had sensitivity of 74.3% and specificity of 72.7%. Carcinoma without nodules was present in 15 patients (15/160 [9.4%]). CONCLUSIONS: The size of mural nodules measured with endoscopic ultrasonography showed high predictive ability. However, about 10% of carcinoma patients did not have nodules, and the handling of the diagnosis in such cases is a problem for the future.

Shimizu Y; Yamaue H; Maguchi H; Yamao K; Hirono S; Osanai M; Hijioka S; Hosoda W; Nakamura Y; Shinohara T; Yanagisawa A

2013-07-01

282

Intrathyroid epithelial thymoma (ITET) and carcinoma showing thymus-like differentiation (CASTLE): CD5-positive neoplasms mimicking squamous cell carcinoma of the thyroid.  

Science.gov (United States)

Carcinoma of possible thymic epithelial origin may occur within the thyroid gland, which was first reported by Miyauchi et al. as intrathyroid epithelial thymoma (ITET). ITET is a rare tumor comprising about 0.08% of all primary thyroid malignancies. It is a low-grade thyroid carcinoma with squamous cell differentiation whose overall survival rate was found to be 71%. Lymph node metastasis at surgery was found in 40% and hematogenous metastases developed in bones, liver and lungs. This tumor grows within the thyroid gland and invades into the thyroid parenchyma as well as into the extrathyroid structures. It is a well-circumscribed solid tumor with a sharp tumor border, but is not capsulated. After fixation, the cut surface of the tumor is gray-white in color and is a solid tumor with lobulation. Tumor calcification was not detected in our 15 cases. The tumor cells show solid sheets of growth with occasional keratinization without follicular or papillary structures. Lymphocytic infiltration in the stroma is one of the most characteristic features of this tumor. The tumor cells are polygonal epithelial cells with distinct nucleoli and ill-defined cell border. Positive immunoreactivity for CD5 is a key feature to differentiate it from undifferentiated carcinoma, poorly differentiated carcinoma, medullary (C cell) carcinoma and high-grade squamous cell carcinoma (so-called primary squamous cell carcinoma) of the thyroid. Negative immunoreactivity for calcitonin, TTF1 and thyroglobulin, and positive immunoreactivity for p63 and KIT are also helpful for differential diagnosis. Nuclear atypia is mild and mitoses are less frequent, with an intermediate proliferation index (MIB-1 labeling index is usually less than 20%), which are also helpful to differentiate it from high-grade primary squamous cell carcinoma of the thyroid. The tumors in our 15 cases demonstrate 3 histological subtypes: keratinizing squamous cell carcinoma type, non-keratinizing basaloid cell carcinoma (lymphoepithelioma-like) type and neuroendocrine carcinoma type, which correspond to subtypes of the mediastinal thymic carcinomas. PMID:23233417

Kakudo, Kennichi; Bai, Yanhua; Ozaki, Takashi; Homma, Kei-ichi; Ito, Yasuhiro; Miyauchi, Akira

2012-12-11

283

Neonatal neoplasms  

International Nuclear Information System (INIS)

Purpose: To describe neoplasms diagnosed in children ? 28 days of age along with their treatment, associated congenital anomalies, and the long-term consequences of the diagnoses and treatments. Methods and Materials: Utilizing autopsy records, a computerized tumor registry, and medical records, we identified patients and stillborns at Duke University Medical Center (DUMC) diagnosed with neoplasms at ? 28 days of age between 1930 and 1998. Results: Twenty-three neonates with neoplasms were identified. There were 7 males (30%) and 16 females (70%). Follow-up of survivors ranged from 4 months to 27 years (mean 9 years). The 20 patients identified via the computerized registry system for 1980-1998 constitute 2% (20/925) of all neoplasms seen in patients ? 16 years of age over this same time period at DUMC. The histologic diagnoses were teratoma/germ cell tumor (n = 8, 35%), neuroblastoma (n = 5, 22%), retinoblastoma (n = 4, 17%), primary central nervous system (CNS) tumor (n = 3, 13%), and one case each of rhabdomyosarcoma, glossal glial choristoma, and hemangioma in the setting of Kasabach-Merritt Syndrome. Of the eight teratoma/germ cell tumor patients, 6 were female (75%) and 2 male (25%). There was one malignant germ cell tumor, 2 immature teratomas, and 5 teratomas. Two of the seven patients with immature teratomas or teratoma were long-term survivors following surgery. The one patient with malignant germ cell tumor, treated with surgery and chemotherapy, died. Associated anomalies were imperforate anus, congenital absence of a limb, left ventricular hypertrophy, fusion or absence of toes, coarctation of the aorta, and pulmonary valve dysplasia. Of the five children with neuroblastoma, 4 were female. INSS Stages were 1 (n = 1), 2A (n = 1), 3 (n = 1), and 4S (n = 2). Two were treated with surgery + chemotherapy + radiotherapy; two with surgery + chemotherapy; and one with surgery alone. Four children are long-term survivors. Associated congenital anomalies and medical problems were ventricular septal defect, seizure disorder, and Fanconi's anemia. A child with a dumbbell neuroblastoma, treated with surgery and chemotherapy, is paraplegic. Of the four children with retinoblastoma, two were female. Two had trilateral disease and two bilateral. Three of the four had a family history of retinoblastoma. The two children with trilateral retinoblastoma died after therapy with surgery, craniospinal and orbital irradiation, and chemotherapy. Two children with bilateral disease are long-term survivors: one treated with radiotherapy + chemotherapy and one with radiotherapy alone. They have marked orbital bone growth abnormalities. The three patients with CNS tumors were female. The histologies were glioblastoma multiforme, anaplastic astrocytoma, and malignant mixed oligodendroglioma. Two of the patients are long-term survivors after surgery + chemotherapy. Six children received eight courses of radiation therapy: 2 for Stage 4S neuroblastoma with respiratory compromise from an enlarging liver and 4 for retinoblastoma. The two infants with trilateral retinoblastoma received two courses of irradiation each: one of the treatment of intraocular tumor and a second, at an older age, for the pineal tumor. The most serious complication of anesthesia was a case of enterobacter cloacae sepsis in the central venous access line used for repetitively administering the anesthetic. Conclusion: The most common neonatal neoplasm histologic diagnoses are teratoma/germ cell tumor, neuroblastoma, and retinoblastoma. Neonatal neoplasms may be associated with congenital anomalies. Radiation therapy is administered infrequently in a population highly susceptible to late ill effects. When radiotherapy is required, anesthesia may be repetitively administered to aid in reproducible treatment.

2000-04-01

284

A taller-than-wide shape in thyroid nodules in transverse and longitudinal ultrasonographic planes and the prediction of malignancy.  

UK PubMed Central (United Kingdom)

BACKGROUND: A "taller-than-wide" shape is associated with thyroid malignancy, but taller-than-wide in which plane is most accurate is unclear. We determined in which ultrasonography (US) plane a taller-than-wide shape is most predictive of malignancy. METHODS: A total of 471 thyroid nodules from 435 patients were studied. The final diagnosis was based on histopathology in 145 nodules in 120 patients, and cytology in the remaining patients. A taller-than-wide shape was defined as a ratio of ?1, calculated by dividing the anteroposterior diameter by the transverse diameter. Three criteria were formulated as follows: criterion 1, a taller-than-wide in any plane as a suspicious feature; criterion 2, that in the transverse plane; criterion 3, that in the longitudinal plane. The sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (Az) were compared among the three criteria. RESULT: Of the 471 lesions, 125 (26.5%) were classified as malignant, and 346 (73.5%) were classified as benign. Criterion 1 showed high sensitivity (68%) and negative predictive value (87.7%), whereas criteria 2 and 3 showed high specificity (83.5% and 94.5%, respectively). The Az vale of criterion 1 was significantly higher than criteria 2 and 3 (p values?=?0.0061 and 0.0362, respectively). CONCLUSIONS: A taller-than-wide shape was a useful US feature for predicting thyroid malignancy. Criterion 1, a taller-than-wide shape in either transverse or longitudinal plane, was most accurate and sensitive for predicting thyroid malignancy among the three criteria.

Moon HJ; Kwak JY; Kim EK; Kim MJ

2011-11-01

285

Lessons to be learned: a case study approach. Lateral aberrant thyroid tissue: is it always malignant?  

UK PubMed Central (United Kingdom)

Traditionally 'lateral aberrant thyroid' tissue present in cervical lymph nodes in the face of a clinically normal thyroid gland is held to be a metastasis from an occult primary thyroid carcinoma. A patient in whom follicular thyroid tissue was found in a lymph node lateral to the carotid sheath in the presence of a thyroid gland which was histologically free of cancer is herewith presented.

Escofet X; Khan AZ; Mazarani W; Woods WG

2007-01-01

286

Ex vivo imaging of human thyroid pathology using integrated optical coherence tomography and optical coherence microscopy  

Science.gov (United States)

We evaluate the feasibility of optical coherence tomography (OCT) and optical coherence microscopy (OCM) for imaging of benign and malignant thyroid lesions ex vivo using intrinsic optical contrast. 34 thyroid gland specimens are imaged from 17 patients, covering a spectrum of pathology ranging from normal thyroid to benign disease/neoplasms (multinodular colloid goiter, Hashimoto's thyroiditis, and follicular adenoma) and malignant thyroid tumors (papillary carcinoma and medullary carcinoma). Imaging is performed using an integrated OCT and OCM system, with thyroid tissues. With further development of needle-based imaging probes, OCT and OCM could be promising techniques to use for the screening of thyroid nodules and to improve the diagnostic specificity of fine needle aspiration evaluation.

Zhou, Chao; Wang, Yihong; Aguirre, Aaron D.; Tsai, Tsung-Han; Cohen, David W.; Connolly, James L.; Fujimoto, James G.

2010-01-01

287

Second primary neoplasms among 53?159 haematolymphoproliferative malignancy patients in Sweden, 1958–1996: a search for common mechanisms  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The Swedish Family-Cancer Database was used to analyse site-specific risk of second primary malignancies following 53?159 haematolymphoproliferative disorders (HLPD) diagnosed between 1958 and 1996. Standardized incidence ratio (SIR) of a second malignancy was calculated as the ratio of observed to ...

Dong, C; Hemminki, K

288

"Evaluation of thyroid’s cold nodules with 99mTc-MIBI and serum thyroglobulin for diagnosis of malignant and benign nodules "  

Directory of Open Access Journals (Sweden)

Full Text Available Objectives: As finding of an accurate noninvasive way for differential diagnosis between malignant and benign nodules is of great importance, recently 99mTc-MIBI is suggested for this purpose.In this study we evaluated the usefulness of this radiotracer, as well as, measuring of serum level of Tg as a differential diagnostic test of malignant and benign nodules. Methods: Twelve patients with ages of 25 to 65 years old, all of them had single cold nodule of thyroid in scan with 99mTco4- were evaluated with 99mTc-MIBI scan 15 min. and 2 hrs .after iv. injection of 10 mci radiotracer on routine views of ANT, RAO, and LAO.The images evaluated semiquantitatively and were considered positive if there was uptake superior to normal thyroid tissue on early and delayed images (score = 3). Then patients underwent measuring serum level of Tg with method of RIA .Finally, FNA was performed from all patients and the samples interpretated by cytopathologist. Results: In the MIBI scans 6 patients showed increased uptake(hot nodule),3 partially uptake(warm nodule) and 3 absence of uptake(cold nodule).results of FNA in 3(50%) cases of 6 patients with hot nodules were papillary carcinoma which all of them underwent surgery and the pathologic reports confirmed the presence of papillary carcinoma. Two cases (33.3%) were follicular proliferation and one (16.7%) adenoma. No malignancy were reported in the cases of warm and cold nodules (3 patients for each case), that is, 3 adenoma in the warm nodules, and 2 cyst and one adenoma in the cold nodules. In the affected patients to papillary carcinoma the levels of serum Tg were above the 70 ng/ml in all of three cases, lower than 60 ng/ml in the adenoma, lower than 50 ng/ml in the cases of follicular proliferation and finally lower than 20 ng/ml in the cases of thyroid cyst. Conclusion: All of the cold nodules in 99mTc-MIBI scan were benign as adenoma or cyst and the warm nodules also correlated with benign entities. In this study we concluded that, patients with cold nodule in the MIBI scan and lower Tg level, most likely have benign nodules such as cyst, but those with prominent hot nodule in MIBI scan and higher Tg level, have the higher chance of thyroid's cancer as well as benign lesions such as adenoma, and so, this radiotracer isn't specific for differential diagnosis of thyroid malignancy.

E. Gharepapagh; Sh. Dabiri Oskooyi; A. Fooladi Sarabi

2006-01-01

289

Pode a gestação influenciar a evolução de nódulo tireoidiano maligno?/ Can pregnancy influence the outcome of a malignant thyroid nodule?  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Os autores descrevem um nódulo tireoidiano com padrões ultrassonográfico e citopatológico benignos que diminuiu mais de 50% em três anos e se modificou durante a gestação, constatando-se que era carcinoma papilífero. Conclui-se que a gestação pode aumentar o risco de malignização ou acelerar o crescimento de nódulo tireoidiano maligno preexistente, corroborando dados da literatura. Abstract in english The authors report the case of a patient with a thyroid nodule with benign sonographic and cytopathological features that had presented a decrease of more than 50% in three years and changed its pattern during her pregnancy, being diagnosed as papillary carcinoma. It was concluded that pregnancy can either increase the risk for malignant transformation or accelerate the growth of a malignant thyroid nodule, corroborating pre-existing literature data.

