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1

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

2010-06-01

2

NDRG1 protein overexpression in malignant thyroid neoplasms  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English 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 stim [...] uli, 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

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

2010-06-01

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

OpenAIRE

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. Resul...

Shah Sejal; Faquin William; Izquierdo Roberto; Khurana Kamal

2009-01-01

4

Malignant neoplasms in organ transplant recipients  

International Nuclear Information System (INIS)

Radiologic and clinicopathologic features were analyzed in 29 recipients with 31 malignant neoplasms. Malignant neoplasms included ten non-Hodgkin lymphomas, one case of Hodgkin disease, and 19 carcinomas of the skin, colon, head and neck, thyroid, lung, uterus, and vulva. Lymphoma had the most widespread organ involvement, with spread to lymph nodes, central nervous system, liver, spleen, muscle, and native and transplanted kidney. Comparison of cyclosporine-treated and -untreated recipients indicated that the latter had a shorter interval from transplantation to tumor diagnosis (4 vs 54 months) and demonstrated more extensive tumor spread

5

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

2012-12-01

6

[Uncommon variants of malignant melanocytic neoplasms].  

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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

7

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

8

Radiation induced thyroid neoplasms 1920 to 1987: A vanishing problem  

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Radiation for benign diseases has been implicated as an etiologic factor in thyroid cancer. From 1930-60, over 2 million children may have been exposed to therapeutic radiation and it is estimated that up to 7% may develop thyroid cancer after a 5-40 year latency. Thyroid stimulating hormone, secondary to radioinduced hypothyroidism, has been implicated as causative in animals. Such data has led to expensive screening programs in high risk patients. Because of a decline in irradiation for benign diseases in children over the last 2 decades, we questioned whether the incidence of radiation induced thyroid neoplasms (RITN) was also decreasing. Twenty-six of 227 patients (11%) with thyroid malignancies seen at our institution from 1974-87 had a history of previous head and neck irradiation. These included 13 papillary, 3 follicular, and 7 mixed carcinomas as well as 2 lymphomas and 1 synovial cell sarcoma. None of these 26 patients had abnormal thyroid function tests at presentation. Mean latency from irradiation to the diagnosis of thyroid cancer was 25.4 years (6-55 year range). Compared to the reported increasing incidence of RITN from 1940-70, there appears to be a significant decrease since 1970. Based on our analysis, the use of expensive screening programs in high risk populations may no longer be warranted. Additionally, the routine use of thyroid replacement in previously irradiated chemically hypothyroid patients is not recommended.30 references recommended.30 references

9

Multiple primary malignant neoplasms among atomic bomb survivors  

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Statistical observations for multiple primary malignant neoplasms (MPMN) were made on 94 autopsy cases including 23 A-bomb survivors exposed at ? 2,000 m (group 1), 32 exposed at > 2,000 m or entering the city after the bombing (group 2), and 39 non-exposed patients (group 3). The incidence of MPMN for men and women was highest in group 2 and in group 1, respectively. MPMN was the most common in the seventh and eighth decades. The average age was five-year older in men than in women. MPMN with leukemia and thyroid cancer had occurred in two young patients of group 1. Overall, the ratio of men to women was 1.4. The most common first primary was leukemia in group 1, lung cancer in group 2, and liver cancer in group 3; the second primary was thyroid cancer in groups 1 and 3, and gastric cancer in group 2. Multiple primaries tended to occur in association with cervical cancer, leukemia, and thyroid cancer in group 1, and with cancer of the stomach, colorectum, and lung in group 2. The common combination pattern was as follows: leukemia and thyroid cancer in group 1; lung cancer and gastric cancer in group 2; and gastric cancer and colorectal cancer or liver cancer and gastric and/or thyroid cancer in group 3. Autopsy-proven occult or early cancer accounted for 92 % of thyroid cancer, 50 % of endometrial cancer, and 38 % of prostatic cancer. (Namekawa, K.)

10

Primary malignant neoplasms of the lacrimal gland.  

OpenAIRE

The clinical characteristics and outcome of 50 primary malignant neoplasms of the lacrimal gland are reviewed: 38 (76%) adenoid cystic carcinomas, six (12%) carcinomas arising in pleomorphic adenoma, and six (12%) adenocarcinomas or other types of carcinoma. Most patients presented with a short history and pain, though pain tended to occur less often and later with adenocarcinoma than with adenoid cystic carcinoma. Pain was unrelated to the duration of symptoms, invasion of bone, loss of trig...

Wright, J. E.; Rose, G. E.; Garner, A.

1992-01-01

11

[Malignant gynecologic neoplasms during menopause. Authors' experience].  

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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. PMID:7478091

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

1995-06-01

12

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

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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

2010-09-01

13

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.)

14

Radiotherapy of malignant thyroid tumours  

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Radiotherapy of malignant thyroid tumours is usually secondary to surgical treatment. Operation should be as radical as possible but also be connected with as little risk as possible and take account of the possibility of radiotherapy. Radiotherapy here means radioiodine therapy as well as external radiotherapy. Radioiodine therapy is employed for local treatment of the thyroid with the objective of radical tumour destruction, either to destroy tumour foci or residues in apparently normal thyroid tissue or for complete elimination of the thyroid as metastases can be detected and treated reliably only after elimination of the thyroid. Radioiodine therapy is also used for the treatment of accumulating metastases; especially in small-focus lung metastases, it has a remittent or even a curative effect. Practical aspects of 131I-therapy are discussed, including radiation protection regulations and side-effects. Generally, external megavolt therapy with an intended curative effect on the primary tumour and the regional excretory ways is used in all types of tumour with the exception of differential thyreocyte carcinomas of stage T0sub(-)2N0M0 or in case of metastases distant from the primary tumour (M1). Palliative radiotherapy should be applied as early as possible in order to prevent pathological fractures, to give relief of pain, and to reduce local symptoms. Aspects of information and guidance of the patits of information and guidance of the patient and after-care are discussed. Results of the treatment and the prognosis of the patient are determined by the following factors: Histology, tumour stage, sex, age. The best prognosis is given for women under 40 with differentiated carcinoma and stage T0sub(-)2N0M0 (five-years survival rate 80%). Early detection, advances in surgery, radiotherapy and hormone therapy, and adherence to the above guidelines have improved the prognosis significantly. (orig./MG)

15

Malignant neoplasm rate in inhabitants of the Kozloduy NPP area  

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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

16

Malignant lymphoma and the thyroid gland  

International Nuclear Information System (INIS)

Among 4325 goiter patients first examined in the period from February 1980 to April 1982, 5 cases of lymphoma appearing primarily in the thyroid gland were discovered incidentally. During the same period 13 patients with anaplastic thyroid carcinoma were observed. 5 of 23 systematically examined patients who had already known extrahyroidal malignant non-Hodgkin's lymphomas and lymphoma patient examined by chance exhibited a secondary thyroid gland lymphoma, that is, a secondary infiltration of the enlarged thyroid. Altogether, 29 patients with malignant non-Hodgkin's lymphoma (Kiel classification) were examined. Of 8 Hodgkin's disease patients none showed clinical or cytological evidence of thyroid infiltration. The clinical symptoms of primary lymphoma of the thyroid gland corresponded to those of anaplastic thyroid carcinoma. A positive differential diagnosis of the two tumours succeeded cytologically. The secondary lymphoma of the thyroid also could only be diagnosed cytologically. Patients with Hodgkin's lymphoma and non-Hodgkin's lymphoma were always found to be euthyroid. Autoimmunological phenomena (antimicrosomal and antithyreoglobulin autoantibodies) as an indicator of lymphocytic thyroiditis could only be examined among 11 patients. Two patients with secondary lymphoma of the thyroid showed positive titers. A small cell anaplastic thyroid carcinoma could not be diagnosed in any of 37 patients with anaplastic thyroid cancer out of an enlarged patient collecticancer out of an enlarged patient collective (period under consideration: 1976-1982). (orig.)

17

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 mis 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

18

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

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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.

Dimitrios Hadjidakis

2012-01-01

19

Malignant neoplasms among atomic bomb survivors following radiation therapy  

International Nuclear Information System (INIS)

A second follow-up survey for radiation therapy exposure among a fixed cohort of A-bomb survivors originally numbering 20,000 persons identified 55 more who had received radiation therapy, and 7 more therapy-associated malignancies. In the previous and present investigations, 12 postirradiation malignancies were identified among 190 cohort members (6%) who received radiation therapy. This investigation underscored the necessity for documenting exposures to ionizing radiation for medical reasons, especially exposures incurring relatively high doses among persons at relatively high risk of developing neoplasms, such as A-bomb survivors, and in malignancy epidemiology to exclude bias in estimates of risk. (Auth.)

20

Salivary gland malignant neoplasms: treatment and prognosis  

International Nuclear Information System (INIS)

A retrospective analysis of 183 patients with malignant salivary gland tumors treated between 1955 and 1978 is presented. The analysis showed that radiation therapy lowered the recurrence rates after surgery and controlled approximately one-third of the inoperable tumors. A dose-response relationship exists and the data suggest that the radiation dose should not be less than that corresponding to a CRE-value of 1950 reu (70 Gy/7 weeks). Histology, location and clinical stage are important prognostic factors

21

Pediatric thyroid nodules and malignancy.  

Science.gov (United States)

Proper management of pediatric thyroid nodules is crucial to achieving good outcomes. It is important to obtain a thorough history, including prior radiation exposure and family history of thyroid cancer and any symptoms of hypothyroidism or hyperthyroidism. A complete physical examination with special attention to the thyroid gland and any cervical lymphadenopathy is important. Nodules between 5 and 10 mm with risk factors (clinical or sonographic) and all nodules greater than 10 mm should undergo a fine-needle aspiration biopsy. A comprehensive center of pediatric specialists is the best environment for treatment of these patients. PMID:25439549

Jatana, Kris R; Zimmerman, Donald

2015-02-01

22

Second Malignant Neoplasms and Cardiovascular Disease Following Radiotherapy  

OpenAIRE

Second malignant neoplasms (SMNs) and cardiovascular disease (CVD) are among the most serious and life-threatening late adverse effects experienced by the growing number of cancer survivors worldwide and are due in part to radiotherapy. The National Council on Radiation Protection and Measurements (NCRP) convened an expert scientific committee to critically and comprehensively review associations between radiotherapy and SMNs and CVD, taking into account radiobiology; genomics; treatment (ie,...

Travis, Lois B.; Ng, Andrea K.; Allan, James M.; Pui, Ching-hon; Kennedy, Ann R.; Xu, X. George; Purdy, James A.; Applegate, Kimberly; Yahalom, Joachim; Constine, Louis S.; Gilbert, Ethel S.; Boice, John D.

2012-01-01

23

Thyroid fine-needle aspiration cytology: Performance data of neoplastic and malignant cases as identified from 1558 responses in the ASCP Non-GYN Assessment program thyroid fine-needle performance data  

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BACKGROUND Fine-needle aspiration of the thyroid is a common procedure, with an established role in reducing unnecessary thyroid surgery and identifying neoplasms and malignancies. METHODS The study evaluated 1558 responses in the American Society for Clinical Pathology (ASCP) Non-GYN Assessment program of aspirates of thyroid neoplasms and malignancies and placed them into the following groups: group A (target or correct interpretation), group B (incorrect interpretation as a benign thyroid nodule), group C (incorrect interpretation malignant aspirate as thyroid neoplasm), and group D (malignant diagnosis with incorrect interpretation). In clinical practice, responses in groups A, C, and D would lead to surgical excision, whereas responses in group B would not. RESULTS Of a total of 1558 responses, 78.5% of the responses were in group A, 8.5% in group B, 3.75% in group C, and 9.25% in group D. By individual diagnosis, the group rates were 86.5%, 0%, 11%, and 2.5% for anaplastic thyroid carcinoma; 83%, 5.5%, 4.25%, and 7.25% for papillary thyroid carcinoma; 79%, 7%, 6%, and 8% for medullary thyroid carcinoma; 83.5% 6.75%, 0%, and 9.75% for Hürthle cell neoplasm; and 61%, 22%, 0%, and 17% for follicular neoplasm in groups A, B, C, and D respectively. CONCLUSIONS Fine-needle aspiration was effective in diagnosing thyroid neoplasms and malignancies and in separating thyroid nodules into surgical and nonsurgical categories. Data from a large group of cytology professionals showed good performance; however, there is room for improvement, especially in making specific diagnoses. In particular, follicular neoplasm and follicular variant of papillary thyroid carcinoma were challenging diagnoses for participants. Cancer (Cancer Cytopathol) 2014;122:745–750. © 2014 The Authors. Cancer Cytopathology published by Wiley Periodicals, Inc. on behalf of American Cancer Society. Data from 1558 responses in the American Society for Clinical Pathology Non-GYN Assessment program for thyroid fine-needle aspirates from thyroid neoplasms and malignancies were evaluated for the correct diagnostic interpretation as well as classifying the incorrect responses into treatment-based groups (nonsurgical benign thyroid nodule, thyroid neoplasm, or malignancy). Participants generally performed well, except for the entities of follicular neoplasm and follicular variant of papillary carcinoma, which were challenging diagnoses to program participants. PMID:24913410

Eilers, Stan G; LaPolice, Paula; Mukunyadzi, Perkins; Kapur, Umesh; Wendel Spiczka, Amy; Shah, Ajay; Saleh, Husain; Adeniran, Adebowale; Nunez, Amberly; Balachandran, Indra; Clark, Jennifer J; Lemon, Larry

2014-01-01

24

Atypia of undetermined significance on thyroid fine needle aspiration: surgical outcome and risk factors for malignancy  

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Purpose This study was performed to analyze the surgical pathology results of the "atypia of undetermined significance" (AUS) category from thyroid fine needle aspiration (FNA) and to describe the characteristics to distinguish a malignant from a benign nodule. Methods A retrospective analysis was done on 116 patients who underwent thyroid surgery from December 2008 to December 2012, following a diagnosis of AUS from preoperative thyroid FNA. We investigated the age, gender, size and site of the nodules, ultrasonographic criteria, cytological features, the number of atypia results after repeated FNAs, surgical method, and final pathologic results. Results Sixty-five out of 116 patients underwent total thyroidectomy and the rest had partial thyroidectomy. The final pathologic results were 41 malignancies (35.3%) and 75 benign diseases (64.7%). AUS was divided into group 1: 'cannot rule out malignancy' or group 2: 'cannot rule out follicular neoplasm'. After surgery, group 1 revealed papillary thyroid cancer in most cases and group 2 revealed follicular adenoma in most cases. Age over 40 years, ultrasonographic findings suggestive of malignancy, more than 2 results of atypia from repeated FNAs and nodules less than 2 centimeters were risk factors for malignancy on univariate analysis. Multivariate analysis showed that ultrasonographic findings suggestive of malignancy was a significant risk factor for malignancy. Conclusion For proper evaluation of the risk for malignancy in thyroid AUS patients, the ultrasonographic criteria should be considered along with other clinicopathological findings such as age, nodule size, number of atypia, cytologic features. PMID:24761418

Ryu, Young Jae; Jung, Youn Seung; Yoon, Hyun Chul; Hwang, Min Jung; Shin, Sun Hyoung; Cho, Jin Seong; Lee, Ji Shin; Kim, Hee Kyung; Kang, Ho Cheol; Lim, Hyo Soon; Yoon, Jung Han

2014-01-01

25

External irradiation for malignant thyroid tumors  

International Nuclear Information System (INIS)

Thirty-eight patients with residual or recurrent primary thyroid cancers which did not take up I-131 were treated with external beam irradiation. Excluding 5 patients with malignant lymphoma, there were 23 patients with local disease and 10 with distant metastases. Doses ranged from 3500 to 7000 rads (35 to 70 Gy) among the 23 with local disease; local tumor control was achieved in 8. Six are alive and well 2 to 11 years later. External beam irradiation should be considered in locally advanced, incompletely resected, recurrent and metastatic thyroid malignancies of all histological types without I-131 uptake. Reviewed are the age and sex distribution, histology, stage, extent of surgery, and dose and radiotherapy technique as they affect survival and patterns of failure

26

Dupuytren’s disease and the risk of malignant neoplasms  

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The object of this study was the investigation of the risk of occurrence of malignant neoplasms in 508 patients with Dupuytren’s disease (DD) and in 2157 of their 1st degree relatives. In the first stage of the study, we evaluated the tumour spectrum as well as the age of the patient at diagnosis of cancers in DD families along with the observed and expected frequencies of malignancies. In the second stage of the study, we examined the distribution of 20 common mutations/polymorphisms in 12 known cancer susceptibility genes among DD patients and 508 matched healthy controls. No such study has been published to date. Results. No significant differences were noted between malignancies diagnosed among members of DD families and the general population. Molecular examination of 20 mutations/polymorphisms in 12 cancer susceptibility genes in Dupuytren’s patients and controls showed a statistically significant association of one mutation with Dupuytren disease: D312M in XPD (OR?=?1.75, p?=?0.004). We observed a tendency toward changed frequencies of occurrence of central nervous system tumors, laryngeal cancer and non-melanoma skin cancers in DD families. The results of our study indicate a lack of a strong association between Dupuytren disease and familial cancer risk. PMID:24598251

2014-01-01

27

Malignant lymphoma of the thyroid gland  

International Nuclear Information System (INIS)

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

28

Thyroidal malignancy and scintigraphy; Schilddrsenmalignitaet und Szintigrafie  

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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

29

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

International Nuclear Information System (INIS)

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 essentialionable lesion is essential

30

Meningioma as second malignant neoplasm after oncological treatment during childhood  

International Nuclear Information System (INIS)

A total of 38 patients (18 female/20 male) with childhood meningioma were recruited from the German registry HIT-Endo (1989-2009). In 5 cases meningioma occurred as second malignant neoplasm (SMN). Histologies were confirmed by reference assessment in all cases (SMN: 2 WHO I, 1 WHO II, 2 WHO III). The SMNs were diagnosed at a median age of 12.4 years with a median latency of 10.2 years after primary malignancy (PMN; 4 brain tumors, 1 lymphoblastic leukemia; median age at diagnosis 2.7 years). Meningioma occurred as SMN in the irradiated field of PMN (range 12-54 Gy). The outcome after treatment of SMN meningioma (surgery/irradiation) was favorable in terms of psychosocial status and functional capacity in 4 of 5 patients (1 death). We conclude that survivors of childhood cancer who were exposed to radiation therapy at young age harbor the risk of developing meningioma as a SMN at a particularly short latency period in case of high dose exposure. (orig.)

31

Case report: study of a beagle with a malignant ectopic thyroid tumor  

International Nuclear Information System (INIS)

A Segment III beagle was noted clinically to have cervical edema and muffled heart sounds. Radiographically, masses were found at the base of the heart and throughout the lung field. An electrocardiogram revealed right bundle branch blockage. An echocardiogram demonstrated thickening of the left ventricle and conduction disturbances in the heart which could not be visualized by conventional diagnostic techniques. At necropsy, a neoplasm was found at the base of the heart that had extended into the pulmonary artery, right atria-auricle, interatrial septum, dorsal interventricular septum, and between the pericardium and epicardium over the surface of the right and left ventricles. The location of the tumor masses accounted for the clinical signs and the abnormalities in the electrocardiogram and echocardiogram. Light and electron microscopic examination of the neoplasm at the base of the heart and metastatic neoplasms in the lungs, kidney, and pancreas established a diagnosis of malignant ectopic thyroid tumor

32

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 aon 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)

33

Isolated Thyroid Metastasis of Malignant Melanoma with Unknown Primary Origin  

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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

2008-12-01

34

Chronomodulation as a method to increase the efficiency of chemoradiotherapy of malignant neoplasms  

International Nuclear Information System (INIS)

It was shown a using of chronotherapeutic methods to conduct antitumoral treatment of malignant neoplasms is effective means to decrease toxicity. It gives possibility to carry out a program of chemo- and radiotherapy or their combination in corpore

35

Ultrasonographic examinations of the thyroid gland in women at confirmed risk of familial neoplasm  

International Nuclear Information System (INIS)

Detection of new gene mutations, which increase the risk of neoplasm (e.g. breast and thyroid gland) improves the examinations that can help in early diagnosis and quick treatment. The aim of this study was to assess the frequency of asymptomatic focal lesions in ultrasonographic examinations of women at confirmed risk of family neoplasm aggregation. A total of 445 women aged 25-60 years were examined in 2004-2005. 278 patients descended from families with higher frequency of confirmed risk of familial neoplasm (I group), 167 belonged to the control group. Ultrasonographic examinations of the breast and thyroid gland were performed in all women. Patients were divided into selected groups depending on the kind of changes. In the analyzed material asymptomatic focal changes in the thyroid gland were found in 46, 5% of the first group and 61,6% of the control group. The solid-cystic lesions in this material were ascertained in 36% of the first group and 51% of the second group. A large frequency (almost 50%) of the asymptomatic focal changes in thyroid glands were found. Detections of lesions were similar in both groups: the confirmed risk of familial neoplasm group and the control group. On the basis of these findings we can conclude, that it is reasonable to perform screening examinations of thyroid glands in connection with breast's diagnostics. (author)

36

Spatio-temporal models for incidence of malignant neoplasms in the area subjected to radioactive contamination after the Chernobyl accident  

International Nuclear Information System (INIS)

Data from oncology studies performed in the Ukraine, Belarus, and Russia on the number of new patients with cancer (including leukemia) from 1980 through 1990 in 12 regions adjacent to the Chernobyl nuclear power plant are summarized in this paper. Spatio-temporal models for determining the incidence of malignant diseases in the population were developed. The analysis of possible correlations between dose equivalents and incidence of cancer in populations living in the contaminated areas were performed. The incidence of malignant neoplasms, including hemoblastoses, was found to be trending upward during both the pre- and post-accident periods, and the increases were not related to radiation dose. There have been no statistically significant increases in incidences of any tumors (with the possible exception of thyroid tumors), attributable to radiation doses, even in the most contaminated open-quotes controlled areaclose quotes (CA). Three cases of thyroid cancer in 1990 in children living in areas where considerable amounts of radioactive iodine were deposited suggests that the absorbed doses from the intake of radioiodine may have resulted in an increased incidence of thyroid cancers. However, this and other conclusions of the study are necessarily limited by the fact that this is an ecological study with no data on individual cancer cases, and the limited follow-up period of the results of the study signify the need for thorough epidemiological studies based on the ough epidemiological studies based on the study of individuals. 3 refs., 17 figs., 6 tabs

37

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

OpenAIRE

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 t...

Ti?han, Tar?k; Gu?lteki?n, Hu?mayun; C?omunog?lu, Nil

2010-01-01

38

Interphase ribosomal RNA cistron staining in thyroid epithelial cells in Grave's disease, Hashimoto's thyroiditis and benign and malignant tumours of the thyroid gland  

OpenAIRE

Aim—To evaluate the expression of ribosomal cistrons in human thyroid epithelial cells (TECs) of patients with Grave's disease, Hashimoto's thyroiditis and benign and malignant tumours of the thyroid gland.

Mamaev, N. N.; Grynyeva, E. N.; Blagosklonnaya, Y. V.

1996-01-01

39

The diagnostic utility of combination of HMGA2 and IMP3 qRT-PCR testing in thyroid neoplasms.  

Science.gov (United States)

The diagnosis of malignant thyroid tumors in some cytologic and histologic specimens remains challenging. High-mobility group A2 (HMGA2) expression and insulin-like growth factor II mRNA-binding protein-3 (IMP3) expression were evaluated by relative quantitative reverse transcription-polymerase chain reaction (qRT-PCR). The aim of this study was to evaluate whether the combination of HMGA2 and IMP3 qRT-PCR was diagnostically useful in differentiating benign from malignant thyroid neoplasms. Fine-needle aspiration (FNA) specimens from 120 patients including 56 benign lesions and 64 carcinomas were used. The available 80 corresponding formalin-fixed paraffin-embedded (FFPE) thyroid tissues from 66 patients were also included in this study. HMGA2 and IMP3 expression levels were detected by qRT-PCR and reported as relative fold change after normalizing with a calibrator. The diagnostic utilities of HMGA2 and IMP3 qRT-PCR tests were evaluated individually and in combination. In FNA specimens, HMGA2 and IMP3 expression was consistently higher in thyroid malignancies compared with benign lesions in all subgroups except in Hürthle cell tumors. After exclusion of Hürthle cell tumors, the sensitivity was 90.2% for HMGA2, 88.2% for IMP3, and 98% for HMGA2+IMP3; the specificity was 97.1% for HMGA2, 79.4% for IMP3, and 79.4% for HMGA+IMP3. qRT-PCR data showed similar results in FFPE tissues: the sensitivity was 84.2% for HMGA2, 85.7% for IMP3, and 94.7% for HMGA2+IMP3; the specificity was 96.9% for HMGA2, 91.2% for IMP3, and 90.6% for HMGA2+IMP3. qRT-PCR data were concordant between FNA and FFPE samples for HMGA2 (97.4%) and IMP3 (96.9%). The results indicate that HMGA2 qRT-PCR with high specificity may be a useful ancillary technique to assist in the classification of difficult thyroid specimens, excluding Hürthle cell tumors. The HMGA2 and IMP3 qRT-PCR combination model with increased sensitivity and negative predictive value (96.4%) may be useful in screening thyroid cytology specimens. PMID:25356939

Jin, Long; Lloyd, Ricardo V; Henry, Michael R; Erickson, Lori A; Sebo, Thomas J; Rumilla, Kandelaria M; Zhang, Jun

2015-01-01

40

Manifestation of hepatic malignant neoplasm on static Gd-BOPTA enhanced MR imaging  

International Nuclear Information System (INIS)

Objective: To study the manifestation of hepatic malignant neoplasm on static Gd-BOPTA enhanced MR imaging, which supports the diagnosis of hepatic malignant neoplasm using Gd-BOPTA enhanced MR imaging. Methods: In total 29 lesions of hepatic malignant neoplasm underwent both non-enhanced MR imaging and Gd-BOPTA enhanced MR imaging. The images were divided into non-enhanced and static groups. The number, margin, signal intensity of lesions and bile duct system manifestations obtained in the delayed enhanced scan were analyzed respectively. Results: All the marginal area of lesions was clear and sharp. The lesions were enhanced while their signal intensity were lower than that of adjacent liver. On static phase all the extra-hepatic bile passages and the first class branches of intratiepatic bile ducts were well enhanced. Conclusion: In static Gd-BOPTA enhancd MR imaging boundaries of neoplasm lesions were clear and sharp, with a lower signal intensity than liver. This feature may support the diagnosis of hepatic malignant neoplasm using Gd-BOPTA enhanced MR imaging. (authors)

41

Radioiodine treatment for malignant thyroid disease  

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Radioiodine treatment for thyroid disease has been given for half a decade in Sweden. The most common indication for treatment is hyperthyroidism, when iodine uptake is high. The situation in which radioiodine treatment is used in thyroid cancer is less favourable and measures therefore have to be taken to optimize the treatment. Treatment should be performed early in the course of the disease to achieve the highest possible differentiation. Before treatment the iodine and goitrogen intake should be kept low. Stimulation of the thyrocytes by thyroid-stimulating hormone (TSH) should be high. It is conventionally achieved by thyroid hormone withdrawal rendering the patient hypothyroid, or by the recently available recombinant human TSH (rhTSH) which can be recommended for ablation of the thyroid remnant after thyroidectomy and for treatment of metastases in fragile patients unable to undergo hypothyroidism. Finally, stunning - the negative effect of a prior test dose from radioactive iodine - should be avoided.

Berg, Gertrud [Sahlgrenska Univ. Hospital, Goeteborg (Sweden). Dept. of Oncology

2006-12-15

42

Malignant Melanoma of Unknown Primary Site Simulating A Salivary Gland Neoplasm  

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Full Text Available Malignant melanoma with its varied clinical presentations and histomorphological patterns is a perplexing problem both for the diagnosticians and clinicians. A small proportion of melanomas present with metastatic tumors with unknown primary sites and at these sites they mimic the more common primary neoplasms. We hereby report a case of malignant melanoma presenting as a submandibular lump in a 40 year old female. This lump was present for six months and was rapidly increasing in size. On cytology it was diagnosed as salivary gland neoplasm.

Kiran AGARWAL

2011-01-01

43

Malignant Nonfunctioning Neuroendocrine Neoplasm of the Pancreas in a 10-Year-Old Child.  

Science.gov (United States)

Malignant neoplasms of the pancreas are extremely rare in children and only represent a small percentage of pediatric cancer-related deaths. The paucity of cases reported in the literature, in addition to the lack of understanding of biologic behavior, has led to a lack of consensus concerning optimal management strategy. Presentation differs compared to adult counterparts and generally prognosis is improved even when lymph node metastases occur. Here we review the literature and report the case of a 10-year-old autistic female with a malignant nonfunctioning pancreatic endocrine neoplasm of the head of the pancreas successfully extirpated via pancreaticoduodenectomy. PMID:20651972

Marwan, Ahmed; Christein, John D

2009-01-01

44

Radionuclide therapy in the treatment of thyroid malignancy  

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Full Text Available In this paper we presented the principles of performance of radionuclide therapy, its adverse effect, together with mentioned complications obligation to use it only according to directions and the success of the therapy, which is seen through the length of a patient's survival rate. All types of thyroid malignancies are primary cured surgically, by the total or near-total thyreoidectomy, together with lymph node dissection of the neck and with a long-term suppressive- therapy or only substitutive L-thyroxin therapy. Radionuclide therapy is used only for the types of thyroid malignancies where a radionuclide was detected, beta emitter which is distinguished by its selective entering into the primary tumor and metastatic tissue. This therapy is used for patients with differentiated papillary and follicular thyroid carcinoma (DTC and patients with medullary thyroid carcinoma (MTC. By the means of 131-I we additionally cure patients with DTC, by MIBG-131-I we treat patients with MTC, but we also try to cure this malignancy by the specific monoclonal antibodies, marked by 131-I or 90-Y, which is still a part of clinical trial studies. It is very likely that the radioimmune therapy will be the means of cure for malignant thyroid lymphoma (MLT, since this therapy is successful in healing the lymphomas in other locations.

Maleševi? Milica ?.

2003-01-01

45

Triple primary malignant neoplasms including breast, esophagus and base tongue in an elderly male: A case report.  

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Cases involving more than two primary malignant neoplasms are very rare. The present article reports a case of multiple primary malignant neoplasms including esophagus initially followed by right breast and later base of tongue in an elderly male patient, which is extremely a rare combination. PMID:25579565

Rastogi, Madhup; Singh, Sharad; Singh, Sudhir; Gupta, Seema; Dwivedi, Raghav C

2014-01-01

46

Follicular neoplasm of the thyroid gland: unique cytologic appearances in a fine-needle aspiration biopsy.  

Science.gov (United States)

Fine-needle aspiration (FNA) biopsy has become a standard first-line diagnostic procedure for palpable and nonpalpable nodules of the thyroid gland. Six cytologic diagnostic categories have recently been proposed to unify the terminology that is linked to proper clinical management. We report a case of follicular neoplasm diagnosed on FNA specimen that had a very artistic appearance of the microfollicle formation on both Diff-Quik and Papanicolaou-stained slides. PMID:19950399

Gu, Mai; Ghafari, Zahra

2010-09-01

47

Second malignant neoplasms after childhood cancer: a report of three cases of osteogenic sarcoma  

Energy Technology Data Exchange (ETDEWEB)

The rising incidence of second malignant neoplasms after childhood cancer, whilst due in part to increasing numbers of survivors, is also thought to be related to increasingly more intensive combined modality treatment schedules. Three illustrative cases are reported in which radiation therapy in childhood for the first cancer is thought to have been a significant aetiological factor in the pathogenesis of the second malignancy (which in all three patients was an osteogenic sarcoma).

Ironside, J.A.D.

1987-03-01

48

Second malignant neoplasms after childhood cancer: a report of three cases of osteogenic sarcoma  

International Nuclear Information System (INIS)

The rising incidence of second malignant neoplasms after childhood cancer, whilst due in part to increasing numbers of survivors, is also thought to be related to increasingly more intensive combined modality treatment schedules. Three illustrative cases are reported in which radiation therapy in childhood for the first cancer is thought to have been a significant aetiological factor in the pathogenesis of the second malignancy (which in all three patients was an osteogenic sarcoma). (author)

49

Serum levels of sex hormones and expression of their receptors in thyroid tissue in female patients with various types of thyroid neoplasms.  

Science.gov (United States)

Previous studies have demonstrated the expression of estrogen receptor (ER) and progesterone receptor (PR) in thyroid cancer; however, little is known regarding the levels of estrogen, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) in serum and the expression of ER, PR, FSH receptor (FSHR), and LH receptor (LHR) in thyroid tissues of patients with different types of thyroid neoplasms. Serum levels of estrogen, progesterone, FSH, and LH were measured by chemiluminescence, and expression of ER, PR, FSHR, and LHR in thyroid tissue was detected by immunohistochemistry in female patients with thyroid adenoma (n = 70), nodular goiter (n = 73), thyroid papillary cancer (n = 149), poorly differentiated thyroid carcinoma (n = 12), or undifferentiated thyroid carcinoma (n = 8) and in normal controls (n = 60). The positive rates of serum estrogen level and ER? expression were significantly greater in patients with various types of thyroid neoplasms than in normal controls. The positive rates of ER? expression were significantly less in various types of thyroid neoplasms than in normal thyroid tissues, especially in poorly differentiated carcinoma and undifferentiated carcinoma. The negative rates of serum progesterone level and positive rates of PR expression in thyroid tissue were significantly greater in patients with thyroid adenoma, nodular goiter, or thyroid papillary cancer than in normal controls. The positive rates of serum FSH and LH levels and FSHR and LHR expression were significantly greater in the thyroid adenoma group than in other groups. Our findings suggest that thyroid neoplasms might be sex hormone-dependent. The positive expression of ER? and PR often indicates thyroid papillary carcinoma, and the ER? expression status is important for the diagnosis of poorly differentiated carcinoma and undifferentiated carcinoma. In addition, thyroid adenoma is often accompanied by an increase in serum FSH and LH levels, as well as FSHR and LHR expression. Thus, the combined detection of serum levels of sex hormones and expression of their receptors allows for a differential diagnosis and evaluation of the degree of differentiation among various types of thyroid neoplasms. PMID:25305147

Liu, Jia; Chen, Guang; Meng, Xian-Ying; Liu, Zhong-Hui; Dong, Su

2014-12-01

50

Immunohistochemical expression of EGF-R in malignant surface epithelial ovarian neoplasms (SEON).  

Science.gov (United States)

EGF-R expression was found to be increased in 40% of malignant epithelial ovarian neoplasms by an immunohistochemical method. No correlation was found between EGF-R expression and clinical stage. There was a suggestion of reduced survival among tumours with positive EGF-R expression. PMID:8206065

Janinis, J; Nakopoulou, L; Panagos, G; Davaris, P

1994-01-01

51

Thyroid and other neoplasms following childhood scalp irradiation  

International Nuclear Information System (INIS)

In 1968, a comprehensive investigation of the long-term health effects of childhood scalp irradiation treatment for tinea capitis (ringworm of the scalp) was undertaken in Israel. Topics studied included cancer incidence, mortality, mental disorders, scholastic aptitude and achievement, and measures of central nervous system (CNS) function. A second follow-up of cancer incidence and incidence of benign tumors of selected sites is now in progress, using the Israel Cancer Registry, hospital pathology records, and discharge summaries as the main data sources. Because data from the first follow-up demonstrated a significantly elevated risk of cancer of the thyroid and brain but only a slight nonsignificant excess of leukemia, these three sites were chosen for early analysis. This paper presents preliminary data for these selected sites, based on the information available from the Cancer Registry between 1950 and 1978

52

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

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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 < 0.0001) and more prominent in benign than in malignant lesions. 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. The cystic change was evaluated to be a useful sign in the diagnostic differentiation of benign from malignant thyroid lesions, although the size of the lesion must also be taken into account

Lee, Sang Kwon; Kwon, Sun Young; Woo, Seong Ku [Keimyung University Dongsan Medical Center, College of Medicine, Daegu (Korea, Republic of)

2007-03-15

53

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 w 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 < 0.0001) and more prominent in benign than in malignant lesions. 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. The cystic change was evaluated to be a useful sign in the diagnostic differentiation of benign from malignant thyroid lesions, although the size of the lesion must also be taken into account

54

An epidemiologic study of thyroid malignancies - impact of ionizing radiation  

International Nuclear Information System (INIS)

Presented are the design and the first results of a case-control epidemiological study of thyroid malignancies. The cases are patients with the most common radiation-related histological type - differentiated papillar or follicular carcinomas, diagnosed after 1991. Sex and age corresponding controls are patients from different hospitals having no thyroid or oncological diseases. The estimations of individual doses from medical and occupational irradiation as well from the Chernobyl accident are based on data from inquiries and information available in the National Centre of Radiobiology and Radiation Protection, Sofia. Provided is a comparison of the radiation factors with non-radiation agents as goitrogens and chemicals. (author)

55

Role of indium-111 labelled platelet scintigraphy in the management of thrombocytopenic patients with malignant neoplasms  

International Nuclear Information System (INIS)

This study was done to investigate the role of indium-111 labelled platelet scintigraphy in the treatment of thrombocytopenia in patients with malignant neoplasms. The study involved 20 consecutive patients with thrombocytopenia associated with malignant neoplasms or hematological disorders and without evidence of underproduction of megakaryocytes due to chemotherapy or bone marrow infiltration by the malignancy. Splenic sequestration of platelets was evaluated by measuring spenic uptake of 111In-labelled platelets, and findings were correlated with the outcome of splenectomy and medication. Of the 20 patients, 13 had splenic sequestration of platelets. Seven of the 13 patients underwent splenectomy; six of these seven patients experienced a complete response. The other six patients received medication only and showed no response. Of the seven patients without splenic sequestration of platelets, five received medication, and four of them responded to it. 111In-labelled platelet scintigraphy has a role in selecting appropriate therapy and predicting its efficacy in patients with thrombocytopenia associated with malignant neoplasms. (orig.)

56

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<0.001) and spiculated or microlobulated margin (58.3%, p 0.003) were significantly associated with malignancy. In terms of internal solid portion of the nodule, eccentric configuration (68.0%, p<0.001), non-smooth margin (81.3%, p<0.001), hypoechogenecity (30.0%, p<0.042), and microcalcification (89.5%, p<0.001) were more frequently demonstrated in malignant nodules than benign ones. In partially cystic thyroid nodules, understanding the characteristics of US findings is important to make a precise diagnosis of malignant nodules.

57

Malignant neoplasms on the territories of Russia damaged owing to the Chernobyl accident  

International Nuclear Information System (INIS)

The work presents the results of descriptive analysis of development of onco epidemiological situation in six of the most polluted regions owing to the Chernobyl accident in 1981-1994. The growth of malignancies incidence is marked in all territories as well as in the Russian Federation as a whole. The most adverse tendencies have been revealed in the Bryansk, Orel, Ryazan regions. It is marked that the formation of a structure, levels and trends of the malignancies incidence has been occurring under influence of a complex of factors usual up to the accident. The analysis of the data from the specialized cancer-register evidences that the incidence of thyroid malignancies is actively growing in the population of the Bryansk region. The probability of connection of growth of the thyroid cancer incidence in children of the Bryansk region with the Chernobyl accident is reasonably high, but should be confirmed through the application of methods of analytical epidemiology

58

Benign vs malignant soft tissue neoplasms: Limitations of magnetic resonance imaging  

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Full Text Available Aims: Various features have been described in the literature to differentiate benign from malignant lesions. The aim of the present study was to study the accuracy of each of these features and that of magnetic resonance imaging (MRI in diagnosing malignant lesions. Materials and Methods: Fifty-five consecutive patients presenting with neoplastic (both benign and malignant lesions diagnosed clinically and on ultrasound were studied and their MRI features were compared with the findings on surgical exploration and histopathologic examination. Results: There were 32 (58% benign and 23 (42% malignant masses. Malignant masses were more common in patients older than 20 years (83%, and these had symptoms of less than 6 months duration (75%, as against benign lesions. The swelling was painful in 8 malignant masses and these were more common in the upper limbs (61%. Various features of malignant lesions were size more than 5 cm in 83%, change in signal intensity from homogenous on T1-weighted images to heterogenous on T2-weighted images in 74%, irregular margins in 74%, and heterogenous contrast enhancement in 91%. The accuracy of these features was 76%, 58%, 78%, and 60%, respectively. Most benign and malignant lesions were intramuscular in location. A significant number (38% of benign lesions were located in the intermuscular facial plane. Definitive diagnosis was made in 42% of the lesions. Conclusions: MRI is an excellent modality for evaluating soft tissue neoplasms; however, prediction of a specific diagnosis and differentiation of malignant and benign lesions is not always possible.

Sen J

2010-01-01

59

Malignant pleuropulmonary epithelioid hemangioendothelioma - unusual presentation of an aggressive angiogenic neoplasm.  