Kerr, Lucy; Vidigal, Maria Edith Lutz; Rozenkwit, Deborah

2012-02-01

290

Pode a gestação influenciar a evolução de nódulo tireoidiano maligno? Can pregnancy influence the outcome of a malignant thyroid nodule?  

Directory of Open Access Journals (Sweden)

Full Text Available Os autores descrevem um nódulo tireoidiano com padrões ultrassonográfico e citopatológico benignos que diminuiu mais de 50% em três anos e se modificou durante a gestação, constatando-se que era carcinoma papilífero. Conclui-se que a gestação pode aumentar o risco de malignização ou acelerar o crescimento de nódulo tireoidiano maligno preexistente, corroborando dados da literatura.The authors report the case of a patient with a thyroid nodule with benign sonographic and cytopathological features that had presented a decrease of more than 50% in three years and changed its pattern during her pregnancy, being diagnosed as papillary carcinoma. It was concluded that pregnancy can either increase the risk for malignant transformation or accelerate the growth of a malignant thyroid nodule, corroborating pre-existing literature data.

Lucy Kerr; Maria Edith Lutz Vidigal; Deborah Rozenkwit

2012-01-01

291

ISL1 expression is not restricted to pancreatic well-differentiated neuroendocrine neoplasms, but is also commonly found in well and poorly differentiated neuroendocrine neoplasms of extrapancreatic origin.  

Science.gov (United States)

The human insulin gene enhancer-binding protein islet-1 (ISL1) is a transcription factor involved in the differentiation of the neuroendocrine pancreatic cells. Recent studies identified ISL1 as a marker for pancreatic well-differentiated neuroendocrine neoplasms. However, little is known about ISL1 expression in pancreatic poorly differentiated and in extrapancreatic well and poorly differentiated neuroendocrine neoplasms. We studied the immunohistochemical expression of ISL1 in 124 neuroendocrine neoplasms. Among pancreatic neuroendocrine neoplasms, 12/13 with poor differentiation were negative, whereas 5/7 with good differentiation but a Ki67 >20% were positive. In extrapancreatic neuroendocrine neoplasms, strong positivity was found in Merkel cell carcinomas (25/25), pulmonary small cell neuroendocrine carcinomas (21/23), medullary thyroid carcinomas (9/9), paragangliomas/pheochromocytomas (6/6), adrenal neuroblastomas (8/8) and head and neck neuroendocrine carcinomas (4/5), whereas no or only weak staining was recorded in pulmonary carcinoids (3/15), olfactory neuroblastomas (1/4) and basaloid head and neck squamous cell carcinomas (0/15). ISL1 stained the neuroendocrine carcinoma component of 5/8 composite carcinomas and also normal neuroendocrine cells in the thyroid, adrenal medulla, stomach and colorectum. Poorly differentiated neuroendocrine neoplasms, regardless of their ISL1 expression, were usually TP53 positive. Our results show the almost ubiquitous expression of ISL1 in extrapancreatic poorly differentiated neuroendocrine neoplasms and neuroblastic malignancies and its common loss in pancreatic poorly differentiated neuroendocrine neoplasms. These findings modify the role of ISL1 as a marker for pancreatic neuroendocrine neoplasms and suggest that ISL1 has a broader involvement in differentiation and growth of neuroendocrine neoplasms than has so far been assumed. PMID:23503646

Agaimy, Abbas; Erlenbach-Wünsch, Katharina; Konukiewitz, Björn; Schmitt, Anja M; Rieker, Ralf J; Vieth, Michael; Kiesewetter, Franklin; Hartmann, Arndt; Zamboni, Giuseppe; Perren, Aurel; Klöppel, Günter

2013-03-15

292

Color Doppler features of solid, round, isoechoic thyroid nodules without malignant sonographic features: a prospective cytopathological study.  

UK PubMed Central (United Kingdom)

BACKGROUND: No study has examined the malignancy rate and the color Doppler pattern of solid, round, isoechoic thyroid nodules (SRINs) without coexistent malignant sonographic features. We aimed to assess the cytopathological results and color Doppler patterns of SRINs through a prospectively designed study. METHODS: Between January and December 2010, a total of 727 patients underwent consecutive ultrasound (US)-guided fine-needle aspirations (US-FNAs), and 27 patients who had SRINs with the largest diameter ?5 mm at US were prospectively selected and enrolled in the study. The color Doppler pattern of each nodule was classified into one of four categories: scant, peripheral, central, or mixed type. RESULTS: Out of 27 SRINs, 14 were histopathologically confirmed, and 13 were nonsurgically diagnosed by 2 consecutive US-FNAs. Among the 14 surgical SRINs, there were 7 papillary thyroid carcinomas, 2 follicular adenomas, and 5 nodular hyperplasias. All 13 nonsurgical SRINs were finally determined to be benign on the basis of results of US-FNAs and/or long-term US follow-up; thus, the malignancy rate of the SRINs was 25.9% (7/27). There was no significant correlation between the color Doppler pattern and the malignancy rate of SRINs. CONCLUSION: We recommend that US-FNA should be performed for SRIN to rule out malignancy, regardless of its color Doppler pattern.

Kim DW; Jung SJ; Eom JW; Kang T

2013-04-01

293

Computer-aided diagnosis system for classifying benign and malignant thyroid nodules in multi-stained FNAB cytological images.  

Science.gov (United States)

An automated computer-aided diagnosis system is developed to classify benign and malignant thyroid nodules using multi-stained fine needle aspiration biopsy (FNAB) cytological images. In the first phase, the image segmentation is performed to remove the background staining information and retain the appropriate foreground cell objects in cytological images using mathematical morphology and watershed transform segmentation methods. Subsequently, statistical features are extracted using two-level discrete wavelet transform (DWT) decomposition, gray level co-occurrence matrix (GLCM) and Gabor filter based methods. The classifiers k-nearest neighbor (k-NN), Elman neural network (ENN) and support vector machine (SVM) are tested for classifying benign and malignant thyroid nodules. The combination of watershed segmentation, GLCM features and k-NN classifier results a lowest diagnostic accuracy of 60 %. The highest diagnostic accuracy of 93.33 % is achieved by ENN classifier trained with the statistical features extracted by Gabor filter bank from the images segmented by morphology and watershed transform segmentation methods. It is also observed that SVM classifier results its highest diagnostic accuracy of 90 % for DWT and Gabor filter based features along with morphology and watershed transform segmentation methods. The experimental results suggest that the developed system with multi-stained thyroid FNAB images would be useful for identifying thyroid cancer irrespective of staining protocol used. PMID:23690210

Gopinath, Balasubramanian; Shanthi, Natesan

2013-05-21

294

Computer-aided diagnosis system for classifying benign and malignant thyroid nodules in multi-stained FNAB cytological images.  

UK PubMed Central (United Kingdom)

An automated computer-aided diagnosis system is developed to classify benign and malignant thyroid nodules using multi-stained fine needle aspiration biopsy (FNAB) cytological images. In the first phase, the image segmentation is performed to remove the background staining information and retain the appropriate foreground cell objects in cytological images using mathematical morphology and watershed transform segmentation methods. Subsequently, statistical features are extracted using two-level discrete wavelet transform (DWT) decomposition, gray level co-occurrence matrix (GLCM) and Gabor filter based methods. The classifiers k-nearest neighbor (k-NN), Elman neural network (ENN) and support vector machine (SVM) are tested for classifying benign and malignant thyroid nodules. The combination of watershed segmentation, GLCM features and k-NN classifier results a lowest diagnostic accuracy of 60 %. The highest diagnostic accuracy of 93.33 % is achieved by ENN classifier trained with the statistical features extracted by Gabor filter bank from the images segmented by morphology and watershed transform segmentation methods. It is also observed that SVM classifier results its highest diagnostic accuracy of 90 % for DWT and Gabor filter based features along with morphology and watershed transform segmentation methods. The experimental results suggest that the developed system with multi-stained thyroid FNAB images would be useful for identifying thyroid cancer irrespective of staining protocol used.

Gopinath B; Shanthi N

2013-06-01

295

The use of ultrasound elastography in the assessment of malignancy risk in thyroid nodules and multinodular goitres.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The objective of our work is to use a surgical series to analyse the validity of elastography in evaluating the malignancy of thyroid nodules and multinodular goitres. PATIENTS AND METHODS: The study examined 156 patients, 134 women (85.9%) and 22 men (14.1%), who underwent surgery for nodular thyroid disease between October, 2008, and November, 2010. The average age of the patients was 52 years (±14.42). Thirty-six patients (23.1%) presented with a single nodule, and 120 (76.9%) exhibited multinodular goitres. Prior to surgical intervention, all patients underwent colour eco-elastography using a qualitative five-point ordinal scale for nodule classifications. Test results were analysed using a receiver operating characteristic (ROC) curve, and an anatomical pathologic examination of surgical specimens was used as a gold standard diagnostic tool for comparison. RESULTS: Of the 192 nodules analysed, 28 (14.6%) were malignant. Using elastography data, an ROC curve was obtained with an area under the curve of 0.662 (±0.060) and a 95% confidence interval (CI 95%) between 0.545 and 0.779 (p=0.006). By establishing a cut-off point that classified thyroid nodules with an elastographic value greater than or equal to 3 as malignant, we achieved a sensitivity of 75%, specificity of 45.73%, positive predictive value of 19.1%, and negative predictive value of 91%. The positive and negative likelihood ratios were 1.38 and 0.55, respectively. CONCLUSIONS: Ultrasound elastography can provide information regarding malignancy risk in thyroid nodules and multinodular goitres. However, the sensitivity and specificity values obtained in our study are below those reported by other groups, a finding that calls into question the current clinical utility of ultrasound elastography. © 2013 Blackwell Publishing Ltd.

Rivo-Vázquez A; Rodríguez-Lorenzo A; Rivo-Vázquez JE; Páramo-Fernández C; García-Lorenzo F; Pardellas-Rivera H; Casal-Núñez JE; Gil-Gil P

2013-04-01

296

Thyroid  

Energy Technology Data Exchange (ETDEWEB)

This paper approaches the effects of explosions of nuclear weapons on the thyroid, the radiation-induced thyroid diseases due to exposure to external radiation at the time of explosion or from the radioactive fallout, and to exposure to internal irradiation from radioactive iodine that accumulates inside the thyroid glands.

Nagataki, Shigenobu [Radiation Effects Research Foundation, Hiroshima (Japan)

1997-07-01

297

X-ray fluorescence analysis (XRF) and secondary ion mass spectrometry (SIMS) for analysis of iodine concentration in vitro in benign and malignant thyroid tissue  

International Nuclear Information System (INIS)

Full text: The thyroid ability to store and concentrate iodine is of importance for radioiodine therapy in thyroid cancer. It is known that a normal thyroid contains 2-20 mg iodine while the information regarding malignant thyroid tissue is scarce. The purpose of this study was to investigate the iodine concentration in benign compared to malignant tissue. Methods: Thyroid tissue samples from healthy patients and from patients with papillary cancer were collected and frozen in connection with surgery. For the thyroid cancer patients, tissue was taken from both benign and malignant tissue. The iodine concentration was analysed with an XRF system consisting of a 241-Am source and an HPGe detector. When irradiating iodine containing tissue, characteristic X-rays are emitted. That radiation is detected with the strength of the detected signal being proportional to the amount of iodine in the sample. SIMS was used on glutaraldehyde fixed tissue as a histological tool for quantification and localization of iodine by sputtering and analysis of secondary ions. Results: The iodine concentration in benign tissue is considerably higher than in malignant samples. XRF measurements showed a medium iodine concentration in healthy thyroid tissue of 0.5 mg/mL. For the cancer patients, the iodine concentration was 0.3 mg/mL in benign tissue while no iodine could be detected in the malignant samples. These findings were consistent with the results from the SIMS investigation that gave a 100 times lower iodine concentration in malignant than in benign tissue. SIMS also showed that the iodine in benign tissue was predominantly located in the follicle lumen, while in the cancer cells low iodine concentration was found intra cellular as well as in the lumen. Conclusion: Iodine concentration in tissue from papillary cancer can be 100 times lower than in normal thyroid tissue. This is in accordance with the empirical knowledge that thyroid cancer should need about 100 times higher activity of in radioiodine treatment. (author)

2005-11-04

298

Skeletonization approach for characterization of benign vs. malignant single thyroid nodules using 3D contrast enhanced ultrasound  

Science.gov (United States)

High-resolution ultrasonography (HRUS) has potentialities in differential diagnosis between malignant and benign thyroid lesions, but interpretative pitfalls remain and accuracy is still poor. We developed an image processing technique for characterizing the intra-nodular vascularization of thyroid lesions. Twenty nodules (ten malignant) were analyzed by 3-D contrast-enhanced ultrasound imaging. The 3-D volumes were preprocessed and skeletonized. Seven vascular parameters were computed on the skeletons: number of vascular trees (NT); vascular density (VD); number of branching nodes (or branching points) (NB); mean vessel radius (MR); 2-D (DM) and 3-D (SOAM) tortuosity; and inflection count metric (ICM). Results showed that the malignant nodules had higher values of NT (83.1 vs. 18.1), VD (00.4 vs. 0.01), NB (1453 vs. 552), DM (51 vs. 18), ICM (19.9 vs. 8.7), and SOAM (26 vs. 11). Quantification of nodular vascularization based on 3-D contrast-enhanced ultrasound and skeletonization could help differential diagnosis of thyroid lesions.

Molinari, Filippo; Mantovani, Alice; Deandrea, Maurilio; Limone, Paolo; Garberoglio, Roberto; Suri, Jasjit S.

2011-03-01

299

Nulliparity enhances the risk of second primary malignancy of the breast in a cohort of women treated for thyroid cancer  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Many studies have reported an increased risk of developing a second primary malignancy (SPM) of the breast in women treated for thyroid cancer. In this study, we investigated several potential risk factors for this association. The aim of this retrospective cohort study was to identify a subgroup of women surgically treated for papillary thyroid cancer that may benefit from more careful breast cancer screening. Methods A total of 101 women surgically treated for papillary thyroid cancer from 1996 to 2009 with subsequent follow-up were interviewed by phone regarding personal risk factors and lifestyle habits. Only 75 questionnaires could be evaluated due to a 25.7% rate of patients not retrieved or refusing the interview. Data analysis was performed using a multivariate logistic model. Results The standardised incidence ratio (SIR) for breast cancer was 3.58 (95% IC 1.14 - 8.37). Our data suggest a protective effect of multiparity on the development of a SPM of the breast (O.R. 0.15; 95% IC 0.25 - 0.86). Significant associations were not found with other known risk factors including Body Mass Index (BMI), age at first tumour, concurrent metabolic diseases, smoking, physical activity and familiarity. Conclusions This study confirms that a higher incidence of SPM of the breast is observed in women treated for papillary thyroid cancer. Additionally, this risk is increased by nulliparity, thus a strict breast screening program for nulliparous women treated for thyroid cancer may be advisable.

Consorti Fabrizio; Di Tanna Gianluca; Milazzo Francesca; Antonaci Alfredo

2011-01-01

300

Metastatic rhabdomyosarcoma of the thyroid gland, a case report.  

UK PubMed Central (United Kingdom)

The thyroid gland is a known but an unusual site for metastatic tumors from various primary sites. Despite the fact that it is one of the largest vascular organs in the body, clinical and surgical cases have given an incidence of 3% of secondary malignances of the organ. Nevertheless, thyroid metastases are not an exceptional finding at autopsy, they are encountered in 2% to 24% of the patients with malignant neoplasm.Soft tissue sarcomas metastatic to the thyroid are extremely rare as the majority of thyroid metastasis are caused by tumors of the kidneys, lungs, mammary glands, ovaries , and colon or by melanomas.We report a case of 22-years-old woman with right leg rhabdomyosarcoma metastatic to the thyroid gland.

Hafez MT; Hegazy MA; Abd Elwahab K; Arafa M; Abdou I; Refky B

2012-01-01

 
 
 
 
301

Differentiating benign from malignant thyroid nodules using micro ribonucleic acid amplification in residual cells obtained by fine needle aspiration biopsy.  

UK PubMed Central (United Kingdom)

BACKGROUND: Fine needle aspiration biopsy (FNAB) is the most commonly used diagnostic tool to differentiate benign from malignant thyroid nodules. Nevertheless, some FNAB cytology results are not definite. In such cases diagnostic thyroid lobectomy is performed with malignancy rate on final histopathology ranging at 15%-75%. The aim of this study was to improve on the accuracy of FNAB-based cytology by amplification of microRNAs (micro ribonucleic acids [miRs]) from the residual cells left in the FNAB needle after submission for cytology. METHODS: Residual cells were collected from the needle cup after FNAB cytology of 77 consecutive patients with thyroid nodules. miR-enriched RNA was extracted for all patients with cytology showing either follicular lesion or suspicion for malignancy (n=11). The expression of miR-21, -31, -146b, -187, -221, and -222 was determined using real-time polymerase chain reaction. Results were compared with final surgical histopathology. RESULTS: RNA was successfully extracted from all FNAB specimens. Five patients had FNAB cytology suspicious for malignancy. The miR panel was positive in all five (100%). Six patients had follicular lesions on FNAB. The miR panel was positive in three of four patients (75%) with confirmed malignancy and was negative in two of two (0%) patients with benign pathology results. This corresponded to a specificity of 100%, sensitivity of 88%, and accuracy of 90%. CONCLUSIONS: RNA extraction from FNAB residual cells is feasible, and a miR panel amplified from the extracted RNA seems like a promising diagnostic tool in this limited number of patients.

Mazeh H; Levy Y; Mizrahi I; Appelbaum L; Ilyayev N; Halle D; Freund HR; Nissan A

2013-04-01

302

Quantitative and qualitative analysis of telomerase activity in benign and malignant thyroid tissues  

International Nuclear Information System (INIS)

Objective: To study the status of telomerase activity during the development of thyroid tumors, and to determine whether telomerase activity can be used clinically as a molecular marker in the differential diagnosis of thyroid cancer. Methods: Telomerase activity was measured in 37 thyroid carcinomas, 33 benign thyroid lesions and 30 normal thyroid tissue samples by means of a modified TRAP-PCR. The assay was also applied to 15 fine needle aspirates (FNAs) of thyroid carcinomas to test its sensitivity. Results: Thirty-one of 37 thyroid carcinomas (83.8%), 7 of 33 benign thyroid lesions (21.2%), and 4 of 30 adjacent normal thyroid tissue samples expressed telomerase activity, 15 FNAs also had positive telomerase activity, just as their corresponding tissue specimens. The quantitative analysis showed that the telomerase activity was significantly higher in thyroid carcinomas than that in benign thyroid tissue samples. And medullary carcinomas and anaplastic carcinomas had higher levels of telomerase activity than papillary carcinomas. Conclusions: Telomerase activity is a good marker for thyroid carcinomas. The quantitative TRAP-PCR might have more potential application in the differential diagnosis of tumors and the estimation of tumor progression and prognosis. And this sensitive assay could become a useful new modality for supplementing microscopic cytopathology in the detection of cancer cells in small tissue samples and FNAs

2002-01-01

303

Radiation risk of malignant neoplasms in organs of main deposition for plutonium in the cohort of Mayak workers with regard to histological types.  

UK PubMed Central (United Kingdom)

This paper presents the results of analyses of the incidence of malignant neoplasms in lung, liver, and bone and associated connective tissues among Mayak nuclear workers exposed to both internally incorporated plutonium and to external gamma radiation. The study cohort included 22,373 individuals employed at the reactors and radiochemical and plutonium production facilities of the Mayak nuclear complex during 1948-1982 and followed up to the end of 2004. All analyses were carried out by Poisson regression, and the doses used were derived using a recently available update of organ doses, Mayak doses-2008. There was clear evidence for the linear association between internal plutonium dose and the risk of lung cancer. For males, there was evidence of a significant internal plutonium dose response for all histological types of lung cancer evaluated (adenocarcinoma, squamous-cell, and other epithelial); the estimated excess relative risk (ERR)/Gy for adenocarcinoma was the largest (ERR/Gy = 32.5; 95% CI: 16.3; 71.9), about 11-fold higher than that for squamous-cell lung cancer (ERR/Gy = 3.1; 95% CI: 0.3; 9.1). The relationship between liver cancer risk and plutonium exposure was best described by a linear-quadratic (LQ) function, but the LQ effect was diminished after restricting internal doses <2 Gy. Hepatocellular cancer was the most frequently observed type of liver cancer associated with internal plutonium exposure, and hemangiosarcomas were exclusively observed only at high internal plutonium doses (>4 Gy). For malignant neoplasms of bone and associated connective tissues, the trend was not statistically significant in relation to internal plutonium dose, but a statistically significantly higher risk (RR=13.7; 95% CI= 3.0; 58.5) was found among unmonitored female plutonium workers who were employed in the most hazardous plutonium production facility commissioned prior to 1950.

Labutina EV; Kuznetsova IS; Hunter N; Harrison J; Koshurnikova NA

2013-08-01

304

Thyroid neoplasia following radiation therapy for Hodgkin's lymphoma  

Energy Technology Data Exchange (ETDEWEB)

The question of thyroid neoplasia following high-dose radiation treatment to the neck and mediastinum for malignant neoplasms such as Hodgkin's lymphoma in children and young adults has been raised recently. Five patients, 19 to 39 years old, were operated on for thyroid neoplasms that developed following cervical and mediastinal radiation therapy for Hodgkin's lymphoma. Three patients had papillary carcinomas and two had follicular adenomas. The latency period between radiation exposure and the diagnosis of thyroid neoplasm ranged from eight to 16 years. This limited series provided strong support for the recommendation that children and young adults who are to receive high-dose radiation therapy to the head, neck, and mediastinum should receive suppressive doses of thyroxine prior to radiation therapy in order to suppress thyrotropin (thyroid-stimulating hormone) and then be maintained on a regimen of suppression permanently.

McHenry, C.; Jarosz, H.; Calandra, D.; McCall, A.; Lawrence, A.M.; Paloyan, E.

1987-06-01

305

ThyroScreen system: high resolution ultrasound thyroid image characterization into benign and malignant classes using novel combination of texture and discrete wavelet transform.  

UK PubMed Central (United Kingdom)

Using right equipment and well trained personnel, ultrasound of the neck can detect a large number of non-palpable thyroid nodules. However, this technique often suffers from subjective interpretations and poor accuracy in the differential diagnosis of malignant and benign thyroid lesions. Therefore, we developed an automated identification system based on knowledge representation techniques for characterizing the intra-nodular vascularization of thyroid lesions. Twenty nodules (10 benign and 10 malignant), taken from 3-D high resolution ultrasound (HRUS) images were used for this work. Malignancy was confirmed using fine needle aspiration biopsy and subsequent histological studies. A combination of discrete wavelet transformation (DWT) and texture algorithms were used to extract relevant features from the thyroid images. These features were fed to different configurations of AdaBoost classifier. The performance of these configurations was compared using receiver operating characteristic (ROC) curves. Our results show that the combination of texture features and DWT features presented an accuracy value higher than that reported in the literature. Among the different classifier setups, the perceptron based AdaBoost yielded very good result and the area under the ROC curve was 1 and classification accuracy, sensitivity and specificity were 100%. Finally, we have composed an Integrated Index called thyroid malignancy index (TMI) made up of these DWT and texture features, to facilitate distinguishing and diagnosing benign or malignant nodules using just one index or number. This index would help the clinicians in more quantitative assessment of the thyroid nodules.

Acharya UR; Faust O; Sree SV; Molinari F; Suri JS

2012-08-01

306

Prevalence of benign and malignant thyroid nodules in patients with previous history of radiotherapy for Tinea capitis in childhood (in khorosan province)  

International Nuclear Information System (INIS)

[en] Increased prevalence of thyroid cancer was noted in patients with previous history of radiotherapy of the head and neck region in childhood. According to previous research, radiotherapy for Ti nia capitis was using up to 30 years ago in Khorasan Province. This study tries to evaluate prevalence of benign and malignant thyroid nodules and detect and treat these patients earlier to prevent more complications and increased cost. Methods and patients: Using mass media, we recalled all patients with history of radiotherapy for Tinea capitis in childhood. A questionnaire was filled for each patient and thyroid examination, thyroid scan and thyroid sonography were performed. Fine needle aspiration biopsy (FNAB) was done if a thyroid nodule larger than 1 cm was palpable. Serum TSH was measured in all patients. Also thyroid surgery was recommended for all patients with thyroid nodules more than 1 cm. A control group was defined from a group of patients who referred for non thyroidal sonography to radiology department of Ghaem hospital. These patients also were evaluated by clinical examination and thyroid sonography. Results: We studied 180 patients with mean age of 47.7 years and 127 age and sex m etched controls. Thyroid nodules was palpated in 45.5% of patients and 7% of controls (P0.01). The mean largest diameter of nodules were 24.8 mm in patients and 10.8 mm in control group (P

2002-01-01

307

Fine-needle aspiration of follicular lesions of the thyroid. Diagnosis and follow-Up  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract The differential diagnosis of a follicular lesion/neoplasm in thyroid FNA specimens includes hyperplastic/adenomatoid nodule, follicular adenoma and carcinoma, and follicular variant of papillary thyroid carcinoma. In our laboratory we separate follicular lesions of thyroid into hyperplastic/adenomatoid nodule (HN), follicular neoplasm (FON) and follicular derived neoplasm with focal nuclear features suspicious for papillary thyroid carcinoma (FDN). This study reports our experience with 339 cases diagnosed as FON and 120 as FDN. All cases were evaluated for histologic diagnosis, age, sex and size of the nodule. Histopathologic follow-up was available in all cases. The malignancy rate was 22% (74/359) and 72% (86/120) for cases diagnosed as FON and FDN, respectively. In the FON category almost half of the malignant cases were papillary carcinoma. The risk of malignancy was higher in patients younger than 40 yr (53% vs. 30%) than in patients 40 year or more years old and greater in males (41% vs. 33%) than females. No statistically significant relationship was noted between the sizes of the nodules and benign vs. malignant diagnosis. According to this study it is important to divide follicular patterned lesions of thyroid into FON and FDN in the cytology specimens due to significantly different risk of malignancy (22% vs. 72%). In addition, clinical features, including gender and age can be part of the decision analysis in selecting patients for surgery.