Science.gov (United States)

Epithelioid hemangioendothelioma (EHE) of the lung and pleura are rare tumors. Primary pleural EHE are associated with aggressive behavior and poor clinical outcome. Recent advances in EHE include the development of immunohistochemical markers of vascular differentiation, namely Fli-1, and the identification of a specific chromosomal translocation (t(1;3)(p36;q25)). We present a 19 year old male patient with a rapidly progressive malignant neoplasm that presented as a multinodular lung parenchymal process, with associated pleural effusion and thickening. Pathologic examination revealed a pleuropulmonary neoplasm with cytologic features including round to oval epithelioid cells with frequent cytoplasmic vacuoles. Immunohistochemistry confirmed vascular differentiation of tumor cells (CD34, CD31 and Fli-1 positive). While the cytologic features were suggestive of EHE, the aggressive nature of the neoplasm, with disseminated pleuropulmonary involvement, raised the question of whether the neoplasm should be classified as EHE or epithelioid angiosarcoma. Here, we review the clinicopathologic characteristics of pleuropulmonary EHE and the overlap between malignant EHE and angiosarcoma. PMID:24939148

Mucientes, Pablo; Gomez-Arellano, Luisa; Rao, Nagarjun

2014-09-01

60

Ectopic production of the beta subunit of human chorionic gonadotrophin by malignant ovarian neoplasms  

International Nuclear Information System (INIS)

A sensitive and specific radio-immunoassay for the beta subunit of human chorionic gonadotrophin(?-HCG) was performed on serum samples from 18 patients with large pelvic masses. No ?-HCG level was detectable in 8 patients with either benign ovarian tumours or non-ovarian masses. Ten patients had a malignant ovarian neoplasm, and 6 of these (60%) had raised ?-HCG levels. Cystadenocarcinoma of the ovary was the commonest malignant tumour (6/10) and the ?-HCG was raised in 4 patients (66,6%) with this tumour. Serum ?-HCG values therefore appear to be useful in the management of ovarian neoplasms, both for the early diagnosis of occult tumour and for monitoring response to treatment

61

Malignant Nonfunctioning Neuroendocrine Neoplasm of the Pancreas in a 10-Year-Old Child  

OpenAIRE

Malignant neoplasms of the pancreas are extremely rare in children and only represent a small percentage of pediatric cancer-related deaths. The paucity of cases reported in the literature, in addition to the lack of understanding of biologic behavior, has led to a lack of consensus concerning optimal management strategy. Presentation differs compared to adult counterparts and generally prognosis is improved even when lymph node metastases occur. Here we review the literature and report the c...

Marwan, Ahmed; Christein, John D.

2009-01-01

62

Application of laparoscopic pelvic lymphadenectomy assisted radical vaginal hysterectomy(LARVH) for malignant uterine neoplasm  

OpenAIRE

Objective To assess the feasibility and therapeutic efficacy of radical vaginal pan-hysterectomy or sub-total hysterectomy assisted by laparoscopic pelvic lymphadenectomy for malignant uterine neoplasm.Methods During the period of Oct.2006 to April 2010,radical vaginal pan-hysterectomy or sub-total hysterectomy assisted by laparoscopic pelvic lymphadenectomy were performed in 38 patients with cervical cancers and 6 patients with endometrial cancers.The intra-and post-operative data and follow...

Chen, Li; Zhao, En-feng; Li, Wei-ping; Zhou, Ning; Peng, Hong-mei; Liu, Hui

2011-01-01

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Long-term risk of second malignant neoplasm after a cancer in childhood.  

OpenAIRE

The risk of subsequent second malignant neoplasm was studied in a cohort of 634 patients, treated for a childhood cancer at the Gustave Roussy Institute between 1942 and 1969, and in complete remission five years after diagnosis. The most frequent types of first primary cancers (FPC) were Wilms' tumours (28% of the children), neuroblastomas (16%), lymphomas (12%) and soft tissue sarcomas (11%). Median follow-up duration after FPC was 19 years. Thirty-two patients (obs = 32) developed a total ...

Vathaire, F.; Schweisguth, O.; Rodary, C.; Frana?§ois, P.; Sarrazin, D.; Oberlin, O.; Hill, C.; Raquin, M. A.; Dutreix, A.; Flamant, R.

1989-01-01

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Immunoglobulin and T-cell receptor gene rearrangement analysis in malignant lymphoid neoplasms.  

OpenAIRE

Gene rearrangement analysis using Southern-blot hybridization technique is a standard method for evaluating clonal receptor gene rearrangement. Both clonality and lineage can be identified in lymphoid neoplasms by the demonstration of one or more rearranged antigen receptor genes of the immunoglobulin supergene family-immunoglobulin and T-cell receptor genes. To evaluate the diagnostic applicability of antigen receptor gene rearrangements in the diagnosis of malignant lymphomas and leukemias,...

Park, C. K.; Kim, C. W.; Kim, I. S.; Lee, J. D.

1994-01-01

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Patología maligna tiroidea. Hospital Sabogal, Callao / Malignant thyroid pathology. Callao, Sabogal Hospital  

Scientific Electronic Library Online (English)

Full Text Available SciELO Peru | Language: Spanish Abstract in spanish Objetivos: Determinar las características clínicas del cáncer de tiroides encontrados en la población del Callao. Diseño: Estudio descriptivo retrospectivo. Material y Métodos: Se revisó las historias clínicas de las intervenciones quirúrgicas de la glándula tiroides en el Hospital Nacional Alberto [...] Sabogal Sologuren (HNASS), en el periodo enero de 2000 a diciembre de 2002, cuyo resultado por anatomía patológica fue compatible con neoplasia maligna de dicha glándula. Resultados: Las 45 neoplasias malignas primarias de tiroides encontradas representaron 34,2% de la patología tiroidea operada en el periodo en estudio. El carcinoma papilar se presentó en 100% de los pacientes de sexo masculino y en 82% del sexo femenino; en la mujer, los carcinomas folicular, medular y linfoma representaron 10,3%, 5,1% y 2,6%, respectivamente. El grupo etáreo con mayor incidencia fue entre 50 y 69 años, con una edad promedio de 53 años. Dentro de los diferentes tipos de neoplasias malignas, el más frecuente fue el papilar con 38 casos (84,4%), seguido de los carcinomas folicular y medular con 8,9% y 4,4%, respectivamente. El síntoma más frecuente fue el aumento de volumen (61,5%), seguido de dolor (15,4%), disfagia (10,8%) y disfonía (9,2%); 29,6% se encontraba en estadio I y 59,1% en estadio II; sólo 11,4% estaba en estadio III. Conclusiones: El predominio de casos en mujeres del carcinoma papilar y la clínica asociada, fueron acordes con lo descrito en la literatura. Abstract in english Objective: To determine the clinical characteristics of thyroid cancer at Callao’s population. Design: Descriptive and retrospective study. Material y Methods: Clinical histories and surgical reports that involved the thyroid gland were reviewed. The pathology result had to be compatible with primar [...] y thyroid malignant neoplasm. The study was performed at the Alberto Sabogal Sologuren National Hospital (HNASS) during the period January 2000 through December 2002. Results: Forty-five thyroid malignant neoplasms were identified representing 34,2% of all thyroid neoplasms operated during the period studied. In males papillary carcinoma was present in 100% of cases and in females in 82,1%, followed by both follicular and medullar carcinoma and lymphoma, in 10,2%, 5,1% and 2,6%, respectively. Major incidence was in the 50 to 69 years group, average 53 years. The most frequent malignant neoplasms were papillary carcinoma with 38 cases (84,4%), follicular and medullary carcinoma with 8,9% and 4,4%, respectively. Most frequent symptoms were growing tumor (61,5%), local pain (15,4%), dysphagia (10,8%) and dysphonia (9,2%); 29,6% of cases were on stage I, 59,1% on stage II, and only 11,4% on stage III. Conclusions: Papillary carcinoma occurred mainly in women and clinical features were as described in the literature.

Juan, Oré; Marco, Otárola.

2004-03-01

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Benign and Malignant Nodular Thyroid Disease in Acromegaly. Is a Routine Thyroid Ultrasound Evaluation Advisable?  

Science.gov (United States)

Data on the prevalence of benign and malignant nodular thyroid disease in patients with acromegaly is a matter of debate. In the last decade an increasing incidence of thyroid cancer has been reported. The aim of this study was to evaluate the prevalence of goiter, thyroid nodules and thyroid cancer in a large series of patients with acromegaly with a cross-sectional study with a control group. Six Spanish university hospitals participated. One hundred and twenty three patients (50% men; mean age 59±13 years; disease duration 6.7±7.2 years) and 50 controls (51% males, mean age 58±15 years) were studied. All participants underwent thyroid ultrasound and fine needle aspiration. Cytological analysis was performed in suspicious nodules between 0.5 and 1.0 cm and in all nodules greater than 1.0 cm. Goiter was more frequently found in patients than in controls (24.9 vs. 8.3%, respectively; p<0.001). Nodular thyroid disease as well as nodules greater than 1 cm were also more prevalent in acromegalic patients (64.6%, vs. 28.6%, p<0.05 and 53.3 vs. 28.6%, respectively; p<0.05), and all underwent fine needle aspiration. Suspicious cytology was detected in 4 patients and in none of the controls. After thyroidectomy, papillary thyroid carcinoma was confirmed in two cases (3.3% of patients with thyroid nodules), representing 1.6% of the entire group of patients with acromegaly (2.4% including a case with previously diagnosed papillary thyroid carcinoma). These data indicated that thyroid nodular disease and cancer are increased in acromegaly, thus justifying its routine ultrasound screening. PMID:25127456

Reverter, Jordi L.; Fajardo, Carmen; Resmini, Eugenia; Salinas, Isabel; Mora, Mireia; Llatjós, Mariona; Sesmilo, Gemma; Rius, Ferran; Halperin, Irene; Webb, Susan M.; Ricart, Veronica; Riesgo, Pedro; Mauricio, Dídac; Puig-Domingo, Manel

2014-01-01

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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

2010-01-01

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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

2012-09-01

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"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

2005-05-01

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Microarray Analysis of Thyroid Nodule Fine-Needle Aspirates Accurately Classifies Benign and Malignant Lesions  

OpenAIRE

Current preoperative diagnostic procedures for thyroid nodules rely mainly on the cytological interpretation of fine-needle aspirates (FNAs). DNA microarray analysis has been shown to reliably distinguish benign and malignant thyroid nodules in surgically resected specimens, but its diagnostic potential in thyroid FNA has not been examined. In the present study, the expression profiles of 50 benign thyroid lesions and papillary thyroid carcinoma tissue samples were compared, generating a list...

Lubitz, Carrie C.; Ugras, Stacy K.; Kazam, J. Jacob; Zhu, Biaxin; Scognamiglio, Theresa; Chen, Yao-tseng; Fahey, Thomas J.

2006-01-01

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Clinicopathological aspects of malignant salivary gland neoplasms - a study of 150 cases at AFIP, Rawalpindi (Pakistan)  

International Nuclear Information System (INIS)

To study the clinico pathological aspects of malignant salivary gland tumors, diagnosed at AFIP, Rawalpindi (Pakistan). Study Design: Descriptive study Place and Duration of Study: Armed Forces Institute of Pathology, Rawalpindi from Jan 2005-Dec 2009. Patients and Methods: The study included all the cases diagnosed as malignant salivary gland tumors in the last five years. Records of all the tumors of head and neck region that presented during this period were analyzed and out of these clinico pathological features of malignant salivary gland tumors were studied. The data analysis included the age, gender, site of tumor and histopathological pattern. Results: A total of 18685 malignant tumors presented in the last five years. Out of these, malignant tumors of head and neck were 2165. Total malignant salivary gland tumors were found out to be 150 with an overall frequency of 0.8% and frequency in head and neck malignancies was found out to be 6.9%. The age ranged from 6-80 years (mean 48.02 + 1.23). Of these 150 cases, 58.7% were males and 41.3 were females with a male to female ratio of 1.4:1. The most common tumor seen was muco epidermoid carcinoma (49.3%) followed by adenoid cystic carcinoma (31.3%). A total of 48.7% of the tumors originated in minor salivary glands. Parotid gland was the second most commonly involved site (40.7%). Conclusion: Malignant salivary gland neoplasms are a common malignancy of head and neck region and their frequency is slightly more in n and their frequency is slightly more in our population. Almost half of the tumors originated in minor salivary glands and muco epidermoid carcinoma was the most common type of malignancy. (author)

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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)

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Predictive factors associated with malignancy of intraductal papillary mucinous pancreatic neoplasms  

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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

2010-11-01

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Preoperative diagnosis of multiple primary malignant neoplasm in gastrointestinal and breast cancers. Impact of FDG-PET/CT  

International Nuclear Information System (INIS)

The reports of multiple primary malignant neoplasm (MPMN) have increased due to the development of imaging technologies that have influenced the extension of the 5-year relative survival rate for all cancers. Integrated positron emission and computed tomography (PET/CT) with 18F-fluorodeoxyglucose (FDG) has shown its advantages for detecting, staging, evaluating the prognosis, and offering better insights for survivors, their families and physicians. The aim of this study was to retrospectively investigate the impact of whole-body FDG-PET/CT in detecting MPMN during the initial staging work-up of gastrointestinal and breast malignancy, and to describe their characteristics. The cases were identified by reviewing the Dokkyo Medical University Hospital PET Center's database, searching for patients referred from the Department of Surgical Oncology and the Department of Gastroenterological Surgery, who underwent preoperative staging with whole-body FDG PET/CT at our center between January 2007 and December 2009. A total of 778 patients matched these criteria. Of them, 40 PET/CT reports mentioned suspicious cases of MPMN. The medical records of these 40 cases were retrieved and examined. The follow-up data of these patients was reviewed until February 2010. Of 778, 32 patients were diagnosed with additional unexpected cancers, which 27 (3.5%) were incidental double cancers and 5 (0.64%) had triple primary lesions. Overall 37 MPMN, twelve corresponded to stage 0,l 37 MPMN, twelve corresponded to stage 0, nineteen to stages I-II, three to stages III-IV, and three remained uncertain. Sensitivity and positive predictive value of FDG PET/CT in detecting a controversial lesion were 76.5% and 70.3%, respectively. The colorectum was the most common site for synchronous MPMN (17 of 37 cancers 45.9%), followed by stomach (9; 24.3%), prostate (3; 8.1%), thyroid (3; 8.1%), breast (2; 5.4%), biliary duct (1; 2.7%), kidney (1; 2.7%), and lung (1; 2.7%). FDG PET/CT was useful for finding multiple primary malignant neoplasm with a relatively high sensitivity. Physicians should pay special attention to rule out the presence of unexpected additional primary lesions in initial staging work-up for colorectal cancer. (author)

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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)

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Pattern of thyroid malignancy at a University Hospital in Western Saudi Arabia.  

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There is a lot of controversy regarding thyroid malignancy investigations and management. We recommend that thyroid cancer patients should be treated by a team of endocrinologist, pathologist, experience thyroid surgeon, nuclear medicine and external radiotherapy physician to achieve an optimum care and good prognosis.

Faiza A. Qari

2004-07-01

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Serum thyroglobulin adds no additional value to ultrasonographic features in a thyroid malignancy.  

Science.gov (United States)

We investigated the adjunctive role of preoperative serum thyroglobulin (Tg) in the diagnosis of thyroid nodules. A retrospective study was performed on 374 thyroid nodules (363 benign and 11 malignant) in 360 patients (296 women and 64 men; mean age, 50.1 years; range, 16-86 years) between December 2010 and July 2011. We evaluated clinicopathologic characteristics of patients and ultrasonographic (US) features of the lesions including presurgical Tg levels. Univariate and multivariate analysis were used to determine independent predictors of malignancy. Serum Tg was positively correlated with nodule size and thyroid volume (P < 0.001). There was no difference in serum Tg levels between malignant and benign nodules. Suspicious US features of thyroid nodules were the only independent predictors of malignancy (P< 0.001). Preoperative serum Tg was not useful in differentiating thyroid cancer from benign nodules. Suspicious US features were the only predicting factors for malignancy. PMID:25415866

Youn, Inyoung; Sung, Ji Min; Kim, Eun-Kyung; Kwak, Jin Young

2014-12-01

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The value of apparent diffusion coefficients (ADCs) in the diagnosis of malignant bone neoplasms  

International Nuclear Information System (INIS)

Objective: To evaluate the value of apparent diffusion coefficients (ADCs) in the diagnosis of malignant bone neoplasms. Methods: Eighteen cases with consecutive primary malignant bone neoplasms of the knee were prospectively enrolled in the study. Each patient had a controlled preoperative MRI including a SSEPI-DWI sequence. With the help of a pathologist, spatially localized histological sampling study of the postoperative specimens was performed. ADCs of viable tumor (intra- and extraosseous part), peritumoral edema (including soft tissue edema and intramedullary edema), and tumor necrosis of the neoplasms confirmed by spatially localized histological sampling or following up were calculated and compared. Results: Mean ADCs of viable tumor, peritumoral muscle edema, peritumoral marrow edema, tumor necrosis, normal muscle, and normal marrow were (1.181 ± 0.236) x 10-3 mm2/s (intraosseous part)/(1.158 ± 0.259) x 10-3 mm2/s (extraosseous part), (2.347 ± 0.233) x 10-3 mm2/s, (1.997 ± 0.119) x 10-3 mm2/s, (2.230 ± 0.208) x 10-3 mm2/s, (0.486 ± 0.313) x 10-3 mm2/s, and (0.483 ± 0.288) x 10-3 mm2/s, respectively. Statistical differences were significant among all these tissues (F=153.131, P=0.000). The ADCs of viable tumor were higher than that of normal tissues (P<0.05) and lower than that of edematous or necrotir than that of edematous or necrotic tissues (P<0.05). Conclusion: ADCs calculation will be a quantitative method in differentiating viable tumor from peritumoral edema , and viable tumor from tumor necrosis, thus, it may help in deciding the exact extent of the tumor and evaluating the volume of the necrotic tumor after chemotherapy. (author)

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Thyroid nodules: risk stratification for malignancy with ultrasound and guided biopsy  

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Abstract Replacing palpating fingers with an ultrasound (US) probe has resulted in an epidemic of thyroid nodules. Despite the high prevalence of thyroid nodules in the general population, thyroid malignancy is rare. Although no imaging modality can accurately predict the nature of every nodule, high-resolution US is the most sensitive, easily available and cost-effective diagnostic test available to detect thyroid nodules, measure their dimensions and identify their structure. The presence of calcifications, irregular spiculated outline, hypoechogenicity in a solid nodule, chaotic intranodular vascularity and an elongated shape are well-known US features of malignancy in thyroid nodules. Cervical lymph node metastasis and extrathyroidal extension of a thyroid nodule are highly specific for malignancy but seen infrequently. Spongiform nodules, purely or predominantly cystic nodules, nodules with well-defined hypoechoic halo and echogenic as well as isoechoic nodules are usually benign. None of the US characteristics have 100% accuracy in detecting or excluding malignancy. Fine-needle biopsy is currently the best triage test for pre-operative evaluation of a thyroid nodule. There is no significant difference in the risk for malignancy between palpable and non-palpable nodules and size is not a reliable indicator for their malignant potential. The best tool for risk stratification for malignancy in thyroid nodules is US and guided biopsy of nodules with suspicious imaging features. This is especially relevant in patients with multinodular goitre. PMID:22203727

Anil, Gopinathan; Hegde, Amogh; Chong, F.H. Vincent

2011-01-01

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Second malignant neoplasms in childhood acute lymphoblastic leukemia: primitive neuroectodermal tumor of the chest wall with germline p53 mutation as a second malignant neoplasm.  

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About 80% of children treated for acute lymphoblastic leukemia (ALL) will be long-term survivors. Second malignant neoplasm (SMNs) are a devastating sequelae observed on these children, with an estimated cumulative risk of 2-3.3% fifteen years after diagnosis. Primitive neuroectodermal tumor of bone (PNET) is rarely observed as a SMN following treatment of childhood ALL. The authors described the occurrence of a chest wall PNET of the bone at the site of a central line placement associated with both germ-line and tumor cell p53 mutation in a 8-year-old boy 1 year after completing therapy for standard risk ALL. A review of the literature of 25,051 children treated for ALL discovered 230 SMNs (0.99%), and only one case of PNET of the bone was noted among this group. The occurrence of a SMN in children treated for ALL is a rare event. Such an occurrence, in particular the development of an unusual SMN, should be evaluated for a germline p53 mutation. PMID:15114597

Suarez, Carlos R; Bertolone, Salvatore J; Raj, Ashok B; Coventry, Susan

2004-05-01

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Indications and limitations of the radiotherapy of malignant neoplasms. 2. ed.  

International Nuclear Information System (INIS)

General remarks on the topic of oncoradiology precede the discussion of the problems of special oncoradiology concerning the respiratory system, the digestive tract, the mamma, the female genitals, the male genitals, the urinary tract, the nervous system, the hematopoietic system, the non-Hodgkin lymphomas, and malignant meoplasms of the supporting apparatus, of the thyroid, of the eye including malignant exophthalmus, of the ear, and of the skin. Each chapter contains introductory notes on morphological, radiobiological, and clinical aspects followed by discussions of the results of treatment, of the planning of radiotherapeutic measures as well as of problems of the patient's follow-up care. Numerous bibliographic references conclude the individual chapters. Of interest to physicians and scientists working in the field of radiotherapy

82

THYROID FUNCTION IN MALIGNANT PEDIATRIC PATIENTS AFTER RADIOTHERAPY  

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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

2000-06-01

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

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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

2013-02-01

84

Second malignant neoplasms in patients treated for Hodgkin's disease with radiotherapy or radiotherapy and chemotherapy  

International Nuclear Information System (INIS)

The incidence of second malignant neoplasms (SMN) was assessed in 248 patients with Hodgkin's disease (HD) treated by radiotherapy alone (XRT) or in combination with chemotherapy (XRT + C) between January/1960 and June/1977. Radiation therapy was categorized as less than extended field (< EF), extended field (EF) or total nodal irradiation (TNI). Chemotherapy ws scored as single agent (SAC) or multiagent (MAC). MAC consisted primarily of either nitrogen mustard, vincritine, prednisone and procarbazine (MOPP) or cyclophosphamide, vinblastine, procarbazine and prednisone (CVPP). Ten metachronous malignancies occurred 1-21 years (median 10 years) after the diagnosis of HD. With a median follow-up of 6 years the observed-to-expected ratio (O/E) was 4.2 for XRT alone and 7.6 for XRT+MAC. For 46 patients with greater than or equal to10 years follow-up (median 13 years) the O/E ratio was 16.1 for XRT and 26.5 for XRT+MAC. All SMN occurred in patients who had not had a splenectomy at or prior to the time of HD diagnosis. Only four of nine solid SMN were within treatment portals or near portal margins. The diagnosis of another malignant neoplasm was made prior to or simultaneous with the diagnosis of HD in four additional patients. This observation, and the occurrence of five of six SMN outside of the treatment field in the XRT alone group, suggest that there may be factor(s) associated with the incidence of SMN in HD in addition to treatment itselfatment itself

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[Gerontological aspects of age-dependent mortality from malignant neoplasms of the population in the Russian Federation].  

Science.gov (United States)

The demographic analysis of population-age mortality from malignant neoplasms of the population of RF in the years 1980-2008 enables to see the real presentation of the positive impact of medicine and the negative impact of the environment, but also to reveal fundamental biological processes that determine the health and life expectancy of Russian men and women. The authors allocate the leading role in the origin and development of malignant tumors for the aging process. PMID:23734501

Mamaev, V B; Burlakova, E B; Kuznetsov, L V

2012-01-01

86

Visualization of lung malignant neoplasms with 99mTc-MIBI  

International Nuclear Information System (INIS)

The significance of 99mTc-MIBI in diagnosis of histologically proven malignant lung neoplasms is studied. 46 patients aged 35 till 65 are investigated - 29 with primary lung carcinoma, 5 with metastases and 12 as controls. All patients are preliminary studied by X-ray, computerized tomography, fibrobronchoscopy with biopsy and histological verification. 99mTC-MIBI is administered intravenously in dose of 555 MBq in a volume of 0.4-0.6 ml. The scintigraphic study is carried out on 60-th min with 'Nuclear Ohio Sigma 410' gamma camera. Positive findings are observed in 25 patients with primary carcinoma and in 4 patients with metastatic lungs. Negative findings are found in 4 patients with primary carcinoma and in 1 patient with metastatic lung. The controls have shown negative results. The applied chemotherapy and radiotherapy suppress the inclusion of 99mTc-MIBI in the tumor focus. The topography, size and distribution of the neoplasms are determined, as well as the efficiency of the treatment. 1 tabs., 3 figs. 6 refs. (orig.)

87

Malignant melanoma and papillary thyroid carcinoma that were diagnosed concurrently and treated simultaneously: A case report  

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Malignant melanoma can be successfully treated when it is identified in its early stages, but the disease is associated with a poor prognosis when it is detected in an advanced stage. Papillary thyroid carcinoma is a thyroid cancer that has a good prognosis. The present study reports a rare case of malignant melanoma and papillary thyroid carcinoma that were diagnosed concurrently and treated simultaneously. The present patient was a 37-year-old male, in whom examination of a skin biopsy that was obtained from a lesion in the right retroauricular region revealed the lesion to be consistent with malignant melanoma. The patient underwent radical neck dissection upon the detection of malignant melanoma metastasis to the sentinel lymph node. Metastases of papillary thyroid carcinoma were detected in four out of 38 lymph nodes. The patient was then diagnosed with papillary thyroid carcinoma and underwent total thyroidectomy. The patient was administered with high-dose followed by moderate-dose interferon-? therapy for the treatment of malignant melanoma. The patient also received concurrent radioactive iodine therapy for the treatment of papillary thyroid carcinoma, at the same time as the interferon therapy. The two primary tumors of the patient were treated successfully. During therapy, no serious side-effects were observed, with the exception of fever caused by high-dose interferon therapy. Malignant melanoma and papillary thyroid carcinoma may occur concurrently, although this is rarely observed. The present study reports a rare case that demonstrates that the two tumors can be successfully treated simultaneously. PMID:25436010

OZGUN, ALPASLAN; TUNCEL, TOLGA; EMIRZEOGLU, LEVENT; CELIK, SERKAN; BILGI, OGUZ; HAHOLU, ABDULLAH; URHAN, MUAMMER; KARAGOZ, BULENT

2015-01-01

88

Malignant melanoma and papillary thyroid carcinoma that were diagnosed concurrently and treated simultaneously: A case report.  

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Malignant melanoma can be successfully treated when it is identified in its early stages, but the disease is associated with a poor prognosis when it is detected in an advanced stage. Papillary thyroid carcinoma is a thyroid cancer that has a good prognosis. The present study reports a rare case of malignant melanoma and papillary thyroid carcinoma that were diagnosed concurrently and treated simultaneously. The present patient was a 37-year-old male, in whom examination of a skin biopsy that was obtained from a lesion in the right retroauricular region revealed the lesion to be consistent with malignant melanoma. The patient underwent radical neck dissection upon the detection of malignant melanoma metastasis to the sentinel lymph node. Metastases of papillary thyroid carcinoma were detected in four out of 38 lymph nodes. The patient was then diagnosed with papillary thyroid carcinoma and underwent total thyroidectomy. The patient was administered with high-dose followed by moderate-dose interferon-? therapy for the treatment of malignant melanoma. The patient also received concurrent radioactive iodine therapy for the treatment of papillary thyroid carcinoma, at the same time as the interferon therapy. The two primary tumors of the patient were treated successfully. During therapy, no serious side-effects were observed, with the exception of fever caused by high-dose interferon therapy. Malignant melanoma and papillary thyroid carcinoma may occur concurrently, although this is rarely observed. The present study reports a rare case that demonstrates that the two tumors can be successfully treated simultaneously. PMID:25436010

Ozgun, Alpaslan; Tuncel, Tolga; Emirzeoglu, Levent; Celik, Serkan; Bilgi, Oguz; Haholu, Abdullah; Urhan, Muammer; Karagoz, Bulent

2015-01-01

89

The diagnostic value of 99Tcm-MIBI imaging to benign and malignant thyroid lesions  

International Nuclear Information System (INIS)

Objective: To observe the characteristic of 99Tcm-MIBI double-phase imaging, and compared with the pathologic result to discuss and evaluate the diagnostic and difference diagnostic value of early-imaging and delayed-imaging to benign and malignant lesion in thyroid. Methods: Eighty-nine pathological proven thyroid lesions patients were included in this study (38 cases of thyroid cancer and 51 cases of thyroid benign lesion). 99Tcm-MIBI early-imaging and delayed-imaging of thyroid were performed, and comparatively analyzed the T/NT ratio of early-imaging and delayed-imaging of thyroid cancer and thyroid benign lesion. Results: There was no significance in the T/NT ratio of 99Tcm-MIBI early-imaging between thyroid cancer group (T/NT=1.32±0.03) and thyroid benign lesion group (T/NT=1.26±0.22) (t=0.63, P>0.05). The T/NT ratio of delayed-imaging was high (T/NT=1.72±0.39) than that of benign lesion (T/NT=1.20±0.36), and there was statistically significance between them (t=3.45, P99Tcm-MIBI early-imaging but specify is low, and specify is high for diagnosing thyroid cancer using 99Tcm-MIBI delayed-imaging, which is better for differencing malignancy from benignity in thyroid. (authors)

90

Comparison of Na+/I- symporter expression rate in malignant and benign thyroid diseases: immunohistochemical study  

International Nuclear Information System (INIS)

Previous studies have not showed consistent results for the level of expression of sodium/iodide symporter (NIS) in thyroid diseases, especially malignant tumor. We undertook this study to evaluate the distribution of NIS expression in malignant thyroid diseases and compare with that in benign thyoid disease. Total patients were 119 cases (Men 15, 48±13 yrs). Total number of samples were 205 pieces. In malignant thyroid disease, there were 153 samples: 90 in papillary carcinoma, 4 in follicular carcinoma, 2 in medullary carcinoma and 57 in metastatic lymph node. In benign thyroid disease, there were 52 samples: 36 in goiter/cyst, 11 in thyroiditis and 5 in follicular adenoma. Using immunohistochemical methods, we probed 205 samples with monoclonal anti-NIS Ab. Grading of staining was scored as 0 (negative or absent), 1 (weakly positive), 2 (moderately positive) or 3 (strongly positive). Expression rate (ER) of NIS positivity in individual disease entity was expressed as percentage of total number divided by number in 2 plus 3 grade. ERs of malignant thyroid diseases were 63% in papillary carcinoma, 81% in metastatic lymph node, 71% in follicular carcinoma and 100% in medullary carcinoma. ERs of benign thyroid disease were 53% in goiter/cyst, 64% in thyroiditis and 40% in follicular adenoma. ER of benign thyroid deceases was higher than benign thyroid diseases (71% vs 54%). Grading of NIS expression in papillary carcinoma or goiter/cyst was heterogeneously distributediter/cyst was heterogeneously distributed in considerable cases. Normal tissue also showed heterogeneous distribution or NIS expression, which was not correlated with that of primary lesion. In papillary thyroid carcinoma, distribution of NIS expression was heterogeneous and increased, and not different compared with that of benign thyroid disease

91

Intrathyroidal thymic tissue mimicking a malignant thyroid nodule in a 4-year-old child  

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Intrathyroidal thymic tissue is rare and may be confused with a malignant thyroid nodule because of hyperechoic dots mimicking calcifications. We report the case of a thyroid nodule with malignant ultrasonographic findings in a 4-year-old child, which was confirmed cytologically as ectopic thymic tissue. The sonographic findings of ectopic thymus were similar to those of the thymus; therefore, clinicians should be familiar with ultrasonography findings of normal thymic tissue.

So Hyun Park

2014-01-01

92

Resection of advanced stage malignant retroperitoneal neoplasms with tumor thrombus extending into the right atrium: report of four cases.  

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Surgery for retroperitoneal neoplasms with a tumor thrombus extension into the right atrium is challenging. This study reviewed four surgical cases of advanced stage malignant neoplasms with the tumor thrombus extending into the right atrium. The malignant neoplasms involved the kidney in two patients, and the liver and adrenal gland in one each. The tumor thrombus was removed through a longitudinal cavotomy and right atriotomy in all cases. The inferior vena cava reconstruction was performed by directly closing it in one patient and by pericardial patch suturing in another. Cardiopulmonary bypass was used for all procedures and a Pringle maneuver was used to reduce bleeding from the liver in three. There was no perioperative or hospital death. Two of the four with renal cell carcinoma were alive 7 and 13 months after the surgery. One with hepatocellular carcinoma died of recurrent malignancy after 4 months, while the patient with an adrenal carcinoma remained disease free after surgery. These cases indicate the safety of the present procedure. Although the long-term results are still unknown, there were favorable early results and a lack of perioperative complications. Surgical challenges in resecting an intracardiac extension of retroperitoneal malignancy require close cooperation among the attending urologist, and both gastrointestinal and cardiovascular surgeons. PMID:21264766

Shudo, Yasuhiro; Matsumiya, Goro; Sakaguchi, Taichi; Fujita, Tomoyuki; Yamauchi, Takashi; Sawa, Yoshiki

2011-02-01

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In vitro chemosensitivity of paclitaxel and other chemotherapeutic agents in malignant gestational trophoblastic neoplasms.  

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This is the first report on the ATP cell viability assay as a chemosensitivity test system for gestational trophoblastic neoplasms (GTN). We obtained chemosensitivity profiles in two established trophoblastic cell lines and four fresh tumors. Ten drugs were tested in vitro in the two cell lines JAR and JEG-3. The IC50 values of the 10 chemotherapeutic agents tested were very similar for both cell lines. The three most active drugs in these cell lines were VP-16, paclitaxel and vincristine. This is the first report on the activity of paclitaxel in trophoblastic cell lines. We furthermore evaluated this assay for chemosensitivity testing in four fresh malignant GTN tumors: one placental site trophoblastic tumor, one chorocarcinoma and two invasive moles. The placental site trophoblastic tumor specimen revealed to be rather chemoresistant in vitro whereas the other three tumors were chemosensitive. From our cell line data we conclude that the ATP cell viability assay is a practicable assay for chemosensitivity testing of GTN cell lines and gives repeatable results. However, the value of this assay for fresh GTN chemosensitivity testing needs to be defined. PMID:7756689

Koechli, O R; Schaer, G N; Sevin, B U; Perras, J P; Schenk, V; Rodriguez, M; Untch, M; Steren, A; Haller, U

1995-02-01

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Neurofibromin specific antibody differentiates malignant peripheral nerve sheath tumors (MPNST) from other spindle cell neoplasms.  

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Malignant peripheral nerve sheath tumors (MPNST) derive from the Schwann cell or perineurial cell lineage and occur either sporadically or in association with the tumor syndrome neurofibromatosis type 1 (NF1). MPNST often pose a diagnostic challenge due to their frequent lack of pathognomonic morphological or immunohistochemical features. Mutations in the NF1 tumor suppressor gene are found in all NF1-associated and many sporadic MPNST. The presence of NF1 mutation may have the potential to differentiate MPNST from several morphologically similar neoplasms; however, mutation detection is hampered by the size of the gene and the lack of mutational hot spots. Here we describe a newly developed monoclonal antibody binding to the C-terminus of neurofibromin (clone NFC) which was selected for optimal performance in routinely processed formalin-fixed and paraffin-embedded tissue. NFC immunohistochemistry revealed loss of neurofibromin in 22/25 (88 %) of NF1-associated and 26/61 (43 %) of sporadic MPNST. There was a strong association of neurofibromin loss with deletions affecting the NF1 gene (P neurofibromin in 2/8 myxofibrosarcomas, 2/12 (16 %) pleomorphic liposarcomas, 1/16 (6 %) leiomyosarcomas, and 4/28 (14 %) unclassified undifferentiated pleomorphic sarcomas. However, loss of neurofibromin was not observed in 22 synovial sarcomas, 27 schwannomas, 23 solitary fibrous tumors, 14 low-grade fibromyxoid sarcomas, 50 dedifferentiated liposarcomas, 27 myxoid liposarcomas, 13 angiosarcomas, 9 extraskeletal myxoid chondrosarcomas, and 7 epitheloid sarcomas. Immunohistochemistry using antibody NFC may substantially facilitate sarcoma research and diagnostics. PMID:24464231

Reuss, David E; Habel, Antje; Hagenlocher, Christian; Mucha, Jana; Ackermann, Ulrike; Tessmer, Claudia; Meyer, Jochen; Capper, David; Moldenhauer, Gerhard; Mautner, Victor; Frappart, Pierre-Olivier; Schittenhelm, Jens; Hartmann, Christian; Hagel, Christian; Katenkamp, Kathrin; Petersen, Iver; Mechtersheimer, Gunhild; von Deimling, Andreas

2014-04-01

95

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

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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.

Taddei, Phillip J.; Howell, Rebecca M.; Krishnan, Sunil; Scarboro, Sarah B.; Mirkovic, Dragan; Newhauser, Wayne D.

2010-12-01

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137Cs contents in residents of the Vitebsk Oblast who died of malignant neoplasms of various localizations  

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The 137Cs contents in internal organs of Vitebsk Oblast residents who died of either various malignant neoplasms or non-oncological diseases are compared. The 137Cs specific activity is determined in internal organs sampled at autopsy. Direct gamma-spectrometry is used with a Ce-Li detector, the sensitivity being 0.4 Bq/kg. The radiocesium specific activity in organs of Vitebsk Oblast residents who died of malignant neoplasms are similar to that for residents who died of non-oncological diseases. The relatively higher 137Cs incorporation levels have been observed in stomach, pancreas, bladder and lungs. The higher 137Cs content organs of cancer patients is found for cancer of sigmoid colon, ovary, esophagus, brain and for leukemia

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Spatial autocorrelation calculations of the nine malignant neoplasms in Taiwan in 2005–2009: a gender comparison study  

OpenAIRE

Spatial analytical techniques and models are often used in epidemiology to identify spatial anomalies (hotspots) in disease regions. These analytical approaches can be used to identify not only the location of such hotspots, but also their spatial patterns. We used spatial autocorrelation methodologies, including Global Moran's I and Local Getis-Ord statistics, to describe and map spatial clusters and areas in which nine malignant neoplasms are situated in Taiwan. In addition, we used a logis...

Tsai, Pui-jen

2011-01-01

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Second malignant neoplasms after a first cancer in childhood: temporal pattern of risk according to type of treatment  

OpenAIRE

The variation in the risk of solid second malignant neoplasms (SMN) with time since first cancer during childhood has been previously reported. However, no study has been performed that controls for the distribution of radiation dose and the aggressiveness of past chemotherapy, which could be responsible for the observed temporal variation of the risk. The purpose of this study was to investigate the influence of the treatment on the long-term pattern of the incidence of solid SMN after a fir...

Vathaire, F.; Hawkins, M.; Campbell, S.; Oberlin, O.; Raquin, M-a; Schlienger, J-y; Shamsaldin, A.; Diallo, I.; Bell, J.; Grimaud, E.; Hardiman, C.; Lagrange, J-l; Daly-schveitzer, N.; Panis, X.; Zucker, J-m

1999-01-01

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Thyroid treatment and its possible influence on occurrence of malignant tumors after diagnostic 131I  

International Nuclear Information System (INIS)

The extent to which thyroid surgery, thyroid hormone medication or other forms of thyroid therapy were applied after diagnostic administration of 131I has been determined in 871 patients of the 10,133 patients reported previously. The relevant information was obtained from questionnaires and from hospital records. Of the 871 patients at least 58 per cent had received no form of thyroid treatment and 33 per cent had had some form of treatment, while in 9 per cent no information could be obtained. The large difference between the number of malignant tumors observed in the 10,133 patients after exposure to 131I and the number expected from UNSCEAR's risk figures for radiation-induced thyroid carcinoma (47-124 cases) cannot be ascribed to the various forms of thyroid treatment given after the 131I administration. (Auth.)

100

Thyroid suppression and medical ablation for differentiated thyroid cancer  

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Patients with thyroid cancer benefit from treatment with exogenous thyroid hormone for two reasons: it provides adequate levels of thyroid hormone to peripheral tissues, and it reduces the level of thyrotropin, which may be an important growth factor in patients with differentiated malignant neoplasms. The use of radioactive iodine for thyroid cancer is highly controversial. Its most appropriate applications are in follicular cancers, in older patients, and in distant functioning metastases. Its value in papillary cancer is questionable, particularly in young patients. There is a great need for effective basic and clinical research on the natural course of differentiated thyroid cancer and the effects of specific therapies

101

Thallium-201-chloride thyroid scintigraphy to evaluate benign and/or malignant nodules: usefulness of the delayed scan  

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The purpose of this study is to evaluate benign and/or malignant thyroid tumors with 201T1 thyroid scan. We studied 76 cases of histologically verified thyroid tumors, all seen as cold nodules on the 123I thyroid scan. 201T1 thyroid scan was performed 5-15 minutes (early scan) and 3-5 hours (delayed scan) after intravenous administration of 1.5-2.0 mCi of 201T1. In 35 (94.6%) of 37 malignant tumors (anaplastic carcinoma, six; papillary carcinoma, 23; follicullar carcinoma, five; epidermoid carcinoma, one;malignant lymphoma, 1), 201T1 accumulated in the cold nodule of the 123I thyroid scan on both early and delayed scans. On the other hand, the delayed 201T1 scans, we were able to differentiate most malignant thyroid tumors from those which were benign. False-negative and -positive cases are discussed

102

Lung scanning using microspheres labeled with radioactive isotopes in the diagnosis and evaluation of therapeutic results in pulmonary malignant neoplasms.  