Deveci M Salih; Deveci Güzin; LiVolsi Virginia; Baloch Zubair

2006-01-01

308

Management of thyroid follicular proliferation: an ultrasound-based malignancy score to opt for surgical or conservative treatment.  

Science.gov (United States)

This study was conducted to evaluate whether ultrasound characteristics of thyroid nodules with a known cytologic diagnosis of "follicular pattern" (indicative of follicular hyperplasia, follicular adenoma or follicular carcinoma) can be used to define a nodule malignancy score to limit surgery to selected, higher-risk cases. In pre-operative ultrasound results of patients diagnosed with a "follicular pattern" on cytology who subsequently underwent surgery, each nodule feature was given a score from 0 (most likely benign) to 2 (most likely malignant), resulting in a total score ranging from 0 to 11. The total nodule score (total malignancy score) was then compared with the definitive histologic diagnosis. According to our results, surgery is advisable in patients with score ?4 (79% of carcinomas), ultrasound follow-up seems to be appropriate for patients with a score of 3 (21% of carcinomas) and no action is recommended for patients with score <3 (only benign nodules). PMID:23743097

Pompili, Giovanni; Tresoldi, Silvia; Primolevo, Alessandra; De Pasquale, Loredana; Di Leo, Giovanni; Cornalba, Gianpaolo

2013-06-04

309

High incidence of synchronous or metachronous breast cancer in patients with malignant and benign thyroid tumor or tumor-like disorders.  

UK PubMed Central (United Kingdom)

BACKGROUND: Although many reports indicated an association between thyroid diseases and breast cancer, such an association still remains controversial. The present study was aimed to clarify the association of thyroid diseases with the breast cancer incidence. In the patients with benign and malignant thyroid tumor or tumor-like disorders, the incidence of other malignancies was surveyed, and the frequency of thyroid cancer in patients with breast cancer was also surveyed. PATIENTS AND METHODS: Between 1982 and 2005, a total of 201 female patients received surgery for tumor or tumor-like disorders, including 65 carcinoma, 68 adenoma, 61 adenomatous goiter and 7 chronic thyroiditis cases. Their outcomes were surveyed in December 2006. Furthermore, during the same periods, 340 female patients underwent breast cancer surgery and their outcomes were also surveyed in December 2006. RESULTS: The overall incidence rate of breast cancer was 16.4% (33/201) in the patients, who received thyroid surgeries and was much higher than other malignancies: 2.0% gastric cancer, 1.0% uterine and colorectal cancer. The incidence rate of breast cancer in each disease was 13.8% for thyroid cancer, 16.2% for adenoma and 21.3% for adenomatous goiter, but no incidence for chronic thyroiditis. On the other hand, in the patients with breast cancer during the same period in our department, the frequency of thyroid cancer was only 2.1% (7/340). CONCLUSION: It appears that thyroid cancer, adenoma and adenomatous goiter were associated with the risk of breast cancer, but chronic thyroiditis was not related.

Nio Y; Iguchi C; Itakura M; Toga T; Hashimoto K; Koike M; Omori H; Sato Y; Endo S

2009-05-01

310

Non-Alpine thyroid angiosarcoma.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Angiosarcoma is a very rare entity of soft tissue neoplasm with an aggressive and destructive biological behavior. Thyroid angiosarcoma is usually reported in Alpine regions, with only exceptionally rare cases arising in non-mountainous areas. In the Alpine regions it constitutes 2-10% of all malignant thyroid tumors. PRESENTATION OF CASE: We report a case of a thyroid non-Alpine angiosarcoma in a 71-year-old female with a 10 years old multinodular goiter. The cervical mass underwent rapid growth in the last year, and she was referred for surgical treatment. A 15cm mass was found on the right side of the neck invading adjacent tissues and displacing the trachea without obvious invasion of this organ. Fine needle aspiration cytology showed "carcinoma". Lung metastasis were present. Although difficult, total thyroidectomy was possible with resection of an esophageal implant. Post-operatively, she had respiratory failure that eventually recovered, but, on 39th post-operative day, she died of violent hemoptysis, probably due to invasion by mediastinal metastasis. DISCUSSION: A clear distinction between angiosarcoma and anaplastic carcinoma of the thyroid is considerably difficult, despite treatments and prognosis are practically the same. However, in recent years, a thyroid malignancy exhibiting phenotypical features of endothelial differentiation was described. Keratin positivity cannot be reported as necessarily indicative of epithelial differentiation. CONCLUSION: Optimal treatment for thyroid angiosarcoma remains unclear, not only because the prognosis is poor, despite multimodal therapeutic efforts, but also because it is a very rare entity.

Gouveia P; Silva C; Magalhães F; Santos C; Guerreiro E; Santos F; Gomes T

2013-01-01

311

Clinical significance of histone deacetylase (HDAC)-1, HDAC-2, HDAC-4, and HDAC-6 expression in human malignant and benign thyroid lesions.  

UK PubMed Central (United Kingdom)

Histone deacetylases (HDACs) have been associated with human malignant tumor development and progression, and HDAC inhibitors are currently being explored as anticancer agents in clinical trials. The present study aimed to evaluate the clinical significance of HDAC-1, HDAC-2, HDAC-4, and HDAC-6 proteins' expression in human malignant and benign thyroid lesions. HDAC-1, HDAC-2, HDAC-4, and HDAC-6 proteins' expression was assessed immunohistochemically on paraffin-embedded thyroid tissues obtained from 74 patients with benign and malignant thyroid lesions. Enhanced HDAC-2 and HDAC-6 expression was significantly more frequently observed in malignant, compared to benign, thyroid lesions (p?=?0.0042 and p?=?0.0069, respectively). Enhanced HDAC-2, HDAC-4, and HDAC-6 expression was significantly more frequently observed in cases with papillary carcinoma compared to hyperplastic nodules (p?=?0.0065, p?=?0.0394, and p?=?0.0061, respectively). In malignant thyroid lesions, HDAC-1, HDAC-4, and HDAC-6 expression was significantly associated with tumor size (p?=?0.0169, p?=?0.0056, and p?=?0.0234, respectively); HDAC-2 expression with lymphatic and vascular invasion (p?=?0.0299 and p?=?0.0391, respectively); and HDAC-4 expression with capsular invasion (p?=?0.0464). The cellular pattern of HDAC-1 and HDAC-2 distribution (nuclear vs. nuclear and cytoplasmic) presented a distinct discrimination between malignant and benign thyroid lesions (p?=?0.0030 and p?=?0.0028, respectively) as well as between papillary carcinoma and hyperplastic nodules (p?=?0.0036 and p?=?0.0028, respectively). HDAC-1, HDAC-2, HDAC-4, and HDAC-6 may be associated with the malignant thyroid transformation and could be considered as useful biomarkers and possible therapeutic targets in this neoplasia.

Giaginis C; Alexandrou P; Delladetsima I; Giannopoulou I; Patsouris E; Theocharis S

2013-07-01

312

Role of RET codonic mutations in the surgical management of medullary thyroid carcinoma in pediatric age multiple endocrine neoplasm type 2 syndromes.  

UK PubMed Central (United Kingdom)

PURPOSE: Hereditary medullary thyroid carcinoma (MTC) therapy is surgical resection. Because the genetic screening was available, the early diagnosis of the disease has been possible. The purpose of this study was to evaluate the role of the genetic test in the management of these children and to draw some information about the surgical timing. METHODS: Thirteen patients underwent total thyroidectomy at our institute between 1995 and 2007. Seven patients underwent a curative thyroidectomy, and 6 patients underwent a prophylactic thyroidectomy. Two patients were operated with a minimally invasive video-assisted technique. We studied the following parameters: age, risk level associated to the RET gene mutations, aim of surgery (curative or prophylactic), tumor histopathologic features, lymph node involvement, and distal metastases. RESULTS: We found a statistical association between cancer maximum diameter and some parameters analyzed: age of patients, aim of surgery, single or multifocal MTC, and number of organs involved by distal metastases. Cancer diameter at the moment of diagnosis seems to increase according to the aggressiveness of RET gene mutation found. CONCLUSIONS: The best strategy to cure MTC is to prevent it. Genetic screening could be a fundamental tool in the management of multiple endocrine neoplasm type 2 children. An improvement of scientific knowledge regarding RET gene alterations and an early and appropriate use of genetic tests could allow a better understanding of the correct surgical timing and a wider use of less aggressive surgical procedures.

Spinelli C; Di Giacomo M; Costanzo S; Elisei R; Miccoli P

2010-08-01

313

Intranuclear cytoplasmic inclusions in cytologically suspicious or malignant thyroid nodules: identification and correlation with echogenicity and size of the nodules.  

UK PubMed Central (United Kingdom)

Intranuclear inclusions (ICI) represent one cytological feature suggestive of malignancy. The aims of this study are (1) to correlate ICI with size and echogenicity of the thyroid nodules that, at fine-needle aspiration cytology (FNAC), are suspiciously malignant (THY4) or malignant (THY5); and (2) to ascertain whether ICI alone or combined with some ultrasonography (US) characteristics would help in predicting malignancy. We studied 90 consecutive thyroid nodules (THY4 n = 60 or THY5 n = 30) from 90 patients, who subsequently underwent thyroidectomy. Prior to thyroidectomy, all 90 nodules were examined by the US-guided FNAC. A cytology/histology correlation was performed. The results showed that 70 nodules were cancerous (82.2 %, THY4 = 73.3 %, THY5 = 100 %). ICI positive (ICI+) were 53/90 nodules (THY4 = 48.3 %, THY5 = 80.0 %), of which three (all THY4) were benign. The maximum diameter was smaller in the 53 ICI +ve than in the 37 ICI -ve nodules (14.2 ± 5.4 vs. 20.0 ± 9.4 mm, P = 0.0001; median volume 1.32 vs. 4.03 ml). In the THY4 smaller hypoechoic nodules, malignancy rate was 95 % with greater probability to detect ICI compared with non-hypoechoic nodules of >20 mm in maximum diameter (31 (75.6 %) vs. 4 (23.5 %), P = 0.0002). Based on the results, we conclude that ICI detection is associated with relatively smaller size and hypoechoic appearance in THY4 or THY5 nodules. In the THY4 nodules, when coupled with these US characteristics, ICI identification selects lesions with high chances of malignancy.

Arena S; Latina A; Stornello M; Saraceno G; Benvenga S

2013-09-01

314

The Role of Computed Tomography in the Diagnosis of Carotid Artery Invasion by Malignant Neoplasms of the Neck  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction: Awareness of invasion of the walls of the carotid arteries by malignant head and neck tumors is of great clinical importance before surgery and can change patient management. This study was designed to assess the diagnostic value of Computed Tomography (CT) in distinguishing carotid artery (CA) invasion by neck malignant tumors according different criteria. "nMaterials and Methods: CT with contrast was performed on 40patients with malignant neck tumors before surgery. Abnormal CT findings were categorized into 6 types: I, tumor encasement equal or greater than 270 degrees; II, tumor encasement greater than 180 degrees; III, compression; IV, displacement; V, segmental deletion of fat planes between tumor and CA and VI, ill-defined CA wall;. The CT appearances of all tumors were prospectively compared with surgical and histopathological findings as gold standard. "nResults: Abnormal CT findings in our patients according to the different types were; I: 6 tumors; II: 17 tumors; III: 2 tumors; IV: 8 tumor; V: 33 tumors and VI: 7 tumors. Surgical findings recorded that tumors invaded the CA in 13cases. The sensivity, specificity, positive and negative predictive values and accuracy (all with %95 confidence interval) for the different types were analyzed and the results showed type I, V and VI were statistically significant. "nConclusion: CT is the most frequently used imaging modality in diagnosing the tumoral location and staging but it isn't a definite way in diagnosing CA involvement by malignant lesions.However, our study demonstrated that type (I), (V) and (VI) can be valuable in the determination. "nKeywords: Computed Tomography, Carotid Artery, Neck Malignant Tumors

Leila Aghaghazvini; Hashem Sharifian; Habib Mazaher

2009-01-01

315

Reliability of different radioisotopic techniques in diagnosing solitary hot spots in the spine of patients with malignant neoplasm.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Early diagnosis of spinal metastases is of key importance in further therapeutic management. OBJECTIVES: The aim of the study was to assess the reliability of single-photon emission computed tomography (SPECT) or SPECT and computed tomography (SPECT/CT) in the diagnosis of solitary hot nodules in the spine identified by scintigraphy. PATIENTS AND METHODS: In this retrospective study, 70 patients with neoplastic disease and a solitary nodule detected in the spine were analyzed. Using a SPECT/CT ?-camera, the type and site of the foci in the vertebra were analyzed. Bone scintigraphy, SPECT, and CT were performed. Reliability of the results was assessed depending on the applied technique. RESULTS: In malignant lesions, increased isotope uptake was observed in the vertebral body with the posterior arch (89%), the body and both arches (67%), and the body alone (14%). In benign lesions, increased uptake was observed in the body area or in the joint area. Using SPECT, 25 of 27 cases (93%) of foci were properly classified as malignant. Using SPECT/CT, malignant lesions were observed in 26 of 27 cases (96%). Using SPECT, 19 of 43 cases were identified as benign (44%), and using SPECT/CT, 31 of 43 were identified as benign (72%). The agreement between SPECT and SPECT/CT was higher for malignant lesions (89%) than for benign lesions (67%). The use of CT in SPECT/CT examinations allowed to change the SPECT diagnosis of malignant lesions to that of benign lesions in 50% of the cases. CONCLUSIONS: The criteria used in the diagnosis of solitary nodules in the spine direct the diagnosis largely towards noncancerous lesions. Reliability of positive assessment was significantly lower than that of negative one - 51% in SPECT and 68% in SPECT/CT. A hybrid SPECT/CT camera is more reliable than SPECT alone in the assessment of spinal lesions.

Górska-Chrz?stek M; Kovacevicz-Ku?mierek K; Chrz?stek J; Niewiadomski D; Bienkiewicz M; Tryniszewski W; Maziarz Z; Ku?mierek J

2013-01-01

316

Altered expression of key players in vitamin D metabolism and signaling in malignant and benign thyroid tumors.  

Science.gov (United States)

1,25-Dihydroxyvitamin D(3) (1,25(OH)(2)D(3)), the active form of vitamin D, mediates antitumor effects in various cancers. The expression of key players in vitamin D signaling in thyroid tumors was investigated. Vitamin D receptor (VDR) and CYP27B1 and CYP24A1 (respectively activating and catabolizing vitamin D) expression was studied (RT-PCR, immunohistochemistry) in normal thyroid, follicular adenoma (FA), differentiated thyroid cancer (DTC) consisting of the papillary (PTC) and follicular (FTC) subtype, and anaplastic thyroid cancer (ATC). VDR, CYP27B1, and CYP24A1 expression was increased in FA and DTC compared with normal thyroid. However, in PTC with lymph node metastasis, VDR and CYP24A1 were decreased compared with non-metastasized PTC. In ATC, VDR expression was often lost, whereas CYP27B1/CYP24A1 expression was comparable to DTC. Moreover, ATC with high Ki67 expression (>30%) or distant metastases at diagnosis was characterized by more negative VDR/CYP24A1/CYP27B1 staining. In conclusion, increased expression of key players involved in local 1,25(OH)(2)D(3) signaling was demonstrated in benign and differentiated malignant thyroid tumors, but a decrease was observed for local nodal and especially distant metastasis, suggesting a local antitumor response of 1,25(OH)(2)D(3) in early cancer stages. These findings advocate further studies with 1,25(OH)(2)D(3) and analogs in persistent and recurrent iodine-refractory DTC. PMID:22511602

Clinckspoor, Isabelle; Hauben, Esther; Verlinden, Lieve; Van den Bruel, Annick; Vanwalleghem, Lieve; Vander Poorten, Vincent; Delaere, Pierre; Mathieu, Chantal; Verstuyf, Annemieke; Decallonne, Brigitte

2012-04-17

317

Altered expression of key players in vitamin D metabolism and signaling in malignant and benign thyroid tumors.  

UK PubMed Central (United Kingdom)

1,25-Dihydroxyvitamin D(3) (1,25(OH)(2)D(3)), the active form of vitamin D, mediates antitumor effects in various cancers. The expression of key players in vitamin D signaling in thyroid tumors was investigated. Vitamin D receptor (VDR) and CYP27B1 and CYP24A1 (respectively activating and catabolizing vitamin D) expression was studied (RT-PCR, immunohistochemistry) in normal thyroid, follicular adenoma (FA), differentiated thyroid cancer (DTC) consisting of the papillary (PTC) and follicular (FTC) subtype, and anaplastic thyroid cancer (ATC). VDR, CYP27B1, and CYP24A1 expression was increased in FA and DTC compared with normal thyroid. However, in PTC with lymph node metastasis, VDR and CYP24A1 were decreased compared with non-metastasized PTC. In ATC, VDR expression was often lost, whereas CYP27B1/CYP24A1 expression was comparable to DTC. Moreover, ATC with high Ki67 expression (>30%) or distant metastases at diagnosis was characterized by more negative VDR/CYP24A1/CYP27B1 staining. In conclusion, increased expression of key players involved in local 1,25(OH)(2)D(3) signaling was demonstrated in benign and differentiated malignant thyroid tumors, but a decrease was observed for local nodal and especially distant metastasis, suggesting a local antitumor response of 1,25(OH)(2)D(3) in early cancer stages. These findings advocate further studies with 1,25(OH)(2)D(3) and analogs in persistent and recurrent iodine-refractory DTC.

Clinckspoor I; Hauben E; Verlinden L; Van den Bruel A; Vanwalleghem L; Vander Poorten V; Delaere P; Mathieu C; Verstuyf A; Decallonne B

2012-07-01

318

VON RECKLINGHAUSEN’S DISEASE ASSOCIATED WITH PAPILARY THYROID CARCINOMA AND MALIGNANT MELANOMA WITH MULTIPLE METASTASIS – CASE REPORT  

Directory of Open Access Journals (Sweden)

Full Text Available We present the case of a 56 years old, women, known with Recklinghausen’s Disease (RD) since 15 years old. She was in the evidence of Iasi Endocrynology Clinic with nodulary goitre since ’97, being treated with Euthyrox until 2005. Due to symptomatology worsening (asphyxia feeling, agitation, palpitations, insomnia, irritability, dizziness) and to thyroid increase the surgical procedure was recommended. A right lobeisthmectomy was performed in 2005, but the Histopathology Exam revealed an occult Papillary Thyroid Carcinoma (PTC) pT1NxMxG1 (sclerous infiltrative 3 mm node) on joint nodular goitre with metaplasia, hemorrhage, sclero hyalinisation and lymphomatous thyroiditis aspects. She was treated with L Thyroxin, chemotherapy (Cisplatinum, Dacarbazin) and radioactive iodine therapy. After oncological evaluation she was addressed to the First Surgery Clinic for thyroidectomy totalisation and the treatment of an umbilical tumour occurred after the fourth cure (June-July 2005). The patient was evaluated by physical exam, ultrasonography and computed tomography (cervical and abdominal) which revealed tumours in the cervical region and in the liver. Thyroidectomy totalisation with limphadenectomy and an abdominal laparoscopy and biopsy were performed. The pathologic exam diagnosed multiple metastasis of malignant melanoma (MM) localized in the cervical region, in the liver, great omentum and cervical limphatic nodes. The postoperative follow-up revealed multiple bone mestastasis from the malignanat melanoma. The case particularities were: association of RD with 2 primitive malignant tumours (occult PTC and MM), both diagnosed histopathologically and the multiple bone metastasis developed in a short time.

D. Niculescu; Liliana Fortu; Madalina Jacota

2006-01-01

319

Superficial CD34-positive fibroblastic tumor: report of 18 cases of a distinctive low-grade mesenchymal neoplasm of intermediate (borderline) malignancy.  

UK PubMed Central (United Kingdom)

Fibroblastic mesenchymal tumors show a spectrum of biological behavior, from benign to fully malignant. We report our experience of two decades with a distinctive, previously undescribed low-grade fibroblastic tumor of the superficial soft tissues. Eighteen cases were identified within our consultation files, previously coded as 'low-grade sarcoma, not further classified' and 'malignant fibrous histiocytoma, low grade'. The tumors occurred in adults (median age 38 years, range 20-76 years) of either sex (10 males and 8 females), ranged in size from 1.5 to 10?cm (mean 4.1?cm), and were confined to the superficial soft tissues of the thigh (N=5), knee (N=2), and other sites. Histological features included a fascicular growth pattern of the neoplastic spindled cells with striking, often bizarre cellular pleomorphism and variably prominent nucleoli. Necrosis was seen in one case. All cases showed strong, diffuse CD34 positivity and 68% of tested cases demonstrated focal cytokeratin expression. Desmin, ERG, FLI-1, smooth muscle actin, and S100 protein were negative. TP53 overexpression was absent. Fluorescence in-situ hybridization studies for TGFBR3 and/or MGEA5 rearrangements were negative in all tested cases. Clinical follow-up was available in 13 patients (median duration of 24 months; range 1-104 months). Twelve of 13 patients had no disease recurrence. One patient had regional lymph node metastases, 7 years after incomplete excision of the primary tumor. All patients are currently alive and disease free. The unique clinicopathological features of superficial CD34-positive fibroblastic tumor define them as a novel subset of low-grade fibroblastic neoplasms, best considered to be of borderline malignancy.Modern Pathology advance online publication, 26 July 2013; doi:10.1038/modpathol.2013.139.

Carter JM; Weiss SW; Linos K; Dicaudo DJ; Folpe AL

2013-07-01

320

Second neoplasms following radiotherapy or chemotherapy for cancer  

Energy Technology Data Exchange (ETDEWEB)

While radiotherapy and antineoplastic chemotherapy often control malignancies they may, paradoxically, cause new cancers to develop as long-term complications. Although almost any type of neoplasm can occur, radiation-induced malignancies are most likely to affect the myelopoietic tissues and the thyroid gland. The former tissues are also most frequently involved by chemotherapy. The combination of intensive radiotherapy and intensive chemotherapy is particularly leukemogenic. Acute myeloid leukemia has occurred with increased frequency following treatment of Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, ovarian cancer, polycythemia vera, carcinoma of the thyroid gland, and carcinoma of the breast. Radiation-induced malignancies usually occur in the field of irradiation. Tumors developing in an irradiated field include a substantial number of soft tissue sarcomas or osteosarcomas. There is a 20-fold increase of second cancers following treatment of childhood malignancies, mostly sarcomas of bone and soft tissues, but including leukemia, and carcinomas of the thyroid gland, skin, and breast. The latent period between radiotherapy and the appearance of a second cancer ranges from 2 years to several decades, often being 10-15 years. With chemotherapy the mean latent period is shorter, approximately 4 years. The mechanism of oncogenesis by radiotherapy or chemotherapy is poorly understood and probably involves a complex interplay of somatic mutation, co-oncogenic effects, depression of host immunity, stimulation of cellular proliferation, and genetic susceptibility.

Penn, I.

1982-02-01

 
 
 
 
321

Acute aggravation of subdural fluid collection associated with dural metastasis of malignant neoplasms: case report and review of the literature.  

UK PubMed Central (United Kingdom)

A 63-year-old woman was admitted to our hospital with serious headache and vomiting. Five months before admission, she had undergone surgery for a primary advanced gastric cancer. Neuroradiological examinations revealed subdural fluid collection. We twice performed evacuation of the subdural fluid collection. However, aggravation of her state of consciousness progressed and she passed away. Histological examinations demonstrated that the dural veins were infiltrated by numerous tumor cells that produced mucus; however, ruptured vessels were not found. Furthermore, the subdural fluid collection increased shortly after the initial operation. We infer that the cause of the collection, which was associated with the dural metastasis of malignant tumors, was not only mucin secretion by tumor cells but also a rapid increase in perfusion pressure in the vessels of the dura mater, resulting in extravasation of plasma components into the subdural space. Our case demonstrates that the pathogenetic mechanism that is specific for subdural fluid collection caused by dural metastasis of malignant tumors differs from the mechanism of production of subdural hematoma associated with dural metastasis.

Kimura S; Kotani A; Takimoto T; Yoshino A; Katayama Y

2013-09-01

322

Evaluación clínica de la salud oral de niños con neoplasias malignas/ Clinical Assessment of Oral Health of children with Malignant Neoplasm  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Objetivo: Este estudio de carácter descriptivo visó evaluar clínicamente niños con neoplasias malignas y poner de manifiesto la relación entre el status de salud bucal y la ocurrencia de complicaciones estomatológicas. Pacientes y métodos: la salud bucal de 40 niños con neoplasias malignas (grupo I) fue evaluada clínicamente mediante examen físico extra e intra oral, obtención del índice de placa visible, índice de sangrado gingival e índice de dientes caria (more) dos, ausentes y obturados y simultáneamente fueron observadas las complicaciones estomatológicas desarrolladas en esos pacientes. El status de salud bucal de éstos niños fue comparado al de niños saludables (grupo II). Resultados: los niños del grupo I presentaron índices de sangrado gingival y experiencia de caries menores que los del grupo II, por otro lado, el índice de placa visible fue ligeramente mayor en los niños del grupo I, sin embargo, sólo hubo diferencia estadísticamente significativa en el valor del CAO-D/cao-d entre ambos grupos (p = 0.002). En el grupo I, 16 niños desarrollaron conjuntamente 61 complicaciones estomatológicas, con predominancia de la mucositis, seguida del sangrado oral espontáneo, candidiasis y xerostomia. Conclusión: Pacientes bajo tratamiento antineoplásico, presentando higiene oral deficiente, tienen mayor riesgo de desarrollar complicaciones estomatológicas. Abstract in english Objective: In this descriptive study were assessment clinically children with malignant neoplasm, to evidence the correlation between oral health status and the occurrence of stomatologic complications. Patients and methods: Were evaluated the oral health conditions of 40 children with malignant neoplasm (group I) through intra and extra oral physic examination, obstention of Visible Plate Index, Gingival Bleeding Index and Decayed, Missed and Filled Teeth Index; simultan (more) eously were observed the stomatologic complications developed in this patients. The oral health status of the children of group I was compared to the healthy children (group II). Results: The children of group I presented Gingival Bleeding Index and caries experience lower than children of group II, in other hand, the Visible Plate Index was lightly greater in children of group I, nevertheless existed statistical difference in the value of the DMF-T/dmf-t between both groups (p = 0.002). In the group I, 16 children developed together 61 stomatologic complications, with predominance of oral mucositis, followed by spontaneous oral bleeding, candidiasis and xerostomy. Conclusions: Patients in anti neoplastic therapy with deficient oral hygiene had high risk of develop stomatologic complications.