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In 25 patients with malignant pulmonary neoplasms 38 scintiscanning investigations were carried out using the method of albumin microspheres labeled with 131I, technetium -99 m, or indium -113 m and macrocolloids of ferric hydroxide labeled with 113mIn. In 10 patients with infiltration of the main or lobar bronchi scintiscanning demonstrated in 9 cases complete absence of perfusion of one lung. In these cases routine radiological investigations demonstrated normal perfusion and aeration of lung parenchyma in the involved lung. Among 13 cases of carcinoma situated in segmental or subsegmental bronchi the areas with absent perfusion were in 7 cases larger than changes observed during radiological examination. Scintiscanning investigations were used also for evaluation of therapeutic results of synchronized chemotherapy in malignant neoplasms of this organ. Scintiscanning is a method well tolerated by the patients and it may be performed repeatedly in the same case for evaluation changes in perfusion disturbances caused by malignant lung neoplasms. It may be helpful in choice of a proper method of treatment. PMID:1223822

Dziuk, E; Dzurak, W; Siekierzy?ski, M; Jedrzejczak, W W; Czarnecki, C

1975-01-01

103

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.

Kristensen Annemarie T

2009-12-01

104

Venous obstruction of thyroid malignancy origin: the Antoine Lacassagne Institute experience  

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Full Text Available Abstract Background and aims To show the benefits of Ultrasonography in the diagnosis of great vein involvement in the neck and mediastinum in thyroid malignancies (primary or secondary in our experience and to report patient outcomes. Methods Clinical data were collected from the thyroid unit database of the Antoine Lacassagne Institute. Results Of 1171 patients with thyroid cancer treated at our institution over the last 18 years, we retrospectively identified nine patients (0.8%, three women and six men, aged 34–81 years (median age: 70 years presenting with malignant thyroid tumor of median diameter 45 mm (range: 23–87 having venous obstruction of thyroid malignancy origin. Two patients underwent multimodal therapy. All other patients underwent external beam radiation therapy alone ± chemotherapy or palliative care. Ultrasound (US provided particularly useful information on venous involvement characteristics. Median survival was 7 months and median progression-free survival was 6 months. Survival in our series was worse than that of previously reported series despite diagnosis of vein involvement at an early stage in 2/3 cases using US. Conclusion Despite small numbers of patients, it seems that aggressive treatment modalities including surgery are required to improve survival. In our experience, US was a useful non-invasive method to describe tumor extensions to great veins of the neck (invasion versus compression, tumor thrombus versus blood clot and should be recommended to depict early venous invasion in cases of suspected thyroid malignancy.

Benisvy Danielle

2009-04-01

105

Acute exacerbation of Hashimoto thyroiditis mimicking anaplastic carcinoma of the thyroid: A complicated case.  

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The fibrous variant of Hashimoto thyroiditis is uncommon, accounting for approximately 10% of all cases of Hashimoto thyroiditis. We report a case of this variant that behaved like a malignant neoplasm. The patient was a 69-year-old man who presented with a right-sided anterior neck mass that had been rapidly growing for 2 weeks. Fine-needle aspiration cytology revealed clusters of large multinucleated cells suggestive of an anaplastic carcinoma. A week after presentation, we ruled out that possibility when the mass had shrunk slightly. Instead, we diagnosed the patient with an acute exacerbation of Hashimoto thyroiditis on the basis of laboratory findings. We performed a right thyroid lobectomy, including removal of the isthmus, to clarify the pathology and alleviate pressure symptoms. The final diagnosis was the fibrous variant of Hashimoto thyroiditis, with no evidence of malignant changes. Physicians should keep in mind that on rare occasions, Hashimoto thyroiditis mimics a malignant neoplasm. PMID:25531848

Kanaya, Hiroaki; Konno, Wataru; Fukami, Satoru; Hirabayashi, Hideki; Haruna, Shin-Ichi

2014-12-01

106

The value of contrast-enhanced 64-row CT in differentiating benign from malignant serous ovarian neoplasms  

International Nuclear Information System (INIS)

Objective: To assess the diagnostic value of contrast-enhanced 64-row CT scanning in deciding benign or malignant serous ovarian tumors. Methods: Fifty-eight cases of serous ovarian tumors proved pathologically were reviewed, including 25 malignant tumors, 25 benign, 8 borderline tumors. All patients underwent 64-row CT scanning, including plain scanning and contrast-enhance scanning. The tumors' shape, density, blood supply and enhancement features were evaluated. Results: Twenty-five cases of benign serous cystic adenoma were mostly unicameral, and showed a moderate mural enhancement only in 4 cases (16%) due to chronic pelvic infection and the others (21/25, 84%) had no of slight enhancement. Malignant tumors were cystic-solid mass with unclear margin, irregular shape and septa. Twenty-two cases of serous cystadenocarcinoma out of 25 cases (88%) appeared obvious enhancement and other 3 cases no enhancement. And 7 cases out of 8 (87.5%) borderlined serous cystadenomas showed different enhancement patterns. Conclusion: Benign ovarian serous neoplasms were mostly unicameral and no strong mural enhancement, suggesting a lack of blood supply. While, there were obvious enhancement in the ovarian serous cystadenocarcinoma and borderline serous cystadenoma with malignant potential. The 64-row CT is helpful for differentiating the nature of the serous ovarian neoplasm. (authors)

107

Prevalence of BRAF T1799A mutations in benign and malignant thyroid tumors and tumor-like thyroid lesions  

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Full text: An increased incidence of thyroid cancer after the Chernobyl accident evoked a strong need in an early and accurate cancer diagnosis. Spectrum of thyroid diseases is wide, ranging from tumor-like lesions such as thyroiditis and various types of goiter, benign adenomas to malignant follicular, papillary, medullary and anaplastic (undifferentiated) cancer. Differential morphological diagnosis of these diseases is sometimes complicated. Therefore, much of attention has been recently paid to additional auxiliary diagnostic means, in particular to molecular and genetic assays. One of the most informative markers of papillary thyroid carcinoma (PTC) is a BRAF point mutation that has been shown to occur with a relatively high rate in PTCs but not in follicular cancer and benign lesions. The purpose of the current study was an investigation of hotspot BRAF T1799A mutation prevalence in a series of tumor-like thyroid lesions and thyroid tumors. For the study we collected thyroid tissue specimens from 44 patients living in the central region of the Russian Federation (8 males and 36 females; age range 23 to 69 years, 46 years old, mean) who were surgically treated in the Clinic of Medical Radiological Research Center of Russian Academy of Medical Sciences. Included in the study were 32 cases of malignant thyroid tumors (26 papillary, 4 follicular and 2 medullary carcinomas), 5 benign (follicular adenomas), and 7 tumor-like lesions (5 nodular goiters and 2 lymphocyticsions (5 nodular goiters and 2 lymphocytic thyroiditis). Histological classification was made according to the criteria described by LiVolsi (1990) and Rosai and colleagues (1992). Remaining excess tissue specimens of thyroid benign and malignant lesions and surrounding normal thyroid not needed for histological examination were used for DNA extraction. Genomic DNA was analyzed for the BRAF mutations by mutant allele specific polymerase chain reaction. DNA from PTC tissue previously determined to harbor mutant BRAF was used as a positive control. BRAF T1799A mutation was detected in 7 of 26 PTCs included in the study but not in follicular or medullary carcinoma, benign tumors and thyroid tumor-like lesions. No mutations were found in adjacent normal thyroid tissue in all cases including those tested positive for BRAF T1799A. Histological analysis showed that among 26 PTCs studied, 18 had conventional papillary architecture and 8 cases were follicular variant of PTC. Mutations were detected in conventional type PTCs only (38.9%, 7/18), but not in follicular variant tumors. The occurrence of BRAF T1799A mutation did not correlate with tumor metastatic potential although such observation may be due in part to a relatively small number of appropriate cases available for the study. As a whole, our data demonstrate that BRAF T1799A mutation is a prevalent mutational event in papillary thyroid carcinoma and its presence strongly correlates with conventional PTC hypostat but not with follicular variant that is in line with results of other laboratories. The findings suggest that detection of BRAF mutation may be used for molecular diagnostic purposes both preoperatively (on fine needle aspiration biopsy material) and after surgical treatment for differential diagnosis of papillary carcinoma to distinguish it from other histological types of thyroid cancer

108

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

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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?0.83) in hyper vascular internal flow signals and RI 0.93(0.67?1.00) in hypo vascular internal flow signals, and measured PI was 1.39 (1.03?2.11), 2.71 (0.97?4.81),respectively. and in benign nodules, measured RI was 0.65 (0.5?0.88) and PI was 0.92 0.65 (0.5?0.88) and PI was 0.92 (0.59?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

109

Pattern of thyroid malignancy at a University Hospital in Western Saudi Arabia  

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The aim is to study the incidence of thyroid cancer in surgically treated nodular thyroid disease, clinicopathological characteristics and treatment results. A retrospective review of 45 patients with thyroid malignancy at King Abdul-Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia during a 3-years period between January 2000 through to December 2003 was carried out. Analysis of clinicopathologic characteristics, age correlation to different risk factors, outcome of surgery and radioiodine treatment. A total of 120 thyroidectomies were performed during the 3-years period, January 2000 through to December 2003 at King Abdul-Aziz University Hospital. Forty-five (37.5%) patients had histopathology confirmed diagnosis of thyroid cancer. Eighty-two point two percent cases of papillary carcinoma, 4.4% follicular type and 6.7% anaplastic and medullary carcinoma of thyroid. Mean age was 40.5 +/- 14.8 years. Male preponderance was seen in this study with males: females ratio is 1.1:1. Nodular goiter was the most frequent presentation, observed in 30 (66.7%) cases. Fine needle aspiration cytology was suggestive of malignancy in 76% of cases. Ninety-seven patients with papillary carcinoma received ablative dose of radioiodine with average dose of 100-200 mCi. One female patient with follicular carcinoma of thyroid with bone, lung, and brain metastases received 4 doses of radioiodine with total dose of 800 mCi. Mortality rate was (2.2%), one patient died of complication (2.2%), one patient died of complication of invasive anaplastic carcinoma with invasion of the trachea. There is a lot of controversy regarding thyroid malignancy investigations and management. We recommend that thyroid cancer patients should be treated by a team of endocrinologist, pathologist, experience thyroid surgeon, nuclear medicine and external radiotherapy physician to achieve an optimum care and good prognosis. (author)

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Incidence of malignant thyroid tumors in humans after exposure to diagnostic doses of 131I. II. Estimation of thyroid gland size, thyroid radiation dose, and predicted versus observed number of malignant thyroid tumors  

International Nuclear Information System (INIS)

The size of the thyroid glands was analyzed for 10% of the patients in a selected group that had been exposed to diagnostic doses of 131I. The mean thyroid gland weight +- SD was 50 +- 33 g for patients 20 or more years of age and 10 +- 5 g for patients less than 20 years of age. With the present follow-up, diagnostic doses of 131I appeared not to be associated with an increased risk for later development of malignant thyroid tumors. Possible reasons for the difference between the observed number of such tumors and the number expected (47 to 124) on the basis of risk estimates of the United Nations Scientific Committee on the Effects of Atomic Radiation are discussed

111

Significance of ultrasound features in predicting malignant solid thyroid nodules: Need for fine-needle aspiration  

International Nuclear Information System (INIS)

The purpose of this study was to provide sonographic and colour flow criteria helpful for differentiation between benign and malignant solid thyroid nodules. Methods: This prospective study was carried out at Sindh Institute of Urology and Transplantation (SIUT), Karachi Pakistan from 01.05.07 to 31.12.08. Sonographic scans of 78 thyroid nodules in 66 patients were performed and characteristics of thyroid nodules that were studied included microcalcifications, an irregular or microlobulated margins, marked hypoechogenicity, a shape that was taller than it was wide and color flow pattern in Color Doppler ultrasound. The presence and absence of characteristics of nodules were classified as having positive or negative findings. If even one of these sonographic features was present, the nodule was classified as positive (malignant). If a nodule had none of the features described, it was classified as negative (benign). The final diagnosis of a lesion as benign (n = 53) or malignant (n = 25) was confirmed by fine needle aspiration biopsy, and patients who were proved to have benign lesions were followed-up for 6 months and malignant lesions which were proved on histopathology after FNA were subjected to surgery. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were then calculated on the basis of our proposed classification method. Results: Among 78 solid thyroid nodules 35 lesions were classified as positive considering the re classified as positive considering the sonographic characteristics and 23 of them were proved to be malignant on histopathology. Out of 43 lesions which were classified as negative, 2 were proved to be malignant. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy based on our sonographic classification method were 93.8%, 66%, 56.1%, 95.9%, and 74.8%, respectively. Conclusion: Ultrasound is valuable for identifying many malignant or potentially malignant thyroid nodules. No single ultrasound criterion is reliable in differentiating all benign from malignant thyroid nodules, but many US features aid in predicting the benign or malignant nature of a given nodule. Fine-needle aspiration biopsy should be performed on thyroid nodules classified as positive, regardless of palpability. (author)

112

Clinical evaluation of 67Ga scanning in the diagnosis of anaplastic carcinoma and malignant lymphoma of the thyroid  

International Nuclear Information System (INIS)

While 67Ga uptake has been reported to be highly variable and nonspecific in the diagnosis of malignant tumors of the thyroid, it has also been observed to depend on the histological nature of the lesion. For this reason, the behavior of 67Ga in various types of thyroid cancer was investigated in a prospective study of 86 patients with thyroid masses compatible with anaplastic carcinoma or malignant lymphoma. The study demonstrated a distinct difference in uptake between well-differentiated adenocarcinoma of the thyroid and the more undifferentiated anaplastic carcinoma and malignant lymphoma

113

Surface-enhanced Raman spectroscopy for differentiation between benign and malignant thyroid tissues  

Science.gov (United States)

The aim of this study was to evaluate the potential of applying silver nano-particle based surface-enhanced Raman scattering (SERS) to discriminate different types of human thyroid tissues. SERS measurements were performed on three groups of tissue samples including thyroid cancers (n = 32), nodular goiters (n = 20) and normal thyroid tissues (n = 25). Tentative assignments of the measured tissue SERS spectra suggest interesting cancer specific biomolecular differences. The principal component analysis (PCA) and linear discriminate analysis (LDA) together with the leave-one-out, cross-validated technique yielded diagnostic sensitivities of 92%, 75% and 87.5%; and specificities of 82.6%, 89.4% and 84.4%, respectively, for differentiation among normal, nodular and malignant thyroid tissue samples. This work demonstrates that tissue SERS spectroscopy associated with multivariate analysis diagnostic algorithms has great potential for detection of thyroid cancer at the molecular level.

Li, Zuanfang; Li, Chao; Lin, Duo; Huang, Zufang; Pan, Jianji; Chen, Guannan; Lin, Juqiang; Liu, Nenrong; Yu, Yun; Feng, Shangyuan; Chen, Rong

2014-04-01

114

Papillary carcinoma thyroid with metastasis to ectopic cervical thymus  

OpenAIRE

Abstract Papillary carcinoma of thyroid is the most common type of thyroid neoplasm which is usually confined to the thyroid and tends to metastasize to regional lymph nodes. Distant metastasis occur in up to 15% of cases. Thymic metastasis from any malignant carcinoma is extremely rare with only four cases reported in medical literature. We report a case of papillary carcinoma of thyroid metastasizing to ectopic cervical thymus which has not been previously reported.

Khanday Samina A; Malik Rayees A; Malik Ajaz A; Naqash Sameer H; Mushtaque Majid; Khan Parwez S

2011-01-01

115

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

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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

116

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)

117

Malignant neoplasms of digestive organs (C15-C26) in the Osijek-Baranja County, Croatia.  

Science.gov (United States)

The Institute of Public Health for the Osjek-Baranja County (OBC) has processed the data on cancer patients that were collected from mandatory county hospitals data reports, county bureaus of statistics and the County Register of Deaths. The cancers were defined according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), codes of malignant neoplasms of digestive organs (C15-C26). The aim of this article is to show the size of the problem and the burden of the health care system caused by cancers of the digestive system (C15-C26) in the OBC in the period 2001-2006. This article deals with cancer incidence and mortality data, appertaining age distribution, cancer survival, median age at diagnosis and at death and length of stay in hospitals. The overall incidence and mortality rate from cancer group C15-C26 (101.1 and 80/100,000, respectively, EU standard population) declined in all age groups, comparing the data originating from the 2001-2003 period to the data referring to the 2004-2006 period. The median age at diagnosis of cancer was 67.8 years with a shift of 0.91 year up in second period (the median age in the first period was 67.3 years and in the second one 68.2 years). The median age at diagnosis of cancer in females was 69.7 years while in males was 66.3 years, which represents a difference of 2.9 years in favour of females. The overall relative survival rate of all ages was 23.6%. This figure was slightly bigger for females (24.3%) than for males (23.1%). Concerning all age groups, the number of hospital admissions of males increased during the observation period while the number of hospital admissions of women decreased at the same time. The average length of stay over the six years did not changed significantly. Group of cancer C15-C26 was the most common group of cancers regarding both genders. The five-year relative survival as one of the reliable benchmarks of the quality of the health care system needs to be raised to a great extent in order to come nearer to the EU average within a short period of time. PMID:24851601

Milas, Josip; Samardzi?, Senka; Miskulin, Maja; Mihaljevi?, Silvio; Males, Josip; Puntari?, Dinko

2014-03-01

118

Frequent expression of the variant CD30 in human malignant myeloid and lymphoid neoplasms.  

Science.gov (United States)

We earlier identified a variant of CD30 (CD30v) that retains only the cytoplasmic region of the authentic CD30. This variant is expressed in alveolar macrophages. CD30v can activate the nuclear factor-kappaB (NF-kappaB) as CD30, and its overexpression in HL-60 induced a differentiated phenotype. To better understand the physiological and pathological functions of CD30v, expression of this variant was examined using a multiple approach to examine 238 samples of human malignant myeloid and lymphoid neoplasms. Screening by reverse transcriptase-polymerase chain reaction (RT-PCR) revealed expression of CD30v transcripts in 52 of 72, 7 of 11, 63 of 90, and 7 of 30 samples of acute myeloid leukemia (AML), myeloid blast crisis of myeloproliferative disorders (MBC), and lymphoproliferative disorders (LPDs) of B- and T-cell origin, respectively. CD30v expression was high in monocyte-oriented AMLs (FAB M4 and M5), B-cell chronic lymphocytic leukemia (B-CLL), and multiple myeloma (MM). Using the specific antibody HCD30C2, prepared using a peptide corresponding to the nine amino acids of the amino-terminal CD30v, expression of CD30v protein was detected in 10 of 25 and 2 of 10 AML and ALL samples, respectively. In AMLs, immunocytochemical detection of CD30v revealed the presence of loose clusters of CD30v-expressing cells dispersed amid a population of CD30v-negative blasts. Finally, the parallel expression of CD30v mRNA and protein, as evidenced by Northern and Western blotting, was confirmed in selected cases of AMLs and LPDs. A significant correlation was found between expressions of CD30v and CD30 ligand transcripts in AML and LPD (P = 0.02, odds ratio = 3.2). The association of CD30v with signal-transducing proteins, tumor necrosis factor receptor-associated factor (TRAF) 2, and TRAF5 was demonstrated by coimmunoprecipitation analysis, as was demonstrated for authentic CD30 protein. Expression of transcripts for TRAF1, TRAF2, TRAF3, and TRAF5, as demonstrated by RT-PCR, was noted in leukemic blasts that express CD30v. Collectively, frequent expression of CD30v along with TRAF proteins in human neoplastic cells of myeloid and lymphoid origin provide supportive evidence for biological and possible pathological functions of this protein in the growth and differentiation of a variety of myeloid and lymphoid cells. PMID:10595933

Horie, R; Gattei, V; Ito, K; Imajo-Ohmi, S; Tange, T; Miyauchi, J; Pinto, A; Degan, M; De Iuliis, A; Tassan Mazzocco, F; Rossi, F M; Higashihara, M; Watanabe, T

1999-12-01

119

Percutaneous port-catheter system implantation via left subclavian artery in the treatment of advanced malignant neoplasms  

International Nuclear Information System (INIS)

Objective: To evaluate the value of percutaneous port-catheter system (PCS) implantation via left subclavian artery in the treatment of advanced malignant neoplasms. Methods: The technique was used to treat 200 patients with advanced malignant neoplasms, 178 cases of primary liver carcinoma, 10 cases of metastatic liver cancer, 5 cases of pelvic neoplasm, 4 cases of gallbladder carcinoma, 3 cases of lung cancer. The authors performed implantation of PCS under guidance of DSA and fluoroscopy according to the arterial blood supply of tumors. Body of PCS was subcutaneously implanted below puncture point. The implanted catheter tip was positioned in the target artery. Intra-arterial chemotherapy or chemo-embolization with emulsion of anti-cancerous agents and lipiodol were regularly carried out via PCS. Results: 200 patients were traced for 3 months to 3 years, 202 PCS were implanted in 200 patients. Because of left and right hepatic artery supplied tumor simultaneously in 2 patients with liver cancer, another PCS was implanted for the right femoral artery (double PCS). The successful rate was 99%. Complications occurred in 7 cases (3.5%), including indwelling catheter tip dislocation (2 cases, 1%), disconnection between port and catheter after the procedure (1 cases, 0.5%), pneumothorax (2 cases, 1%), skin fester (1 cases, 0.5%), massive blood effusion in subcutaneous tissue (1 cases, 0.5%), target vessel closed off (2 cases, 1%). There was no serious complication. Concl. There was no serious complication. Conclusion: Percutaneous PCS implantation via left subclavian artery is safe, feasible and less traumatic. It provides a safe intra-arterial chemotherapy or chemo-embolization with emulsion of anti-cancerous agents and lipiodol for patient with malignant tumor

120

Fine-Needle Aspiration Cytology of Parathyroid Carcinoma Mimic Hürthle Cell Thyroid Neoplasm  

OpenAIRE

Background. Fine-needle aspiration (FNA) can cause misdiagnosis of cytomorphological findings between parathyroid and thyroid lesions. Case Presentation. A 31-year-old man presented with a palpable neck mass on the right thyroid lobe. FNA cytology was reported as intrathyroidal lymphoid hyperplasia. After 5 years, repeated FNA was done on the enlarged nodule with result of Hürthle cell lesion. Prior to right lobectomy, laboratories revealed elevated serum calcium and parathyroid hormone (PTH...

Chutintorn Sriphrapradang; Pattana Sornmayura; Niramol Chanplakorn; Objoon Trachoo; Pattarana Sae-Chew; Rangsima Aroonroch

2014-01-01

121

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

International Nuclear Information System (INIS)

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

122

Preoperative Measurement of Serum Thyroglobulin to Predict Malignancy in Thyroid Nodules: A Systematic Review.  

Science.gov (United States)

Several articles have assessed the role of preoperative serum thyroglobulin (Tg) as predictor of malignancy of thyroid nodules, with particular focus on nodules with indeterminate cytology. However, the role of serum Tg as diagnostic marker remains unclear. The aim of the study was to perform a systematic review to add more evidence-based data on this topic. A comprehensive literature search was conducted to find relevant published articles on this topic. MeSH terms were: "thyroglobulin" and "predict*". In order to include only recent serum Tg assay methods, we analyzed the timeframe between 2001 and July 31(st), 2014. To expand our search, references of the retrieved articles were also screened. Thirteen studies, including 3?580 patients, were analyzed. Nine out of these studies reported data on thyroid nodules with prior indeterminate cytology. Preoperative serum Tg levels demonstrated suboptimal accuracy in discriminating malignant from benign nodules due to a significant overlap of values between these groups. However, most articles demonstrated a statistically significant difference in mean or median serum Tg between patients with cancer and benign lesions correlated to final histology. Furthermore, most studies reported Tg as independent predictor of malignancy. According to the most recent literature, the preoperative measurement of Tg alone fails to discriminate thyroid cancers from benign lesions. However, our data show that Tg is an independent predictor of malignancy; as a consequence, the presurgical determination of Tg should be considered in patients with thyroid nodules, especially when cytology is indeterminate. PMID:25384015

Trimboli, P; Treglia, G; Giovanella, L

2014-11-10

123

Acoustic radiation force impulse elastography for differentiation of benign and malignant thyroid nodules with concurrent Hashimoto's thyroiditis.  

Science.gov (United States)

The purpose of the study was to explore the diagnostic performance of acoustic radiation force impulse (ARFI) elastography in differential diagnosis between benign and malignant thyroid nodules in patients with coexistent Hashimoto's thyroiditis (HT). A total of 141 pathological proven nodules in 141 HT patients (7 males and 134 females, mean age 50.1 years, range 23-75 years) received conventional ultrasound (US), elasticity imaging (EI) and ARFI elastography, including virtual touch tissue imaging (VTI) and virtual touch tissue quantification (VTQ), before surgery. Shear wave velocity (SWV) and SWV ratio were measured for each nodule on VTQ. The US, EI and ARFI elastography features were compared between benign and malignant nodules in HT patients. Receiver operating characteristic curve (ROC) analyses and area under curve (AUC) were performed to assess the diagnostic performance. Pathologically, 70 nodules were benign and 71 nodules were malignant. Significant differences were found between benign and malignant nodules in HT patients for EI (EI score) and ARFI (VTI grade and SWV) (all P value diagnostic performance of ARFI elastography is better than EI. PMID:25636511

Liu, Bo-Ji; Xu, Hui-Xiong; Zhang, Yi-Feng; Xu, Jun-Mei; Li, Dan-Dan; Bo, Xiao-Wan; Li, Xiao-Long; Guo, Le-Hang; Xu, Xiao-Hong; Qu, Shen

2015-03-01

124

Effect of surgery irradiation and chemotherapy on the character of blood serum proteins changes in patients with malignant neoplasms  

International Nuclear Information System (INIS)

In the group of 357 patients with malignant neoplasms character of changes in the levels of essential protein electrophoretic fractions occurring immediately after surgical (carcinoma of the stomach), irradiation (bronchial carcinoma, malignant granuloma) and chemical treatments (breast cancer) was determined. Both surgery and irradiation were associated with the increase in dysproteinemia due to the decrease in total albumins and tendency to increase levels of globulins. In patients with breast cancer after multidrug therapy hypoalbuminemia showed marked tendency to normalize due to both the decrease in excessive serum dilution and increase of this protein level in circulating blood serum. Normalization of alpha-globulins resulted from the decrease in total amount of this fraction in circulating blood serum. (author)

125

Retrospective epidemiologic study on some malignant neoplasms of the blood-forming system in children (0-14 years)  

International Nuclear Information System (INIS)

The results are presented from a case/control epidemiologic study of the radiation effect on malignant neoplasms of blood-forming system in children aged 0-14 years. The cases comprised children with acute myeloleucosis, chronic myeloleucosis and non-Hodgkin malignant lymphoma, who had become ill after 1991. The controls were clinically healthy children matched for sex and age. The assessment of radiation factor was based on data provided by parents in a guided inquiry and on information available at the National Centre of Radiobiology and Radiation Protection, Sofia (BG). Consideration was given to individual doses received prior to and following medical exposure as well as from the Chernobyl accident. (author)

126

P53, Bcl-2, Ki-67 Li (Labeling Index) Status in Benign, Proliferative, And Malignant Ovarian Surface Epithelial Neoplasms  

Science.gov (United States)

Objective Approximately 50% of human malignancies present with mutations in p53, which is the most common tumor suppressor gene involved with human malignancies. Bcl-2 is a protooncogene, and expression of its protein product is associated with a better prognosis in several malignancies. Ki-67 is a marker of cellular proliferation. The purpose of this study was to determine whether simultaneous detection of p53, bcl-2 and Ki-67 using immunohistochemical staining can be used as a diagnostic factor in the assessment of human ovarian epithelial tumors. Materials and Methods The study was performed on formalin-fixed, paraffin-embedded tissue samples from 75 epithelial ovarian tumors, 15 serous cystadenomas, 15 mucinous cystadenomas, 5 borderline serous cystadenomas, 5 borderline mucinous cystadenomas, 15 serous cystadenocarcinomas, 15 mucinous cystadenocarcinomas and 5 endometrioid carcinomas. Immunohistochemical staining was performed using monoclonal antibodies against p53, bcl-2, and Ki-67(MIB1). Results Anti-p53 reactivity was observed in 14 tumors, all of which were malignant tumors, and no reactivity was observed in borderline or benign tumors. Overexpression of bcl-2 was observed in 12 benign neoplasms (40%), 5 of which were borderline (50%), but was not observed in any of the malignant tumors. There was a statistically significantly higher level of Ki-67 LI positivity in the malignant tumors than in the benign and borderline tumors (p<0.005). Conclusion These data show significant differences in the expression of these markers in ovarian tumors and suggest a possible role for these tumor-associated genes as supplemental tools in diagnostic pathology. Furthermore, our findings support the redesignation of low malignant potential tumors (current nomenclature) to benign ovarian carcinoma. PMID:25610057

Gursan, Nesrin; Sipal, Sare; Calik, Muhammed; Gundogdu, Cemal

2009-01-01

127

Frequency and significance of pulmonary nodules on thin-section CT in patients with extrapulmonary malignant neoplasms  

International Nuclear Information System (INIS)

Purpose: To determine the frequency and significance of pulmonary nodules detected on thin-section CT in patients with extrapulmonary malignant neoplasms. Materials and methods: The institutional review board approved this study. This study retrospectively evaluated 308 patients with extrapulmonary carcinomas or sarcomas and had undergone thin-section chest CT (2 mm slice thickness) for staging. Three radiologists identified non-calcified nodules and evaluated the size, the growth and the distance from the nearest pleural surface. The characteristics of the nodules were defined based on the results of either a diagnostic biopsy or nodule growth. Results: One or more non-calcified pulmonary nodules were detected in 75% of the patients (233/308). One hundred and thirty-seven of these patients had nodules that met the criteria of either benign or malignant nodules. Nodules smaller than 10 mm were more likely to be benign, whereas those 10 mm or greater were more likely to be malignant (22/26, 85%; P < .0001). Most nodules less than 10 mm from the pleura were benign (91%), whereas approximately half of the nodules 10 mm or more away from the pleura were malignant (20/43, 47%; P < .0001). Patients with melanoma, sarcoma, or testicular carcinoma were more likely to have malignant nodules. A multivariable analysis demonstrated the nodule size (P < .0001) and distance from the pleura were predictive of malignancy. Conclusion: The nodule detection rate on thin-section CT in pale detection rate on thin-section CT in patients with extrapulmonary malignancy is high. Most of the nodules smaller than 10 mm or less than 10 mm from the pleura are benign.

128

Epstein-Barr Virus-Associated Lymphoid Malignancies: The Expanding Spectrum of Hematopoietic Neoplasms  

OpenAIRE

Ubiquitous Epstein-Barr virus (EBV) infects not only B cells but also T and NK cells, and is associated with various lymphoid malignancies. The spectrum of EBV-associated lymphoid malignancies is expanding from Burkitt lymphoma to the newly defined systemic EBV+ T cell lymphoproliferative disease of childhood and hydroa vacciniforme-like lymphoma. However, some EBV-associated malignancies are not defined well and overlap other diseases. Furthermore, the role of EBV in tumorigenesis of lymphoi...

JUN-ICHI KAWADA; HIROSHI KIMURA; YOSHINORI ITO

2013-01-01

129

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

2009-10-01

130

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish 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. Abstract in english 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 asso [...] ciation 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.

2009-10-01

131

Characteristic Dynamic Enhancement Pattern of Magnetic Resonance Imaging for Malignant Thyroid Tumor: A Preliminary Report  

International Nuclear Information System (INIS)

The purpose of this study is to determine the characteristic dynamic enhancement pattern of magnetic resonance (MR) imaging for malignant thyroid tumor. Eight patients who were pathology proven to have a malignant thyroid tumor, preoperatively. There are 5 papillary carcinomas, 1 medullary carcinoma, 1 follicular carcinoma, and 1 fine needle aspiration biopsy proven atypical cell. Based on preoperative MR imaging, we compared the dynamic MR enhancement pattern relating to the pathologic type. On contrast agent-enhanced dynamic T1-weighted image (T1WI), 5 papillary carcinoma and one medullary carcinoma showed delayed enhancement compared to normal parenchyma. In addition, one follicular carcinoma shows stronger enhancement than normal parenchyma, with one papillary carcinoma showing a persistent decrease in enhancement compared to normal parenchyma. Although this study is limited by a small patients population, the data suggests that delayed enhancement on enhanced dynamic T1WI is a possible characteristic MR finding of a malignant thyroid tumor. I think that the comparison of MR imaging between benign and malignant nodules is required for a correct characterization.

132

Characteristic Dynamic Enhancement Pattern of Magnetic Resonance Imaging for Malignant Thyroid Tumor: A Preliminary Report  

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The purpose of this study is to determine the characteristic dynamic enhancement pattern of magnetic resonance (MR) imaging for malignant thyroid tumor. Eight patients who were pathology proven to have a malignant thyroid tumor, preoperatively. There are 5 papillary carcinomas, 1 medullary carcinoma, 1 follicular carcinoma, and 1 fine needle aspiration biopsy proven atypical cell. Based on preoperative MR imaging, we compared the dynamic MR enhancement pattern relating to the pathologic type. On contrast agent-enhanced dynamic T1-weighted image (T1WI), 5 papillary carcinoma and one medullary carcinoma showed delayed enhancement compared to normal parenchyma. In addition, one follicular carcinoma shows stronger enhancement than normal parenchyma, with one papillary carcinoma showing a persistent decrease in enhancement compared to normal parenchyma. Although this study is limited by a small patients population, the data suggests that delayed enhancement on enhanced dynamic T1WI is a possible characteristic MR finding of a malignant thyroid tumor. I think that the comparison of MR imaging between benign and malignant nodules is required for a correct characterization.

Park, Young Nam; Hwang, Hee Young; Shim, Young Sup; Byun, Sung Su; Choi, Hye Young; Kim, Hyung Sik [Dept. of Radiology, Gil Hospital, Gachon University College of Medicine and Science, Incheon (Korea, Republic of)

2011-11-15

133

[Distribution of Cs-137 in the human body with malignant neoplasms of various localizations].  

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137Cs-concentrations and distribution in internal organs and malignant tumor tissues from cadavers and patients operated on for cancer were identified by gamma spectrometry in clinics of Vitebsk Region. Non-uniform distribution patterns in different organs were registered, irrespective of the presence or absence of malignancy. PMID:10853420

Kirillov, L M; Krylov, Iu V; Zhavoronok, S V; Kalinin, A A; Panashchenko, V V; Frolov, Iu I; Lektorov, V N; Lakisov, P P; Makarov, M M; Riabov, S N; Smirnova, N P

2000-01-01

134

Epstein-Barr Virus-Associated Lymphoid Malignancies: The Expanding Spectrum of Hematopoietic Neoplasms  

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Full Text Available Ubiquitous Epstein-Barr virus (EBV infects not only B cells but also T and NK cells, and is associated with various lymphoid malignancies. The spectrum of EBV-associated lymphoid malignancies is expanding from Burkitt lymphoma to the newly defined systemic EBV+ T cell lymphoproliferative disease of childhood and hydroa vacciniforme-like lymphoma. However, some EBV-associated malignancies are not defined well and overlap other diseases. Furthermore, the role of EBV in tumorigenesis of lymphoid malignancies is still not clear. Further studies are necessary to clarify the pathogenesis of EBV-associated lymphoid malignancies for a better classification of each disease and for the establishment of effective treatment.

JUN-ICHI KAWADA

2013-08-01

135

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

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For 1950 - 80, 194 ovarian cancer cases were ascertained among the 70,030 females of the RERF Life Span Study (LSS-E85) sample, and 106 autopsied cases with benign ovarian neoplasms were ascertained among all 3,046 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 histological type. The age-adjusted ovarian cancer incidence rates showed a statistically significant increase with increased exposure dose, both in the entire exposed group (P 0.10). The distribution of histological types of both cancer and benign tumor of the ovary did not vary significantly with radiation dose. The data are consistent with the hypothesis that radiation injury of ovaries with secondary excess of gonadotrophic hormones are important causative factors in the development of ovarian neoplasms. (author)

136

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

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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 < 0.01). Conclusions: Tetrofosmin scintigraphy can be used as an alternative agent to Tl-201 and Tc99m-Sestamibi in difagent to Tl-201 and Tc99m-Sestamibi in differentiation of benign from malignant thyroid nodules. (author)

137

Comparison of Na{sup +}/I{sup -} symporter expression rate in malignant and benign thyroid diseases: immunohistochemical study  

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Previous studies have not showed consistent results for the level of expression of sodium/iodide symporter (NIS) in thyroid diseases, especially malignant tumor. We undertook this study to evaluate the distribution of NIS expression in malignant thyroid diseases and compare with that in benign thyoid disease. Total patients were 119 cases (Men 15, 48{+-}13 yrs). Total number of samples were 205 pieces. In malignant thyroid disease, there were 153 samples: 90 in papillary carcinoma, 4 in follicular carcinoma, 2 in medullary carcinoma and 57 in metastatic lymph node. In benign thyroid disease, there were 52 samples: 36 in goiter/cyst, 11 in thyroiditis and 5 in follicular adenoma. Using immunohistochemical methods, we probed 205 samples with monoclonal anti-NIS Ab. Grading of staining was scored as 0 (negative or absent), 1 (weakly positive), 2 (moderately positive) or 3 (strongly positive). Expression rate (ER) of NIS positivity in individual disease entity was expressed as percentage of total number divided by number in 2 plus 3 grade. ERs of malignant thyroid diseases were 63% in papillary carcinoma, 81% in metastatic lymph node, 71% in follicular carcinoma and 100% in medullary carcinoma. ERs of benign thyroid disease were 53% in goiter/cyst, 64% in thyroiditis and 40% in follicular adenoma. ER of benign thyroid deceases was higher than benign thyroid diseases (71% vs 54%). Grading of NIS expression in papillary carcinoma or goiter/cyst was heterogeneously distributed in considerable cases. Normal tissue also showed heterogeneous distribution or NIS expression, which was not correlated with that of primary lesion. In papillary thyroid carcinoma, distribution of NIS expression was heterogeneous and increased, and not different compared with that of benign thyroid disease.

Kang, Do Young; Jeong, Young Jin; Lee, Kyung Eun; Park, Heon Soo; Yoo, Young Hyun; Roh, Mee Sook [Donga University College of Medicine, Busan (Korea, Republic of)

2006-02-15

138

Malignant cystic renal neoplasms in infants and children: Imaging differential considerations  

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The majority of malignant renal tumors in infants and children display characteristics of solid masses on various imaging modalities. However, a number of these lesions may appear partially or entirely cystic due to hemorrhage, necrosis, or true cyst formation. It is often difficult to differentiate these malignant lesions from more common benign cystic renal and retroperitoneal abnormalities. Wilms tumors, malignant mesoblastic nephroma, and renal pelvic carcinoma with predominatly cystic findings on imaging are presented. They are compared with benign renal and retroperitoneal lesions which they may mimic, including multilocular cystic nephroma, congenital ureteropelvic junction obstruction and its variants, duplication anomalies with complications, and adrenal hemorrhage

139

An 8-year evaluation of nasal and paranasal sinuses malignant neoplasms in Tehran University of Medical Sciences hospitals  

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Full Text Available Introduction: Nasal and paranasal sinuses malignant neoplasms are usually diagnosed in advanced stages because of non-specific and benign symptoms. In this study we evaluated the symptoms, pathology and treatment of paranasal sinuses malignancies in patients admitted to Tehran University of Medical Sciences affiliated hospitals. Material and Methods: In this descriptive study, medical files of patients diagnosed with paranasal sinus malignancies and admitted to Imam Khomeini and Amir Aalam hospitals between 2000-2007 were evaluated. Results: Of 75 patients, 47 were male and 28 were female. The mean age was 55±14.1 years. The most common sinus involvement was seen in Maxillary sinuses (86.7% and 18 patients had concurrent involvement of other sinuses. The most common pathology was squamous cell carcinoma (40% and the most common clinical symptom was nasal obstruction (%28. Distant metastasis was found in 46 patients and 42 patients presented with eye involvement Eleven patients underwent endoscopic resection. Conclusion: The presence of eye involvement and distant metastasis in a large number of the patients showed that diagnosis of paranasal cancers is delayed because of their nonspecific symptoms. Therefore further education of clinical manifestations of paranasal sinus cancers is emphasized. 