Gordón-Núñez, MA; Pereira Pinto, L; Souza, BL; Oliveira, PT; Fernandes, MZ

2005-06-01

323

Evaluación clínica de la salud oral de niños con neoplasias malignas Clinical Assessment of Oral Health of children with Malignant Neoplasm  

Directory of Open Access Journals (Sweden)

Full Text Available Objetivo: Este estudio de carácter descriptivo visó evaluar clínicamente niños con neoplasias malignas y poner de manifiesto la relación entre el status de salud bucal y la ocurrencia de complicaciones estomatológicas. Pacientes y métodos: la salud bucal de 40 niños con neoplasias malignas (grupo I) fue evaluada clínicamente mediante examen físico extra e intra oral, obtención del índice de placa visible, índice de sangrado gingival e índice de dientes cariados, ausentes y obturados y simultáneamente fueron observadas las complicaciones estomatológicas desarrolladas en esos pacientes. El status de salud bucal de éstos niños fue comparado al de niños saludables (grupo II). Resultados: los niños del grupo I presentaron índices de sangrado gingival y experiencia de caries menores que los del grupo II, por otro lado, el índice de placa visible fue ligeramente mayor en los niños del grupo I, sin embargo, sólo hubo diferencia estadísticamente significativa en el valor del CAO-D/cao-d entre ambos grupos (p = 0.002). En el grupo I, 16 niños desarrollaron conjuntamente 61 complicaciones estomatológicas, con predominancia de la mucositis, seguida del sangrado oral espontáneo, candidiasis y xerostomia. Conclusión: Pacientes bajo tratamiento antineoplásico, presentando higiene oral deficiente, tienen mayor riesgo de desarrollar complicaciones estomatológicas.Objective: In this descriptive study were assessment clinically children with malignant neoplasm, to evidence the correlation between oral health status and the occurrence of stomatologic complications. Patients and methods: Were evaluated the oral health conditions of 40 children with malignant neoplasm (group I) through intra and extra oral physic examination, obstention of Visible Plate Index, Gingival Bleeding Index and Decayed, Missed and Filled Teeth Index; simultaneously were observed the stomatologic complications developed in this patients. The oral health status of the children of group I was compared to the healthy children (group II). Results: The children of group I presented Gingival Bleeding Index and caries experience lower than children of group II, in other hand, the Visible Plate Index was lightly greater in children of group I, nevertheless existed statistical difference in the value of the DMF-T/dmf-t between both groups (p = 0.002). In the group I, 16 children developed together 61 stomatologic complications, with predominance of oral mucositis, followed by spontaneous oral bleeding, candidiasis and xerostomy. Conclusions: Patients in anti neoplastic therapy with deficient oral hygiene had high risk of develop stomatologic complications.

MA Gordón-Núñez; L Pereira Pinto; BL Souza; PT Oliveira; MZ Fernandes

2005-01-01

324

Sclerosing paraganglioma: report of 19 cases of an unusual variant of neuroendocrine tumor that may be mistaken for an aggressive malignant neoplasm.  

Science.gov (United States)

Nineteen cases of a distinctive variant of paraganglioma characterized by extensive collagen deposition resulting in a pattern of growth that resembled an invasive malignant neoplasm are described. The patients were 3 men and 16 women, 32 to 69 years of age (mean, 50.5 years). The tumors were located in the carotid body region, parapharyngeal region, and mediastinum. Tumor size ranged from 2 to 6 cm in greatest diameter. Grossly, the tumors were described as rubbery to firm, tan-red, and with extensive areas of sclerosis. Histologic examination showed nests and cords of tumor cells separated by broad bands of fibrous tissue. The tumor cells ranged from round to polygonal with abundant cytoplasm to elongated spindle cells with scant cytoplasm. Nuclear cytomegaly was present focally enhancing the atypical appearance of the tumor cell population in 17 cases. Mitoses were sparse (<1 x 10 HPF), and there was no evidence of necrosis in any of the cases. Foci of vascular and perineural invasion were present in 2 and 4 cases, respectively. The most striking morphologic feature was the presence of irregular cords and bands of hyalinized fibrous tissue that compartmentalized the lesion into irregular nests, islands, or cords of tumor cells, imparting them with an infiltrative appearance. All the tumors showed positive immunostaining for chromogranin, synaptophysin, and monoclonal neuron specific enolase. S-100 protein stains identified a sustentacular cell network, whereas cytokeratin AE1/AE3 was negative in all cases. Clinical follow-up in 14 cases, ranging from 2 months to 20 years (mean follow-up, 6.6 years) showed evidence of local recurrence in 2 cases and the development of a separate tumor in the contralateral neck in 1 case. The remainder of patients were free of recurrence or metastasis following simple local excision. Because of the prominent sclerosis, a diagnosis of an invasive malignant neoplasm was initially considered in the majority of cases. Sclerosing paraganglioma should be included in the differential diagnosis of sclerosing lesions of the head and neck region and mediastinum. Appropriate immunohistochemical stains may be of aid for establishing the correct diagnosis. PMID:16330936

Plaza, Jose Antonio; Wakely, Paul E; Moran, Cesar; Fletcher, Christopher D M; Suster, Saul

2006-01-01

325

Expression analysis of B-Raf oncogene in V600E-negative benign and malignant tumors of the thyroid gland: correlation with late disease onset.  

UK PubMed Central (United Kingdom)

B-Raf, a member of the Raf serine/threonine kinase family, is an intermediate molecule in the mitogen-activated protein kinase pathway, which relays extracellular signals from the cell membrane to the nucleus via a cascade of phosphorylation events, ultimately promoting cancer development. This pathway is usually activated in human neoplasias. The purpose of this study was to investigate the role of B-Raf in thyroid pathology. We scanned for the presence of mutations at codon 600 (V ? E) of the B-Raf gene, using a PCR-RFLP assay. In tumors with no mutation (32 benign and malignant thyroid tumors) and in their adjacent normal tissue, we measured the expression levels of B-Raf gene, using a quantitative real-time PCR (qPCR) assay. B-Raf expression in V600E-negative tumors deviated from the normal pattern, since it was overexpressed in 42 % of benign samples and downregulated in 54 % of malignant specimens. Hashimoto's thyroiditis also seemed to play an important role, since benign specimens with Hashimoto's thyroiditis had a 2.2-fold higher B-Raf expression than samples without thyroiditis (1.71 ± 0.63 vs. 0.78 ± 0.13). Statistical analysis revealed that B-Raf deregulation postponed disease onset by more than 10 years in both benign and malignant thyroid (benign: 55.6 ± 3.9 vs. 45.3 ± 3.3, p = 0.049; malignant: 52.2 ± 3.5 vs. 33.0 ± 7.9, p = 0.020). From the above results, we deduce that in the absence of mutation activation, B-Raf overexpression or downregulation is a protective event, since it delays the development of both malignant and benign thyroid tumors.

Derdas SP; Soulitzis N; Balis V; Sakorafas GH; Spandidos DA

2013-03-01

326

Thyroid disease associated with exposure to the Nevada nuclear weapons test site radiation: a reevaluation based on corrected dosimetry and examination data.  

UK PubMed Central (United Kingdom)

BACKGROUND: A study was begun in 1965 to 1966 to determine whether children exposed to radioactive iodine from nuclear weapons testing at the Nevada Test Site from 1951 through 1962 were at higher risk of thyroid disease. In 1993, we reported that among those examined in 1985 to 1986 (Phase II) there was an association between radiation from the Nevada Test Site and thyroid neoplasms. METHODS: We reevaluated the relationship between exposure to Nevada Test Site fallout and thyroid disease using newly corrected dose estimates and disease outcomes from the Phase II study. A prospective cohort of school children 12 to 18 years old living in Utah, Nevada, and Arizona was first examined for thyroid disease in 1965 to 1966 and reexamined in 1985 to 1986. In the Phase II report, 2497 subjects formed the basis for this analysis. Thyroid disease, including thyroid neoplasms and thyroiditis, was expressed as cumulative incidence and risk ratios (RRs) with a dose-response expressed as excess risk ratio (ERR/Gy). RESULTS: The RR between thyroid radiation dose in the highest dose group and thyroid neoplasms increased from 3.4 (in the earlier analysis) to 7.5. The RR for thyroiditis increased from 1.1 to 2.7 with an ERR/Gy of 4.9 (95% confidence interval = 2.0 to 10.0). There were too few malignant thyroid neoplasms to estimate risk. CONCLUSIONS: Persons exposed to radioactive iodine as children have an increased risk of thyroid neoplasms and autoimmune thyroiditis up to 30 years after exposure.

Lyon JL; Alder SC; Stone MB; Scholl A; Reading JC; Holubkov R; Sheng X; White GL Jr; Hegmann KT; Anspaugh L; Hoffman FO; Simon SL; Thomas B; Carroll R; Meikle AW

2006-11-01

327

Predicted risks of second malignant neoplasm incidence and mortality due to secondary neutrons in a girl and boy receiving proton craniospinal irradiation  

Science.gov (United States)

The purpose of this study was to compare the predicted risks of second malignant neoplasm (SMN) incidence and mortality from secondary neutrons for a 9-year-old girl and a 10-year-old boy who received proton craniospinal irradiation (CSI). SMN incidence and mortality from neutrons were predicted from equivalent doses to radiosensitive organs for cranial, spinal and intracranial boost fields. Therapeutic proton absorbed dose and equivalent dose from neutrons were calculated using Monte Carlo simulations. Risks of SMN incidence and mortality in most organs and tissues were predicted by applying risks models from the National Research Council of the National Academies to the equivalent dose from neutrons; for non-melanoma skin cancer, risk models from the International Commission on Radiological Protection were applied. The lifetime absolute risks of SMN incidence due to neutrons were 14.8% and 8.5%, for the girl and boy, respectively. The risks of a fatal SMN were 5.3% and 3.4% for the girl and boy, respectively. The girl had a greater risk for any SMN except colon and liver cancers, indicating that the girl's higher risks were not attributable solely to greater susceptibility to breast cancer. Lung cancer predominated the risk of SMN mortality for both patients. This study suggests that the risks of SMN incidence and mortality from neutrons may be greater for girls than for boys treated with proton CSI.

Taddei, Phillip J.; Mahajan, Anita; Mirkovic, Dragan; Zhang, Rui; Giebeler, Annelise; Kornguth, David; Harvey, Mark; Woo, Shiao; Newhauser, Wayne D.

2010-12-01

328

Increment of platelet during radiation therapy in malignant neoplasm patients injected subcutaneously with a mycobacterium tuberculosis-derived arabinomannan (Z-100). Report of two cases  

International Nuclear Information System (INIS)

[en] The decrease of hematologic cells is one of the most severe morbidities in radiation therapy. Thrombocytopenia in particular has no effective treatment methods except blood transfusion. Thus, avoiding severe thrombocytopenia is considered to be one of the most important concerns. We treated 2 patients who had increment of platelets during radiation therapy in malignant neoplasm following subcutaneous injection with a mycobacterium tuberculosis-derived arabinomannan (Z-100). One patient was an 84-year-old woman suffering from uterine cervical carcinoma and the other was a 73-year-old woman suffering from non-Hodgkin's lymphoma. In both patients, platelets decreased after radiation therapy. Following subsequent injection of Z-100 subcutaneously, an increase in platelets was observed. The mechanisms of Z-100 to increase platelets in these patients are obscure, although some interleukins (IL) such as IL-6 might be related to the increment of the platelets. Thus, further studies will be required to evaluate the mechanisms of the increment of platelet in patients injected with Z-100. (author)

2004-01-01

329

Predicted risks of second malignant neoplasm incidence and mortality due to secondary neutrons in a girl and boy receiving proton craniospinal irradiation  

International Nuclear Information System (INIS)

The purpose of this study was to compare the predicted risks of second malignant neoplasm (SMN) incidence and mortality from secondary neutrons for a 9-year-old girl and a 10-year-old boy who received proton craniospinal irradiation (CSI). SMN incidence and mortality from neutrons were predicted from equivalent doses to radiosensitive organs for cranial, spinal and intracranial boost fields. Therapeutic proton absorbed dose and equivalent dose from neutrons were calculated using Monte Carlo simulations. Risks of SMN incidence and mortality in most organs and tissues were predicted by applying risks models from the National Research Council of the National Academies to the equivalent dose from neutrons; for non-melanoma skin cancer, risk models from the International Commission on Radiological Protection were applied. The lifetime absolute risks of SMN incidence due to neutrons were 14.8% and 8.5%, for the girl and boy, respectively. The risks of a fatal SMN were 5.3% and 3.4% for the girl and boy, respectively. The girl had a greater risk for any SMN except colon and liver cancers, indicating that the girl's higher risks were not attributable solely to greater susceptibility to breast cancer. Lung cancer predominated the risk of SMN mortality for both patients. This study suggests that the risks of SMN incidence and mortality from neutrons may be greater for girls than for boys treated with proton CSI.

2010-12-07

330

Assessment of malignancy for atypia of undetermined significance in thyroid fine-needle aspiration biopsy evaluated by whole-slide image analysis.  

UK PubMed Central (United Kingdom)

Atypia of undetermined significance (AUS) in thyroid fine-needle aspiration (FNA) has a low to intermediate incidence of malignancy, and objective criteria could allow for improved assessment of malignancy. Consecutive thyroid FNA AUS cases with surgical excision were selected. Whole-slide images (WSIs) were evaluated for basic criteria by image analysis, including total groups and nuclear/cytoplasmic (N/C) ratio. The 44 cases encompassed 23 benign and 21 malignant entities. Seventeen (81%) of 21 malignant cases and 11 (48%) of 23 benign cases had an N/C ratio of 0.50 or less. An N/C ratio of 0.50 or less had an odds ratio for malignancy of 4.64 (P = .03). A combined category of an N/C ratio of 0.50 or less and greater than 20 cell groups had an odds ratio for malignancy of 7.0 (P = .04). Establishing defined objective WSI criteria has the potential to provide an assessment of malignancy for AUS thyroid FNA cases.

Collins BT; Collins LE

2013-06-01

331

Application of 18F-FDG PET/CT imaging for differentiating malignant from benign breast neoplasms  

International Nuclear Information System (INIS)

Objective: To investigate the clinical value of 18F-fluorodeoxyglucose (FDG) PET/CT imaging for differentiating breast cancer from benign breast mass. Methods: Thirty-four patients with a total of 41 suspicious masses underwent 18F-FDG PET/CT imaging within 10 d before surgery(except 1 case). The imaging protocol included prone PET/CT scanning (2 bed) at 40 min post-injection of 5.55 MBq/kg 18F-FDG and 3 h delayed scanning when necessary. After correction of measured attenuation, decay and scatter and iterative reconstruction, PET data were analyzed semi-quantitatively by calculating standardized uptake values (SUV) and target-to-non-target ratios (T/NT). Visual analysis was performed using transverse, sagittal and coronal slices as well as three-dimension reprojection images. Results: Twenty-seven malignant and 7 benign breast lesions of 34 patients detected by this modality were proven histologically after surgery. Visual analysis of 18F-FDG PET/CT gave a sensitivity of 92.59%, specificity of 6/7 and positive predictive value of 96.15%. Conclusion: 18F-FDG PET/CT is a valuable tool for differentiating breast cancer from benign breast masses. (authors)

2005-01-01

332

In vitro and in vivo characterizations of established human follicular carcinoma cell line derived from thyroid cancer; A novel model for well-differentiated thyroid malignant tumor  

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A continuous cell line, named SMC R86 F1, was established from a surgically resected primary thyroid lesion. The cell grew as an adhering monolayer with a doubling time of about 25 hours in modified Eagle's medium supplemented with fetal bovine serum. When the cells were transplanted into athymic nude mice, tumors developed at the site of inoculation. The cells not only showed epithelial origin upon light and electron microscopic examination but also possessed a biosynthetic marker human thyroglobulin (hTg). In order to examine the iodide trapping ability of the xenografts, radioiodine at doses of 3.7 MBq was injected into the peritoneum of [sup 131]I treated nude mice bearing xenografts at about 4 weeks after the cell inoculation. Judging from the results of scintigraphic, autoradiographic and biodistribution studies, viable tissue of the xenografts in the treated mice had the ability to trap radioiodine. Histological sections of the xenografts resected from the treated mice consisted of follicle-like and trabecular growing structures, and immunohistochemically the cytoplasm of the tissues was hTg positive. The cells possessed the ability to trap radioactive iodine in vitro under the control of TSH. In addition, the expression of iodinated 19S Tg in the cell cytoplasms in the monolayer cultures was revealed by immunoblotting and autoradiographic assays. These observations provide strong evidence that the SMC R86 F1 cell line possesses well-differentiated properties of the malignant thyroid follicular epithelial cells. (author).

Tsuda, Takatoshi (Sapporo Medical Coll. (Japan))

1992-08-01

333

Fine Needle Aspiration Cytology of Pediatric Thyroid Nodules  

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Full Text Available Objective: The objectives were to evaluate fine needle aspiration cytology results of 39 pediatric patients, and the pathologies that cause childhood thyroid nodules, and to review the literature on the subject.Material and Method: Thyroid fine needle aspiration cytology results of 39 pediatric patients were retrospectively reviewed. Associated diseases, thyroid functions, anti-thyroid antibody levels, ultrasonographic findings and number of nodules were also evaluated.Results: The vast majority of patients with thyroid nodules were cytopathologically diagnosed as benign (97.3%). Of these patients, 64.8% (24 patients) were diagnosed as nodular goiter and 35.2% (13 patients) as lymphocytic thyroiditis. Thyroid malignancy was found in two patients; one was diagnosed as follicular neoplasm/ minimal invasive follicular carcinoma on surgical evaluation while the other was a secondary tumor (Burkitt's lymphoma). The majority of our subjects were females (66.6%): the female/male ratio was 2:1 for nodular goiter and 3.3:1 for thyroiditis. Surgical resection was performed in 5 patients (4 cases of nodular goiter, 1 suspicious for malignancy) and cytological diagnoses were confirmed by histology.Conclusion: Our study confirmed the utility of fine needle aspiration cytology in childhood thyroid disorders along with a possible higher incidence of nodular thyroiditis in childhood. Nodular autoimmune thyroiditis, focal thyroiditis and thyroid cancer in children are discussed and attention is drawn to some special subtypes of thyroid cancer and some benign lesions that can cause difficulty in interpreting fine needle aspiration cytology and frozen sections at this age.

Ayper KAÇAR; ?rem PAKER; Gül?ah KABAÇAM BAYRAM; Fatma DEM?REL; Emrah ?ENEL; Murat KIZILGÜN

2010-01-01

334

Salivary gland neoplasms in children.  

UK PubMed Central (United Kingdom)

PURPOSE: Salivary gland neoplasms in pediatric population are extremely rare. The aim of the present study was to determine the clinicopathologic characteristics of salivary gland neoplasms in patients younger than 19 years at our institution. METHODS: During a 38-year period, a total of 119 pediatric patients met the diagnosis of epithelial salivary gland neoplasms. Clinicopathologic parameters were reviewed. RESULTS: There were 87 (73.1%) benign and 32 (26.9%) malignant neoplasms. The mean age of pediatric patients was 15.1 years. The male-to-female ratio was 1:1.25. One hundred thirteen cases occurred among patients not younger than 10 years. The highest frequency of epithelial salivary gland neoplasms was pleomorphic adenoma (70.6%). Mucoepidermoid carcinoma (16 cases) was the most common malignant tumor in the salivary gland, occupying 50.0% of the malignancies and 13.4% of all salivary gland neoplasms. CONCLUSIONS: Salivary gland neoplasms in Chinese pediatric patients are rare. There is a female predominance. Most of the tumors occur among patients not younger than 10 years. The most common benign tumor is pleomorphic adenomas, and the most common malignant tumor is mucoepidermoid carcinomas.

Deng R; Huang X; Hao J; Ding J; Hu Q

2013-03-01

335

Guideline for therapy of malignant thyroid tumours. Pleading for an actualization  

International Nuclear Information System (INIS)

[en] Total (or near total) thyroidectomy (TE) followed by radioiodine (131I) ablation (RIA) of residual thyroid tissue is considered to be the ideal treatment for differentiated thyroid carcinoma. However, the actual guideline of the DGN (German Society of Nuclear Medicine) recommends for the so-called papillary microcarcinoma of the thyroid (PMC) no further therapeutic strategy (no complete TE, no 131I-ablation of the remaining lobe). PMC has been defined as papillary carcinoma measuring 1 cm (T1) in maximal diameter according to the World Health Organization classification system for thyroid tumours (1988). The new WHO-classification (starting in 2003) defines the T1-tumour measuring 2 cm in maximal diameter. The authors demand a new, modern guideline, following the new WHO classification. This includes, that despite the overall excellent prognosis for patients with PMC, the treatment of patients with T1-tumours of the new WHO-classification (including the 'old' PMC) should not be different from the treatment of patients with conventional papillary thyroid carcinoma, i.e. complete surgery (TE and central lymph node dissection) followed by RIA of residual thyroid tissue. The authors argue that it is not appropriate to consider the tumour size as the single most important key factor for therapy and prognosis. Even small tumours may have poor prognostic factors, such as lymph node metastasis, multifocality or molecular characteristics (expression of oncogenes). (orig.)

2004-01-01

336

Infrared spectra of thyroid tumor tissues  

Science.gov (United States)

We used infrared spectroscopy methods to study thyroid tumor tissues removed during surgery. The IR spectra of the surgical material are compared with data from histological examination. We show that in malignant neoplasms, the spectra of proteins in the region of C=O vibrations are different from the spectra of these substances in benign tumors and in tissues outside the pathological focus at a distance >1 cm from the margin of the tumor. The differences in the spectra are due to changes in the supermolecular structure of the proteins, resulting from rearrangement of the system of hydrogen bonds. We identify the spectral signs of malignant pathologies.

Tolstorozhev, G. B.; Skornyakov, I. V.; Butra, V. A.

2010-07-01

337

Combination of Caspy2 and IP-10 gene therapy significantly improves therapeutic efficacy against murine malignant neoplasm growth and metastasis.  

Science.gov (United States)

It has been shown that Caspy2, a zebrafish active caspase, can efficiently suppress the growth of malignant tumor. The present study was designed to test whether combined gene therapy with IP-10, a potent antitumor chemokine, and Caspy2 would improve therapy efficacy. Recombinant plasmid expressing both Caspy2 and IP-10 genes was mixed with DOTAP-cholesterol nanoparticles. Immunocompetent mice bearing CT26 colon carcinoma, B16-F10 melanoma, and 4T1 breast carcinoma were treated with the complex. We found that the combined gene therapy more efficiently inhibited tumor growth, while efficiently prolonging the survival of tumor-bearing animals, compared with monotherapy. Moreover, a significant reduction in spontaneous lung metastasis could be observed in the 4T1 breast carcinoma model. Infiltration of CD8(+) T lymphocytes was also observed. In addition, apoptotic cells were widely detected by TUNEL assay and caspase-3 immunostaining in coadministered tumor tissues. The combination treatment also successfully inhibited angiogenesis and tumor cell proliferation as assessed by CD31 and Ki-67 immunostaining, respectively. Furthermore, depletion of CD8(+) T lymphocytes could significantly abrogate the antitumor activity, whereas the depletion of CD4(+) cells or natural killer cells showed partial abrogation. Rechallenged CT26 tumors were rejected in all of the surviving mice treated by combination therapy. Our results suggest that combined therapy with Caspy2 and IP-10 can significantly enhance antitumor activity by acting as an immune response initiator, apoptosis inducer, and angiogenesis inhibitor, which may be important for further applications in clinical cancer therapy. PMID:22548488

Zhang, Na; Yang, Yang; Cheng, Lin; Zhang, Xiao-mei; Zhang, Shuang; Wang, Wei; Liu, Sheng-yong; Wang, Shu-ya; Wang, Rui-bo; Xu, Wen-jing; Dai, Lei; Yan, Nv; Fan, Ping; Dai, Li-xia; Tian, Hong-wei; Liu, Lei; Deng, Hong-xin

2012-07-20

338

Combination of Caspy2 and IP-10 gene therapy significantly improves therapeutic efficacy against murine malignant neoplasm growth and metastasis.  

UK PubMed Central (United Kingdom)

It has been shown that Caspy2, a zebrafish active caspase, can efficiently suppress the growth of malignant tumor. The present study was designed to test whether combined gene therapy with IP-10, a potent antitumor chemokine, and Caspy2 would improve therapy efficacy. Recombinant plasmid expressing both Caspy2 and IP-10 genes was mixed with DOTAP-cholesterol nanoparticles. Immunocompetent mice bearing CT26 colon carcinoma, B16-F10 melanoma, and 4T1 breast carcinoma were treated with the complex. We found that the combined gene therapy more efficiently inhibited tumor growth, while efficiently prolonging the survival of tumor-bearing animals, compared with monotherapy. Moreover, a significant reduction in spontaneous lung metastasis could be observed in the 4T1 breast carcinoma model. Infiltration of CD8(+) T lymphocytes was also observed. In addition, apoptotic cells were widely detected by TUNEL assay and caspase-3 immunostaining in coadministered tumor tissues. The combination treatment also successfully inhibited angiogenesis and tumor cell proliferation as assessed by CD31 and Ki-67 immunostaining, respectively. Furthermore, depletion of CD8(+) T lymphocytes could significantly abrogate the antitumor activity, whereas the depletion of CD4(+) cells or natural killer cells showed partial abrogation. Rechallenged CT26 tumors were rejected in all of the surviving mice treated by combination therapy. Our results suggest that combined therapy with Caspy2 and IP-10 can significantly enhance antitumor activity by acting as an immune response initiator, apoptosis inducer, and angiogenesis inhibitor, which may be important for further applications in clinical cancer therapy.