Mohsen Naraghi

2009-07-01

140

CT findings in the differential diagnosis of benign and malignant thyroid tumor  

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We analysed CT findings of thyroid mass to determine the difference between a benign and a malignant mass and to evaluate the differential findings, if any. The subjects were 87 cases with a pathologically proven thyroid mass (malignancy in 66 cases, benign mass in 21 cases). CT findings were retrospectively analysed. For the primary masses, bilaterality, size, margin, attenuation of the mass, spotty portion with distinct high attenuation(which may suggest calcification), necrosis, cystic change, solid portion within the cyst, and invasion of adjacent structures were evaluated. For the lymph nodes, size, high attenuated spotty portion, necrosis, cystic change, and solid portion within the cyst were evaluated. CT findings of thyroid masses and lymph nodes were evaluated in order to determine whether these were benign of malignant. Statistical analysis was performed using the Mann-Whitney U-Wilcoxon rank sum test. In malignant masses, compared with benign, an indistinct margin of the mass(48% vs 19%), in vasion of adjacent structures(53% vs 0%), and associated lymph node enlargement(50% vs 0%) were more frequent. With regard to bilaterality, size, attenuation, high-attenuated spotty portion(which may suggest calcification), necrosis, cystic change, and solid portion within the cyst, there was no significant difference between benign andmalignant masses. In masses of the former type, enlarged lymph node or invasion or adjacent structure were not seen at all. When the papillary solid portion within the cystic mass was additionally evaluated, papillary carcinoma was the most common finding(77% 14/18). General findings of malignancy such as margin, invasion of the mass, and lymph node enlargement are of help in the differential diagnosis of a malignant mass. High attenuated spotty portion, which may suggest calcification within the mass, or size of the mass are non-specific findings, and are not helpful in differential diagnosis. The papillary solid portion within the cyst of the mass could suggest papillary carcinoma as a first possibility and could be helpful in differential diagnosis.

Jung, Hye Weon; Han, Moon Hee; Kim, Hong Dae; Chang, Kee Hyun; Kang, Heung Sik; Im, Jung Gi [Seoul Natiional Univ. College of Medicine, Seoul (Korea, Republic of)

1996-04-01

141

Neck ultrasonography as preoperative localization of primary hyperparathyroidism with an additional role of detecting thyroid malignancy  

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Objective: To evaluate and compare the diagnostic performances of high-resolution ultrasonography and {sup 99m}Tc-sestamibi scintigraphy for the preoperative localization of abnormal parathyroid glands and to evaluate the ability of US for additional diagnostic roles in detecting thyroid malignancy in patients with pHPT. Materials and methods: Preoperative localization images of 115 parathyroid adenomas from high-resolution ultrasonography (US) and {sup 99m}Tc-sestamibi scintigraphy (SS) were studied from 105 patients, who had undergone parathyroidectomy. Sensitivity, accuracy, and positive predictive value were calculated for the identification of adenomas in lesions and patients for both US and SS, respectively, and US and SS diagnostic performances were compared using generalized estimating equation. Results: Preoperative imaging by both modalities localized 105 (93.8%) of the 112 parathyroid lesions confirmed at surgery and histology. Sensitivity, accuracy, and positive predictive value were 93.1% and 92.2%, 90.4% and 89.5%, and 96.9% and 96.9% by US and SS, respectively, without any statistically significant differences (P = 0.796, 0.796, 0.879). US found incidental thyroid nodules in 47 patients (47/107, 43.9%), and 7 patients (7/107, 6.5%) were confirmed to have malignancy based on pathology results (all had papillary thyroid carcinoma). Conclusion: Neck ultrasonography and {sup 99m}Tc-sestamibi scintigraphy are complementary methods of the preoperative localization of parathyroid adenomas. Neck ultrasounds add an additional thyroid gland evaluation, and can be useful in the detection of incidental thyroid gland lesions, especially malignant nodules.

Kwon, Joon Ho; Kim, Eun-Kyung [Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 120-752 (Korea, Republic of); Lee, Hye Sun [Biostatistics Collaboration Unit, Medical Research Center, Yonsei University College of Medicine, Seoul 120-752 (Korea, Republic of); Moon, Hee Jung [Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 120-752 (Korea, Republic of); Kwak, Jin Young, E-mail: docjin@yuhs.ac [Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 120-752 (Korea, Republic of)

2013-01-15

142

Neck ultrasonography as preoperative localization of primary hyperparathyroidism with an additional role of detecting thyroid malignancy  

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Objective: To evaluate and compare the diagnostic performances of high-resolution ultrasonography and 99mTc-sestamibi scintigraphy for the preoperative localization of abnormal parathyroid glands and to evaluate the ability of US for additional diagnostic roles in detecting thyroid malignancy in patients with pHPT. Materials and methods: Preoperative localization images of 115 parathyroid adenomas from high-resolution ultrasonography (US) and 99mTc-sestamibi scintigraphy (SS) were studied from 105 patients, who had undergone parathyroidectomy. Sensitivity, accuracy, and positive predictive value were calculated for the identification of adenomas in lesions and patients for both US and SS, respectively, and US and SS diagnostic performances were compared using generalized estimating equation. Results: Preoperative imaging by both modalities localized 105 (93.8%) of the 112 parathyroid lesions confirmed at surgery and histology. Sensitivity, accuracy, and positive predictive value were 93.1% and 92.2%, 90.4% and 89.5%, and 96.9% and 96.9% by US and SS, respectively, without any statistically significant differences (P = 0.796, 0.796, 0.879). US found incidental thyroid nodules in 47 patients (47/107, 43.9%), and 7 patients (7/107, 6.5%) were confirmed to have malignancy based on pathology results (all had papillary thyroid carcinoma). Conclusion: Neck ultrasonography and 99mTc-sestamibi scintigraphy are complementary methods of the preoperative localization of parathyroid adenomas. Neck ultrasounds add an additional thyroid gland evaluation, and can be useful in the detection of incidental thyroid gland lesions, especially malignant nodules

143

A three-gene panel that distinguishes benign from malignant thyroid nodules.  

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Reliable preoperative diagnosis of malignant thyroid tumors remains challenging because of the inconclusive cytological examination of fine-needle aspiration biopsies. Although numerous studies have successfully demonstrated the use of high-throughput molecular diagnostics in cancer prediction, the application of microarrays in routine clinical use remains limited. Our aim was, therefore, to identify a small subset of genes to develop a practical and inexpensive diagnostic tool for clinical use. We developed a two-step feature selection method composed of a linear models for microarray data (LIMMA) linear model and an iterative Bayesian model averaging model to identify a suitable gene set signature. Using one public dataset for training, we discovered a three-gene signature dipeptidyl-peptidase 4 (DPP4), secretogranin V (SCG5) and carbonic anhydrase XII (CA12). We then evaluated the robustness of our gene set using three other independent public datasets. The gene signature accuracy was 85.7, 78.8 and 85.7%, respectively. For experimental validation, we collected 70 thyroid samples from surgery and our three-gene signature method achieved an accuracy of 94.3% by quantitative polymerase chain reaction (QPCR) experiment. Furthermore, immunohistochemistry in 29 samples showed proteins expressed by these three genes are also differentially expressed in thyroid samples. Our protocol discovered a robust three-gene signature that can distinguish benign from malignant thyroid tumors, which will have daily clinical application. PMID:25175491

Zheng, Bing; Liu, Jun; Gu, Jianlei; Lu, Yao; Zhang, Wei; Li, Min; Lu, Hui

2015-04-01

144

201Tl-chloride thyroid scintigraphy to evaluate benign and/or malignant nodules: usefulness of the delayed scan  

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The purpose of this study is to evaluate benign and/or malignant thyroid tumors with 201Tl thyroid scan. Researchers studied 76 cases of histologically verified thyroid tumors, all seen as cold nodules on the 123I thyroid scan. 201Tl thyroid scan was performed 5-15 minutes (early scan) and 3-5 hours (delayed scan) after intravenous administration of 1.5-2.0 mCi of 201Tl. In 35 (94.6%) of 36 malignant tumors (anaplastic carcinoma, six; papillary carcinoma 23; follicular carcinoma, five; epidermoid carcinoma, one; malignant lymphoma, 1) 201Tl accumulated in the cold nodule of the 123I thyroid scan on both early and delayed scans. On the other hand, the delayed 201Tl scan was negative in 35 out of 39 (89.7%) benign tumors. Employing early and delayed 201Tl scans, researchers were able to differentiate most malignant thyroid tumors from those which were benign. False-negative and -positive cases are discussed

145

Solitary extramedullary plasmocytoma of the thyroid: a case report and histological approach to plasma cells infiltrate in the thyroid gland.  

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Background: Solitary extramedullary plasmacytoma (SEP) is a rare malignant neoplasm arising from plasma cells. SEP mostly occurs in the upper respiratory tract. Thyroid gland is rarely affected (multiple myeloma was negative. Conclusions: SEP should be considered in the differential diagnosis of a rapidly enlarging thyroid nodule and be distinguished from involvement of thyroid in multiple myeloma, mucosa-associated lymphoid tissue lymphoma, plasma cell granuloma and medullary carcinoma. Clinical correlation and immunohistochemistry are crucial in avoiding pitfalls. PMID:25363715

Wilmars, Maud Mertens de; Knoops, Laurent; Sempoux, Christine; Galant, Christine; Geets, Xavier; Poirel, Hélène A; Ameye, Geneviève; Camboni, Alessandra

2014-11-01

146

Differentiation of malignant and benign solitary thyroid nodules using 30- and 120-minute tc-99m MIBI scans.  

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Technetium-99m methoxy isobutylisonitrate (MIBI) has been found to be taken up by various tumors, including thyroid cancer. We prospectively evaluated 77 patients with cold thyroid solitary nodules on Tc-99m pertechnetate scintigraphy to evaluate the diagnostic value of Tc-99m MIBI scintigraphy. The aim of this study was to find out if thyroid nodules can be characterized on the basis of retention of MIBI and whether preoperative evaluation of malignancy is possible using this method. Single injection, dual-phase (30 and 120 minutes) thyroid scintigraphy using Tc-99m MIBI was performed in all these patients. In the following days and weeks, all patients underwent surgery. Using the 120/30-minute thyroid lesion to background radiouptake ratio (RUR), malignant and benign thyroid nodules could be separated with a sensitivity, specificity, and positive predictive value of 84.4%, 95.45%, and 93.33%, respectively. The mean RUR for malignant thyroid lesions was found to be 1.57+/-0.32, whereas for benign lesions, the ratio was significantly lower, 0.32+/-0.19. In conclusion, fine needle aspiration cytology along with the 120/30 minutes Tc-99m MIBI scintigraphy ratio appears to be useful in the preoperative assessment of solitary thyroid nodules. PMID:15311117

Sharma, Rajnish; Mondal, Anupam; Shankar, L Ravi; Sahoo, M; Bhatnagar, Parul; Sawroop, K; Chopra, M K; Kashyap, Ravi

2004-09-01

147

Spontaneous internal jugular vein thrombosis and recurrent laryngeal nerve palsy: a rare simultaneous presentation of an occult malignant neoplasm.  

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Internal jugular vein thrombosis is an uncommon potentially life-threatening disorder caused by various conditions. Non-spontaneous internal jugular vein thrombosis is an uncommon condition associated in the pre-antibiotic area with deep-neck infections. Currently iatrogenic trauma to the internal jugular vein from catheterisation and repeated intravenous injections by drug abusers are the leading causes of thrombosis. Spontaneous internal jugular vein thrombosis may occur when there are no apparent pre-disposing mechanical or inflammatory causes although a few of these patients may harbour an occult malignant neoplasm. Hence, careful investigation and follow-up are vital. Thrombosis in Trousseau's syndrome is usually confined to the vascular system of the extremities and the viscera. However, secondary to the paraneoplastic hypercoagulable state, thrombosis can occur in the large veins of the head and neck region. We understand this to be the first case where spontaneous internal jugular vein thrombosis and ipsilateral recurrent laryngeal nerve paralysis were the only initial manifestations of an occult malignancy. PMID:9015435

Kalan, A; Tariq, M; Harar, R P; Gatland, D

1996-12-01

148

Histopathological pattern of ovarian neoplasms and their age distribution in the western region of Saudi Arabia.  

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Benign ovarian neoplasms are more common than malignant ones. The most common benign ovarian neoplasm is serous cystadenoma and the commonest malignant neoplasm is serous cystadenocarcinoma. The prevalence of malignant ovarian neoplasms increases with increasing age.

Layla S. Abdullah

2012-01-01

149

Accuracy of Contrast-Enhanced Computed Tomography (CT Scan in Differentiation of Malignant Parotid Neoplasms: New Approaches for Better Diagnosis  

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Full Text Available   Introduction: One of the most important preoperative concerns in patients with parotid neoplasms is the probability of malignancy. In this study, we evaluated the accuracy of different findings of contrast-enhanced CT scan in differentiation of malignant parotid neoplasms. Also we have presented the results of new approaches in this regard. Materials and Methods: All patients with noninflammatory parotid masses were considered in this study in a one year period. All patients with one or more of these conditions were excluded from the study: age under 15 years old, patients who underwent previous biopsy or fine needle aspiration and the time interval between imaging and surgery was more than 10 days. Finally 33 patients were entered to the study. Of all cases, 18 (54.6% were male and the mean age was 43.3±17.6 years (15-78. All patients underwent a facial and neck contrast enhanced CT scanning in the supine position and axial sections (5 mm thickness and 5 mm interval were performed from the temporomandibular joint (TMJ upper border to the thoracic inlet. Ten seconds after intravenous bolus injection of 100cc Omnipaque 240 mg I/cc, imaging began. For all parotid masses, 8 imaging findings were evaluated which consisted of the tumor size [maximum value of parotid tumor short-axis diameter], Hunsfield unit (HU [considered in section performed 120 seconds after contrast medium injection; region of interest (ROI was considered as a 5 mm diameter circle in the central part of the region with the highest visual density of the mass],visual density, heterogenecity, tumor border, tumor location, tumor extension to the other neck spaces and cervical adenopathy. Surgery was performed for all patients and the histopathologic evaluation was done as gold standard. For dichotomous variables, the diagnostic indices [including sensitivity(Se., specificity (Sp, positive predictive value (PPV, negative predictive value(NPV, positive likelihood ratio (LR+ and negative likelihood ratio (LR-] were calculated. For continuous variables (including tumor size and HU the receiving operating characteristic (ROC curve was assessed and the selected cut points were yielded. Results: Totally 13 patients showed malignant tumor in pathology (39.4%. Deep lobe involvement, extension to the other neck spaces and adenopathy were higher in malignant tumors [all P-Values<0.018]. Among dichotomous variables, the best Se. was for enhancement pattern (Se=0.85 while Sp=0.4 and the best Sp. was for extension and adenopathy [Sp=0.95 for both, Se=0.38 for extension and 0.46 for adenopathy]. Among seven variables of enhancement pattern, density, tumor location, tumoral extension, lymphadenopathy, Hu greater than 69 and tumoral size greater than 29 mm, if the patient showed equal or greater than 6 variables in favor of malignancy, the Sp was 1. The area under the curve (AUC of ROC curve was 0.75 [95% CI=0.57-0.92] for Hu and 0.76 [95% CI=0.6-0.92] for size [both P-Values<0.02]. We multiplied the tumor size and Hu and plotted the ROC curve for this new variable. The AUC of this new variable was 0.83 [P-Values=0.002,95% CI=0.68-0.96]. Considering the cut off point of 2050 for this variable yielded the Se of 0.85 and Sp of 0.75 for malignant tumors. Conclusion: Considering individual findings together could improve the diagnostic accuracy of CT.

Shervin Sharifkashany

2009-01-01

150

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

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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

151

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

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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, Peyman; Fulay, Suyash; Beriwal, Sushil, E-mail: beriwals@upmc.edu

2013-09-01

152

Clinical evaluation of 24 cases of primary thyroid malignant lymphoma  

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We analyzed open biopsy in diagnosing primary thyroid lymphoma (PTL) and tumor management with compression symptoms and therapy. We retrospectively studied 24 subjects diagnosed with PTL from December 1997 to June 2010.Open biopsy was done in 23 of 24 subjects. Incisional biopsy was done in 14, 13 of whom yielded sufficient materials in the first biopsy. Excisional biopsy was done in the remaining 9, 2 of whom developed permanent recurrent laryngeal nerve palsy after biopsy. The five with airway obstruction underwent incisional biopsy followed by immediate steroid administration of dexamethasone or methylprednisolone. All had histopathologically confirmed diagnosis and airway symptoms were resolved within a few days. Multidisciplinary therapy including chemotherapy, radiotherapy, and surgery was applied in 20 of 24 subjects. Single therapy was done in 4-chemotherapy in 2 and radiotherapy and surgery in 1 each. Overall results were satisfactory, with a 92% 10-year disease-free survival rate and an 86% 10-year overall survival rate based on the Kaplan-Meier method with 46-month median follow up. When diagnosing PTL, especially large tumors spreading into extrathyroid tissue, incisional biopsy is more advantageous in histopathological diagnosis than excisional biopsy due to the lower risk of surgical complications. In a case involving a small intrathyroidal nodule, excisional biopsy is safer and more diagnostically accurate. In an airway obstruction emergency, once a defn airway obstruction emergency, once a definitive diagnosis is made, steroid administration plus endotracheal intubation, if necessary, for airway management is optimal management. Subjects with stage IE mucosa-associated lymphoid tissue (MALT) lymphomas can be treated with radiotherapy or surgery alone. Those with diffuse large B-cell lymphoma (DLBCL) or greater than stage IE MALT lymphoma, however, should be treated with multidisciplinary therapy because they have a potentially poor outcome. (author)

153

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

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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: Th 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.

154

A threshold value in Shear Wave elastography to rule out malignant thyroid nodules: A reality?  

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Objectives: To evaluate hability of a threshold value in ShearWave™ elastography to rule out malignant thyroid nodules while studying its pertinence in association with morphological signs. Equipment and methods: 148 patients (110 women and 38 men; 52.5 y.o. 15.8) referred for surgery of thyroid nodules underwent standard ultrasound as well as elastography. Characteristics of the morphological signs and maximum elastographic index were calculated in relation to histology. Association of morphological signs alone and then of elastography was also evaluated. One hundred and fifty one nodules were studied on a double-blind basis. Results: 297 nodules were studied. Thirty-five cancers were detected (11.6%). Elastographic index was higher in malignant nodules (115 kPa 60.4) than in benign nodules (41 kPa 25.8) (p < 0.001, Student's t-test). Cut off value of 66 kPa was the best to discriminate malignant nodules with a sensitivity of 80% (CI 95%, 62.5; 90.9) and a specificity of 90.5% (CI 95%, 86.1; 93.6) (p = 0.0001). Association of elastography and morphological ultrasound signs presented a sensitivity of 97% (CI 95%, 83.3; 99.8) and a negative predictive value of 99.5% (CI 95%, 95.6; 99.9). Interobserver reproducibility proved to be excellent with an interclass correlation of 0.97 (CI 95%, 0.96; 0.98) (p < 0.001). Conclusion: The 66 kPa threshold in Shear Wave elastography is the best ultrasound sign to rule out malignant thyroid nodules. The method is simple, quantitative, reproducible and usable in the study of nodules larger than 3 cm. Progress must still be made in the study of calcified nodules and follicular tumors.

Veyrieres, J.-B., E-mail: jbveyrieres@hotmail.fr [Département d’imagerie médicale, Hôpital d’Instruction des Armées St Anne, Bd Saint Anne, BP 20545 Toulon cedex (France); Albarel, F., E-mail: frederique.albarel@ap-hm.fr [Département médical d’endocrinologie et des pathologies métaboliques, Hôpital Universitaire la Timone, Assistance publique des Hôpitaux de Marseille, 264 rue Saint Pierre, 13385 Marseille cedex 5 (France); Lombard, J. Vaillant, E-mail: Josiane.vaillant@ap-hm.fr [Département d’imagerie médicale, Hôpital Universitaire la Timone, Assistance publique des Hôpitaux de Marseille, 264 rue Saint Pierre, 13385 Marseille cedex 5 (France); Berbis, J., E-mail: Julie.berbis@ap-hm.fr [Département de santé publique, Université de Médecine, 27, Bd Jean Moulin, 13385 Marseille cedex 5 (France); Sebag, F., E-mail: frederic.sebag@ap-hm.fr [Département de chirurgie des pathologies endocriniennes et métaboliques, Hôpital Universitaire la Timone, Assistance publique des Hôpitaux de Marseille, 264 rue Saint Pierre, 13385 Marseille cedex 5 (France); and others

2012-12-15

155

A threshold value in Shear Wave elastography to rule out malignant thyroid nodules: A reality?  

International Nuclear Information System (INIS)

Objectives: To evaluate hability of a threshold value in ShearWave™ elastography to rule out malignant thyroid nodules while studying its pertinence in association with morphological signs. Equipment and methods: 148 patients (110 women and 38 men; 52.5 y.o. 15.8) referred for surgery of thyroid nodules underwent standard ultrasound as well as elastography. Characteristics of the morphological signs and maximum elastographic index were calculated in relation to histology. Association of morphological signs alone and then of elastography was also evaluated. One hundred and fifty one nodules were studied on a double-blind basis. Results: 297 nodules were studied. Thirty-five cancers were detected (11.6%). Elastographic index was higher in malignant nodules (115 kPa 60.4) than in benign nodules (41 kPa 25.8) (p < 0.001, Student's t-test). Cut off value of 66 kPa was the best to discriminate malignant nodules with a sensitivity of 80% (CI 95%, 62.5; 90.9) and a specificity of 90.5% (CI 95%, 86.1; 93.6) (p = 0.0001). Association of elastography and morphological ultrasound signs presented a sensitivity of 97% (CI 95%, 83.3; 99.8) and a negative predictive value of 99.5% (CI 95%, 95.6; 99.9). Interobserver reproducibility proved to be excellent with an interclass correlation of 0.97 (CI 95%, 0.96; 0.98) (p < 0.001). Conclusion: The 66 kPa threshold in Shear Wave elastography is the best ultrasound sign to rule out malignant thyroid nodules. The method is simple, quantitative, reproducible and usable in the study of nodules larger than 3 cm. Progress must still be made in the study of calcified nodules and follicular tumors.

156

Malignant transformations in ovarian teratomas: a report of four cases.  

Science.gov (United States)

Mature cystic teratoma (MCT) is a common ovarian neoplasm in young females. A secondary malignant transformation occurs rarely in cystic teratomas at an older age. These secondary malignant neoplasms most commonly are squamous cell carcinomas (SCCs). Various mechanisms are reported, but the exact aetiology is unknown. We report three cases of SCC arising in cystic teratoma and one case of papillary thyroid neoplasm as secondary transformation. The SCCs were arising from the cyst wall, while the papillary thyroid malignancy arose from the normal-looking thyroid epithelium. Histologically, all SCC cases were poorly differentiated. Poor prognostic features for secondary transformations include size more than 10 cm, older age and rapid growth. Data is scarce regarding their appropriate treatment. However, surgical debulking is necessary. Platinum-based adjuvant regimens and taxanes are recommended in cases of advanced disease. In this paper we review and share our experience with this rare disorder. PMID:25252524

Hannan, Abdul; Awan, Umm-e-Kalsoom; Siddiqui, Neelam; Muzaffar, Narjis

2014-08-01

157

Frequent Expression of the Variant CD30 in Human Malignant Myeloid and Lymphoid Neoplasms  

OpenAIRE

We earlier identified a variant of CD30 (CD30v) that retains only the cytoplasmic region of the authentic CD30. This variant is expressed in alveolar macrophages. CD30v can activate the nuclear factor-?B (NF-?B) as CD30, and its overexpression in HL-60 induced a differentiated phenotype. To better understand the physiological and pathological functions of CD30v, expression of this variant was examined using a multiple approach to examine 238 samples of human malignant myeloid and lymphoid n...

Horie, Ryouichi; Gattei, Valter; Ito, Kinji; Imajo-ohmi, Shinobu; Tange, Tsuyoshi; Miyauchi, Jun; Pinto, Antonio; Degan, Massimo; Iuliis, Angela; Tassan Mazzocco, Francesca; Rossi, Francesca Maria; Higashihara, Masaaki; Watanabe, Toshiki

1999-01-01

158

CT findings in the differential diagnosis of benign and malignant thyroid tumor  

International Nuclear Information System (INIS)

We analysed CT findings of thyroid mass to determine the difference between a benign and a malignant mass and to evaluate the differential findings, if any. The subjects were 87 cases with a pathologically proven thyroid mass (malignancy in 66 cases, benign mass in 21 cases). CT findings were retrospectively analysed. For the primary masses, bilaterality, size, margin, attenuation of the mass, spotty portion with distinct high attenuation(which may suggest calcification), necrosis, cystic change, solid portion within the cyst, and invasion of adjacent structures were evaluated. For the lymph nodes, size, high attenuated spotty portion, necrosis, cystic change, and solid portion within the cyst were evaluated. CT findings of thyroid masses and lymph nodes were evaluated in order to determine whether these were benign of malignant. Statistical analysis was performed using the Mann-Whitney U-Wilcoxon rank sum test. In malignant masses, compared with benign, an indistinct margin of the mass(48% vs 19%), in vasion of adjacent structures(53% vs 0%), and associated lymph node enlargement(50% vs 0%) were more frequent. With regard to bilaterality, size, attenuation, high-attenuated spotty portion(which may suggest calcification), necrosis, cystic change, and solid portion within the cyst, there was no significant difference between benign andmalignant masses. In masses of the former type, enlarged lymph node or invasion or adjacent structure were not seen at all. When the papructure were not seen at all. When the papillary solid portion within the cystic mass was additionally evaluated, papillary carcinoma was the most common finding(77% 14/18). General findings of malignancy such as margin, invasion of the mass, and lymph node enlargement are of help in the differential diagnosis of a malignant mass. High attenuated spotty portion, which may suggest calcification within the mass, or size of the mass are non-specific findings, and are not helpful in differential diagnosis. The papillary solid portion within the cyst of the mass could suggest papillary carcinoma as a first possibility and could be helpful in differential diagnosis

159

Evaluation of Diagnostic Value of Ultrasonography and Color Doppler in Differentiation between Malignant and Benign Thyroid Nodules  

OpenAIRE

Background/Objective: As the usage of ultrasound in the evaluation of thyroid nodules is increasing, we decided to evaluate the diagnostic value of ultrasound (US) and Doppler (CFD) findings in comparison with cytology (FNA) and eventually pathology results to establish the relative importance of US and CFD features as indicators of malignancy."nPatients and Methods: This prospective study started from June 2008 to October 2009. Two-hundred four patients with thyroid nodules were evaluat...

Hadi Majidi; Abbas Hedayatiasl

2010-01-01

160

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)

161

Prognostic role of microRNA-205 in multiple human malignant neoplasms: a meta-analysis of 17 studies  

Science.gov (United States)

Objective MicroRNA-205 (miRNA-205) was revealed as an attractive prognostic tumour biomarker in recent studies. However, the results of different studies have been inconsistent. We conducted a meta-analysis to elucidate the precise predictive value of miRNA-205 in various human malignant neoplasms. Design Meta-analysis. Data sources Qualified studies were identified up to 5 June 2014 by performing online searches in PubMed, EMBASE and Web of Science, and additional quality evaluations. Participants Seventeen eligible studies with 4827 patients were ultimately enrolled in this meta-analysis. Outcome measures The heterogeneity between studies was assessed using I2 statistics. Pooled HRs with 95% CIs for patient survival and disease recurrence were calculated to investigate the correlation between miRNA-205 expression and cancer prognosis. Results Our results indicate that elevated miRNA-205 was significantly associated with enhanced overall survival in the breast cancer subgroup (HR=0.78, 95% CI 0.67 to 0.91) and superior disease-free survival/recurrence-free survival in the adenocarcinoma subgroup (HR=0.68, 95% CI 0.49 to 0.94). Conclusions miRNA-205 is a promising biomarker for predicting the recurrence and progression of patients with adenocarcinomas or breast cancer. Owing to its complex roles, further relevant studies are warranted. PMID:25613953

Zhang, Jia-yi; Sun, Meng-yan; Song, Ning-hong; Deng, Zhong-lei; Xue, Chun-yu; Yang, Jie

2015-01-01

162

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

Science.gov (United States)

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

2013-08-01

163

Thyroid neoplasia in long-term Segment III beagles  

International Nuclear Information System (INIS)

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

164

Estimate of the uncertainties in the relative risk of secondary malignant neoplasms following proton therapy and intensity-modulated photon therapy  

OpenAIRE

Theoretical calculations have shown that proton therapy can reduce the incidence of radiation-induced secondary malignant neoplasms (SMN) compared with photon therapy for patients with prostate cancer. However, the uncertainties associated with calculations of SMN risk had not been assessed. The objective of this study was to quantify the uncertainties in projected risks of secondary cancer following contemporary proton and photon radiotherapies for prostate cancer. We performed a rigorous pr...

Fontenot, Jonas D.; Bloch, Charles; Followill, David; Titt, Uwe; Newhauser, Wayne D.

2010-01-01

165

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

OpenAIRE

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 autocor...

Pui-Jen Tsai; Cheng-Hwang Perng

2011-01-01

166

[Duodenum-preserving total pancreatic head resection : an organ-sparing operation technique for cystic neoplasms and non-invasive malignant tumors].  

Science.gov (United States)

Cystic neoplasms of the pancreas are being detected and surgically treated increasingly more frequently. Intraductal papillary mucinous neoplasms (IPMN) and mucinous cystic neoplasms (MCN) are primary benign lesions; however, the 5-year risk for malignant transformation has been estimated to be 63 % and 15 %, respectively. Surgical extirpation of a benign cystic tumor of the pancreas is a cancer preventive measure. The duodenum-preserving total pancreatic head resection technique (DPPHRt) is being used more frequently for cystic neoplasms of the pancreatic head. The complete resection of the pancreatic head can be applied as a duodenum-preserving technique or with segmental resection of the peripapillary duodenum. Borderline lesions, carcinoma in situ or T1N0 cancer of the papilla and the peripapillary common bile duct are also considered to be indications for segmental resection of the peripapillary duodenum. A literature search for cystic neoplastic lesions and DPPHRt revealed the most frequent indications to be IPMN, MCN and SCA lesions and 28 % suffered from a cystic neoplasm with carcinoma in situ or a peripapillary malignoma. The hospital mortality rate was 0.52 %. Compared to the Whipple type resection the DPPHRt exhibits significant benefits with respect to a low risk for early postoperative complications and a low hospital mortality rate of impaired compared to the Whipple type resection. PMID:23417612

Beger, H G; Siech, M; Poch, B

2013-05-01

167

Treatment of malignant neoplasms by combined radio- and chemotherapy with cell-cycle synchronization  

International Nuclear Information System (INIS)

Immediate and short-term results are reported from treatment of 12 cases of malignancies affecting the face jaw area by the method of cell-cycle synchronization using 5-fluorouracyl. The patients, ranging from 49 to 73 years of age, presented with developed differentiated planocellular carcinomas distributed according to the TNM system, as follows: T1, N0, M0, 2 subjects; T2, N0, M0, 2 subjects; T3, N1, M0, 4 subjects; and T4, N1, M0, 4 subjects. Based on a scheme, 750 mg 5-fluorouracyl was infused over a 12-hour period (drop-by-drop administration), the procedure being repeated twice weekly up to a total dose of 8.5-11.5 mg. Radiotherapy (gamma teletherapy) followed under the same schedule, namely 8 hours after discontinuing the drop-by drop system, at 500 rad daily tumor dose and 6000-7000 rad total focal dose delivered over a 6-7 week period. Directly after cessation of radiotherapy, clinical disappearance (100) of the tumor was observed in 8 patients, reduction by 90% in 1 patient, and by 80% in 3 patients. No recurrences were noted at 3 months following radiotherapy; the proportion of recurrences did not increase until after the 6th month (40%). The most common local response was radioepithelitis; severe cases calling for temporary interruption of treatment occurred in 7 of the 12 patients. The hematopoietic system showed no deviatiohe hematopoietic system showed no deviations from the norm. No marked general radiation reactions were observed. Long-term results as regards primary tumors and survival will be reported in a second paper. (author)

168

Subsequent malignancies in patients treated with 131-iodine for thyroid cancer  

International Nuclear Information System (INIS)

I-131 was administered to 298 patients with thyroid cancer, and there has been a follow-up of at least two years. Follow-up periods were: 2.5 to 30 years (median 14.5) in living patients, 2.5 to 15 years (median 5.5) in patients dead of tumour ? 2 years after first treatment and 2.5 to 23 years (median nine) in patients dead without tumour. Person-years at risk were (total applied activity of I-131): 1119 (3 to 21 GBq), 1477 (22 to 65 GBq), 521 (61 to 170 Gbq). 33 subsequent malignancies in 31 patients were observed, compared to an expected number of 17. The relative risk of subsequent malignancies is therefore 1.94 with a 95% confidence intervall of 1.15 to 3.05. This increase in the incidence of subsequent malignancies after I-131 treatments is largely due to the significantly increased incidence of leukemia and bladder cancer. Estimated radiation doses to the bone marrow in the patients with leukemia were 301 cGy to 792 cGy and the doses to the bladder in patients with bladder cancer were 2250 cGy to 10, 350 cGy. After a total activity of less than 37 GBq I-131, no cases of bladder cancer or leukemia were observed. The observed number of subsequent malignancies are compared with the expected number according to several dose-effect estimations. (orig.)

169

Can benign and malignant thyroid nodules be differentiated with thallium 201  

International Nuclear Information System (INIS)

The merits of Thallium 201 radionuclide scanning of the thyroid mentioned as soon as 1976 by PALERMO have been confirmed in the 16 last studies published in the international literature. Over 1601 examinations, authors showed that any cold nodule (Tc 99 m or 1 123) which preferentially fixes Thallium 201 as compared to surround thyroid tissue must be operated since some of them are thyroid cancer carriers, some others are carriers of a traditional follicular adenoma or Hurthle-cell adenoma, or a follicular adenoma associated with varied cell atypisms which make difficult the diagnosis between benign and malignant nodules. The analysis of the results published show a 91.3% sensitivity of this diagnosis test, all analysis methods being considered. In case of negative test, it allows eliminating the cancer risk by more than 97% (negative predictive value). Such an examination - as opposed to a cytology test on the isolated nodule only - is valid for any type of nodule, being isolated, multiple or a multinodular goitre where the degeneration risk is close to, or even higher than, that of isolated nodules. (authors)

170

Ruling in or ruling out thyroid malignancy by molecular diagnostics of thyroid nodules  

DEFF Research Database (Denmark)

Routine morphologic cytology is the basis for any kind of (integrated) molecular FNA diagnostics. The rule out (gene expression classifier) approach requires confirmation by independent studies, whereas the rule in approach (detection of BRAF, NRAS, HRAS, and KRAS and PAX8/PPARG- and RET/PTC rearrangements) has been investigated by several groups with overall reproducible results. Moreover, molecular screening for point mutations and rearrangements is feasible in routine air-dried FNA smears, offering several advantages over obtaining additional fresh FNA material. The current panel of somatic mutations (rule in approach) for indeterminate FNAs clarifies only a subgroup of indeterminate FNAs. Therefore, further markers are urgently needed that can reliably identify the malignant, but mutation negative and especially the many benign nodules, among the indeterminate FNAs. miRNA markers and the targeted next generation sequencing (NGS) technology do have the potential to identify those nodules that are mutation negative by current approaches. © 2014 Elsevier Ltd. All rights reserved.

Eszlinger, Markus; Hegedüs, László

2014-01-01

171

Multiple malignant primary neoplasms in patients with gastric neoplasms in the health district of León / Neoplasias primarias malignas múltiples en pacientes con cáncer gástrico en el área sanitaria de León  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: English Abstract in spanish Objetivos: analizar las características de los pacientes con tumores gástricos diagnosticados de una neoplasia primaria maligna múltiple (NPMM) en el área sanitaria de León. Pacientes y método: utilizando los datos del Registro de Tumores del Hospital de León se han seleccionado aquellos pacientes c [...] on tumores gástricos diagnosticados entre 1993 y 2002. Se realizó un seguimiento hasta el 31 de diciembre de 2004 analizando las características de los pacientes diagnosticados de una segunda neoplasia durante el periodo de seguimiento. Resultados: la prevalencia de NPMM fue del 1,96%. El 56% de los pacientes tenían antecedentes oncológicos en familiares de primer grado. Las segundas neoplasias más frecuentes fueron las digestivas (26%) y las urológicas (21%). El 87% de los pacientes fueron diagnosticados del segundo tumor en los primeros dos años. No se observaron diferencias respecto a la supervivencia entre los pacientes con NPMM sincrónicas y metacrónicas. Conclusiones: las NPMM en los pacientes con cáncer gástrico son un problema relevante. Aunque los agentes carcinógenos externos puedan actuar como promotores en el desarrollo de una segunda neoplasia, en estos pacientes parece existir una base genética que favorece el desarrollo del una NPMM. La prevención secundaria es la mejor medida para evitar el desarrollo de una NPMM. Abstract in english Objectives: we analyzed the characteristics of patients with gastric tumors diagnosed with multiple malignant primary neoplasm (MMPN) in the Health District of León. Material and methods: using the information in the Tumor Registry at León Hospital patients selected were those with gastric neoplasms [...] diagnosed between 1993 and 2002. A follow-up was performed until December 31, 2004, and the characteristics of patients diagnosed with a second neoplasm were analyzed. Results: MMPN prevalence was 1,96%; 56% of patients had a history of cancer in first-degree relatives. The most frequent second neoplasms were digestive (26%) and urologic (21%); 87% of patients were diagnosed with a second neoplasm within the first two years. No significative differences in survival were observed among patients with synchronous or metachronous MMPN. Conclusions: MMPN in patients with gastric neoplasms is a relevant problem. While external carcinogenic agents could act as promoters in the development of second neoplasms, these patients seem to have a genetic background favoring the development of MMPN. Secondary prevention is the best measure to avoid MMPN development.

A., Muela Molinero; F., Jorquera Plaza; T., Ribas Ariño; R., Malagón Rojo; V., Espinel Díez; B., Ballesteros del Río; J. L., Olcoz Goñi; J. A., Santos Calderón.

2006-12-01

172

131I treatment response in thyroid neoplasms and evaluation of radiation dose complications. A review of ten years of experience  

International Nuclear Information System (INIS)

Full text: Thyroid cancer (TC) is the most common endocrine malignancy, but its management is still a controversial issue that included an interdisciplinary approach who compounds surgery, radioiodine (RAI) therapy and sometimes external radiation therapy. The aim of our work is to evaluate the role of the RAI treatment in well differenciated thyroid carcinoma and its implication in terms of survival and complications. Methods and Material: we collected data from medical records of 215 patients with confirmed TC, registered from 1990-2004 at the Nuclear Medicine Unit, Hospital Temuco, Chile, who received 50 to 150 mCi RAI therapy four to six weeks after lobectomy, partial or total thyroidectomy. Clinical and laboratory examinations were analyzed including blood count, thorax X Ray, whole body I-131 scans, and serum thyroglobulin. Results: the median age at the diagnosis was 51 years, there were 89% females. All patients were treated surgically and recived postoperative RAI treatment. Total thyroidectomy, subtotal thyroidectomy and nodule excision was done in 69%, 31% and 37% of patients respectively. The histopathologic results included papillary (62%), follicular (24%) and papillary-follicular carcinoma (14%). Regional lymph nodes were positive in 36% and distant metastases were detected in 20 %, located in the lungs in all of those patients. Additional RAI doses between 100-200 mCi were administrated in 35% patients after to wait a period longer than 1 year. The ove wait a period longer than 1 year. The overall survival rate at 14 years was 93 %, and recurrent disease was detected in 15%. at 5 years and 20% at 14 years from the diagnosis. There were no major complications and minimal alterations in the blood count was observed. We conclude that total or near total thyroidectomy followed by RAI treatment appears to benefit for better survival and lower recurrence disease. Favorable prognostic management included radioiodine therapy at the primary treatment using high actvities (more than 100 mCi) after total or near total thyroidectomy. Additional pulmonary metastases did not influence prognosis, and secondary effects were mild and related to the symptoms of hypothyroidism. (author)

173

Ultrasound diagnosis for retrojugular lymphadenopathy in the patient having a history of total thyroidectomy due to thyroid malignancy  

International Nuclear Information System (INIS)

This study aimed to assess the accuracy of ultrasound (US) diagnosis for retrojugular lymphadenopathy in patients who had undergone total thyroidectomy, due to thyroid malignancy. During a follow up period after total thyroidectomy, due to known thyroid malignancy, 41 patients underwent US diagnosis and US guided fine needle aspiration for retrojugular lymphadenopathy. Each lymphadenopathy was prospectively classified by a single radiologist into 1 of 3 diagnostic categories: 'benign', 'indeterminate for malignancy', and 'malignant'. Based on the cytohistopathology result, thyroglobulin tittering, and sonographic follow up, the adequacy of US diagnosis for retrojugular lymphadenopathy was assessed. Of the 41 retrojugular lymphadenopathies, malignant (n = 25) and benign (n = 16) lymphadenopathy were finally confirmed. Excluding 15 lymph nodes with indeterminate US diagnosis, the sensitivity, specificity, positive and negative predictive values, accuracy, and false positive and negative rates of US diagnosis were 100%, 66.7%, 95.8%, 100%, 96.2%, 0%, and 10%, respectively. There was no significant difference in the incidence of retrojugular lymphadenopathy, according to age, sex, and location (p > 0.05). In the patient with a history of total thyroidectomy, due to thyroid malignancy, US diagnosis for retrojugular lymphadenopathy showed a high accuracy

174

Ultrasound diagnosis for retrojugular lymphadenopathy in the patient having a history of total thyroidectomy due to thyroid malignancy  

Energy Technology Data Exchange (ETDEWEB)

This study aimed to assess the accuracy of ultrasound (US) diagnosis for retrojugular lymphadenopathy in patients who had undergone total thyroidectomy, due to thyroid malignancy. During a follow up period after total thyroidectomy, due to known thyroid malignancy, 41 patients underwent US diagnosis and US guided fine needle aspiration for retrojugular lymphadenopathy. Each lymphadenopathy was prospectively classified by a single radiologist into 1 of 3 diagnostic categories: 'benign', 'indeterminate for malignancy', and 'malignant'. Based on the cytohistopathology result, thyroglobulin tittering, and sonographic follow up, the adequacy of US diagnosis for retrojugular lymphadenopathy was assessed. Of the 41 retrojugular lymphadenopathies, malignant (n = 25) and benign (n = 16) lymphadenopathy were finally confirmed. Excluding 15 lymph nodes with indeterminate US diagnosis, the sensitivity, specificity, positive and negative predictive values, accuracy, and false positive and negative rates of US diagnosis were 100%, 66.7%, 95.8%, 100%, 96.2%, 0%, and 10%, respectively. There was no significant difference in the incidence of retrojugular lymphadenopathy, according to age, sex, and location (p > 0.05). In the patient with a history of total thyroidectomy, due to thyroid malignancy, US diagnosis for retrojugular lymphadenopathy showed a high accuracy.

Nam, Seung Min; Kim, Dong Wook [Busan Paik Hospital/Inje Univ. College of Medicine, Busan (Korea, Republic of)

2012-07-15

175

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)

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

176

Ultrasound of thyroid gland  

International Nuclear Information System (INIS)

Full text: A thyroid and parathyroid ultrasound (US) is an imaging test to check the thyroid gland and parathyroid glands and is done to: check for nodules in the thyroid gland, find out whether the thyroid gland is enlarged, to keep track of the size of the thyroid gland during treatment, look for enlarged parathyroid glands caused by disease, guide the placement of the needle during a thyroid biopsy. The thyroid gland is formed by two lobes joined by an isthmus and, in a significant percentage of individuals, the 'pyramidal lobe', a vestige of the thyroglossal duct extending upward from the isthmus. A fibrous capsule surrounds the gland and connects with intrathyroidal fibrous septa forming 'lobules' that become grossly evident in pathologic conditions. Each lobule is supplied by a single artery and contains 20 to 40 'follicles' that average 200 nm in size and contain 'colloid'. Follicles are lined by a monolayer of low-cuboidal 'follicular' cells surrounded by a basement membrane. In fine needle aspiration biopsy (FNAB) specimens, normal follicular cells are typically arranged in follicles, and monolayered sheets arranged in a honeycomb pattern with well-defined borders and nuclei which maintain polarity. Thyroid nodules are extremely common with an estimated prevalence on the basis of palpation that ranges from 3% to 7%. It has been estimated that there is a 5 to 10% lifetime risk of developing a palpable thyroid nodule, most of these nodules are benign, and cliniost of these nodules are benign, and clinicians should be as selective as possible in recommending surgical removal. Although thyroid nodules are a common incidental finding, US should not be performed as a screening test. Moreover, 20% to 48% of patients with one palpable thyroid nodule are found to have additional nodules on US investigation. Thyroid nodules are more common in elderly persons, in women, in those with iodine deficiency, and in those with a history of radiation exposure. Patients with benign thyroid nodules should undergo clinical and US follow-up. Symptomatic goiters, whether euthyroid or hyperthyroid, may be treated surgically or with radioiodine. Malignant or suspicious nodules should be treated surgically after preoperative evaluation with US and FNAB. An ultrasound can reveal which thyroid nodules are larger than 1-1.5 centimeters, requiring further evaluation for cancer. In addition to size, other nodule characteristics that can be noted on a thyroid ultrasound include the following: number of nodules, location of nodules, distinctness of borders, fluid versus solid contents, other nodule contents, such as calcium deposits, or the amount of blood flow (certain newer ultrasound machines can assess blood flow to the thyroid and its nodules). Thyroid lesions discovered on computed tomography (CT) or magnetic resonance imaging (MRI) performed for other reasons have an uncertain risk of malignancy and should undergo US evaluation before considering evaluation with FNA biopsy. Nodules are also detected infrequently by 18F-fluorodeoxyglucose positron emission tomography,but when found they are considered to have higher risk of malignancy. The annual incidence of thyroid malignancies in different parts of the world varies from 0.5 to 10 per 100,000 individuals. Despite its infrequency, it is important to remember that thyroid carcinoma is as prevalent as multiple myeloma, twice as common as Hodgkin's disease, and as frequent as cancers of the esophagus, larynx, mouth, and uterine cervix. Furthermore, thyroid cancer is the most common malignant endocrine tumor, responsible for 64% of deaths attributable to malignant endocrine neoplasms, more than all other endocrine cancers combined. Nevertheless, treatment of thyroid cancer is very successful

177

Thyroid neoplasia following radiation therapy for Hodgkin's lymphoma  

International Nuclear Information System (INIS)

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

178

Radioactive iodine whole body scan (RIWB) strategy in malignant thyroid diseases: an approach to iodine 123 utilisation  

International Nuclear Information System (INIS)

Nevertheless, the scan may be avoided if the expansive malignant intra-thyroidal lesion, treated by total thyroidectomy, has favorable prognosis criteria and there are not anti-thyroglobulin antibodies circulating. Indeed RIWB scan must be used periodically in follow-up of the other cases, scanning, if possible, with iodine-123 in order to avoid the stunning effect The RIWB post-therapeutic scan (after administration of a high activity of 1311) gives, of course, the best information concerning the eventual remaining post-surgery thyroid tissue and the eventual localisation of metastases. Therefore two different propositions has be done in the follow-up of patients with malignant thyroid lesions depending on the prognosis criteria. (author)

179

The immunohistochemical expression of proliferating cell nuclear antigen (PCNA/cyclin) in malignant and benign epithelial ovarian neoplasms and correlation with prognosis.  

Science.gov (United States)

Proliferating cell nuclear antigen (PCNA)/cyclin is considered to be a marker of cell proliferation. The aim of this study was to evaluate the expression of PCNA/cyclin in epithelial ovarian neoplasms (EON) as well as the possible correlation with degree of differentiation, tumour stage and overall survival. The material consisted of 34 benign and 40 malignant EON. Positive nuclear staining was detected in 2/34 (6%) of benign and 23/39 (59%) malignant EON (P < 0.001). Most cases in the high proliferation group were diagnosed in advanced clinical stages. There was no difference in overall survival between nuclear PCNA positive and negative patients, as well as the high and the low proliferation group. In conclusion, the role of PCNA as a marker of malignant potential and prognosis in EON merits further investigation. PMID:8105840

Nakopoulou, L; Janinis, J; Panagos, G; Comin, G; Davaris, P

1993-01-01

180

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

181

Differential profile of ultrasound findings associated with malignancy in mixed and solid thyroid nodules in an elderly female population.  

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Objective. Ultrasonographic characteristics are associated with thyroid malignancy. Our aim was to compare the diagnostic value of ultrasound features in the detection of thyroid malignancy in both solid and mixed nodules. Methods. We prospectively studied female patients (?50 years) referred to ultrasound-guided fine needle aspiration biopsy. Ultrasound features considered suspicious were hypoechogenicity, microcalcifications, irregular margins, high anteroposterior (AP)/axial-ratio, and absent halo. Associations were separately assessed in mixed and solid nodules. Results. In a group of 504 elderly female patients (age?=?69 ± 8 years), the frequency of malignant cytology was 6%. Thirty-one percent of nodules were mixed and 60% were solid. The rate of malignant cytology was similar for mixed and solid nodules (7.4 versus 5.8%, P: 0.56). While in mixed nodules none of the ultrasound characteristics were associated with malignant cytology, in solid nodules irregular margins and microcalcifications were significant (all P < 0.05). The combination of irregular margins and/or microcalcifications significantly increased the association with malignant cytology only in solid nodules (OR: 2.76 (95% CI: 1.25-6.10), P: 0.012). Conclusions. Ultrasound features were of poor diagnostic value in mixed nodules, which harbored malignant lesions as often as solid nodules. Our findings challenge the recommended minimal size for ultrasound-guided fine needle aspiration biopsy in mixed nodules. PMID:25050189

Vera, María Inés; Meroño, Tomás; Urrutia, María Agustina; Parisi, Carina; Morosan, Yanina; Rosmarin, Melanie; Schnitman, Marta; Brites, Fernando; Grisendi, Silvio; Serrano, María Sol; Luciani, Wilfredo; Serrano, Leonardo; Zuk, Carlos; De Barrio, Guillermo; Cejas, Claudia; Faingold, María Cristina; Brenta, Gabriela

2014-01-01

182

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

OpenAIRE

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 e...

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

2006-01-01

183

GNAq mutations are not identified in papillary thyroid carcinomas and hyperfunctioning thyroid nodules.  

Science.gov (United States)

Activating mutations of GNAq protein in a hotspot at codon 209 have been recently described in uveal melanomas. Since these neoplasms share with thyroid carcinomas a high frequency of MAP kinase pathway-activating mutations, we hypothesized whether GNAq mutations could also play a role in the development of thyroid carcinomas. Additionally, activating mutations of another subtype of G protein (GNAS1) are frequently found in hyperfunctioning thyroid adenomas, making it plausible that GNAq-activating mutations could also be found in some of these nodules. To investigate thyroid papillary carcinomas and thyroid hyperfunctioning nodules for GNAq mutations in exon 5, codon 209, a total of 32 RET/PTC, BRAF, and RAS negative thyroid papillary carcinomas and 13 hyperfunctioning thyroid nodules were evaluated. No mutations were identified. Although plausible, GNAq mutations seem not to play an important role in the development of thyroid follicular neoplasms, either benign hyperfunctioning nodules or malignant papillary carcinomas. Our results are in accordance with the literature, in which no GNAq hotspot mutations were found in thyroid papillary carcinomas, as well as in an extensive panel of other tumors. The molecular basis for MAP-kinase pathway activation in RET-PTC/BRAF/RAS negative thyroid carcinomas remains to be determined. PMID:20714830

Cassol, Clarissa A; Guo, Miao; Ezzat, Shereen; Asa, Sylvia L

2010-12-01

184

Differentiation between cavernous hemangiomas and untreated malignant neoplasms of the liver with free-breathing diffusion-weighted MR imaging: Comparison with T2-weighted fast spin-echo MR imaging  

Energy Technology Data Exchange (ETDEWEB)

Objective: To test interobserver variability of ADC measurements and compare the diagnostic performances of free-breathing diffusion-weighted (FBDW) with that of T2-weighted FSE (T2WFSE) MR imaging for differentiating between cavernous hemangiomas and untreated malignant hepatic neoplasms. Materials and methods: Thirty-five patients with cavernous hemangiomas and 35 with untreated hepatic malignant neoplasms had FBDW and T2WFSE MR imaging. Hepatic lesions were characterized with ADC measurement and visual evaluation. Interobserver agreement for ADC measurement was calculated. Association between ADC value and lesion type was assessed using univariate analysis. Sensitivity, specificity and accuracy of ADC values and visual evaluation of MR images for the diagnosis of untreated malignant hepatic neoplasm were compared. Results: ADC measurements showed excellent interobserver correlation (intraclass correlation coefficient = 0.980). Malignant neoplasms had lower ADC values than hemangiomas for the two observers (1.11 x 10{sup -3} mm{sup 2}/s {+-} .21 x 10{sup -3}vs. 1.77 x 10{sup -3} mm{sup 2}/s {+-} .29 x 10{sup -3} for observer 1 and 1.11 x 10{sup -3} mm{sup 2}/s {+-} .19 x 10{sup -3}vs. 1.79 x 10{sup -3} mm{sup 2}/s {+-} .32 x 10{sup -3} for observer 2) and univariate analysis found significant correlations between lesion type and ADC values. Depending on ADC threshold value, accuracy for the diagnosis of malignant neoplasm varied from 82.9% to 94.3%. Using visual evaluation, FBDW showed better specificity and accuracy than T2WFSE MR images for the diagnosis of malignant neoplasm (97.1% vs. 77.1% and 94.3% vs. 62.9%, respectively). Conclusion: FBDW imaging provides reproducible quantitative information and surpasses the value of T2WFSE MR imaging for differentiating between cavernous hemangiomas and untreated malignant hepatic neoplasms.

Soyer, Philippe, E-mail: philippe.soyer@lrb.aphp.fr [Department of Abdominal Imaging, Hopital Lariboisiere-AP-HP and Universite Diderot-Paris 7, 2, rue Ambroise Pare, 75475, Paris Cedex 10 (France); Unite 965 INSERM/Paris7, Hopital Lariboisiere-AP-HP and Universite Diderot-Paris 7, 2, rue Ambroise Pare, 75475, Paris Cedex 10 (France); Corno, Lucie; Boudiaf, Mourad [Department of Abdominal Imaging, Hopital Lariboisiere-AP-HP and Universite Diderot-Paris 7, 2, rue Ambroise Pare, 75475, Paris Cedex 10 (France); Aout, Mounir [Clinical Research Unit, Hopital Lariboisiere-AP-HP and Universite Diderot-Paris 7, 2, rue Ambroise Pare, 75475, Paris Cedex 10 (France); Sirol, Marc; Place, Vinciane; Duchat, Florent; Guerrache, Youcef; Fargeaudou, Yann [Department of Abdominal Imaging, Hopital Lariboisiere-AP-HP and Universite Diderot-Paris 7, 2, rue Ambroise Pare, 75475, Paris Cedex 10 (France); Vicaut, Eric [Clinical Research Unit, Hopital Lariboisiere-AP-HP and Universite Diderot-Paris 7, 2, rue Ambroise Pare, 75475, Paris Cedex 10 (France); Pocard, Marc [Unite 965 INSERM/Paris7, Hopital Lariboisiere-AP-HP and Universite Diderot-Paris 7, 2, rue Ambroise Pare, 75475, Paris Cedex 10 (France); Department of Digestive Diseases, Hopital Lariboisiere-AP-HP and Universite Diderot-Paris 7, 2, rue Ambroise Pare, 75475, Paris Cedex 10 (France); Hamzi, Lounis [Department of Abdominal Imaging, Hopital Lariboisiere-AP-HP and Universite Diderot-Paris 7, 2, rue Ambroise Pare, 75475, Paris Cedex 10 (France)

2011-11-15

185

Value of routine frozen section diagnosis of thyroid lesions.  

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The inability to diagnose follicular carcinoma intraoperatively with frozen section is the most significant factor accounting for the relatively low sensitivity of frozen section diagnosis of thyroid malignant neoplasm. In our institution, frozen section is considered a complementary investigation to emerging fine needle cytopathology in the region.

D. M. Tamimi

2001-11-01

186

Malignant neoplasms of respiratory and intrathoracic organs (C30-C39) in the Osijek-Baranja County, Croatia.  

Science.gov (United States)

The Institute of Public Health of the Osijek-Baranja County in collaborate with different county institutes provide updated information on the cancer occurrence and trends in the Osijek-Baranja County (OBC). The cancers were defined according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), codes of malignant neoplasms of respiratory and intrathoracic organs (C30-C39). The aim of this article was to show the size of cancer problem with the C30-C39 cancer group in the Osijek-Baranja County (OBC). This article processes data on cancer incidence and mortality, appertaining age distribution, median age, cancer survival and length of stay in hospital collected in period 2001-2009. Out of all patients diagnosed with C30-C39 cancers, there were 18.2% of females and 81.8% of males. The total incidence rate in males (119.5/100,000) decreases while the total mortality rate (110.9/100,000) does not change in 9-year period. In the same period, the total mortality rate in females (15.7/100,000) increase moderately. The age-standardized incidence rate was six times higher in males than in females. The overall median age at diagnosis of C30-C39 cancers of both genders was 64.5 years, which exceeds the average age at diagnosis of cancer in general in the OBC by 4.8 years. Five-year relative survival rate was 14.8%, 19.7% for females and 13.7% for males. Male lung and bronchus cancer patients (C34) were 1 year younger at diagnosis of cancer than the respective female patients. An average C30-C39 cancer patient was hospitalized 2.0 times during the course of their illness while the median length of stay in hospital amounted to 16.1 days. The number of hospital admissions in both genders decreased over the 2001-2009 period. In both genders, the total length of stay in hospitals was slightly reduced. Females spent 0.4 days more in hospital than males. The overall incidence and mortality rate in the OBC were among the highest in Europe. However, these rates in females reached neither the Croatian nor the EU average. Other data are similar to those in Europe. PMID:25145000

Milas, Josip; Samardzi?, Senka; Milas, Vesna; Miskulin, Maja; Males, Josip; Mihaljevi?, Silvio

2014-06-01

187

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

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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

2011-12-01

188

Serum carcinoembryonic antigen and carbohydrate antigen 19-9 for prediction of malignancy and invasiveness in intraductal papillary mucinous neoplasms of the pancreas: A meta-analysis  

OpenAIRE

The clinical importance of intraductal papillary mucinous neoplasms (IPMN) of the pancreas has been increasing due to the large number of newly diagnosed cases. A meta-analysis was used to assess the accuracy of serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) for the identification of malignant and invasive IPMN. A literature search of PubMed and Web of Knowledge was conducted. Studies included in the analysis addressed the diagnostic accuracy of serum CEA and CA19...

Wang, Weilin; Zhang, Lufei; Chen, Linghui; Wei, Jianfeng; Sun, Qiang; Xie, Qingshong; Zhou, Xiaohu; Zhou, Dongkai; Huang, Pengfei; Yang, Qifan; Xie, Haiyang; Zhou, Lin; Zheng, Shusen

2014-01-01

189

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 SciELO Cuba | Language: Spanish 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 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 tissue [...] s with malignant neoplasms. Material and Methods: sections of five paraffin blocks from five patients with gastric malignant neoplasms were studied. They were analyzed through 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.

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

2013-06-01

190

A method for scintigraphy with 67-Gallium citrate of malignant thyroid tumors under conditions of previously induced hyperferremia  

International Nuclear Information System (INIS)

A modified method of Smith F. et al for scintigraphy of malignant thyroid tumors with 67Ga-citrate under conditions of previously induced hyperferremia has been applied for the first time in Bulgaria. The patient is injected intravenously with 100 mg Ferrum Hausman, followed two hours later by intravenous injection of 67Ga-citrate in dose 55,5 MBq. Thyroid scintigraphy is performed on the 24. hour. The method allows to shorten the period of patient examination by one day, to reduce signifficantly the radioactivity being introduced and the respective radiation load to the patient. The method may be applied in any radioisotopic laboratory

191

"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

2006-06-01

192

Von Reckling-hausen disease associated to thyroid carcinoma and malignant schwannoma of the chest wall. A case  

International Nuclear Information System (INIS)

The multiple neurofibromatosis is an autosomal dominant hereditary disease associated to malignant schwannoma in about 3% of the cases and very rarely to others cancers. The study provides information on the case of a 32 year-old woman who suffers from this disease and presented two synchronous cancers: a papillary carcinoma of thyroid and a malignant schwannoma of the chest wall. The thyroid tumour was managed with hemithyroidectomy, hormonotherapy and radiotherapy, and the lesion of the thoracic wall was treated with local radical resection application of Marlex mesh and rotation of a musculocutaneous flap of the dorsal muscle. A review of the literature on the clinical aspects of this association and the surgical techniques employed to cover the defect of the chest wall is presented. (authors)

193

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

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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

2012-02-01

194

Malignancy rate in sonographically suspicious thyroid nodules of less than a centimeter in size does not decrease with decreasing size.  

Science.gov (United States)

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 patients of subcentimeter thyroid nodules with one or more suspicious sonographic features and 7,105 with nodule sized 1 cm or more were included. The malignancy rate was higher in those subcentimeter nodules with suspicious sonographic findings than the nodule sized 1cm or more (19.7% vs 7.8%, P < 0.001). We grouped the nodules based on size with mm interval and observed that the malignancy rate did not decrease but the nondiagnostic results increased its size decrement. When we divided the subjects arbitrarily into a 5 mm or smaller and a 6-9 mm sized group, nondiagnostic cytology findings were reported more frequently in the smaller group (24.3% vs 18.1%, P = 0.001), while the rate of "malignant" was similar (18.3% vs 15.5%, P = 0.123) and the rate of "suspicious for malignancy" was higher (6.8% vs 2.9%, P < 0.001). Therefore when we decide to perform FNAC or not in subcentimeter-sized nodules, we should consider sonographic findings and other clinical risk factors but not the nodular size itself. PMID:21286015

Bo, Yul Hwang; Ahn, Hwa Young; Lee, Yun Hee; Lee, Ye Jin; Kim, Jung Hee; Ohn, Jung Hun; Hong, Eun Shil; Kim, Kyung Won; Jeong, In Kyung; Choi, Sung Hee; Lim, Soo; Park, Do Joon; Jang, Hak Chul; Oh, Byung-Hee; Cho, Bo Youn; Park, Young Joo

2011-02-01

195

Contribution of scintigraphy and ultrasonography to the prediction of malignancy in thyroid nodules with indeterminate cytology Contribuição da cintilografia e ultrassonografia para a predição de malignidade em nódulos tireoidianos com citologia indeterminada  

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Full Text Available OBJECTIVE: To evaluate the contribution of 131I scintigraphy and ultrasonography to the prediction of malignancy in thyroid nodules with indeterminate cytology in euthyroid patients. SUBJECTS AND METHODS: The sample consisted of 102 patients with thyroid nodules, submitted to FNAC and presenting an indeterminate cytological diagnosis (follicular neoplasm. RESULTS: Malignancy was observed in 19/25 (76% nodules with suspicious ultrasonographic characteristics versus 5/77 (6.5% without suspicious findings. When 131I scintigraphy showed a cold or hot nodule, the chance of malignancy was 38.5% and 2.5%, respectively. This exam was inconclusive in 10% of the patients. CONCLUSIONS: Surgery is indicated when a thyroid nodule with indeterminate cytology exhibits suspicious ultrasonographic characteristics. Otherwise, 131I scintigraphy can exclude thyroidectomy when reveals uptake in the nodule, which is observed in half the cases.OBJETIVO: Avaliar a contribuição da cintilografia com 131I e da ultrassonografia na predição de malignidade em nódulos tireoidianos com citologia indeterminada em pacientes eutireoidianos. SUJEITOS E MÉTODOS: A amostra foi composta por 102 pacientes com nódulos tireoidianos submetidos à punção aspirativa com agulha fina (PAAF, apresentando citologia indeterminada (neoplasia folicular. RESULTADOS: Malignidade foi encontrada em 19/25 (76% nódulos suspeitos na ultrassonografia versus 5/77 (6,5% naqueles sem características suspeitas. Quando a cintilografia com 131I mostrou nódulo hipo- ou hipercaptante, a chance de malignidade foi 38,5% e 2,5%, respectivamente, e em 10% dos pacientes esse exame foi inconclusivo. CONCLUSÕES: Cirurgia está indicada quando um nódulo tireoidiano com citologia indeterminada exibe características ultrassonográficas suspeitas. Quando não as exibe, a cintilografia com 131I pode dispensar a tireoidectomia se revelar captação correspondente ao nódulo, o que ocorre em metade dos casos.

Pedro Weslley Rosário

2010-02-01

196

Histiocytic/dendritic cell transformation of indolent B-cell neoplasms: Clinical laboratory evidence of lineage conversion in hematolymphoid malignancies  

OpenAIRE

It is well known that pluripotent progenitors of normal hematopoietic cells can differentiate into cell lineages that are distinct in morphology, immunophenotype and biological function [1]. The conventional concept holds that once a hematopoietic progenitor is committed to a given lineage, its fate is sealed and irreversible. This phenomenon of lineage commitment has also been universally observed in hematolymphoid neoplasms in the past.

Endi Wang

2012-01-01

197

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

OpenAIRE

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 expected numbers of second malignancies by applying site-, sex-, age-, period-, residence- and occupation-specific rates in the corresponding population in the Database to the appropriate person-...

Dong, C.; Hemminki, K.

2001-01-01

198

Liver neoplasms: imaging characterization  

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A wide range of both benign and malignant neoplasms may occur in the liver. Although the characterization of focal hepatic lesions may represent a diagnostic challenge for radiologists, typical imaging findings in these lesions allow a correct diagnosis. The present study is aimed at reviewing imaging findings both in the most frequent benign and malignant focal lesion found in the adult liver. (author)

199

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

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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.

Milazzo Francesca

2011-08-01

200

Evaluation of Diagnostic Value of Ultrasonography and Color Doppler in Differentiation between Malignant and Benign Thyroid Nodules  

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Full Text Available Background/Objective: As the usage of ultrasound in the evaluation of thyroid nodules is increasing, we decided to evaluate the diagnostic value of ultrasound (US and Doppler (CFD findings in comparison with cytology (FNA and eventually pathology results to establish the relative importance of US and CFD features as indicators of malignancy."nPatients and Methods: This prospective study started from June 2008 to October 2009. Two-hundred four patients with thyroid nodules were evaluated by US, CFD and FNA in Sari Imam Khomeini Hospital. After data acquisition, SPSS-17 calculated the sensitivity, specificity, negative predictive value (NPV and positive predictive value (PPV for all 12 variables.We also determined cutoff for nodule size by drawing Roc curve and measuring the cutoff. With regression logistic analysis, P value and odds ratio (confidence interval were demonstrated for meaningful variables."nResults: Forty-four patients with inadequate cytology were excluded from the study. In the remaining 210 patients, we had 191 (91% benign, 12 (5.7% suspicious and7 (3.3% malignant nodules in cytology. All patients with malignant cytology and eight patients of the 12 patients with suspicious cytology underwent surgery. After surgery and pathological study, we had malignancy in 11 (5.34% out of 206 nodules. Other results were: nodule size>10mm most sensitive (90.9%, adenopathy most specific (97.9%, margin had the highest PPV (37.55% and nodule size>28mm (our suggested variable had the highest NPV (97.7%. Using the Roc curve, 28mm was our suggestive size for nodule with the highest sensitivity and specificity (p<0.01. After logistic regression analysis of variables, independent indicators of malignancy at US examination were: blurred nodular margin (P=0.0001; OR (CI=21(5-92 and enlarged size of thyroid lobe (P=0.01;OR(CI=6.5(1.5-27."nConclusion: This study demonstrated that no single parameter satisfactorily identifies malignancy. We concluded blurred margin and enlarged thyroid lobe with prominent nodule is the best differentiating factor between missing malignancy and benignity.

Hadi Majidi

2010-05-01

201

Guideline for therapy of malignant thyroid tumours. Pleading for an actualization; Leitlinie zur Therapie maligner Schilddruesentumoren: Plaedoyer fuer eine Aktualisierung  

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Total (or near total) thyroidectomy (TE) followed by radioiodine ({sup 131}I) 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 {sup 131}I-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.)

Wieler, H. [Bundeswehr-Zentralkrankenhaus, Koblenz (Germany). Abt. Nuklearmedizin; Bartenstein, H.P. [Bundeswehr-Zentralkrankenhaus, Koblenz (Germany). Klinik u. Poliklinik fuer Nuklearmedizin; Becker, H.P. [Bundeswehr-Zentralkrankenhaus, Koblenz (Germany). Abt. fuer Allgemein-, Thorax- und Viszeralchirurgie

2004-08-01

202

Neonatal neoplasms  

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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 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

203

Clinicopathological, Biochemical, and Sonographic Features of Thyroid Nodule Predictive of Malignancy among Adult Filipino Patients in a Tertiary Hospital in the Philippines  

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Background Thyroid nodules may harbor cancer in 5% to 15% of cases. Specific clinical and sonographic features predictive of malignancy have been investigated in various populations, but due to differences in epidemiology, risk factors and iodine nutrition status, these predictors may not be valid in the Philippines. This study determined the clinicopathological, biochemical, and sonographic features of thyroid nodules predictive of malignancy among adult Filipino patients at the University of the Philippines-Philippine General Hospital (UP-PGH). Methods We reviewed the medical records of Filipino patients ?19 years of age who underwent thyroid surgery in UP-PGH from 2008 to 2011. Results A total of 837 of 1,670 patients (50.1%) were enrolled in the study, which included 417 benign and 420 malignant tumors. The mean age at diagnosis was 38±11 years, with female predominance. Multiple logistic regression analysis showed that the presence of a hard or firm nodule (odds ratio [OR], 58.8, P<0.001; OR, 12.8, P<0.001), presence of microcalcifications (OR, 11.1; P<0.001), irregular margins on ultrasound (OR, 4.5; P<0.001), and absence of associated symptoms (OR, 2.3; P<0.002) increased significantly the likelihood of thyroid malignancy. Conclusion Similar to international data, the absence of associated symptoms, firm to hard thyroid nodules, and the presence of microcalcifications and irregular margins were significant predictors of thyroid malignancy.

Sison-Peña, Cherrie Mae; Jimeno, Cecilia Alegado

2014-01-01

204

Increased frequency of hematopoietic malignancies in relatives of patients with lymphoid neoplasms: a French case-control study.  

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Lymphoid neoplasms (LNs), including non-Hodgkin's lymphoma (NHL), Hodgkin's lymphoma (HL), lymphoproliferative syndrome (LPS) and multiple myeloma (MM), are among the most frequent cancers ( approximately 17,000 new cases per year in France), after those related to smoking. LNs were investigated using the data from the ENGELA study. ENGELA is a multicenter hospital-based case-control study that was carried out in France over the period September 2000-December 2004. In all, 822 cases (397 NHL,...

Villeneuve, Sara; Orsi, Laurent; Monnereau, Alain; Berthou, Christian; Fenaux, Pierre; Marit, Gerald; Soubeyran, Pierre; Huguet, Franc?oise; Milpied, Noe?l; Leporrier, Michel; Hemon, Denis; Troussard, Xavier; Clavel, Jacqueline

2009-01-01

205

Elevated Vascular Endothelial Growth Factor (VEGF) levels in the blood serum of dogs with malignant neoplasms of the oral cavity.  

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Angiogenesis plays an essential role in the development of a neoplastic tumour by conditioning both its growth and the formation of metastases. The induction of blood vessel growth occurs under the influence of proangiogenic factors, among which Vascular Endothelial Growth Factor (VEGF) seems to be the most important. The aim of this research was to study the level of VEGF measured by ELISA in the serum of dogs with neoplasms of the oral cavity. The study material comprised samples of neoplastic tissue from 17 operated dogs and the serum of the examined animals as well as of dogs from the control group. The tissue samples were taken from dogs of different breeds, aged 6-14 years. The tumour type was determined in accordance with the applicable WHO classification. Blood samples taken from sick dogs and from animals of the control group were centrifuged, and immunoenzymatic labelling of VEGF was performed in the obtained serum using ELISA and R&D system reagents (Quantikine Canine VEGF). All stages of VEGF labelling were performed according to the recommendation of the test manufacturer. The median of VEGF in the serum of the dogs with neoplasms of the oral cavity was 40.64 pg/mL. The lowest value of 14.26 pg/mL was observed in the case of fibrosarcoma, and the highest value of 99.19 pg/mL in the case of squamous cell carcinoma. The VEGF median in the control group amounted to 11.14 pg/mL whereas the VEGF value in the groups of animals diagnosed with benign tumours ranged between 2.30 and 19.74 pg/mL. Elevated VEGF in the blood serum, in comparison with the benign tumour group and the control group, was observed in all examined neoplasms of the oral cavity. It was suggested that overexpression of VEGF can have a prognostic value and is useful in the early detection of neoplasms. PMID:24659713

Sobczy?ska-Rak, Aleksandra; Polkowska, Izabela; Silmanowicz, Piotr

2014-09-01

206

Histiocytic/dendritic cell transformation of indolent B-cell neoplasms: Clinical laboratory evidence of lineage conversion in hematolymphoid malignancies  

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Full Text Available It is well known that pluripotent progenitors of normal hematopoietic cells can differentiate into cell lineages that are distinct in morphology, immunophenotype and biological function [1]. The conventional concept holds that once a hematopoietic progenitor is committed to a given lineage, its fate is sealed and irreversible. This phenomenon of lineage commitment has also been universally observed in hematolymphoid neoplasms in the past.

Endi Wang

2012-03-01

207

Effects of X-irradiation, ovariohysterectomy and estradiol-17? on incidence, benign/malignant ratio and multiplicity of rat mammary neoplasms - a preliminary report  

International Nuclear Information System (INIS)

An overview is given of the effects of X-irradiation, ovariohysterectomy and estradiol-17? administration on mammary tumorigenesis in females of 3 rat strains, viz. the WAG/Rij, BN/BiRij and SD. The 3 rat strains differed significantly in their spontaneous mammary tumor incidence. Female SD rats had the highest incidence (47%) and female BN/BiRij rats the lowest (17%). Female WAG/Rij rats had an intermediate incidence of 29%. The benign/malignant ratio in female WAG/Rij, BN/BiRij and SD rats was 1.0, 2.0 and 7.3, respectively. The average number of mammary gland neoplasms per untreated tumor-bearing female was 1.2 in the WAG/Rij, 1.0 in the BN/BiRij and 1.6 in the SD, whereas the respective maximum numbers were 2, 1 and 5. Ovariohysterectomy almost entirely prevented mammary tumour formation in all 3 rat strains, whereas estrogen treatment enhanced it. In addition, estrogen treatment resulted in an increased number of mammary tumors per tumor-bearing female and changed the benign/malignant ratio into the direction of malignant. X-irradiation increased the mammary tumor incidence in all 3 rat strains, especially of the benign tumors. Estrogen potentiated the effect of irradiation. An effect of irradiation on mammary tumorigenesis was not observed in ovariohysterectomized females of all 3 rat strains. (author)

208

Intraductal papillary mucinous tumor of the pancreas: Usefulness of endoscopic ultrasonography in differentiation of benign and malignant neoplasm  

International Nuclear Information System (INIS)

The purpose of this study was to evaluate the usefulness of endoscopic ultrasonography (EUS) in the differential diagnosis of benign and malignant intraductal papillary mucinous tumor of the pancreas. Seven patients with intraductal papillary mucinous tumor of the pancreas confirmed by operation underwent EUS. After evaluation of findings of EUS, these observations were computed with pathologic findings, and then reevaluated them according to the histologic grade of malignancy. According to the pathologic specimens, three cases of them were malignant and the remaining 4 cases were benign. The subtypes of them were as follows: 2 main duct type, 2 branch duct type, and 3 combined type. All malignant tumors showed the main pancreatic duct dilatation (5-15 mm, mean 9.7 mm) , whereas all benign tumors showed no dilatation of the main pancreatic duct on EUS. The mural nodules of the malignant tumors (12-14 mm) were significantly larger than those od benign lesions (3-4 mm), significantly. EUS is useful for diagnosing intradutal papillary mucinous tumor of the pancreas, particularly for predicting malignancy.

209

Anaplastic carcinoma arising from median ectopic thyroid (thyroglossal duct remnant).  

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The first case of anaplastic carcinoma arising in median ectopic thyroid (thyroglossal duct remnants) in an 84-year-old woman is presented. This expands the spectrum of histologic types of thyroid malignancies reported in this location and supports the theory that these carcinomas arise from thyroid rests associated with thyroglossal ducts. The presence of a histologically benign follicular neoplasm adjacent to the carcinoma suggests the possibility that the anaplastic carcinoma resulted from the transformation of an underlying well-differentiated tumor. Some unusual features of this case are discussed as well as the criteria for establishing the diagnosis of carcinoma arising in a thyroglossal duct remnant. PMID:7306927

Nussbaum, M; Buchwald, R P; Ribner, A; Mori, K; Litwins, J

1981-12-15

210

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

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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

2006-04-01

211

An extremely rare case of testicular malign neoplasm; alveolar subtype of rhabdomyosarcoma with long term follow-up.  

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Full Text Available Testicular neoplasm usually occur in men aged between 15 and 35. These are solid organ tumours and also should be operated when there is a suspicious clinical findings. Testis tumours are levelled after histopathology evaluation. The medical, surgical and follow-up strategies of well know testis tumours, such as seminomas, non-seminom germ cell tumours, have been established. In case of testis tumours rare entities may occur as rhabdomyosarcoma.We here presented a rare case of   alveolar subtype of rhabdomyosarcoma in testis with long term follow-up.

Tumay Ipekci

2014-09-01

212

Evaluation of digital subtraction angiography in preoperative differentiation of benign and malignant nodular lesions of the thyroid  

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The authors have studied digital subtraction angiography (DSA) with 51 patients having benign and malignant nodular lesions of the thyroid. DSA studies were all performed before surgical intervention. Later, DSA imaging patterns were compared with histopathologic findings, retrospectively. The results of DSA technique showed that 3 out of 17 cases were nodules of papillary carcinoma which were blush at the lesion site, six cases were lucent, eight were unclear residuary cases. These DSA findings have indicated that diagnosis of papillary carcinoma were difficult because the DSA findings of papillary carcinoma have no special features. However, two follicular carcinoma and eleven follicular adenoma were all blush at the lesion site. Then, the selection of follicular carcinoma and adenoma from other thyroid nodules seemed possible, however the differentiation between follicular carcinoma and adenoma was impossible. Seventeen adenomatous goiters showed variegated DSA findings, characteristic findings showed lucent at the sites of the lesion which were degenerated enlarged cysts. Thus, it appears that DSA is not a suitable technique for the diagnosis of the thyroid nodule. The purpose of DSA imaging is to infer the compression, sift, obstruction of the common carotid artery and the internal jugular vein owing to a tumor by a less invasive procedure. It would appear that the utilization of DSA must be chosen for the thyroid nodule. (author) (author)

213

Serum carcinoembryonic antigen and carbohydrate antigen 19-9 for prediction of malignancy and invasiveness in intraductal papillary mucinous neoplasms of the pancreas: A meta-analysis.  

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The clinical importance of intraductal papillary mucinous neoplasms (IPMN) of the pancreas has been increasing due to the large number of newly diagnosed cases. A meta-analysis was used to assess the accuracy of serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) for the identification of malignant and invasive IPMN. A literature search of PubMed and Web of Knowledge was conducted. Studies included in the analysis addressed the diagnostic accuracy of serum CEA and CA19-9 and pooled estimates of sensitivity, specificity, positive- and negative-likelihood ratios (PLR and NLR), diagnostic odds ratio (DOR) and receiver operating characteristic curves were calculated using random-effects models. Predefined subgroup analysis was performed. Fifteen studies (published between 2001 and 2013) were analyzed, including a total of 1,629 patients. Pooled estimates of CEA in malignant and invasive IPNM prediction were: Pooled sensitivity, 18 and 18%; pooled specificity, 93 and 95%; PLR, 2.83 and 3.54; NLR, 0.89 and 0.89; and DOR, 3.35 and 3.6, respectively. Pooled estimates of CA19-9 in malignant and invasive IPMN prediction were: Pooled sensitivity, 40 and 52%; pooled specificity, 89 and 88%; PLR, 2.93 and 3.78; NLR, 0.74 and 0.6; and DOR, 4.34 and 6.33, respectively. In conclusion, serum CEA has low sensitivity and high specificity for malignant and invasive IPMN. Serum CA19-9 is a useful non-invasive preoperative tool for differentiating between invasive and benign IPMN and should be taken into account in the decision to perform surgery. PMID:25469245

Wang, Weilin; Zhang, Lufei; Chen, Linghui; Wei, Jianfeng; Sun, Qiang; Xie, Qingshong; Zhou, Xiaohu; Zhou, Dongkai; Huang, Pengfei; Yang, Qifan; Xie, Haiyang; Zhou, Lin; Zheng, Shusen

2015-01-01

214

Follicular thyroid adenoma dominated by spindle cells: report of two unusual cases and literature review  

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Primary spindle cell neoplasms of the thyroid gland are quite rare. They encompass a heterogeneous group of benign and malignant lesions of mesenchymal and epithelial origin. We herein describe two unusual follicular thyroid adenomas dominated by spindle cells with occasional areas of colloid-forming follicular differentiation. The tumors affected a 77-year woman and a 70-year old man; both had a long-history of monoclonal gammopathy of unknown significance (MGUS). One tumor presented as a la...