Zhang N; Yang Y; Cheng L; Zhang XM; Zhang S; Wang W; Liu SY; Wang SY; Wang RB; Xu WJ; Dai L; Yan N; Fan P; Dai LX; Tian HW; Liu L; Deng HX

2012-08-01

339

Sclerosing Mucoepidermoid carcinoma with eosinophilia of the thyroid glands: a case report with clinical manifestation of recurrent neck mass.  

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Sclerosing mucoepidermoid carcinoma with eosinophilia (SMECE) is a recently recognized malignant neoplasm of the thyroid gland. About 14 cases of SMECE have been reported and this is the first reported case in Korea. A 57-year-old woman presented with right neck mass for 20 years. Total thyroidectom...

Chung, J.; Lee, S. K.; Gong, G.; Kang, D. Y.; Park, J. H.; Kim, S. B.; Ro, J. Y.

340

Vocal cord paralysis and recovery with thyroid lymphoma.  

Science.gov (United States)

Vocal cord paralysis has been reported in 33 patients with thyroid lymphoma for an estimated overall incidence of 17%. There is little expectation of vocal cord function recovery, both because neoplastic invasion is believed irreversible and since surgery often necessitates sacrifice of the recurrent laryngeal nerve. Unlike in most well differentiated thyroid malignancies, external radiation therapy plays a vital role in the treatment of thyroid lymphoma. The patient presented here had complete recovery of vocal cord function following radiation therapy for a large thyroid lymphoma associated with vocal cord paralysis. This is the first reported case of such recovery following treatment for a thyroid neoplasm. The rather rapid and complete recovery of neural function suggests that, at least in some, paralysis is caused by reversible compression rather than by neural invasion or tumor-induced neurolysis. PMID:3965829

Jiu, J B; Sobol, S M; Grozea, P N

1985-01-01

 
 
 
 
341

Expression of DNA repair proteins MSH2, MLH1 and MGMT in human benign and malignant thyroid lesions: An immunohistochemical study  

Science.gov (United States)

Summary Background DNA repair is a major defense mechanism, which contributes to the maintenance of genetic sequence, and minimizes cell death, mutation rates, replication errors, DNA damage persistence and genomic instability. Alterations in the expression levels of proteins participating in DNA repair mechanisms have been associated with several aspects of cancer biology. The present study aimed to evaluate the clinical significance of DNA repair proteins MSH2, MLH1 and MGMT in benign and malignant thyroid lesions. Material/Methods MSH2, MLH1 and MGMT protein expression was assessed immunohistochemically on paraffin-embedded thyroid tissues from 90 patients with benign and malignant lesions. Results The expression levels of MLH1 was significantly upregulated in cases with malignant compared to those with benign thyroid lesions (p=0.038). The expression levels of MGMT was significantly downregulated in malignant compared to benign thyroid lesions (p=0.001). Similar associations for both MLH1 and MGMT between cases with papillary carcinoma and hyperplastic nodules were also noted (p=0.014 and p=0.026, respectively). In the subgroup of malignant thyroid lesions, MSH2 downregulation was significantly associated with larger tumor size (p=0.031), while MLH1 upregulation was significantly associated with the presence of lymphatic and vascular invasion (p=0.006 and p=0.002, respectively). Conclusions Alterations in the mismatch repair proteins MSH2 and MLH1 and the direct repair protein MGMT may result from tumor development and/or progression. Further studies are recommended to draw definite conclusions on the clinical significance of DNA repair proteins in thyroid neoplasia.

Giaginis, Constantinos; Michailidi, Christina; Stolakis, Vasileios; Alexandrou, Paraskevi; Tsourouflis, Gerasimos; Klijanienko, Jerzy; Delladetsima, Ioanna; Theocharis, Stamatios

2011-01-01

342

Expression of DNA repair proteins MSH2, MLH1 and MGMT in human benign and malignant thyroid lesions: an immunohistochemical study.  

UK PubMed Central (United Kingdom)

BACKGROUND: DNA repair is a major defense mechanism, which contributes to the maintenance of genetic sequence, and minimizes cell death, mutation rates, replication errors, DNA damage persistence and genomic instability. Alterations in the expression levels of proteins participating in DNA repair mechanisms have been associated with several aspects of cancer biology. The present study aimed to evaluate the clinical significance of DNA repair proteins MSH2, MLH1 and MGMT in benign and malignant thyroid lesions. MATERIAL/METHODS: MSH2, MLH1 and MGMT protein expression was assessed immunohistochemically on paraffin-embedded thyroid tissues from 90 patients with benign and malignant lesions. RESULTS: The expression levels of MLH1 was significantly upregulated in cases with malignant compared to those with benign thyroid lesions (p = 0.038). The expression levels of MGMT was significantly downregulated in malignant compared to benign thyroid lesions (p = 0.001). Similar associations for both MLH1 and MGMT between cases with papillary carcinoma and hyperplastic nodules were also noted (p = 0.014 and p = 0.026, respectively). In the subgroup of malignant thyroid lesions, MSH2 downregulation was significantly associated with larger tumor size (p = 0.031), while MLH1 upregulation was significantly associated with the presence of lymphatic and vascular invasion (p = 0.006 and p = 0.002, respectively). CONCLUSIONS: Alterations in the mismatch repair proteins MSH2 and MLH1 and the direct repair protein MGMT may result from tumor development and/or progression. Further studies are recommended to draw definite conclusions on the clinical significance of DNA repair proteins in thyroid neoplasia.

Giaginis C; Michailidi C; Stolakis V; Alexandrou P; Tsourouflis G; Klijanienko J; Delladetsima I; Theocharis S

2011-02-01

343

Development of a clinical decision model for thyroid nodules  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Thyroid nodules represent a common problem brought to medical attention. Four to seven percent of the United States adult population (10–18 million people) has a palpable thyroid nodule, however the majority (>95%) of thyroid nodules are benign. While, fine needle aspiration remains the most cost effective and accurate diagnostic tool for thyroid nodules in current practice, over 20% of patients undergoing FNA of a thyroid nodule have indeterminate cytology (follicular neoplasm) with associated malignancy risk prevalence of 20–30%. These patients require thyroid lobectomy/isthmusectomy purely for the purpose of attaining a definitive diagnosis. Given that the majority (70–80%) of these patients have benign surgical pathology, thyroidectomy in these patients is conducted principally with diagnostic intent. Clinical models predictive of malignancy risk are needed to support treatment decisions in patients with thyroid nodules in order to reduce morbidity associated with unnecessary diagnostic surgery. Methods Data were analyzed from a completed prospective cohort trial conducted over a 4-year period involving 216 patients with thyroid nodules undergoing ultrasound (US), electrical impedance scanning (EIS) and fine needle aspiration cytology (FNA) prior to thyroidectomy. A Bayesian model was designed to predict malignancy in thyroid nodules based on multivariate dependence relationships between independent covariates. Ten-fold cross-validation was performed to estimate classifier error wherein the data set was randomized into ten separate and unique train and test sets consisting of a training set (90% of records) and a test set (10% of records). A receiver-operating-characteristics (ROC) curve of these predictions and area under the curve (AUC) were calculated to determine model robustness for predicting malignancy in thyroid nodules. Results Thyroid nodule size, FNA cytology, US and EIS characteristics were highly predictive of malignancy. Cross validation of the model created with Bayesian Network Analysis effectively predicted malignancy [AUC = 0.88 (95%CI: 0.82–0.94)] in thyroid nodules. The positive and negative predictive values of the model are 83% (95%CI: 76%–91%) and 79% (95%CI: 72%–86%), respectively. Conclusion An integrated predictive decision model using Bayesian inference incorporating readily obtainable thyroid nodule measures is clinically relevant, as it effectively predicts malignancy in thyroid nodules. This model warrants further validation testing in prospective clinical trials.

Stojadinovic Alexander; Peoples George E; Libutti Steven K; Henry Leonard R; Eberhardt John; Howard Robin S; Gur David; Elster Eric A; Nissan Aviram

2009-01-01

344

Investigation of heavy trace elements in neoplastic and non-neoplastic human thyroid tissue: A study by proton-induced X-ray emissions  

International Nuclear Information System (INIS)

Background: Within the context of developing techniques to facilitate the diagnosis of the thyroid diseases, the elemental composition of pathological thyroid tissue (neoplastic and non-neoplastic) was investigated by proton induced X-ray emission. The proton induced X-ray has been widely sued as a sensitive technique for trace elemental analysis in both biological and medical fields. Materials and Methods: The twenty-eight specimen of thyroid tissue (neoplastic, non-neoplastic and grossly normal tissue ) were obtained from operation of 14 patients with different thyroid diseases. Determination of the heavy trace elements distribution (Fe, Co, Ni, Cu, Zn, As, Se, Br, Rb, Mo, I) was carried out by irradiating of the sample surface with a focused proton beam. Results: Fourteen grossly normal, eleven non-neoplastic and three malignant thyroid neoplasm cases were diagnosed. Trace element contents of the International Atomic Energy Agency M A-B-3/T M fluorescence in situ hybridisation tissue was used as standard for calibration of PIXE set up. Conclusion : The concentration of the heavy trace elements Co, Cu, Zn, and Mo in neoplasm of thyroid were higher than other samples. The concentration of the heavy trace elements, Fe, As, Br, Rb, I, are found to be much lower in neoplasm of thyroid than non-malignant and grossly normal thyroid tissue. The concentration of the Se, Co and I in this study is consistent with the others study but there are differences in the concentration of Fe in our study and consistent with the Iodine concentration was 11 times lower, on average in neoplasm compared with non-neoplastic tissue of thyroid. The low levels of I in thyroid neoplasm are correlated to some pathological factors

2004-01-01

345

FAMILIAL NONMEDULLARY THYROID CANCER  

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Full Text Available Follicular cell-derived thyroid cancer which represents 90-95% of all thyroid malignancies may occur in at least 5% of cases as familial disease. Familial nonmedullary thyroid cancer (FNMTC) is defined as the existence of two or more first degree relatives affected within a family. FNMTC may occur in two situations: pure FNMTC in which FNMTC is the predominant neoplasm although other cancers may occur with increased frequency (non syndromic NMTC) and syndromic NMTC in which other cancers or association of tumors are the most predominant feature and thyroid cancer is associated with known frequency. Most patients with syndromic NMTCs are asymptomatic, but genetic screening for the syndrome allows an early diagnosis and adequate surgery. Syndromic and non-syndromic FNMTC may represent 5-15% from all follicular cell-derived thyroid carcinomas. Four susceptibility loci for pure FNMTC have been described: TCO – familial thyroid carcinoma with oxyphilia on chromosome 19p13.2, FPTC/PRN – familial papillary thyroid carcinoma with papillary renal neoplasia (carcinoma) on chromosome 1q13.2-1q22, NMTC1 – non medullary thyroid carcinoma type 1 on chromosome 2q21, NMG1 – multinodular goiter with papillary thyroid carcinoma on chromosome 14q32. Inheritance is autosomal dominant, but the candidate genes are unknown. Most authors agree that pure FNMTC have a more aggressive behavior: multifocality, bilaterality, association with other thyroid disease (nodules and thyroiditis), trend to spread locally and in lymph nodes, higher recurrence rate, lower disease-free survival. Syndromic FNMTCs occur in the following syndromes in which FNMTC occurs with a known frequency: Familial Adenomatous Polyposis and Gardner’s syndrome (associated FNMTC - 5%), PTEN-hamartoma tumor syndrome (PTEN/PHTS - associated FNMTC - 10%), Carney’s complex (associated FNMTC - 10-25%), Werner’s syndrome (associated FNMTC - up to 18%). Knowing the aggressiveness of FNMTCs, affected individuals must be prospectively researched by screening, aggressively treated and closely monitored. Their relatives must be also monitored for early diagnosis known the phenomenon of genetic anticipation.

Voichi?a Mogo?; Simona Mogo?

2012-01-01

346

Thyroid effects  

International Nuclear Information System (INIS)

Risk coefficients for thyroid disorders have been developed for both 131I and external x or gamma low-LET radiation. A linear, no-threshold model has been used for thyroid neoplasms. A linear, threshold model has been used for other thyroid disorders. Improvements since the Reactor Safety Study were made possible by relevant new animal and human data. Major changes are as follows. Animal data are used to supplement the human experience where necessary. A specific risk estimate model is used for thyroid neoplasms, which accounts for observed effects of gender and age at exposure on risk. For thyroid cancer, the basis of the risk coefficients is the experience of North Americans following x-irradiation for benign disease in childhood. This recognizes possible differences in susceptibility in people of different heritage. A minimum in