Abbas, Agaimy; Thomas, Hahn; Josef, Schroeder; Afaf, Elhag

2012-01-01

215

Papillary Thyroid Cancer in Struma Testis with Malignant Transformation in the Lung Associated with Trisomy 17 Successfully Treated with Total Thyroidectomy and Radioiodine Ablation  

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Background Struma testis is a rare entity, and there are only few reports on the malignant transformation of a testicular teratoma to papillary thyroid carcinoma in the literature. In this report, we describe the malignant transformation of struma testis with distant lung metastasis associated with trisomy 17 and a coexisting papillary microcarcinoma in the thyroid. Case Report A 56-year-old man presented after a left orchiectomy for an undescended left testicle. Pathologic examination identified a monodermal teratoma composed of thyroid parenchyma and associated with a 1.7-cm papillary thyroid carcinoma. Further evaluation showed a pulmonary mass on a chest CT scan. Total thyroidectomy revealed a 0.5-mm focus of papillary thyroid cancer, and removal of the lung mass confirmed metastatic papillary thyroid cancer. Array-comparative genomic hybridization of both tumors showed trisomy 17 in the struma testes and the lung metastasis. The patient responded well to radioactive iodine ablation and has no evidence of cancer 3 years later. Conclusion To our knowledge, this is the first case of papillary thyroid cancer in struma testes metastatic to the lung. It highlights the difficulties in treating these patients. Surgery to remove cancer foci, followed by radioactive iodine ablation, resulted in an excellent response in our patient. Interestingly, trisomy 17, which has so far been observed only in noninvasive thyroid nodules, was associated with pulmonary metastasis in our patient. PMID:25520651

Barakat, Shadi; Odem, Jamie; Batanian, Jacqueline R.; Raza, Shahzad; Khan, Uzma Z.

2014-01-01

216

Computerized consensus diagnosis: a classification strategy for the robust analysis of MR spectra. I. Application to 1H spectra of thyroid neoplasms.  

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We introduce and apply a new classification strategy we call computerized consensus diagnosis (CCD). Its purpose is to provide robust, reliable classification of biomedical data. The strategy involves the cross-validated training of several classifiers of diverse conceptual and methodological origin on the same data, and appropriately combining their outcomes. The strategy is tested on proton magnetic resonance spectra of human thyroid biopsies, which are successfully allocated to normal or carcinoma classes. We used Linear Discriminant Analysis, a Neural Net-based method, and Genetic Programming as independent classifiers on two spectral regions, and chose the median of the six classification outcomes as the consensus. This procedure yielded 100% specificity and 100% sensitivity on the training sets, and 100% specificity and 98% sensitivity on samples of known malignancy in the test sets. We discuss the necessary steps any classification approach must take to guarantee reliability, and stress the importance of fuzziness and undecidability in robust classification. PMID:7707918

Somorjai, R L; Nikulin, A E; Pizzi, N; Jackson, D; Scarth, G; Dolenko, B; Gordon, H; Russell, P; Lean, C L; Delbridge, L

1995-02-01

217

Methylation levels of sodium-iodide symporter (NIS) promoter in benign and malignant thyroid tumors with reduced NIS expression.  

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DNA methylation regulates gene expression. Aberrant methylation plays an important role in human tumorigenesis. We have previously detected reduced NIS mRNA expression in thyroid tumors as compared to non-tumor tissues. Thus, in this study we investigated whether the methylation of the CpG-island located in the NIS gene promoter was associated with reduced mRNA expression in thyroid tumors. Methylation levels of 30 pairs of samples from 10 benign and 20 malignant thyroid tumors (T) along with matched non-tumor (NT) areas were determined by semiquantitative methylation specific-PCR. NIS methylation was detected in all samples. Methylation levels and frequencies did not differ between the groups and were not associated with BRAF mutational status. Highest methylation levels and frequencies were detected in the 5' region of the CpG-island decreasing toward the 3' end. Intraindividual analysis (T versus NT) showed high tumor methylation levels in 40 % of the samples in the benign group and 30 % in the malignant group, associated with low NIS mRNA expression. No quantitative correlation was detected between methylation levels and mRNA expression in any the groups. The results of this study showed that methylation of NIS promoter is a very frequent event in both benign and malignant tumors as well as in their surrounding tissues, and characterized a non-homogeneous methylation pattern along the CpG island. Therefore, further investigations involving other sites that may be implicated in methylation regulation of NIS expression are warranted. PMID:22945693

Galrão, A L; Sodré, A K; Camargo, R Y; Friguglietti, C U; Kulcsar, M A; Lima, E U; Medeiros-Neto, G; Rubio, I G S

2013-02-01

218

Incidence of malignant hemopathies and thyroid carcinomas in infants less than 15 years old around the nuclear site of Marcoule  

International Nuclear Information System (INIS)

The objective was to determine, for the last ten years (1985-1995), the incidence of malignant blood diseases and thyroid carcinomas for children less than fifteen years old in a periphery of 35 km around the nuclear site of Marcoule. The conclusions are that it does not seem to exist a sur-incidence of these pathologies around Marcoule. But a surveillance register is placed for these carcinomas for the coming years, because of the choices made by the site of Marcoule and the expected developments. (N.C.)

219

Synchronous pancreatic solid pseudopapillary neoplasm and intraductal papillary mucinous neoplasm  

OpenAIRE

Solid pseudopapillary neoplasm (SPN) is a rare and low-grade malignant pancreatic neoplasm composed of poorly cohesive monomorphic neoplastic cells forming solid and pseudopapillary structures with frequent hemorrhagic-cystic degeneration. Intraductal papillary mucinous neoplasm (IPMN) is a pancreatic exocrine tumor composed of intraductal papillary growth of mucin containing neoplastic cells in the main pancreatic duct or its major branches. In the case presented here, a 53-year-old, Japanes...

Kenichi Hirabayashi; Giuseppe Zamboni; Hiroyuki Ito; Masami Ogawa; Yoshiaki Kawaguchi; Tomohiro Yamashita; Toshio Nakagohri; Naoya Nakamura

2013-01-01

220

Detección de marcadores de malignidad en nódulos tiroideos por transcripción reversa y reacción en cadena de la polimerasa (RT-PCR) Detection of malignancy markers in thyroid nodules by reverse transcriptase polymerase chain reaction (RT-PCR)  

OpenAIRE

Nodular thyroid disease is a very common disorder with a low frequency of malignancy. The most accurate diagnostic test is fine needle aspiration biopsy (FNAB) of nodules with cytological analysis of the sample. However, this procedure has some limitations in the diagnosis of follicular and papillary thyroid carcinoma. Aim: To detect mRNA from specific malignancy markers in thyroid nodules and to evaluate their potential correlation with cytological and pathological d...

Pedro Pineda B; Paula Rojas G; Claudio Liberman G; Leonor Moyano S; Irmgadt Goecke S

2003-01-01

221

Diagnostic value of microRNAs in discriminating malignant thyroid nodules from benign ones on fine-needle aspiration samples.  

Science.gov (United States)

Many studies have suggested that microRNAs (miRNAs) might serve as novel diagnostic indicators of thyroid cancer (TC). However, inconsistent results have also been reported. This meta-analysis was conducted to assess the diagnostic value of miRNAs in discriminating malignant thyroid nodules from benign ones on fine-needle aspiration samples. A systematic literature search for relevant literature published up to April 5, 2014 was conducted in PubMed, Embase, Chinese National Knowledge Infrastructure (CNKI), and Chinese Biological Medicine (CBM) databases. Data from different studies were pooled to estimate the summary sensitivity (SEN), specificity (SPE), positive likelihood ratios (PLR), negative likelihood ratios (NLR), diagnostic odds ratio (DOR), using the random-effect model. Summary receiver operator characteristic curves (SROCs) were plotted and areas under the SROC curve (AUC) were calculated to evaluate the overall test performance. Between-study heterogeneity was tested using the Q tests and the I (2) statistics. Potential sources of heterogeneity were analyzed through subgroup analyses and meta-regression. Deeks' funnel plot asymmetry test was performed to evaluate publication bias. All analyses were performed using STATA 12.0 software. Eighteen studies from 7 articles, including 543 patients with malignant thyroid nodules (n?=?266) and benign ones (n?=?277), were included in this meta-analysis. The pooled SEN was 0.77 (95 % CI: 0.70-0.83), SPN was 0.75 (95 % CI: 0.68-0.81), PLR was 3.1 (95 % CI: 2.4-4.0), NLR was 0.30 (95 % CI: 0.23-0.39), DOR was 10 (95 % CI: 7-16), and AUC was 0.83 (95 %CI: 0.79-0.86). Subgroup analyses indicated that multiple miRNAs assays showed a higher diagnostic accuracy than single miRNA assays. In conclusion, this meta-analysis suggests that miRNAs analysis can significantly improve diagnostic accuracy for differentiating malignant thyroid nodules from benign indeterminate ones on fine-needle aspiration (FNA) samples. With further confirmation, multiple miRNAs assays may play a critical role as a complement to fine-needle aspiration biopsy (FNAB). PMID:24943685

Zhang, Yang; Zhong, Qi; Chen, Xiaohong; Fang, Jugao; Huang, Zhigang

2014-09-01

222

Increased frequency of hematopoietic malignancies in relatives of patients with lymphoid neoplasms: a French case-control study  

Science.gov (United States)

Lymphoid neoplasms (LN), including non-Hodgkin’s lymphoma (NHL), Hodgkin’s lymphoma (HL), lymphoproliferative syndrome (LPS) and multiple myeloma (MM), are among the most frequent cancers (approximately 17,000 new cases per year in France), after those related to smoking. LN were investigated using the data from the ENGELA study. ENGELA is a multicenter hospital-based case-control study that was carried out in France over the period September 2000 – December2004. In all, 822 cases (397 NHL, 149 LH, 168 SLP and 108 MM) and 752 controls were included and described 5481 and 5188 first degree relatives, respectively. A positive association with a familial history of hematopoietic cancer was observed for LN (OR = 1.7 [1.0–2.8]) overall and for LPS (OR = 3.2 [1.4–6.8]). The associations with HL (OR = 10.4 [2.0–53.8]) and NHL (OR = 2.4 [1.0–5.9]) were stronger for men. The associations were also stronger when the disease had been diagnosed before the relatives were aged 45 years. The results mainly support the involvement of genetic factors and suggest that at least some of those factors may be sex-linked. However, the slight overrepresentation of affected spouses among the cases might also support the responsibility of environmental factors. PMID:19058175

Villeneuve, Sara; Orsi, Laurent; Monnereau, Alain; Berthou, Christian; Fenaux, Pierre; Marit, Gerald; Soubeyran, Pierre; Huguet, Françoise; Milpied, Noël; Leporrier, Michel; Hemon, Denis; Troussard, Xavier; Clavel, Jacqueline

2009-01-01

223

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  

Energy Technology Data Exchange (ETDEWEB)

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

224

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

2005-06-01

225

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 ats 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)

226

Diagnostic value of frozen section study for thyroid nodules in patients referred to Shariati Hospital 1997-2000  

OpenAIRE

Frozen section is a useful method in the diagnosis of different malignancies including those of thyroid origin. However, there are still controversies about its application, sensitivity and specificity for thyroid neoplasm. In this study, diagnostic value of frozen section (FS) was compared with permanent histopathologic and Fine Needle Aspiration (FNA). In this study, which was conducted in process research method, permanent sample, FNA, and frozen section results in 214 patients was compare...

"Shirzad M; Hedayat A; Kamalian N; Larijani B; Baradar Jalily R "

2001-01-01

227

(18)F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography in Malignancies of the Thyroid and in Head and Neck Squamous Cell Carcinoma : A Review of the Literature  

DEFF Research Database (Denmark)

18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is a valuable diagnostic tool in a spectrum of malignant and benign conditions, because of a high sensitivity to detect even very small lesions with increased metabolism. This review focuses on the use of FDG-PET/CT in malignancies of the thyroid gland and in head and neck squamous cell carcinoma.

Lauridsen, Jeppe Kiilerich; Rohde, Max

2015-01-01

228

Plasma thyroglobulin in detecting thyroid carcinoma after childhood head and neck irradiation  

International Nuclear Information System (INIS)

The level of thyroglobulin in plasma was measured in 904 subjects with a history of head and neck irradiation during childhood to evaluate its potential value in screening for and differentiating thyroid neoplasms. Mean plasma thyroglobulin level was significantly elevated in subjects with nodular thyroid disease versus those without evidence of nodules (49.8 versus 27.0 ng/ml). However, the overlap with normal subjects does not allow thyroglobulin assays to serve as the only screening procedure. The mean levels in subjects with benign and malignant thyroid nodules were indistinguishable (48.8 versus 53.9 ng/ml). Thirteen percent of otherwise normal-appearing subjects had elevated values that may represent clinically inapparent thyroid disease. It is concluded that in screening large numbers of persons at risk for thyroid neoplasia, thyroglobulin assays are useful in combination with other modes of evaluation. The assay is without value in distinguishing benign from malignant disease

229

Thyroid nodule treatment in Obrero Hospital nº 2, CNS Cochabamba, january 2007 to june 2010 (Tratamiento del nodulo tiroideo, Hospital Obrero Nº 2, CNS, Cochabamba, periodo enero-2007 a junio-2010)  

OpenAIRE

Introduction: Since a biologic point of view, Thyroid nodules are relatively common and a different kind of injuries. The most of solitary tumors are benign injuries, such as: nodular hyperplasia, with is located in one only place, Cyst of thyroiditis is a variety of follicular adenomas, which it is about 90% of neoplasm nodules. In women, Thyroid cancer represents approximately 1,9% of all malignant neoplasm; in men, it is 0,3%. Diagnosis and therapeutic clinical study must begin with a comp...

Requena-Urioste Alberto; Chuca-Tumiri Alfredo; Choque-Verduguez Jimena

2010-01-01

230

Estimate of the uncertainties in the relative risk of secondary malignant neoplasms following proton therapy and intensity-modulated photon therapy  

Science.gov (United States)

Theoretical calculations have shown that proton therapy can reduce the incidence of radiation-induced secondary malignant neoplasms (SMN) compared with photon therapy for patients with prostate cancer. However, the uncertainties associated with calculations of SMN risk had not been assessed. The objective of this study was to quantify the uncertainties in projected risks of secondary cancer following contemporary proton and photon radiotherapies for prostate cancer. We performed a rigorous propagation of errors and several sensitivity tests to estimate the uncertainty in the ratio of relative risk (RRR) due to the largest contributors to the uncertainty: the radiation weighting factor for neutrons, the dose-response model for radiation carcinogenesis and interpatient variations in absorbed dose. The interval of values for the radiation weighting factor for neutrons and the dose-response model were derived from the literature, while interpatient variations in absorbed dose were taken from actual patient data. The influence of each parameter on a baseline RRR value was quantified. Our analysis revealed that the calculated RRR was insensitive to the largest contributors to the uncertainty. Uncertainties in the radiation weighting factor for neutrons, the shape of the dose-risk model and interpatient variations in therapeutic and stray doses introduced a total uncertainty of 33% to the baseline RRR calculation.

Fontenot, Jonas D.; Bloch, Charles; Followill, David; Titt, Uwe; Newhauser, Wayne D.

2010-12-01

231

Estimate of the uncertainties in the relative risk of secondary malignant neoplasms following proton therapy and intensity-modulated photon therapy  

Energy Technology Data Exchange (ETDEWEB)

Theoretical calculations have shown that proton therapy can reduce the incidence of radiation-induced secondary malignant neoplasms (SMN) compared with photon therapy for patients with prostate cancer. However, the uncertainties associated with calculations of SMN risk had not been assessed. The objective of this study was to quantify the uncertainties in projected risks of secondary cancer following contemporary proton and photon radiotherapies for prostate cancer. We performed a rigorous propagation of errors and several sensitivity tests to estimate the uncertainty in the ratio of relative risk (RRR) due to the largest contributors to the uncertainty: the radiation weighting factor for neutrons, the dose-response model for radiation carcinogenesis and interpatient variations in absorbed dose. The interval of values for the radiation weighting factor for neutrons and the dose-response model were derived from the literature, while interpatient variations in absorbed dose were taken from actual patient data. The influence of each parameter on a baseline RRR value was quantified. Our analysis revealed that the calculated RRR was insensitive to the largest contributors to the uncertainty. Uncertainties in the radiation weighting factor for neutrons, the shape of the dose-risk model and interpatient variations in therapeutic and stray doses introduced a total uncertainty of 33% to the baseline RRR calculation.

Fontenot, Jonas D [Department of Medical Physics, Mary Bird Perkins Cancer Center, Baton Rouge, LA (United States); Bloch, Charles [Department of Radiation Oncology, Washington University, Saint Louis, MO (United States); Followill, David; Titt, Uwe; Newhauser, Wayne D, E-mail: jfontenot@marybird.co [Department of Radiation Physics, Unit 94, The University of Texas M D Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX (United States)

2010-12-07

232

Risk of Secondary Malignant Neoplasms From Proton Therapy and Intensity-Modulated X-Ray Therapy for Early-Stage Prostate Cancer  

International Nuclear Information System (INIS)

Purpose: To assess the risk of a secondary malignant neoplasm (SMN) from proton therapy relative to intensity-modulated radiation therapy (IMRT) using X-rays, taking into account contributions from both primary and secondary sources of radiation, for prostate cancer. Methods and Materials: A proton therapy plan and a 6-MV IMRT plan were constructed for 3 patients with early-stage adenocarcinoma of the prostate. Doses from the primary fields delivered to organs at risk of developing an SMN were determined from treatment plans. Secondary doses from the proton therapy and IMRT were determined from Monte Carlo simulations and available measured data, respectively. The risk of an SMN was estimated from primary and secondary doses on an organ-by-organ basis by use of risk models from the Committee on the Biological Effects of Ionizing Radiation. Results: Proton therapy reduced the risk of an SMN by 26% to 39% compared with IMRT. The risk of an SMN for both modalities was greatest in the in-field organs. However, the risks from the in-field organs were considerably lower with the proton therapy plan than with the IMRT plan. This reduction was attributed to the substantial sparing of the rectum and bladder from exposure to the therapeutic beam by the proton therapy plan. Conclusions: When considering exposure to primary and secondary radiation, proton therapy can reduce the risk of an SMN in prostate patients compared with contemporary IMRT.y IMRT.

233

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.

234

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)

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)

235

Estimate of the uncertainties in the relative risk of secondary malignant neoplasms following proton therapy and intensity-modulated photon therapy  

International Nuclear Information System (INIS)

Theoretical calculations have shown that proton therapy can reduce the incidence of radiation-induced secondary malignant neoplasms (SMN) compared with photon therapy for patients with prostate cancer. However, the uncertainties associated with calculations of SMN risk had not been assessed. The objective of this study was to quantify the uncertainties in projected risks of secondary cancer following contemporary proton and photon radiotherapies for prostate cancer. We performed a rigorous propagation of errors and several sensitivity tests to estimate the uncertainty in the ratio of relative risk (RRR) due to the largest contributors to the uncertainty: the radiation weighting factor for neutrons, the dose-response model for radiation carcinogenesis and interpatient variations in absorbed dose. The interval of values for the radiation weighting factor for neutrons and the dose-response model were derived from the literature, while interpatient variations in absorbed dose were taken from actual patient data. The influence of each parameter on a baseline RRR value was quantified. Our analysis revealed that the calculated RRR was insensitive to the largest contributors to the uncertainty. Uncertainties in the radiation weighting factor for neutrons, the shape of the dose-risk model and interpatient variations in therapeutic and stray doses introduced a total uncertainty of 33% to the baseline RRR calculation.

236

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 induction period for thyroid neoplasms following irradiation is used to define periods at risk. An upper bound risk coefficient for cancer induction following exposure to 131I is based on human experience at relatively low dose exposures. While the overall lifetime risks of death due to thyroid cancer are consistent with projections by the ICRP, BEIR III, and UNSCEAR Reports, the current model permits greater flexibility in determining risk for population subgroups. 88 references, 8 tables

237

Detection of BRAFV600E mutation on papillary thyroid carcinoma and metastatic malignant melanoma by fine-needle aspiration cytology: how genetic testing may drive toward personalized medicine.  

Science.gov (United States)

A genetic link between cutaneous melanoma and thyroid cancer (TC) has been identified. A high percentage of both melanomas and papillary carcinomas of the thyroid harbors a recurrent mutation (i.e., BRAF(V600E) ) in the BRAF oncogene. Herein, we report the case of a 65-year-old man with papillary TC and cutaneous malignant melanoma metastatic to masseter muscle, both characterized by BRAF mutation. This is one of the rare reports in which a complete molecular characterization has been performed. As the patients with papillary thyroid carcinoma have a higher risk of malignant melanoma and vice versa, continuous monitoring of such patients, with either of these tumors is necessary. Fine-needle aspiration cytology is useful as shown in the present case. PMID:24574369

Rocca, Bruno Jim; Ambrosio, Maria Raffaella; Ginori, Alessandro; Disanto, Andrea

2014-10-01

238

Tumor sólido pseudopapilar del páncreas: ¿Una neoplasia de bajo potencial maligno? / Solid pseudopapillary tumor of the pancreas: a neoplasm of low malignant potential?  

Scientific Electronic Library Online (English)

Full Text Available SciELO Peru | Language: Spanish Abstract in spanish INTRODUCCIÓN: El tumor sólido pseudopapilar del páncreas es considerado una neoplasia de bajo potencial maligno, por lo que la radicalidad del abordaje quirúrgico es aún controversial. PACIENTES Y MÉTODOS: Se describe y analiza en forma retrospectiva los datos clínicos, radiológicos, de laboratorio, [...] el reporte operatorio y el resultado patológico de 7 pacientes que fueron diagnosticados y operados por tumor sólido pseudopapilar del páncreas en el período 2003 al 2010, en nuestra institución. RESULTADOS: Seis pacientes fueron de sexo femenino y uno masculino. La mediana de edad fue 35 años (rango: 15-49). El síntoma más frecuente fue dolor abdominal (100%). Se presentó ictericia en un paciente (14.3%). La apariencia radiológica mixta sólido-quística fue la más frecuente. En 5 pacientes el tumor se localizó en la cabeza del páncreas (71.4%) y en 2 se ubicó en la cola (28.6%). La mediana del tamaño tumoral fue de 93 mm (rango: 20-150) Se realizó 4 procedimientos de Whipple (57.1%), 2 pancreatectomías distales con esplenectomía (28.6%), una por vía laparoscópica y una resección local. En 2 casos (28.6%) se encontró el borde de sección pancreático comprometido. Se presentó morbilidad en 4 pacientes. No hubo mortalidad postoperatoria, ni reoperaciones. Cuatro tumores mostraron comportamiento maligno (57.1%): infiltración de cápsula esplénica y metástasis hepática metacrónica (1), infiltración de arteria mesentérica superior (1), metástasis linfática (1) y metástasis hepática sincrónica, infiltración duodenal e invasión linfovascular (1). No se detectó mortalidad por la enfermedad durante el período de seguimiento que fue en promedio 26 meses (rango: 6-70 meses). CONCLUSIÓN: El tumor sólido pseudopapilar es una neoplasia con alto potencial maligno en nuestra experiencia, por lo que recomendamos una actitud quirúrgica agresiva, con resecciones radicales incluyendo linfadenectomía. Abstract in english BACKGROUND: Solid pseudo papillary tumor of the pancreas is considered a neoplasm of low malignant potential. The radicality of surgical approach is controversial. PATIENTS AND METHODS: We describe and analyze retrospectively the clinical, radiological, laboratory, operative report and pathology res [...] ults of seven patients who were diagnosed and operated by solid pseudo papillary tumor of the pancreas in the period 2003 to 2010, in our institution. RESULTS: Six patients were female and one male. The median age was 35 years (range: 15-49). The most common symptom was abdominal pain (100%). Jaundice in one patient (14.3%). The radiological appearance mixed solid-cystic was the most common. We performed four Whipple procedures (57.1%), 2 distal pancreatectomy with splenectomy (28.6%), one by laparoscopy and the other by local resection. Morbidity presented in four patients. There was no postoperative mortality or reoperation. Five tumors were located in the pancreatic head (71.4%) and two in the tail (28.6%). The median tumor size was 93 mm (range: 20-150). Two (28.6%) were R1 resections. Four tumors showed malignant behavior (57.1%): splenic capsule and infiltration of metachronous liver metastases (1), infiltration of superior mesenteric artery (1), lymphatic metastasis (1) and synchronous liver metastases, and lymphovascular invasion duodenal infiltration (1). There was no mortality from the disease during the average follow-up of 26 months (range 6-70 months). CONCLUSION: Solid pseudo papillary tumor is a neoplasm with high malignant potential in our experience. We recommend an aggressive surgical approach with radical resection including lymphadenectomy.

Gustavo, Reaño; José, De Vinatea; José, Arenas; Fritz, Kometter; Luis, Villanueva; Edgar, Gonzáles; Mónica, Uribe; Jorge, Tang; Guillermo, Casas; Hernán, Robledo.

2011-01-01

239

Value of the Diffusion-Weighted MRI in the Differential Diagnostics of Malignant and Benign Kidney Neoplasms – Our Clinical Experience  

Science.gov (United States)

Summary Background Diffusion-weighted imaging (DWI) is an MRI modality using strong bipolar gradients to create a sensitivity of the signal to the thermally-induced Brownian motions of water molecules and in vivo measurement of molecular diffusion. The apparent diffusion coefficient (ADC) is a quantitative parameter calculated from DWI images which is used as a measure of diffusion. DWI allows to obtain comprehensive information on morphological and functional state of the kidney during a single examination without contrast medium administration. The purpose of the study was to evaluate the value of DWI in differentiating benign and malignant solid kidney tumors based on the initial stage of the study. Material/Methods The study included 19 adult patients with pathologically verified renal tumors: 9 patients with clear cell subtype of the renal cell carcinoma, 5 patients with oncocytoma and 5 patients with angiomyolipoma (AML). In addition, 5 healthy volunteers with completely normal findings according to kidney ultrasound were included into this study and set as reference. All patients underwent renal MR imaging which included DWI with subsequent ADC measurement. MR imaging was performed with a 1.5 T body scanner using an eight-channel phased-array body coil. Results The mean ADC value of ccRCC was significantly lower than that of normal renal parenchyma (2.11±0.25×10?3 mm2/s vs. 3.36±0.41×10?3 mm2/s, pangiomyolipoma the ADC value was 2.36±0.32×10?3 mm2/s vs. 2.11±0.25×10?3 mm2/s; p<0.05 and in patients with oncocytoma – 2.75±0.27×10?3 mm2/s vs. 2.11±0.25×10?3 mm2/s; p<0.05. The difference in ADC values in patients with high and low ccRCC grades was observed. Conclusions DWI can be used to characterize renal lesions; the ADC of a renal lesion can be potentially used as an additional parameter to help determine the appropriate clinical management. PMID:25202435

Mytsyk, Yulian; Borys, Yuriy; Komnatska, Iryna; Dutka, Ihor; Shatynska-Mytsyk, Iryna

2014-01-01

240

Long-term follow-up sonography of benign cystic thyroid nodules after a percutaneous ethanol injection: the incidence of malignancy-mimicking nodules  

International Nuclear Information System (INIS)

To evaluate the incidence of malignancy-mimicking sclerosed thyroid nodules, from long-term follow-up ultrasonography (US) after an US-guided percutaneous ethanol injection (PEI). We examined 86 benign cystic thyroid nodules from 80 patients. The nodules were classified into two groups based on whether an aspiration (Group A, n = 26) or non-aspiration (Group B, n 60) of infused ethanol was performed. The final follow-up US over 12 months was performed in all patients. Of the 86 nodules, the cystic portion of 82 (95.3%) cases, from 76 patients, completely disappeared subsequent to the first follow-up US (Group A, n = 24, Group B, n = 58) (Chi-square test, ? > 0.05). Moreover, 46 sclerosed thyroid nodules showed two or more of the 'five sonographic criteria' upon a follow-up US (Group A, n = 13, 50.0%, Group B, n = 32, 53.3%). A higher ratio of the cystic portion of the nodules was associated with a higher incidence of the 'five sonographic criteria' for malignancies detected via a follow-up US (? < 0.01; Student's t-test). For the long-term follow-up US, the 'five sonographic criteria' were observed in half the patients who received US-guided PEI. Also, by acknowledging the possibility that sonographic findings mimic a malignancy, since the sclerosed thyroid nodule, patients may avoid an unnecessary biopsy

241

Carcinoma of the thyroid in children: not as malignant as in adults  

International Nuclear Information System (INIS)

Thyroid caner in the young, though extremely bizzare at presentation, surprisingly behaves very indolently as soon as local control has been achieved. Unlike its adult phenotype, it behaves almost akin to benign tumor. This series is a retrospective analysis of all cases of thyroid carcinoma encountered in subjects below the age of 20 years, at the Tata Memorial Hospital from 1965 to 1980. Surgery formed the mainstay of treatment, but in no way did the radicality of the surgery influence the overall survival. Surgical clearance and lymph node positivity showed a calculated p value indexing at p>0.95 and p>0.05 respectively both of which were not significant, hence reflecting no significant impact on the overall survival. The same stood out for well differentiated carcinomas. Radioactive iodine formed the primary modality of treatment for residual or recurrent disease. (author). 26 refs., 10 tabs

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Comparative evaluation of angiography and computed tomography in 34 cases with malignant neoplasm of the liver, bile duct, gallbladder and pancreas  

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In 34 cases with malignant neoplasm of the liver, bile duct, gallbladder and pancreas, angiographic and CT finding were studied. 1) As CT findings, the margin of many hepatomas and almost all liver metastasis were able to be found except for some hepatomas. In many hepatomas, it was also found that there were lower parts in low density area. These lesions are seemed due to necrosis or hemorrhage. Metastatic carcinomas which had angiographic finding of much diffuse hypervasculature were seen as uniform low density area. On the other hand, those which had peripheral hypervasculature and of which the angiographic findings were some ring-like tumor stains were shown as the more obvious low density areas. These lesions became smaller by contrast enhancement, because the peripheral part of the lesion was changed to isodensity as normal liver. This phenomenon was not seen in the large a vasculer liver metastasis. 2) The dilatation of the partial intrahepatic bile duct was found in many intrahepatic cholangiomas (hiler type), but rare in hepatoma and liver metastasis. At the same time, CT showed low density areas which had ill-defined margin and did not coincide with tumor location. The low density area may suggest inflammatory change but it was not certified why these area did not coincide with tumor location. 3) In most extrahepatic bile duct carcinoma, the encasement of portal vein was shown on angiography. CT showed bile duct dilatation in all patient. These two findings tation in all patient. These two findings might be rarely found in gallbladder carcinoma because of its location. 4) Unresectable pancreas carcinomas were easily diagnosed by CT and angiography, but it is impossible to find early pancreas carcinoma by conventional second generation CT examination. (author)

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Recurrent papillary urothelial neoplasm of low malignant potential. Subtle architectural disorder detected by quantitative analysis in DAXX-immunostained tissue sections.  

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The aim of the study was to identify subtle changes in the so-called architectural predominant order in nonrecurrent and recurrent papillary urothelial neoplasm of low malignant potential (PUNLMP). Quantitative analysis was performed with a software package written in LabVIEW (National Instruments, Austin, TX) in DAXX-immunostained tissue sections. Twelve cases of PUNLMP with papillary fronds sectioned lengthwise through the core were investigated and subdivided as follows: 7 nonrecurrent and 5 recurrent PUNLMP cases. Six cases of normal urothelium (NU) were included. When an epithelial thickness threshold is set at 108 ?m (ie, 400 pixels), there is a complete separation between NU and PUNLMP; however, nonrecurrent and recurrent cases fall in the same range of thickness. In setting a nuclear elongation factor threshold at 2.1, there are differences between the 2 PUNLMP groups, recurrent PUNLMP and NU cases, showing a somewhat similar proportion of elongated nuclei. The nuclear orientation separates nonrecurrent from recurrent PUNLMP groups; however, NU cases do not appear as a separate group from the 2 PUNLMP groups. In combining epithelial thickness, nuclear elongation, and orientation in a multivariate analysis, the 2 PUNLMP groups appear separate between them and from NU. NU is less thickened than the 2 PUNLMP groups and shows a combination of elongated and less elongated nuclei. Elongated nuclei are more numerous in nonrecurrent PUNLMP, whereas the nuclei in recurrent PUNLMP are less elongated and less polarized than in the other group. Such finding can be used routinely to identify those PUNLMP patients who will have recurrence. PMID:24565208

Castellini, Paolo; Montironi, Maria A; Zizzi, Antonio; Scarpelli, Marina; Mazzucchelli, Roberta; Lopez-Beltran, Antonio; Cheng, Liang; Paone, Nicola; Montironi, Rodolfo

2014-04-01

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Risk of a Second Malignant Neoplasm After Cancer in Childhood Treated With Radiotherapy: Correlation With the Integral Dose Restricted to the Irradiated Fields  

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Purpose: After successful treatment of cancers in childhood, the occurrence of second malignant neoplasm (SMN) came to the fore. Few studies have considered the relationship between the radiation dose received and the risk of developing an SMN. To take into account the heterogeneity of the dose distribution so as to evaluate the overall risk of an SMN after a childhood cancer, we therefore focused on the integral dose restricted to the irradiated fields. Methods and Materials: The study was performed in a cohort of 4,401 patients who were 3-year survivors of all types of childhood cancer treated between 1947 and 1986 in France and Great Britain. For each patient, the integral dose was estimated for the volume inside the beam edges. Results: We found a significant dose-response relationship between the overall risk of an SMN and the estimated integral dose. The excess relative risk for each incremental unit of the integral dose was only 0.008 in a linear model and 0.017 when a negative exponential term was considered, when adjusted for chemotherapy. The risk of SMN occurrence was 2.6 times higher in the case of irradiation. However among patients who had received radiotherapy, only those who had received the highest integral dose actually had a higher risk. Conclusions: The integral dose in our study cannot be considered as a good predictor of later risks. However other studies with the same study design are obviously needed to evaluate the use of the integral dose as evaluate the use of the integral dose as a tool for decision making concerning different radiotherapy techniques

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

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Full Text Available SciELO Spain | Language: Spanish 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 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. 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 neo [...] plasm (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.

2005-06-01

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Fine Needle Aspiration Biopsy of Thyroid Nodules: Diagnostic Value, Technical Aspects, Analysis of Results  

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Full Text Available The goal of the study was to determine diagnostic value of fine needle aspiration biopsy (FNAB in detection of malignant thyroid tumors based on retrospective analyses of 40696 FNAB of patients with thyroid nodules. Results. Comparison of the results of FNAB with postoperative histological examination data from 3004 patients revealed that the rate of false positive cytopathological results was 1.2% and the rate of false negative results was 1.8%. The sensitivity reached 99.67%. The specificity of FNAB when taking into account follicular lesions dropped to 16.29%, while leaving follicular lesions - 94.29%. Cytological results of 49609 FNAB of patients with thyroid nodules according to Bethesda system were arranged as follows: noninformative results - 8%, benign nodules - 81.9% (colloid nodules - 71.6%, autoimmune thyroiditis - 10.2%, subacute thyroiditis and others - 0.02%, follicular lesions - 7.2% (follicular neoplasm - 7.1%, follicular lesion of indeterminate value - 0.1%, suspicious for malignancy - 0.02%, malignant tumor - 3%, among the latter papillary carcinoma - 93%. Malignant tumors, according to postoperative histological examination, were detected among the group with cytological diagnosis “follicular neoplasm” in 16.3% of cases. After performing FNAB of regional lymph nodes with suspicious ultrasound signs the metastases of papillary carcinoma were revealed in 24.6% of cases. Application of FNAB in clinical practice at our Center to all patients with thyroid nodules of 1 cm in size and larger resulted in increment of thyroid operations for oncological indications from 12.5% in 2004 to 53% in 2012. Conclusion. FNAB under ultrasound control is the most informative differential method for thyroid diseases, permitting to reveal primary and metastatic thyroid lesions. FNAB allow to evade nonobligatory diagnostic operations in many patients.

R A Chernikov

2013-12-01

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Evaluation of dosimetry of radioiodine therapy in benign and malignant thyroid disorders by means of iodine-124 and PET  

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The aim of this study was to evaluate the use of 124I positron emission tomography (PET) to determine the dosimetry of radioiodine therapy in hyperthyroidism and thyroid cancer. Phantom studies to assess the accuracy of PET were performed using an EEC phantom with spheres of different diameters filled with 3-30 MBq of 124I. Patient dosimetry was derived from PET data obtained 1-13 days after simultaneous oral administration of a therapeutic dose of 131I and a diagnostic dose of 124I. The obtained data were compared with findings from intratherapeutic probe measurements and clinical outcome. The phantom studies confirmed that 124I can be quantitated by PET (imprecision ?10%), and volumetry is feasible for nodules 123I or the simultaneous administration of 131I on the accuracy of the PET quantification and the probe measurements was ruled out by phantom measurements with solutions of 131I, 124I and123I in various ratios. In autonomous nodular goitres, radioiodine uptake measured by PET varied from 25.4% to 64.3% and was not significantly different from that obtained by a scintillation probe (24.1%-73.1%, correlation coefficient r=0.91). Comparison of uptake and effective half-life in normal tissue versus autonomous nodules revealed significant differences in uptake but not in effective half-life uptake but not in effective half-life [uptake 2.0-8.3 kBq/(ml x MBq) in normal tissue vs 12.6-29.3 kBq/(ml x MBq) in nodules; half-life 97.8-156.7 h in normal tissue vs 73.3-192.3 h in nodules]. Calculated radiation doses ranged between 177 and 633 Gy for autonomous nodules and between 47 and 126 Gy for normal tissue. In thyroid cancer patients, doses between 350 and 1,420 Gy were achieved in thyroid remnants and between 70 and 170 Gy in tumour metastases. It is concluded that 124I and PET are suitable for evaluation of the dosimetry of radioiodine therapy in benign and malignant thyroid diseases. The applied technique might be particularly useful for quantitative dose-response studies in radioiodine treatment and further investigations of stunning phenomena. (orig.)

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Modulation of human leukocyte antigen and intracellular adhesion molecule-1 surface expression in malignant and nonmalignant human thyroid cells by cytokines in the context of extracellular matrix.  

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Interactions between malignant cells and their environment are achieved via cell-surface receptors and adhesion molecules. The extracellular matrix (ECM) and ECM-bound cytokines modulate the expression of cell-surface molecules on target malignant cells, which may lead to changes in their susceptibility to cytolysis, in their ability to present antigens, and in the induction of local immune-cell activation and patrol. Eventually, these alterations may culminate in either the destruction, or escape and proliferation, of the tumor. We studied the effects of the ECM and its components in a "naive" form or following binding of the inflammatory cytokines interferon gamma (IFNgamma) and tumor necrosis factor alpha (TNFalpha) on the surface expression of human leukocyte antigen (HLA) class-I, HLA class-II (HLA-DR), and intracellular adhesion molecule-1 (ICAM-1), on nonmalignant and malignant thyroid cells. The basal expression of HLA class-I molecules was not significantly changed either by naive ECM and its components or by ECM-bound cytokines. ECM synergized with IFNgamma and TNFalpha in inducing HLA-DR molecules on nonmalignant and malignant thyrocytes, with higher HLA-DR levels on the malignant cells. The laminin component, in particular, synergized with IFNgamma. Basal ICAM-1 expression on nonneoplastic cells was not significantly affected by the cytokines when grown in the absence of ECM, but was significantly upregulated when cells were cultured on ECM. In contrast, in malignant thyrocyte cultures, ECM significantly attenuated IFNgamma- and TNFalpha-mediated enhancement of ICAM-1 expression. We concluded that signals derived from ECM-embedded cytokines participate in the regulation of key thyroid cell surface molecules and, thus, may affect the final outcome of human thyroid malignancies. PMID:11128721

Miller, A; Kraiem, Z; Sobel, E; Lider, O; Lahat, N

2000-11-01

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Sclerosing Mucoepidermoid Carcinoma of The Thyroid Gland  

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Full Text Available An extremely rare case of sclerosing mucoepidermoid carcinoma (SMECE of the thyroid in a 22-year-old woman is reported. The patient initially presented with a thyroid nodule. Fine needle aspiration cytology of the nodule showed features of a malignant tumor that was different from the usual types of thyroid carcinoma. Total thyroidectomy and right cervical lymph node dissection were performed, and pathology confirmed SMECE. The patient remains asymptomatic and no further recurrence or metastasis has been noted in the postoperative course of five years. She is the youngest patient with SMECE in literature. In this report, we briefly present the clinical and biologic course of this patient’s neoplasm and also review the associated literature. Turk Jem 2008; 12: 39-41

Reyhan Ersoy

2008-05-01

250

Cancer of the thyroid and salivary glands  

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The relationship of atomic bomb exposure to tumors of the head and neck has been studied in detail for the thyroid and salivary gland. It has been deomonstrated by animal experiments and studies conducted on those undergoing radiation therapy of the neck during childhood, and on those exposed to radioactive fallout from hydrogen-bomb tests in the Marshall Islands, that thyroid neoplasms can be induced by radiation. Although it was assumed that radiation would ahve a similar effect on the salivary gland located near the thyroid gland, it was in the 1970s that studies were commenced on the salivary gland. A study of the Adult Health Study population presented data which show that the incidence of salivary gland tumors was 9.3-fold higher in the group exposed to 300+ rad than in the control group and when confined only to malignant tumors the incidence was 21.8-fold higher

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Virtual touch tissue imaging on acoustic radiation force impulse elastography: a new technique for differential diagnosis between benign and malignant thyroid nodules.  

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Objectives- Acoustic radiation force impulse elastography is a newly developed ultrasound elasticity imaging technique that included both Virtual Touch tissue quantification and Virtual Touch tissue imaging (VTI; Siemens Medical Solutions, Mountain View, CA). This study aimed to evaluate the usefulness of VTI in differentiating malignant from benign thyroid nodules. Methods- This study included 192 consecutive patients with thyroid nodules (n = 219) who underwent surgery for compressive symptoms or suspicion of malignancy. Tissue stiffness on VTI elastography was scored from 1 (soft) to 6 (hard). The VTI scores between malignant and benign thyroid nodules were compared. The intraobserver and interobserver agreement for VTI elastography was also assessed. Results- On VTI elastography: score 1 was found in 84 nodules (all benign); score 2 in 37 nodules (3 papillary carcinomas and 34 benign nodules); score 3 in 25 nodules (1 medullary carcinoma, 6 papillary carcinomas, and 18 benign nodules); score 4 in 53 nodules (50 papillary carcinomas and 3 benign nodules); score 5 in 17 nodules (14 papillary carcinomas and 3 benign nodules); and score 6 in 3 nodules (all papillary carcinomas). A VTI elasticity score of 4 or greater was highly predictive of malignancy (P< .01), and the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 87.0% (67 of 77), 95.8% (136 of 142), 91.8% (67 of 73), 93.1% (136 of 146), and 92.7% (203 of 219), respectively. The ? values were 0.69 for intraobserver agreement and 0.85 for interobserver agreement. Conclusions- Virtual Touch tissue elasticity imaging has great potential as an adjunctive tool combined with conventional sonography for differential diagnosis between benign and malignant thyroid nodules. PMID:24658938

Zhang, Yi-Feng; He, Yong; Xu, Hui-Xiong; Xu, Xiao-Hong; Liu, Chang; Guo, Le-Hang; Liu, Lin-Na; Xu, Jun-Mei

2014-04-01

252

Incidence of malignant neoplasi in single nodules of the thyroid gland  

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Two hundred and seventy-two cases are presented of single nodular goiter of the thyroid gland, confirmed by histopathology, diagnosed and teated in the Head and Neck Department of Instituto Nacional do Cancer, Rio de Janeiro, Brazil. This experience demonstrated that the carcinoma occurrence, in these nodes, is low; as a routine, they are ressected-and it is shown that there's need for better selection of patients for surgery. It is believed that there's no doubt about the efficiency of the association of clinical data, scintillography, ultra soud results, suppression therapy and citology of aspiration biopsy in the surgical selection of patients. (Author)

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Cytodiagnosis of thyroid lesions-usefulness and pitfalls: A study of 288 cases  

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Full Text Available Background: Fine needle aspiration cytology (FNAC of the thyroid gland has been widely and successfully utilized for diagnosis. Aim: Our aim was to demonstrate the effectiveness of this cheap and simple procedure for the diagnosis of different thyroid lesions, particularly, differentiation of malignant and nonmalignant lesions. In addition, we sought to highlight probable causes of error and possible remedies in the cases showing lack of correlation between cytological and histological diagnoses. Materials and Methods: A total of 288 cases of thyroid swellings were aspirated in our two-year study period. Cases were divided into four groups, namely, aspiration inadequate where diagnosis was not offered; a nonneoplastic group which included different goiters and thyroiditis; an indeterminate group which included cases showing features of follicular or Hurthle cell neoplasms, and a malignant group that included nonfollicular malignant tumors of the thyroid. Cases showing cytohistologic disparity were reevaluated. Results: Almost 14% of the cases could not be reported because of inadequate aspiration, however, an overall cytohistological correlation was achieved in 82.66% of all cases. Sensitivity and specificity for the diagnosis of malignancy were 92.7 and 98.2%, respectively. There were four false negative malignant cases with one false positive case and 13 cases failed to show any cytohistological correlation. Conclusions: FNAC is the single most important test for preoperative assessment of thyroid pathology if attention is paid to the clinical features and collection of samples from proper sites.

Guhamallick M

2008-01-01

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Características clínicas, ultrasonográficas y anatomopatológicas de pacientes operados por sospecha de malignidad tiroidea / Clinical, ultrasonographic and anatomopathological characteristics of patients operated on for suspected thyroid malignancy  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Introducción: el carcinoma tiroideo se caracteriza por su lenta evolución y elevado porcentaje de curación. Objetivo: describir las características clínicas, ultrasonográficas y anatomopatológicas de los pacientes operados. Métodos: estudio descriptivo, retrospectivo. Se utilizaron para obtener el d [...] ato primario las historias clínicas de los pacientes que cumplieron con los criterios de inclusión: operados por sospecha de malignidad tiroidea, mayores de 18 años de edad que contaron con datos completos demográficos, clínicos, sonográficos y anatomopatológicos, y que estuviesen inscritos en el hospital. Se confeccionaron tablas de distribución de frecuencias. Se aplicó la prueba de comparación de proporciones para describir la significación estadística de las variables estudiadas en relación con la malignidad tiroidea. Resultados: el 81,8 % de los pacientes afectados de malignidad tiroidea correspondió al género femenino. El 39,4 % de estos correspondieron al grupo de edad entre 41 y 50 años, el 75,8 % de este grupo de pacientes correspondió al examen sonográfico con un área del nódulo tiroideo mayor de 10 mm, el 53,3 % de estos pacientes presentó como morfología tiroidea el nódulo único, y el 75,8 % presentó como resultado de la citología con aguja fina un carcinoma de tiroides. El 91 % presentó como clasificación histológica carcinoma papilar. Conclusiones: la mayor frecuencia de carcinoma fue la variante papilar. Se encontró de forma predominante en mujeres con edades entre los 41 y 50 años que tenían nódulos mayores de 1 cm. Abstract in english Introduction: thyroid carcinoma is characterized by slow progression and high recovery percentage. Objective: to describe the clinical, ultrasonographic and anatomopathological characteristics of patients operated on for thyroid malignancy. Methods: retrospective and descriptive study for which the [...] primary data were collected from the medical histories of patients who met the inclusion criteria. These criteria comprised surgery for suspected thyroid malignancy, age over 18 years, and complete demographic, clinical, ultrasonographic and anatomopathological data and registration at the hospital. Frequency distribution tables were drawn up. The ratio comparison test was applied to describe the statistical significance of the studied variables with respect to the thyroid malignancy. Results: in the group of patients with thyroid malignancy, 81.8 % were females, 39.4 % aged 41 to 50 years. The ultrasonographic test showed that 75.8 % of them had a thyroid nodule area greater than 10 mm, 53.3 % presented solitary nodule morphology whereas the result of the fine needle aspiration cytology was thyroid carcinoma. The histological classification yielded papillary carcinoma in 91 % of patients. Conclusions: the papillary carcinoma was the most common, particularly in females aged 41 to 50 years who had over 1 cm nodules.

Adalberto, Infante Amorós; Zussel, Rodríguez Obret; Regla, Ramos Duarte.

2014-08-01

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Cost-effectiveness of 99mTc-MIBI in the evaluation of thyroid nodules for malignancy: a new lease of life for an old radiopharmaceutical?  

International Nuclear Information System (INIS)

For many years it has been known that MIBI (methoxyisobutylisonitrile) scintigraphy can also be used in the diagnostic work-up of scintigraphically cold and therefore suspicious thyroid nodules in connection with fine needle biopsy. Recently, in a comparable meta-analysis in conjunction with a prior 99m-Tc pertechnate thyroid scintigraphy it was shown that MIBI scintigraphy can achieve a very high negative predictive value ranging from 88% to 100% with a mean of 97%. This indicates that a negative MIBI scan will obviate the need to surgically remove the thyroid nodule for definitive histological clarification in the large majority of patients, as the risk of malignancy in such a nodule is very low.

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Cost-effectiveness of {sup 99m}Tc-MIBI in the evaluation of thyroid nodules for malignancy: a new lease of life for an old radiopharmaceutical?  

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For many years it has been known that MIBI (methoxyisobutylisonitrile) scintigraphy can also be used in the diagnostic work-up of scintigraphically cold and therefore suspicious thyroid nodules in connection with fine needle biopsy. Recently, in a comparable meta-analysis in conjunction with a prior 99m-Tc pertechnate thyroid scintigraphy it was shown that MIBI scintigraphy can achieve a very high negative predictive value ranging from 88% to 100% with a mean of 97%. This indicates that a negative MIBI scan will obviate the need to surgically remove the thyroid nodule for definitive histological clarification in the large majority of patients, as the risk of malignancy in such a nodule is very low.

Verburg, Frederik A.; Mottaghy, Felix M. [RWTH Aachen University Hospital, Department of Nuclear Medicine, Aachen (Germany); Maastricht University Medical Center, Department of Nuclear Medicine, Maastricht (Netherlands); Behrendt, Florian F. [RWTH Aachen University Hospital, Department of Nuclear Medicine, Aachen (Germany); Heinzel, Alexander [RWTH Aachen University Hospital, Department of Nuclear Medicine, Aachen (Germany); Research Centre Juelich, Institute for Neuroscience and Medicine (INM-4), Juelich (Germany)

2014-01-15

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Presence of lung metastases in bitches affected by malignant mammary neoplasms in Medellin (Colombia) / Presencia de tumores mamarios malignos con metástasis a pulmón en perras en Medellín (Colombia)  

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Full Text Available SciELO Colombia | Language: English Abstract in spanish Objetivo. Definir la presencia de metástasis pulmonar en perras con tumores mamarios. Materiales y métodos. En una muestra de 30 perras atendidas en el Hospital Veterinario de la Universidad de Antioquia (Medellín, Colombia) con diagnóstico de tumores mamarios, al momento de la consulta, fueron regi [...] strados las variables clínicas y el grado de compromiso de las glándulas mamarias y de los nódulos linfáticos. Imágenes radiográficas latero-laterales y ventro-dorsales del tórax fueron tomadas para la identificación de hallazgos radiográficos compatibles con metástasis pulmonar. Biopsias mamarias afectadas fueron sometidas a estudio histopatológico y clasificación del tipo de tumor. Los datos fueron analizados mediante estadística descriptiva. Resultados. La edad promedio (± error estándar) al diagnóstico clínico fue 10.87 ± 2.65 años de edad. La raza más frecuentemente afectada fue la French poodle (46.6%) seguida de perros cruzados (13.3%) y Schnauzer (10%). El carcinoma fue el tumor más hallado (81%) seguido del adenoma (8.1%) y otros tipos de tumor (10.8%). Las glándulas mamarias más afectadas fueron las inguinales derecha (70%) e izquierda (66.6%). Cinco de las 30 pacientes (16.6%), presentaron metástasis a pulmón. Entre estas, 4 de 5 (80%) tenían carcinoma complejo. Conclusiones. El carcinoma complejo fue la neoplasia más frecuente y es el tipo más relacionado con metástasis pulmonar. Abstract in english Objective. To define the presence of lung metastasis in bitches with malignant mammary neoplasms. Materials and methods. Thirty female dogs that were attended at Veterinary Hospital (University of Antioquia, Medellin, Colombia) were selected for the study. At consultation clinical variables and grad [...] e of mammary and inguinal lymph node compromise were registered. Latero-lateral and ventral-dorsal radiographic images of thorax were done for identification of radiographic lesions suggestive of lung metastasis. At surgery biopsies of affected mammary glands were taken for histopathological study and classification of tumors. Data were analyzed by descriptive statistics. Results. The average (± standard error) age at clinical diagnosis was 10.87±2.65 year old. French poodle (46.6%) cross-breed (13.3%) and Schnauzer (10%) were the breeds most frequently affected by mammary tumors. The most frequent tumor found was carcinoma (81%), followed by adenoma (8.1%), and other types (10.8%). The most frequently affected mammary glands by tumors were the right and the left inguinal glands (70% and 66.6%, respectively). Five out of 30 bitches (16.6%) had lung metastasis according to radiographic examination. From this group of dogs, 4 out of 5 neoplasms (80%) were diagnosed as complex carcinoma by histopathology diagnosis. Conclusions. We provide evidence suggesting that complex carcinoma is the most frequent mammary tumor in bitches in our city and it is highly related to lung metastasis.

Brigitte, Gómez J; María, Ramírez R; Juan, Maldonado E.

2983-29-01

258

Optimal carbon dioxide insufflation pressure during robot-assisted thyroidectomy in patients with various benign and malignant thyroid diseases  

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Full Text Available Abstract Background Currently, data are not available concerning a safe insufflation pressure that provides a proper view of the surgical field without adverse metabolic and hemodynamic changes in humans undergoing the robot-assisted thyroidectomy bilateral axillo-breast approach (BABA using the da Vinci robotic surgical system. The purpose of this study was to determine the optimal carbon dioxide (CO2 insufflation pressure in patients with various benign and malignant thyroid diseases when using the da Vinci robotic surgical system. Methods A total of 32 patients underwent thyroid surgery at 6 (n = 15, 9 (n = 15, and 12 (n = 2 mmHg. The partial pressure of carbon dioxide (PaCO2, pH, cardiac output, heart rate, and mean arterial pressure were measured at baseline, 30 min and 1, 1.5, and 2 hours after CO2 insufflation, and 30 min after desufflation. Results CO2 insufflation of 12 mmHg caused severe facial subcutaneous emphysema, hypercarbia, and acidosis during robot-assisted thyroidectomy with BABA. The study was stopped before completion for the patients’ safety in accordance with the study protocol. Applying 6- or 9- mmHg of CO2 insufflation pressure caused increases in PaCO2 and decreases in arterial pH. However, vital signs were stable and pH and PaCO2 were within the physiologic range during the surgery in the 6- and 9-mmHg groups. Conclusions We propose that a CO2 insufflation pressure under 10 mmHg in robot-assisted thyroidectomy with BABA is the optimal insufflation pressure for patient safety.

Kim Hoon

2012-09-01

259

Ultrasound Spectrum of Papillary Breast Neoplasms  

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Papillary breast neoplasms show a wide spectrum of pathologic changes, and the hallmark of these tumors is the presence of a fibrovascular core. Histologically, papillary breast neoplasms can be broadly divided into benign papillomas, atypical papillomas, and malignant papillary lesions. The papillary breast neoplasms have been described as having a varied appearance, but review of the imaging spectrum is limited. The purpose of this article is to review the characteristic sonographic features of the broad spectrum of papillary breast neoplasms from benign papillomas to malignant papillary lesions

260

The Evolution of Biomarkers in Thyroid Cancer—From Mass Screening to a Personalized Biosignature  

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Full Text Available Thyroid cancer is the most common malignancy of the endocrine system. The diagnosis of thyroid nodules, made by neck examination and ultrasonography, is a common event occurring in over 50% of the patient population over the age of 50. Yet, only 5% of these patients will be diagnosed with cancer. Fine needle aspiration biopsy is the gold standard for diagnosing thyroid nodules. However, 10–15% of these biopsies are inconclusive, ultimately requiring a diagnostic thyroid lobectomy. Consequently, research in thyroid biomarkers has become an area of active interest. In the 40 years since calcitonin was first described as the biomarker for medullary thyroid cancer, new biomarkers in thyroid cancer have been discovered. Advances in genomic and proteomic technologies have defined many of these novel thyroid biomarkers. The purpose of this article is to provide a comprehensive literature review of how these biomarkers have evolved from simple screening tests into a complex array of multiple markers to help predict the malignant potential and genetic signature of thyroid neoplasms.

Raymon H. Grogan

2010-05-01

261

Treatment for malignant struma ovarii in the eyes of thyroid surgeons: a case report and study of Chinese cases reported in the literature.  

Science.gov (United States)

Malignant struma ovarii (MSO) is a rare malignant ovarian germ cell tumor that has been scarcely reported by thyroid surgeons focusing on treatment. There are no golden standards for its treatment. There has not been any Chinese case included in the English language literatures. This is the first study by collecting all Chinese cases with clinical information. We emphasize on using I therapy after operation.Presented is a case of struma ovarii with malignant histologic features who underwent definitive initial surgery of reproductive system tumors and a total thyroidectomy combined with thyroid-stimulating hormone (TSH)-suppressive therapy following treatment with I. Furthermore, a Chinese full-text database literature search for cases of MSO was performed, and advisable clinical data were collected following our treatment advice.Clinical data from 34 additional cases were compiled. As Chinese genetic background and environment are different from those of Western countries, our clinical data closely mirror theirs in some aspects. In addition, we provide a rare gene mutation type of MSO by the case from our department.Integrating literatures with the experience of thyroid surgeons, we recommend "multidisciplinary joint treatment" for MSO, namely traditional radical initial surgery of ovarian cancer and a total thyroidectomy combined with TSH-suppressive therapy following treatment with I for those who do not desire preservation of fertility. PMID:25474425

Luo, Jiang-rong; Xie, Chun-bao; Li, Zhi-hui

2014-11-01

262

Tumor-to-tumor metastases to follicular variant of papillary thyroid carcinoma: histologic, immunohistochemical, and molecular studies of two unusual cases.  

Science.gov (United States)

Tumor-to-tumor metastasis in thyroid neoplasms is exceedingly uncommon. Two unusual cases of breast carcinoma and renal cell carcinoma metastatic to follicular variant papillary carcinoma are reported. On histologic sections, the donor tumor cells infiltrated the substance of the recipient tumor and the angiolymphatic channels, but the bulk of metastatic tumor was confined within the thyroid carcinoma. Immunohistochemical stains as well as molecular studies confirmed the origin of both donor tumors, as well as the diagnosis of follicular variant of papillary carcinoma in the recipient tumors. Distinguishing between two such tumor populations may be difficult when the donor tumor cells morphologically resemble primary neoplasms of the recipient organ. A history of previous malignancy and ancillary studies can be helpful in making this distinction and rendering the correct diagnosis. A brief review of literature and discussion of tumor-to-tumor metastasis in thyroid neoplasms is also presented. PMID:19707890

Yu, Jing; Nikiforova, Marina N; Hodak, Steven P; Yim, John H; Cai, Guoping; Walls, Andrew; Nikiforov, Yuri E; Seethala, Raja R

2009-01-01

263

Hepatitis C Virus Infection is Probably Associated with Autoimmune Disorders and Malignancies but not with Autoimmune Thyroiditis  

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Full Text Available In this study initially consecutive patients with Autoimmune Thyroiditis (AT were taken in the Endocrinology Polyclinics. Beside that age and sex-matched patients with HCV infection and control cases were randomly studied in the Gastroenterology and Internal Medicine Polyclinics, respectively. One hundred and seventy-two patients with AT, 62 with HCV infection and 110 control cases were studied. AT was diagnosed in eight (12.9% cases of the HCV infecteds? group and this ratio was 11.8% (13 cases in the control group (p>0.05. Similarly, HCV infection was detected in one (0.5% case of AT group and this ratio was 0.9% (one case in the control group (p>0.05. Parallel to these results, prevalences of antithyroid peroxidase and/or antithyroglobulin antibodies were detected as 29.0% (18 cases and 32.7% (36 cases in the HCV infecteds? and control groups, respectively (p>0.05. As another face of the results, it was detected one case of monoclonal gammopathy of undetermined significance and one case of lichen planus in the HCV infecteds? group. As a conclusion, HCV infection may be associated with autoimmune disorders and malignancies but not with AT.

Guven Kuvandik

2007-01-01

264

Evaluation of non-palpable thyroid nodules by ultra sound guided fine needle aspiration cytology  

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Full Text Available The aim of this study was to see the usefulness of fine needle aspiration by “theBethesdasystem for reporting Thyroid Cytopathology” (TBS- RTC for non palpable thyroid nodules through ultrasound-guidance for the evaluation and treatment planning of nonpalpable thyroid lesions. This study was conducted on 200 patients with non palpable thyroid nodules which are very low lying or felt on swallowing; in Department of Pathology and Radiology since January 2011 to June 2012. The patients were scanned and USG- FNAC was performed and reporting was done by “TBSRTC”. Of the 200 specimens 17 samples were nondiagnostic or unsatisfactory (Class I, 145 samples were benign (Class II, 20 samples were showing Atypical of Undetermined Significance (AUS or Follicular Lesion of Undetermined Significance (FLUS; (Class III, 6 were showing follicular neoplasm or suspicious for a follicular neoplasm (Class IV, 7 samples were suspicious for malignancy (Class V and 5 samples were positive for malignancy (Class VI. On comparison of ultrasound guided FNAC with histopathology the sensitivity for correct diagnosis was 93%, specificity was 86%, positive predictive value was 37%, negative predictive value was 99% and accuracy was 86%. USG-FNAC is a useful modality for the evaluation and treatment planning of nonpalpable thyroid lesions smaller than5 mmin the maximum diameter. TBSRTC is the best method of reporting but class III and IV are the main pitfall of this system for reporting Thyroid Cytopathology and show high sensitivity, specificity and accuracy.

Kanwal Saba

2013-02-01

265

Parasitic thyroid nodule in hashimoto's thyroiditis.  

Science.gov (United States)

We present a case of parasitic thyroid nodule in a 62-year-old woman with Hashimoto's thyroiditis. The patient underwent right hemithyroidectomy for a 15-mm nodule suspicious for malignancy. A recurrential ipsilateral lymph nodule was identified and removed. Conclusive histopathologic study confirmed that the mass was an extracapsular thyroid nodule (parasitic nodule). PMID:22975523

González-González, Abel; Mate, Luis A; Cabra, Jesús E

2008-08-01

266

Neoplasms in persons treated with x-rays in infancy: fourth survey in 20 years  

International Nuclear Information System (INIS)

The incidence of neoplastic disease was determined by a mail survey of 2,872 young adults given x-ray treatments in infancy and of their 5,005 nonirradiated siblings. Newly diagnosed benign and malignant neoplasms appeared more frequently in the irradiated subjects than in their siblings or the age- and sex-matched general population of upstate New York. Only thyroid neoplasms occurred in sufficient numbers to permit statistical analysis for the effects on incidence of sex, age, and dose, and of being in a high-risk group (sub-group C). Thyroid cancers developed earlier in life than did benign neoplasms, especially in boys; benign goiters occurred after smaller doses, predominantly in females. Females had a greater risk of developing thyroid cancer than males--2.3 times for females of all ages and 5 times for young adults. Except for young adult females, there was no definite age effect. The risk of cancer (but not of benign goiter) was proportional to the thyroid dose, with a linear risk coefficient of 2.5/year/million people exposed to 1 rad for the entire irradiated population and 4.0 for subgroup C. The high risk of thyroid cancer in subgroup C may be the result of the high percentage of Jews, who had a 3.4-fold greater risk than non-Jews. Young adult Jewish females had a 17-fold increased risk. An incidental observation was an apparent increased incidence of asthma and rare diseases with abnormal immunologic features in the irradiated population. (auth)he irradiated population. (auth)

267

Neoplasms in persons treated with x-rays in infancy: fourth survey in 20 years.  

Science.gov (United States)

The incidence of neoplastic disease was determined by a mail survey of 2,872 young adults given X-ray treatments in infancy and of their 5,005 nonirradiated siblings. Newly diagnosed benign and malignant neoplasms appeared more frequently in the irradiated subjects than in their siblings or the age- and sex-matched general population of upstate New York. Only thyroid neoplasms occurred in sufficient numbers to permit statistical analysis for the effects on incidence of sex, age, and dose, and of being in a high-risk group (sub-group C). Thyroid cancers developed earlier in life than did benign neoplasms, especially in boys; benign goiters occurred after smaller doses, predominantly in females. Females had a greater risk of developing thyroid cancer than males--2,3 times for females of all ages and 5 times for young adults. Except for young adult females, there was no definite age effect. The risk of cancer (but not of benign goiter) was proportional to the thyroid dose, with a linear risk coefficient of 2.5/year/million people exposed to 1 rad for the entire irradiated population and 4.0 for subgroup C. The high risk of thyroid cancer in subgroup C may be the result of the high percentage of Jews, who had a 3.4-fold greater risk than non-Jews. Young adult Jewish females had a 17-fold increased risk. An incidental observation was an apparent increased incidence of asthma and rare diseases with abnormal immunologic features in the irradiated population. PMID:1159831

Hempelmann, L H; Hall, W J; Phillips, M; Cooper, R A; Ames, W R

1975-09-01

268

Percutaneous alcohol injection (PAI) of thyroid nodule  

Energy Technology Data Exchange (ETDEWEB)

Percutaneous alcohol injection (PAI) is a new sclerosing method for treatment of diseases such as cyst, malignant tumor and benign neoplasm. Percutaneous alcohol injection of 26 cases (adenomatous goiter 23 cases, follicular adenoma 2 cases and recurrent papillary carcinoma 1 case) of thyroid nodules were done with 23-G needle under the guidance of ultrasonography. After then, we followed up thyroid function test, ultrasonographical size and volume of nodules, cytologic examination and complications of treatment. The results were as follows: 1. With 0.5-1 cc alcohol injection, the mean volume of thyroid nodules were reduced after PAI to 59% (N=26) at 1 month, and to 33% (N=14, cases of additional PAI) at 6 month, of the base line volume (100%) before PAI. 2. There were no significant changes at 1 and 6 months follow-up of TFT after PAI in all cases as compared with base line studies. 3. In conclusion, ultrasonic guided PAI for thyroid nodule is simple, useful and cost-effective method, and recommendable in cases of mixed and solid nodules resistant to medical treatment, refuse of surgery because of cosmetic problem and recurrent malignant tumors.

Nah, Hae Kyeong; Kim, Yoon Sook; Lee, Shin Hyung; Yoon, Chong Hyun; Kim, Chong Soon [National Medical Center, Seoul (Korea, Republic of); Suh, Won Hyuck [Korea University College of Medicine, Seoul (Korea, Republic of)

1989-12-15

269

Unusual Presentation of Cystic Papillary Thyroid Carcinoma  

OpenAIRE

Papillary thyroid carcinoma is the most common thyroid malignancy, accounting for 80% of all thyroid cancers. The most common presentation of thyroid cancer is an asymptomatic thyroid mass or a nodule. Usually as thyroid enlarges, it extends in to mediastinum. Papillary thyroid carcinoma presentation as multiple true cystic swelling extending from neck to anterior chest wall in subcutaneous plane is not present in the literature. We present a rare case of cystic papillary thyroid carcinoma wh...

Patil, Vijayraj S.; Abhishek Vijayakumar; Neelamma Natikar

2012-01-01

270

Thioredoxin and thioredoxin reductase expression in thyroid cancer depends on tumour aggressiveness.  

Science.gov (United States)

Thyroid cancer is the second most common malignancy following breast cancer in Arab females. Thioredoxin (TRX) is a small multi-functional redox protein with both intracellular and extracellular functions. The protein exists in either a reduced form (thioredoxin-SH2) or an oxidized form (thioredoxin-S2). TRX acts as an enhancement for growth factors and stimulates the growth of cancer cells. In this study of thyroid neoplasms, involving 121 female and 62 male patients, expression of TRX and TRX-R was studied using purified mouse anti-human TRX monoclonal antibody and anti-human TRX-R antiserum from rabbits, respectively. In order to delineate tumour cell growth, proliferating cell nuclear antigen (PCNA) polyclonal antibody was used. Compared to normal thyroid tissue, expression of TRX and TRX-R was increased in the cytoplasm and nuclei of thyroid cancer cells. Furthermore, TRX expression correlated with that of TRX-R. Of the 183 thyroid neoplasms investigated, overexpression of TRX-R was found in different types of neoplasms. The majority of carcinomas showed a correlation between strongly positive TRX and TRX-R expression and neoplastic cellular proliferation, as measured by PCNA. This indicates that increased TRX and TRX-R expression may be associated with tumourigenesis by acting as an autocrine growth stimulus. This study suggests that TRX immunoreactivity in thyroid tumours is a function of malignancy and cancer progression. In addition, secreted TRX can also act as an extracellular growth factor for both normal and tumour cells and enhance the sensitivity of the cells. Furthermore, this study emphasizes the potential benefits of anti-TRX/TRX-R agents in cancer therapeutics in the treatment of thyroid cancer. PMID:20392995

Lincoln, David T; Al-Yatama, Fatma; Mohammed, Fawziah M A; Al-Banaw, Anwar G; Al-Bader, Maie; Burge, Matthew; Sinowatz, Fred; Singal, Pawan K

2010-03-01

271

Additional value of FDG PET/CT to contrast-enhanced CT in the differentiation between benign and malignant intraductal papillary mucinous neoplasms of the pancreas with mural nodules  

International Nuclear Information System (INIS)

This study aimed at determining the additional value of F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT to contrast-enhanced CT in the differentiation between benign and malignant intraductal papillary mucinous neoplasms (IPMNs) of the pancreas with mural nodules. This retrospective review of medical records was approved by our institutional review board. The preoperative PET/CT images of 16 non-diabetic patients with surgically proven IPMN, where mural nodules of 3 mm or larger were shown by preoperative contrast-enhanced CT, were retrospectively evaluated. The 16 patients were divided into two groups: 7 patients with benign IPMN [adenoma (n=1) and borderline tumor (n=6)] and 9 patients with malignant IPMN [carcinoma in situ (CIS) (n=8) and invasive carcinoma (n=1)]. Nuclear medicine physician blinded to the pathologic assessment of malignancy of IPMN set a spherical volume of interest (VOI) over the mural nodules on PET/CT images and recorded the peak standardized uptake value (SUVmax) in the VOI, referring the contrast-enhanced CT images. Statistical differences in the size of mural nodule, the diameter of main pancreatic duct (MPD), and SUVmax of the tumors between benign IPMNs and malignant IPMNs were compared using the Mann-Whitney U test. Statistical significance was set at pmax of the malignant IPMNhe SUVmax of the malignant IPMNs with mural nodules of 3 mm or larger was higher than that of benign IPMNs (2.7±0.6 vs. 1.9±0.3, p<0.01). Meanwhile, there was no significant difference in mural nodule diameter and MPD diameter between the two groups. FDG PET/CT showed an excellent diagnostic accuracy for the differentiation between malignant and benign IPMNs with mural nodules: the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy in malignant IPMN with mural nodule of FDG PET/CT were 77.8, 100, 100, 77.8, and 87.5 for the cutoff value of 2.3; and 100, 57.1, 75.0, 100, and 81.3 for the cutoff value of 2.0, respectively. The result of this study indicates that FDG PET/CT can provide additional information for the differentiation between benign and malignant IPMNs of the pancreas with mural nodules. (author)

272

Thyroid Cytopathology Reporting by the Bethesda System: A Two-Year Prospective Study in an Academic Institution  

Science.gov (United States)

Background. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has attempted to standardize reporting and cytological criteria in aspiration smears. Aims. The objective of this study was to analyze the thyroid cytology smears by TBSRTC, to determine the distribution of diagnostic categories and subcategories, to analyze cytological features, and to correlate the cytopathology with histopathology, wherever surgery was done. Materials and Methods. This was a prospective study of 225 fine needle aspirations (FNA) of thyroid nodules. All fine needle aspiration cytology (FNAC) diagnoses were classified according to the features given in the monograph of TBSRTC into nondiagnostic/unsatisfactory (ND/UNS), benign, atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), follicular neoplasm/suspicious of a follicular neoplasm (FN/SFN), suspicious for malignancy (SFM), and malignant. Cytohistological correlation was done, when surgical material was available. Results. The distribution of various categories from 225 evaluated thyroid nodules was as follows: 7.2% ND/UNS, 80.0% benign, 4.9% AUS/FLUS, 2.2% FN, 3.5% SFM, and 2.2% malignant. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated. Conclusions. TBSRTC is an excellent reporting system for thyroid FNA. It also provides clear management guidelines to clinicians to go for follow-up FNA or surgery and also the extent of surgery.

Mehra, Payal; Verma, Anand Kumar

2015-01-01

273

Sonographic Appearance of Primary Thyroid Lymphoma-Preliminary Experience  

Science.gov (United States)

Objective Primary thyroid lymphoma (PTL) is an uncommon thyroid malignancy. Despite the rarity of PTL, it is important to recognize PTL promptly because its management differs from that of all the other thyroid neoplasms. This study was designed to investigate the sonographic features of PTL. Methods Twenty-seven pathologically confirmed PTLs were categorized into diffuse and non-diffuse type. Sonographic features including thyroid size, thyroid background echotexture, lesion size, echogenecity, calcification, vascularity, cervical lymphadenopathy of each type were retrospectively analyzed. Results All 27 PTLs were diffuse large B-cell lymphomas and were accompanied by diffuse Hashimoto's thyroiditis. Ten were diffuse type and seventeen were non-diffuse type sonographically. The observations in diffuse group included goiter (10/10, 100.0%), marked echogenesity (10/10, 100.0%), heterogeneous echotexture (10/10, 100.0%), and cervical lymphadenopathy (4/10, 40.0%). The observations in non-diffuse group included marked hypoechogenicity (17/17, 100.0%), heterogeneous background thyroid gland (17/17, 100.0%), goiter (15/17, 88.2%), increased vascularity (8/13, 61.5%), mulifocality (10/17, 58.8%), and cervical lymphadenopathy (7/17, 41.2%). Conclusions Although some common features were found, the sonographic appearance of PTL is unspecific, especially for the diffuse type. Therefore, interventional diagnostic procedures should be warranted in the clinical settings when PTL is suspected. PMID:25474402

Xia, Yu; Wang, Liang; Jiang, Yuxin; Dai, Qing; Li, Xiaoyi; Li, Wenbo

2014-01-01

274

Anaplastic thyroid cancer, tumorigenesis and therapy.  

LENUS (Irish Health Repository)

Anaplastic thyroid cancer (ATC) is a fatal endocrine malignancy. Current therapy fails to significantly improve survival. Recent insights into thyroid tumorigenesis, post-malignant dedifferentiation and mode of metastatic activity offer new therapeutic strategies.

O'Neill, J P

2010-03-01

275

Late cutaneous metastases to the face from malignant pleural mesothelioma: A case report and review of the literature  

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Full Text Available Abstract Background Malignant Mesothelioma is a rare primary neoplasm affecting the serosal membranes. During its relative short course, this malignant neoplasm can give local and, rarely, distant haematogenous metastases in different organs. The reported metastatic sites include liver, lung, heart, brain, thyroid, adrenals, kidneys, pancreas, bone, soft tissue, skin and lymph nodes. Case Presentation We report a sixty one year-old man with a history of malignant pleural epithelioid mesothelioma treated with six cycles of Pemetrexed and Carboplatin completed 03/11/04 followed by radiotherapy to the drain site 250 Kv/TD20Gy/5F completed 13/12/2004. Then he developed multiple facial skin lesions 4 years later. These lesions were proved to be metastatic malignant sarcomatoid mesothelioma. Conclusion Mesothelioma metastases should be suspected in any known Mesothelioma patient with newly developed skin lesion.

Lawrence Julia

2009-11-01

276

Postirradiation carcinoma of the thyroid gland  

International Nuclear Information System (INIS)

In the early 1920's many infants and children received x-ray therapy for such conditions as enlarged thymus, hypertrophy of the tonsils and adenoids, cervical adenitis, sinusitis, and so forth. Unfortunately, the thyroid gland frequently received direct or scattered irradiation during these treatments. As the irradiated population has grown older it has become apparent that these people have an increased incidence of thyroid cancer. Recent publicity on this problem in the newspaper, radio, and television has alarmed individuals or their parents who in turn have consulted their physicians for advice. All individuals with a history of head and neck irradiation should be considered as having an increased risk of developing thyroid cancer. These patients should be examined every two years indefinitely. Fortunately, only a small percentage of irradiated individuals develop thyroid tumors. Most of the tumors found have been benign. Those which are malignant have been well differentiated, papillary, or follicular neoplasms which grow slowly, metastasize relatively late, and are curable by surgical removal before metastasis has occurred. If on palpation of the thyroid gland one or more firm, discrete nodules are palpated, these should be removed regardless of other findings. A scan may be useful in assessing the functional status of the nodule and may give some indication as to whether the nodule is malignant or benign. If the scan shows a cold area which corresponds with a pows a cold area which corresponds with a palpable mass, the patient should be considered for prompt surgical exploration. If the scan shows a hot nodule, it is usually not malignant, but should be closely observed for change

277

Case of concurrent Riedel's thyroiditis, acute suppurative thyroiditis, and micropapillary carcinoma  

OpenAIRE

Riedel's thyroiditis (RT) is a rare chronic inflammatory disease of the thyroid gland. It is characterized by a fibroinflammatory process that partially destroys the gland and extends into adjacent neck structures. Its clinical manifestation can mask an accompanying thyroid neoplasm and can mimic invasive thyroid carcinoma. Therefore, diagnosis can be difficult prior to surgical removal of the thyroid, and histopathologic examination of the thyroid is necessary for a definite diagnosis. The c...

Hong, Ji Taek; Lee, Jung Hwan; Kim, So Hun; Hong, Seong Bin; Nam, Moonsuk; Kim, Yong Seong; Chu, Young Chae

2013-01-01

278

Processing by factor analysis of dynamic dual isotope studies using 99Tcm and 201Tl within a middle energy band. Evaluation in thyroid nodule malignancy  

International Nuclear Information System (INIS)

Simultaneous investigations with two isotopes are currently restricted because of a spectral overlap. The factor analysis of spectral and dynamic structures (FASDS) method is shown to achieve accurate spectral separation. In addition, it estimates underlying dynamic mechanisms. Twenty-six patients were injected simultaneously with 99Tcm-pertechnetate and 201Tl-chloride to assess the malignancy of solitary thyroid nodules. List-mode acquisition of spectral, temporal and spatial coordinates of events allows the reconstruction of an image sequence indexed by time and energy. FASDS proceeds in two steps. First it yields both dynamic and spatial information related to each isotope (99Tcm and 201Tl) and partially removes the scatter component. Then it estimates the underlying kinetics and associated spatial distributions of each isotope. Using the 201Tl component, an index was derived from the uptake ratio between nodules and normal thyroid tissue. Concerning the detection of malignant nodules the method indicated no false negative in our limited group of 26 patients. One false positive result was found which could not be classified by the investigation of the 201Tl dynamic components contained in the reconstructed 201Tl factor sequence. (Author)

279

Struma ovarii with follicular thyroid-type carcinoma and neuroendocrine component: case report  

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Full Text Available Abstract Struma ovarii (SO is a slow-growing ovarian neoplasm with thyroid tissue as its predominant component. It is an uncommon neoplasm, usually asymptomatic with an unknown risk of malignant transformation. Due to difficulties in assessing the rare biological nature and the discrepancies in the reported cases, a consensus on the appropriate treatment has not been definitively reached. A 50-year-old female was subjected to upper gut endoscopy which showed a 30-mm mass located in the gastric antrum, suggestive of mesenchimal tumor. Incidentally, a pelvic CT scan also documented a solid mass in the right adnexa, with morphological characteristics of ovarian neoplasm. The patient underwent gastrectomy, total hysterectomy, bilateral salpingo-oophorectomy with lymph node dissection, and omentectomy. Histology documented the presence of gastric cavernous angioma, and, in the right adnexa, foci of follicular thyroid-type carcinoma arising in SO with a well-differentiated neuroendocrine component. Here we report and discuss the clinical and morphological presentation of follicular thyroid-type carcinoma arising in SO. The neoplasm was discovered incidentally and had a favorable clinical outcome at 1-year follow-up.

Selvaggi Federico

2012-05-01

280

Avaliação de fatores clínicos, laboratoriais e ultrassonográficos preditores de malignidade em nódulos tiroidianos Evaluation of clinical, laboratorial and ultrasonographic predicting factors of malignancy in thyroid nodules  

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Full Text Available OBJETIVO: Avaliar risco de malignidade de nódulos tiroidianos por meio de aspectos clínicos, laboratoriais, ultrassonográficos e citológicos. PACIENTES E MÉTODOS: 741 nódulos de 407 pacientes. RESULTADOS: A citologia foi benigna (60,5%, indeterminada (23,3%, maligna (8,6% ou não diagnóstica (7,6%. A prevalência de câncer nas citologias indeterminadas foi 18,5% (16% nas lesões foliculares, 44% nas suspeitas. O diagnóstico de malignidade foi 17,2% (n = 70. A frequência de câncer em mulheres (15,2% foi menor do que em homens (27,9%. Houve uma relação inversa entre idade e risco de câncer. Não houve significância estatística na prevalência de câncer de acordo com número, tamanho dos nódulos ou níveis de TSH. Hipoecogenicidade e microcalcificações ao ultrassom foram fatores de risco. CONCLUSÃO: O risco de malignidade foi maior em homens, nódulos hipoecogênicos, com microcalcificações e inversamente relacionado à idade. O nível de TSH não foi um preditor independente de malignidade.OBJECTIVE: To evaluate the risk of malignancy in thyroid nodules through clinical, laboratory, ultrasonographic and cytological aspects. PATIENTS AND METHODS: 741 nodules of 407 patients. RESULTS: The cytology was benign (60,5%, indeterminate (23,3%, malignant (8,3% or nondiagnostic (7,6%. The prevalence of cancer in indeterminate citology was 18,5% (16% in follicular lesions, 44% in suspicious. The diagnosis of malignancy was 17,2% (n = 70. The frequency of cancer in women (15,2% was lower than in men (27,9%. There was an inverse relation between age and cancer risk. There was no statistical significance in the prevalence of cancer according to number, size of nodules or TSH levels. Hypoechogenicity and microcalcifications on ultrasound were risk factors. CONCLUSION: The risk of malignancy was higher in men, hypoechoic nodules, with microcalcifications and was inversely related to age. The TSH level was not an independent factor predictive of malignancy.

Ana Luiza Silva Rio

2011-02-01

281

Avaliação de fatores clínicos, laboratoriais e ultrassonográficos preditores de malignidade em nódulos tiroidianos / Evaluation of clinical, laboratorial and ultrasonographic predicting factors of malignancy in thyroid nodules  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Avaliar risco de malignidade de nódulos tiroidianos por meio de aspectos clínicos, laboratoriais, ultrassonográficos e citológicos. PACIENTES E MÉTODOS: 741 nódulos de 407 pacientes. RESULTADOS: A citologia foi benigna (60,5%), indeterminada (23,3%), maligna (8,6%) ou não diagnóstica (7,6% [...] ). A prevalência de câncer nas citologias indeterminadas foi 18,5% (16% nas lesões foliculares, 44% nas suspeitas). O diagnóstico de malignidade foi 17,2% (n = 70). A frequência de câncer em mulheres (15,2%) foi menor do que em homens (27,9%). Houve uma relação inversa entre idade e risco de câncer. Não houve significância estatística na prevalência de câncer de acordo com número, tamanho dos nódulos ou níveis de TSH. Hipoecogenicidade e microcalcificações ao ultrassom foram fatores de risco. CONCLUSÃO: O risco de malignidade foi maior em homens, nódulos hipoecogênicos, com microcalcificações e inversamente relacionado à idade. O nível de TSH não foi um preditor independente de malignidade. Abstract in english OBJECTIVE: To evaluate the risk of malignancy in thyroid nodules through clinical, laboratory, ultrasonographic and cytological aspects. PATIENTS AND METHODS: 741 nodules of 407 patients. RESULTS: The cytology was benign (60,5%), indeterminate (23,3%), malignant (8,3%) or nondiagnostic (7,6%). The p [...] revalence of cancer in indeterminate citology was 18,5% (16% in follicular lesions, 44% in suspicious). The diagnosis of malignancy was 17,2% (n = 70). The frequency of cancer in women (15,2%) was lower than in men (27,9%). There was an inverse relation between age and cancer risk. There was no statistical significance in the prevalence of cancer according to number, size of nodules or TSH levels. Hypoechogenicity and microcalcifications on ultrasound were risk factors. CONCLUSION: The risk of malignancy was higher in men, hypoechoic nodules, with microcalcifications and was inversely related to age. The TSH level was not an independent factor predictive of malignancy.

Ana Luiza Silva, Rio; Rosa Paula Mello, Biscolla; Danielle Macellaro, Andreoni; Cléber Pinto, Camacho; Cláudia Cristina Doimo, Nakabashi; Maria da Conceição de Oliveira Carneiro, Mamone; Elza Setsuku, Ikejiri; Luiza K., Matsumura; Jairo Tabacow, Hidal; Rui Monteiro de Barros, Maciel; Reinaldo Perrone, Furlanetto.

2011-02-01

282

Ptimary thyroid lymphomas and other rare thyroid tumors  

OpenAIRE

Primary thyroid lymphomas are rare. Surgery is seldom indicated. The aim of the study is to find out the main characteristics of primary thyroid lymphomas in our patients, indications for surgery and the possibility of treatment, frequency and characteristics of rare thyroid tumors. Method: retrospective study of 1044 patient operated for malignant thyroid tumor. Results: From 1995 to may 2003, we operated upon 15 patients with primary thyroid lymphomas, 2 men and 13 women mean age of 50.12 y...

Boži? Vesna; Havelka Marija J.; Tati? Svetislav B.; Kalezi? Nevena K.; Kaži? Milena; Živi? Rastko; Krgovi? Ksenija Lj.; Paunovi? Ivan R.; Živaljevi? Vladan R.; Dikli? Aleksandar ?.

2003-01-01

283

Thyroid stem cells: lessons from normal development and thyroid cancer  

OpenAIRE

Ongoing advances in stem cell research have opened new avenues for therapy for many human disorders. Until recently, however, thyroid stem cells have been relatively understudied. Here, we review what is known about thyroid stem cells and explore their utility as models of normal and malignant biological development. We also discuss the cellular origin of thyroid cancer stem cells and explore the clinical implications of cancer stem cells in the thyroid gland. Since thyroid cancer is the most...

Thomas, Dolly; Friedman, Susan; Lin, Reigh-yi

2008-01-01

284

Assessment of malignancy rate in thyroid nodules according to the Bethesda system of fine-needle aspiration. Report from a tertiary center in the Southwestern region of Saudi Arabia.  

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Applying a standard terminology reporting system for thyroid FNA may enhance the communication between pathologists and clinicians, assists them to find out the rate of malignancy in each cytologic group, and facilitating a more consistent approach for patients' management.

Mubarak M. Al-Shraim

2012-02-01

285

Thyroid surgery.  

Science.gov (United States)

Diseases of the thyroid are common and surgical treatment is often the preferred option. Thyroid surgery is becoming subspecialised and falls within the repertoire of maxillofacial, and head and neck surgeons. Multidisciplinary management of most patients with diseases of the thyroid is key to providing the best care particularly for those with malignancies and retrosternal extension. To reduce postoperative complications a meticulous search for, and protection of the recurrent laryngeal nerve and parathyroid glands, with an incision along the skin crease in the lower neck, which can be extended for neck dissection, are paramount. Recent advances in thyroid surgery include ultrasound-guided cervical plexus block, use of the Harmonic Scalpel(®) (Ethicon Endo-Surgery, Inc., USA), intraoperative nerve stimulation to monitor the recurrent laryngeal nerve, use of TissuePatch™ 3 (Tissuemed Ltd., Leeds, UK) adhesive sealant, and minimal access surgery. PMID:22192610

Cheng, Leo H-H; Hutchison, Iain L

2012-10-01

286

Metilación del receptor de la hormona estimulante del tiroides: marcador diagnóstico de malignidad en cáncer de tiroides / Methylation of the thyroid stimulating hormone receptor: diagnostic marker of malignity in thyroid cancer  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se analizó el estado de metilación del promotor del gen para el receptor de la hormona estimulante del tiroides (TSH) en el diagnóstico de tumores tiroideos de origen epitelial. El estudio se realizó en tejido tiroideo obtenido de bloques de parafina de diferentes patologías tiroideas (carcinoma pap [...] ilar, folicular e indiferenciado, y adenomas foliculares). El trabajo se realizó empleando la técnica de modificación del ADN con bisulfito de sodio y el análisis del estado de la metilación del gen RTSH se realizó por el método de reacción en cadena de la polimerasa específica para metilación. Encontramos metilación del promotor para el gen del receptor de TSH en los carcinomas papilares (33 de 40; 82,5 %), en los 10 carcinomas indiferenciados (100 %) y en 10 de los 15 carcinomas foliculares analizados (66,6 %). En cambio, no se observó metilación en los 8 adenomas foliculares analizados. Se propone la metilación del gen para el receptor de TSH como un nuevo marcador diagnóstico de malignidad, y una base para emplear agentes desmetilantes conjuntamente con la terapia con radioyodo, en los pacientes con cáncer de tiroides de origen epitelial que no respondan a la terapia. Abstract in english 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 a [...] nd 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.

María Teresa, Marrero Rodríguez.

2007-12-01

287

Metilación del receptor de la hormona estimulante del tiroides: marcador diagnóstico de malignidad en cáncer de tiroides Methylation of the thyroid stimulating hormone receptor: diagnostic marker of malignity in thyroid cancer  

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Full Text Available Se analizó el estado de metilación del promotor del gen para el receptor de la hormona estimulante del tiroides (TSH en el diagnóstico de tumores tiroideos de origen epitelial. El estudio se realizó en tejido tiroideo obtenido de bloques de parafina de diferentes patologías tiroideas (carcinoma papilar, folicular e indiferenciado, y adenomas foliculares. El trabajo se realizó empleando la técnica de modificación del ADN con bisulfito de sodio y el análisis del estado de la metilación del gen RTSH se realizó por el método de reacción en cadena de la polimerasa específica para metilación. Encontramos metilación del promotor para el gen del receptor de TSH en los carcinomas papilares (33 de 40; 82,5 %, en los 10 carcinomas indiferenciados (100 % y en 10 de los 15 carcinomas foliculares analizados (66,6 %. En cambio, no se observó metilación en los 8 adenomas foliculares analizados. Se propone la metilación del gen para el receptor de TSH como un nuevo marcador diagnóstico de malignidad, y una base para emplear agentes desmetilantes conjuntamente con la terapia con radioyodo, en los pacientes con cáncer de tiroides de origen epitelial que no respondan a la terapia.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.

María Teresa Marrero Rodríguez

2007-12-01

288

Radioactive iodine whole body scan (RIWB) strategy in malignant thyroid diseases: an approach to iodine 123 utilisation; La strategie d'utilisation de la scintigraphie corporelle a l'iode: interet de l'iode 123  

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Nevertheless, the scan may be avoided if the expansive malignant intra-thyroidal lesion, treated by total thyroidectomy, has favorable prognosis criteria and there are not anti-thyroglobulin antibodies circulating. Indeed RIWB scan must be used periodically in follow-up of the other cases, scanning, if possible, with iodine-123 in order to avoid the stunning effect The RIWB post-therapeutic scan (after administration of a high activity of 1311) gives, of course, the best information concerning the eventual remaining post-surgery thyroid tissue and the eventual localisation of metastases. Therefore two different propositions has be done in the follow-up of patients with malignant thyroid lesions depending on the prognosis criteria. (author)

Munsch, R.C. [Centre Hospitalier de Valence, Service Medecine Nucleaire, 26 (France)

2003-04-01

289

Pheochromocytoma of the Adrenal gland Scaled Score (PASS) to separate benign from malignant neoplasms: a clinicopathologic and immunophenotypic study of 100 cases.  

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No comprehensive series has evaluated the histologic features of pheochromocytoma to separate benign from malignant pheochromocytoma by histomorphologic parameters only. Fifty histologically malignant and 50 histologically benign pheochromocytomas of the adrenal gland were retrieved from the files of the Armed Forces Institute of Pathology. The patients included 43 females and 57 males, with an age range of 3-81 years (mean 46.7 years). Patients usually experienced hypertension (n = 79 patients). The mean tumor size was 7.2 cm (weight was 222 g). Histologically, the cases of malignant pheochromocytomas of the adrenal gland more frequently demonstrated invasion (vascular [score = 1], capsular [score = 1], periadrenal adipose tissue [score = 2]), large nests or diffuse growth (score = 2), focal or confluent necrosis (score = 2), high cellularity (score = 2), tumor cell spindling (score = 2), cellular monotony (score = 2), increased mitotic figures (>3/10 high power fields; score = 2), atypical mitotic figures (score = 2), profound nuclear pleomorphism (score = 1), and hyperchromasia (score = 1) than the benign tumors. A Pheochromocytoma of the Adrenal gland Scaled Score (PASS) weighted for these specific histologic features can be used to separate tumors with a potential for a biologically aggressive behavior (PASS > or =4) from tumors that behave in a benign fashion (PASS <4). The pathologic features that are incorporated into the PASS correctly identified tumors with a more aggressive biologic behavior. Application of these criteria to a large cohort of cases will help to elucidate the accuracy of this grading system in clinical practice. PMID:11979086

Thompson, Lester D R

2002-05-01

290

MR imaging of ovarian neoplasms  

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MR imaging of 105 patients with surgically proved ovarian neoplasms was performed on a 0.6-T superconducting magnet using two-dimensional spin-echo technique. Findings were correlated with CT and US scans. In both benign (n = 27) and malignant (n = 78) cases, the primary site was identified, but only some benign cysts, dermoid cysts, and endometriomas had characteristic appearances. The sensitivity and specificity of MR imaging in staging ovarian carcinomas will be compared to those of CT. MR imaging and CT were nonspecific in distinguishing benign from malignant disease and equivalent in defining the intrapelvic extent; however, CT was better for detection of abdominal implants, adenopathy, and ascites

291

Case presentation – thyroid lymphoma  

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Full Text Available Malignant tumors of the thyroid gland account for about 1% of thenewly diagnosed malignant tumors each year, and their incidence inwomen is twice the incidence in men. According to the WHO classification (2004 thyroid tumors are divided into: carcinoma of the thyroid, adenoma and similar tumors, and other thyroid tumors which include: teratomas, angiosarcomas, paragangliomas and others, as well as primary lymphomas and plasmacytomas. Primary thyroid lymphomasare defined as lymphomas which originate in the thyroid gland. This study presents the case of a 68-year-old patient with a thyroid lymphoma, which caused compression of the airways. In the patientpresented there was reduced activity of the thyroid gland. The dominant symptoms were: breathing difficulties, hoarse voice and the enlargement of the thyroid. An ultrasound examination was performedbefore surgery on the neck, which showed a multinodular thyroid,with compromised and compressed trachea to the right and rear. Anemergency surgical procedure was performed to reduce the tumor.Pathohistological diagnosis confirmed diffuse large B cell lymphoma.The aim of the study was to present a patient with a thyroid lymphoma, who had previously not had any immunological changes to the gland,that is, she had not had any chronic lymphocyte thyroiditis, but due to the compressive syndrome it was necessary to perform an emergencysurgical procedure to reduce the tumor.

Belkisa Izi?

2011-11-01

292

Metastatic neoplasms of the central nervous system  

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Metastatic neoplasms to the central nervous system are often encountered in the practice of surgical neuropathology. It is not uncommon for patients with systemic malignancies to present to medical attention because of symptoms from a brain metastasis and for the tissue samples procured from these lesions to represent the first tissue available to study a malignancy from an unknown primary. In general surgical pathology, the evaluation of a metastatic neoplasm of unknown primary is a very complicated process, requiring knowledge of numerous different tumor types, reagents, and staining patterns. The past few years, however, have seen a remarkable refinement in the immunohistochemical tools at our disposal that now empower neuropathologists to take an active role in defining the relatively limited subset of neoplasms that commonly metastasize to the central nervous system. This information can direct imaging studies to find the primary tumor in a patient with an unknown primary, clarify the likely primary site of origin in patients who have small tumors in multiple sites without an obvious primary lesion, or establish lesions as late metastases of remote malignancies. Furthermore, specific treatments can begin and additional invasive procedures may be prevented if the neuropathologic evaluation of metastatic neoplasms provides information beyond the traditional diagnosis of ''metastatic neoplasm.'' In this review, differential cytokeratins, adjuvant markers, and organ-specific antibodies are described and the immunohistochemical signatures of metastatic neoplasms that are commonly seen by neuropathologists are discussed

293

Update on lacrimal gland neoplasms: Molecular pathology of interest.  

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Lacrimal gland neoplasms are rare and much of our knowledge of the behavior and molecular pathogenesis of these tumors comes from study of the similar, but more numerous salivary gland neoplasms. After briefly discussing the classification of lacrimal gland neoplasms, I review three areas of emerging knowledge in the pathogenesis of these neoplasms: (1) the concept of adenoid cystic carcinoma with high-grade transformation and the associated cytogenetic changes; (2) recent analysis of the MYB-NFIB gene fusion in adenoid cystic carcinoma, and; (3) overexpression of HER2 in malignant salivary and lacrimal neoplasms. PMID:23960983

White, Valerie A

2012-04-01

294

Histopathologic reproducibility of thyroid disease in an epidemiologic study  

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An investigation of the long-term effects of childhood scalp irradiation demonstrated a significantly increased risk of thyroid tumors in the irradiated population. Because of the complexity of thyroid cancer diagnosis, a histopathologic slide review of 59 of the 68 patients (irradiated and nonirradiated) with thyroid disease was undertaken. The review revealed 90% agreement (kappa = +0.85, P less than 0.01) between the original and review diagnosis. Four of 27 cases previously diagnosed as malignant were reclassified as benign, yielding a cancer misdiagnosis rate of 14.8%. All four of the misdiagnosed cancers were of follicular or mixed papillary-follicular type. As a result of the histologic review, the ratio of malignant to benign tumors decreased from 2.55 to 1.75. Since disagreement in diagnosis was similar in the irradiated and nonirradiated groups, the relative risk of radiation-associated neoplasms did not change substantially. The histopathologic review shows that although there were some problems in diagnostic reproducibility, they were not statistically significant and did not alter our previous conclusions regarding radiation exposure. However, a 15% reduction in the number of malignancies might affect epidemiologic studies with an external comparison as well as geographic or temporal comparisons

295

Malignant epithelioid hemangioendothelioma of the lip: a case report and comprehensive literature review.  

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Malignant epithelioid hemangioendothelioma (MEH), also known as high-risk epithelioid hemangioendothelioma, is a low- to intermediate-grade vascular malignancy originally described as a vascular neoplasm of endothelial origin. This very rare vascular neoplasm has been described mainly in soft tissue, but also in various organs and locations, including the liver, lung, brain, colon, lymph nodes, peritoneum, spleen, bone, skin, heart, soft tissues, and vascular system. Several cases have been described in the head and neck, including the submandibular gland, parotid gland, nasal cavity, parapharyngeal space, maxilla, maxillary sinus, occipital bone, oral cavity, thyroid gland, neck, scalp, larynx, and mandible. This case report is the first description of MEH presenting as an exophytic lower-lip lesion. PMID:24268966

Robinson, Allen A; Tolentino, Lucilene F; Uyanne, Jettie; Melrose, Raymond; Calhoun, Colonya C

2014-04-01

296

Retrospective Comparison of Histopathologic Results of Thyroid Fine-Needle Aspiration Biopsies  

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Full Text Available Objective: To determine the utility of fine needle aspiration biopsy (FNAB in the evaluation of thyroid lesions at our faculty by comparing the results of FNAB and pathology report results of the patients who underwent surgery.Methods: The study population consisted of 347 ultrasonography guided thyroid nodule biopsies. The cytological results were classified as benign, suspicious for malignancy, malignant and inadequate material.Results: Cytological results were reported as 347 (84.1% benign nodules, 35 (3.8% malignant suspicious nodules, 21 (2.3% malignant nodules and 92 (9.9% inadequate materials. 35 patients (20.6% were male aged between 20-74 years old (45.0±6.2 and 135 patients (79.4% were female aged between 15-85 (36.6±7.1 years old. Examined the results of resection, FNA of the success of a benign diagnosis (sensitivity, 75.9%, 31.3% in the success of follicular neoplasm., success in the diagnosis of malignancy was 14.3%.Conclusion: Fine needle aspiration biopsy is a functional and reliable diagnosing method. The use of US guidance is helpful to obtain adequate sample from nodules. Fine needle aspiration biopsy has become the gold standard to diagnose thyroid nodules.

Erdem H et al.

2012-05-01

297

Risk factors of thyroid cancer in Babol, Northern Iran  

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Background : Thyroid cancer is the most common endocrine malignancy. Several risk factors were found to play a role in thyroid cancer. The purpose of the study was to determine the risk factors for thyroid cancer, in Babol, north of Iran.

Moazezi, Zoleika; Mahmoudi, Mahmoud; Yahyahpour, Yousef; Alaleh, Alireza

2011-01-01

298

Anaplastic thyroid carcinoma presenting as bilateral pleural effusion  

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Anaplastic thyroid cancer presenting as bilateral malignant pleural effusion is rarely reported. We present a case who presented solely with respiratory symptoms and subsequently found to be having bilateral malignant pleural effusion secondary to anaplastic thyroid cancer.

Sodhi, R.; Sindhwani, G.; Chandra, S.; Anand, D.

2014-01-01

299

Equivalent doses in thyroid tissue and residual body dose from radioiodine treatment of benign and malignant disorders of the thyroid as determined under therapeutic conditions  

International Nuclear Information System (INIS)

The doses actually administered to patients undergoing radiotherapy for hyperthyroidism (104), autonomous adenoma (16) and goiter without functional anomaly (22) averaged 90, 165 and 100 Sv. Attempts were made to elucidate the causes of deviations between the predetermined dose and that actually administered, which occurred quite irrespective of whether a one-staged or split-dose regimen was used. Significant differences were occasionally also seen between the individual doses of fractionation regimens in respect of their uptake and effective half-life in the thyroidal tissue. It was calculated that the mean body dose remaining after each administration of radioactivity amounted to 0.6 mSv/MBq. In the majority of patients examined, clinical follow-up observations could be made for periods ranging from 6 to 41 months. Records were kept of all the results obtained. Further analyses were made to assess the mean residual body dose of carcinoma bearers subjected to wholebody radioiodine scintigraphy in the follow-up (14 patients) as well as of patients, in which secondary radioiodine treatment was carried out after thyroidectomy (59 patients). This was found to vary between 0.05 and 0.07 mSv/MBq. The significant discrepancies formerly determined for uptake rate and effective half-life between the individual sessions of one treatment course were confirmed by these examinations. (VHE)

300

[Diagnostic usefulness of stepwise discriminant analysis employing the values of CA125, TPA, IAP, CEA and ferritin in sera measured simultaneously for gynecological malignant neoplasms].  

Science.gov (United States)

The values for CA125, TPA, IAP, CEA, and ferritin in sera were measured simultaneously in 68 healthy nonpregnant females and 133 patients with various gynecological diseases, and examined by stepwise discriminant analysis. The usefulness and the limits for diagnosis of various gynecological diseases were investigated for each tumor marker. Also, the diagnostic usefulness of stepwise discriminant analysis employing the values for five tumor markers in sera was studied for gynecological malignancies compared with that of measuring serum CA125 alone. Because the mean values for CA125 in sera were increased specifically in the ovarian cancer patient group compared with those of other tumor markers in sera, the measurement of serum CA125 was considered to be more useful in diagnosing ovarian cancer than that of the other tumor markers. The mean values for CA125 in sera, however, were also increased more significantly in the groups of patients with endometriosis and normal pregnancies than in the group of healthy nonpregnant females (p less than 0.005). In the stepwise discriminant analysis employing the values for CA125 and four other tumor markers in sera, the diagnostic usefulness of each tumor marker was demonstrated in the early diagnosis, the differential diagnosis, and the determination of complete remission after several therapies for ovarian cancers. PMID:2997349

Yabushita, H; Masuda, T; Hattori, A; Noguchi, M; Ito, Y; Nakanishi, M; Ishihara, M

1985-09-01

301

Carcinossarcoma tireoidiano em um cão / Thyroid carcinosarcoma in a dog  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Uma cadela de dois anos de idade, sem raça definida, apresentou disfagia e aumento de volume da região cervical ventral, correspondendo à região tireoidiana. Duas massas localizadas nessa região foram removidas cirurgicamente. O cão morreu poucos dias após a cirurgia e não foi necropsiado. O diagnós [...] tico de carcinossarcoma de tireóide baseou-se na presença de componentes neoplásicos epiteliais e mesenquimais malignos, os quais foram confirmados pela reação imunoistoquímica positiva para citoqueratina e vimentina, respectivamente. A origem tireoidiana foi confirmada pela imunomarcação positiva para tireoglobulina nas células epiteliais foliculares e no colóide. Este é um neoplasma raramente diagnosticado em cães. Abstract in english A two year-old female mongrel dog was presented with dysphagia and focal swelling at the thyroid region. Two masses were surgically removed from that site. The dog died a few days after surgery and it was not submitted to necropsy. The diagnosis of thyroid carcinosarcoma was based on malignant epith [...] elial and mesenchymal cell components of the neoplasm and confirmed by immunohistochemistry for cytokeratin and vimentin, respectively. The thyroid origin was confirmed based on the positive immunostaining for thyroglobulin on the follicular epithelial cells and colloid. This is a neoplasm rarely diagnosed in dogs.

Aline, Rodrigues; Eduardo Kenji, Masuda; Maria Andréia, Inkelmann; Adriano Tony, Ramos; Brenda Maria Ferreira Prado, Marques; Tessie Beck, Martins; Glaucia Denise, Kommers.

1188-11-01

302

Carcinossarcoma tireoidiano em um cão Thyroid carcinosarcoma in a dog  

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Full Text Available Uma cadela de dois anos de idade, sem raça definida, apresentou disfagia e aumento de volume da região cervical ventral, correspondendo à região tireoidiana. Duas massas localizadas nessa região foram removidas cirurgicamente. O cão morreu poucos dias após a cirurgia e não foi necropsiado. O diagnóstico de carcinossarcoma de tireóide baseou-se na presença de componentes neoplásicos epiteliais e mesenquimais malignos, os quais foram confirmados pela reação imunoistoquímica positiva para citoqueratina e vimentina, respectivamente. A origem tireoidiana foi confirmada pela imunomarcação positiva para tireoglobulina nas células epiteliais foliculares e no colóide. Este é um neoplasma raramente diagnosticado em cães.A two year-old female mongrel dog was presented with dysphagia and focal swelling at the thyroid region. Two masses were surgically removed from that site. The dog died a few days after surgery and it was not submitted to necropsy. The diagnosis of thyroid carcinosarcoma was based on malignant epithelial and mesenchymal cell components of the neoplasm and confirmed by immunohistochemistry for cytokeratin and vimentin, respectively. The thyroid origin was confirmed based on the positive immunostaining for thyroglobulin on the follicular epithelial cells and colloid. This is a neoplasm rarely diagnosed in dogs.

Aline Rodrigues

2007-08-01

303

Medullary thyroid carcinoma in female BALB/c mice. A report of 3 cases with ultrastructural, immunohistochemical, and transplantation data.  

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Medullary thyroid carcinoma (MTC) is a neoplasm derived from thyroidal C cells. This tumor occurs spontaneously in several animal species and is relatively common in certain strains of rats. Descriptive reports of such neoplasms in mice, however, have not been published. From several studies using female BALB/c mice, 3 animals were identified that had thyroid neoplasms histologically compatible with MTC. All three primary neoplasms and a first generation transplant from one of them contained ...

Zwieten, M. J.; Frith, C. H.; Nooteboom, A. L.; Wolfe, H. J.; Delellis, R. A.

1983-01-01

304

Papillary thyroid microcarcinoma in a thyroid pyramidal lobe  

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We report an extremely rare case of papillary thyroid microcarcinoma (PTMC) in the thyroid Epub ahead of print pyramidal lobe (TPL). A 48-year-old woman underwent ultrasound-guided fine-needle aspiration for a small thyroid nodule in the right lobe in local clinic, and it revealed a malignant cytology. On preoperative ultrasonography for tumor staging in our hospital, another small suspiciously malignant hypoechoic nodule was detected in the left TPL. Total thyroidectomy and ...

Tae Kwun Ha; Dong Wook Kim; Ha Kyoung Park; Soo Jin Jung

2014-01-01

305

Intrathoracic lymph node metastases from extrathoracic neoplasms.  

Science.gov (United States)

The clinical records of 1,071 cases of extrathoracic malignant neoplasms seen over a 2 year period sere reviewed: 163 had abnormal chest films, and 25 of these showed evidence of mediastinal and/or hilar lymph node metastases. The primary malignancies which metastasized to intrathoracic lymph nodes included eight tumors of the head and neck, 12 genitourinary malignancies, three carcinomas of the breast, and two malignant melanomas. The chest films were analyzed to determine the distribution of lymph node groups involved. Unilateral lymph node enlargement occurred in eight. The most frequently detected lymph node group was the right paratracheal chain (60%), while the subcarinal and posterior mediastinal groups were rarely affected. Of the 25 cases, 10 had radiographic evidence of hematogenous or lymphangitic metastases in addition in the lungs. Metastatic disease from extrathoracic neoplasms should always be considered in the differential diagnosis of hilar and mediastinal adenopathy. PMID:98980

McLoud, T C; Kalisher, L; Stark, P; Greene, R

1978-09-01

306

Evaluation of diffuse thyroid diseases and thyroid nodules by CT  

International Nuclear Information System (INIS)

Imanishi et al. have previously reported that the changes in CT values reveal not only the change in iodine concentration in thyroid follicles, but also represent secondary changes in follicular content and follicular cells and/or interstitial structures. Thus, we performed thyroid CT without contrast material in 138 controls, 417 cases with diffuse thyroid diseases, and 279 cases with thyroid nodules, and evaluated the CT images based on the relation between the change in CT values and pathological changes. In 89% of the controls and 43% of patients with diffuse thyroid diseases, the thyroid CT revealed diffuse high density. In contrast, the 94% of thyroids that demonstrated diffuse low density were from patients with diffuse thyroid diseases. Eighty-four percent of malignant nodules and 64% of benign nodules had inhomogeneous densities, and only 26% of benign thyroid nodules had homogeneous density. However, 71% of nodules that showed high and low densities with regular and clear borders, and 82% of nodules that showed papillary proliferation in a cyst pattern were benign. Although only 58% of nodules with calcification were malignant, 66% of nodules with calcification in the central portion, and 86% of nodules with calcification of a disseminated and convergent pattern in distribution were malignant. Sixty-two percent of thyroids that surrounded nodules had chronic thyroiditis, hypoplasia and/or adenomatous goiter. Thus, unclear borders between a nodule and the surclear borders between a nodule and the surrounding thyroid tissue did not increase the possibility of malignancy. However, the unclear and/or lobulated border between a nodule and extra thyroid tissue increased the possibility of malignancy. We concluded that thyroid CT without contrast material is useful for the diagnosis of thyroid diseases. (author)

307

Factores pronósticos en neoplasias malignas primarias de glándulas salivares: Estudio retrospectivo de 20 años / Prognostic factors in primary malignant salivary gland neoplasms: A 20-year retrospective study  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivo. Analizar los posibles factores pronósticos que pueden influir en la supervivencia y el desarrollo de recurrencias en nuestra serie de pacientes con neoplasias malignas primarias de glándulas salivares. Diseño del estudio. Se realiza un estudio retrospectivo de 75 pacientes con carcinomas g [...] landulares tratados entre 1980 y el 2003. En todos los casos el tratamiento realizado ha sido la cirugía. Se administró radioterapia postoperatoria en un 52% de los pacientes. Se emplea el modelo de Kaplan-Meier para el análisis de supervivencia y el periodo libre de enfermedad. Así mismo, se analiza la posible asociación entre los diversos factores pronósticos y estas variables mediante el test Log Rank para el estudio univariante y el modelo de Cox para el multivariante. Resultado. La supervivencia global y causa-específica de la serie a 5 y 10 años ha sido del 74,9 y 63 y del 77,7 y 65,3% respectivamente. El periodo libre de enfermedad ha sido de 51,8 y 43,2% a 5 y 10 años. De los factores analizados, la localización tumoral, el sexo, el estadio patológico, el tamaño tumoral, la parálisis facial, la infiltración perineural y la infiltración vascular han mostrado una influencia estadísticamente significativa en la supervivencia y/o recurrencias (p Abstract in english Objective. To analyze the possible prognostic factors for survival and disease-free survival in a group of patients with primary malignant salivary gland tumors. Design. Seventy-five patients with salivary gland carcinomas were studied retrospectively from 1980 to 2003. All cases were initially trea [...] ted with surgery. Postoperative radiotherapy was applied in 52% of the patients. Survival and disease-free survival were analyzed with the Kaplan-Meier method. The association between the different prognostic factors and survival was studied with the Log Rank test for univariate analysis and the Cox proportional model for multivariate analysis. Results. The 5-year and 10-year crude survival rates were 74.9% and 63% and cause-specific survival rates were 77.7% and 65.3% respectively. The 5-year and 10-year disease-free survival rates were 51.8% and 43.2%. Tumor location, sex, pathologic stage, tumor size, facial palsy, perineural spread and vascular spread showed statistical significance in survival and recurrence (p

A., Capote Moreno; L., Naval Gías; F.J., Rodríguez-Campo; M.F., Muñoz Guerra; V., Escorial; F.J., Díaz González.

2005-10-01

308

Atypical Fibroxanthoma: An Unusual Skin Neoplasm in Xeroderma Pigmentosum  

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Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder related to defective deoxyribonucleic acid (DNA) repair. Various cutaneous manifestations related to ultraviolet (UV) damage characterize the clinical course. Primary malignant cutaneous neoplasms like squamous cell carcinoma, basal cell carcinoma and malignant melanoma have been reported. Atypical fibroxanthoma is a rare dermal neoplasm occurring in UV-damaged skin. We report an unusual case of atypical fibroxanthoma in a 20-year-old male with XP. PMID:23112360

Bandyopadhyay, Ranjana; Nag, Dipanwita; Bandyopadhyay, Sanjay; Sinha, Swapan Kumar

2012-01-01

309

Histopathological audit of salivary gland neoplasms  

International Nuclear Information System (INIS)

Salivary gland neoplasms are uncommon but important presentation to general surgeons. Objective: To analyze the relative frequency and distribution of Salivary gland neoplasms in our division. Setting: Department of surgery and pathology, Peoples Medical University hospital and GMMMC hospital Sukkur. Study design: Descriptive (case series) Subjects and methods: A total of 40 patients registered for salivary gland tumors from oct 2008 to 0ct 2013 were included in the study. A thorough history, clinical examination, routine haematological and biochemical studies were done in all patients. FNAC was done in all cases. All patients were subjected to surgical intervention on standard rules. Each resected specimen was sent for histopathology. Information about age, gender and tumor location was obtained from clinical record and frequency of different neoplasms was studied from histopathological report. All data was collected on especially designed proforma. Data analysis was done using spss version 17. Results: A total of 40 patients were registered for salivary gland neoplasms. 28 patients (70%) had parotid lesions, 10 patients (25%) had submandibular gland involvement and 2 patients ( 5%) had minor salivary gland tumors. Patients were between 15 - 80 years of age( mean age =34.7 years) 24 patients(60%) were male and 16 (40%) were female,with male to female ratio of 1.5:1.32 . 22 (80%) had benign lesions and 8 patients (20%) had malignant lesions. Pleomorphic adenoma was the most common benign tumor affecting the parotid gland. Adenocarcinoma represented as the most prevelant parotid malignancy. Benign neoplasms occurred in third and fourth decades of life and malignant neoplasms were diagnosed in sixth and seventh decades of life. Conclusion:Salivary gland neoplasms are uncommon but they have occasioned much interest and debate because of broad histological spectrum. The data presented in this study is corroborated with most of the studied literature worldwide. (author)

310

Thyroid-like cholangiocarcinoma of the liver: an unusual morphologic variant with follicular, trabecular and insular patterns.  

Science.gov (United States)

We report the case of a 26-year-old woman with a 19 cm malignant hepatic neoplasm with morphological features that closely resembled a follicular thyroid carcinoma. Despite this, it was interpreted as a cholangiocarcinoma due to the absence of a primary thyroid tumor and the lack of thyroglobulin and TTF-1 immunoreactivity by the hepatic tumor. The left hepatic lobectomy specimen showed an encapsulated and multinodular gray-white mass with cystic and hemorrhagic areas. Microscopically, it displayed predominant macro and microfolicullar patterns with focal solid, trabecular and insular areas. The small and distended follicles contained a colloid-like secretion and were lined by low cuboidal cells with scant cytoplasm, round or oval hyperchromatic nuclei with fine chromatin. The solid areas, trabecular and insular structures were similar to those of follicular or papillary thyroid carcinomas. In addition, some of the neoplastic cells had clear nuclei with occasional grooves. The tumor was positive for cytokeratin (CK) 7, CK 19 and CD138, and negative for TTF-1, thyroglobulin, Hepar-1, Glypican-3, alpha-fetoprotein and neuroendocrine markers. A thyroid neoplasm was excluded clinically and by ultrasound and computed tomography. Although, the residual hepatic parenchyma was initially not cirrhotic, the patient eventually developed cryptogenic cirrhosis. The patient received adjuvant chemotherapy and died of metastatic disease 18 months after surgery. The thyroid-like pattern broadens the morphologic spectrum of cholangiocarcinoma. PMID:23109464

Chablé-Montero, Fredy; Shah B S, Amy; Montante-Montes de Oca, Daniel; Angeles-Ángeles, Arturo; Henson, Donald E; Albores-Saavedra, Jorge

2012-01-01

311

Second malignancies in children: the usual suspects?  

Energy Technology Data Exchange (ETDEWEB)

The aim of this article is to provide an up to date review of second malignant neoplasms (SMN's) following treatment for childhood cancer, referring to their incidence, the role of genetic factors, and how the primary malignancy and treatment received influence the type, site and prognosis of SMN's. The role of genetic factors will be discussed as far as they impact upon a predisposition to later development of SMN's. The primary malignancies that have important associations with SMN's will then be discussed, in particular Hodgkin's disease, retinoblastoma and acute lymphoblastic leukaemia. The important second malignancies will be highlighted, including tumours of the CNS and thyroid, osteosarcoma, secondary acute myeloid leukaemia and melanoma. Emphasis will be put upon identifying which patients are most likely to suffer from these tumours. An important part of the article are case histories. These are provided in combination with illustrations as a useful adjunct to the text, with a particular emphasis on radiological features, diagnosis and screening. Finally, the important but different roles of causal agents, in particular chemotherapy and radiotherapy are highlighted.

Moppett, John; Oakhill, Anthony E-mail: anthony.oakhill@nildram.co.uk; Duncan, Andrew W

2001-06-01

312

Multiple primary malignancies and subtle mucocutaneous lesions associated with a novel PTEN gene mutation in a patient with Cowden syndrome: Case report  

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Full Text Available Abstract Background Cowden syndrome (CS is a cancer predisposition syndrome associated with increased risk of breast, thyroid, and endometrial cancers, and is characterized by development of benign mucocutaneous lesions. Case presentation Here we report on a 58-year-old woman with multiple primary malignancies and subtle mucocutaneous lesions such as small polyps and wart-like papulas. Over a period of 23 years, she developed various malignant neoplasms including thyroid, ovarian, stomach, and colon carcinomas, and a benign meningioma. Direct sequencing analysis of the PTEN gene revealed a novel germline mutation (c.438delT, p.Leu146X. Conclusion This case demonstrates that Cowden syndrome is a multi-system disease that can result in the development of multiple malignant and benign tumors.

K?epelová Anna

2011-03-01

313

Influência da transfusão sanguínea no desenvolvimento de infecção em pacientes com neoplasias malignas do sistema digestório / Influence of blood transfusion on development of infection in patients with malignant neoplasms of the digestive system  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese RACIONAL: A anemia afeta mais de 90% dos pacientes com câncer e mais de 60% são submetidos a transfusões sangüíneas durante ou após o tratamento. OBJETIVO: Determinar a influência da transfusão sangüínea homógena como possível fator relacionado à infecção em paciente com neoplasia maligna do sistema [...] digestório. MÉTODO: Avaliaram-se aleatoriamente prontuários de 400 pacientes com neoplasia maligna do sistema digestório, distribuídos em dois grupos: grupo 1 (n = 200) - pacientes transfundidos e grupo 2 (n = 200) - não-transfundidos. Comparou-se a incidência de infecções entre os dois grupos e suas possíveis interações com idade, sexo, tipo de neoplasia e a terapêutica instituída. RESULTADOS: Não houve relação significativa entre infecção e hemotransfusão sangüínea, idade, sexo, tratamento adotado e natureza do câncer. Não houve diferença na incidência de infecção nos pacientes não-transfundidos (28) em comparação com os hemotransfundidos (31). CONCLUSÃO: A hemotransfusão homógena não foi fator determinante para o surgimento de infecções em pacientes com neoplasias malignas do sistema digestório. Abstract in english BACKGROUND: Anemia affects up to 90% of cancer patients, with more than 60% requiring blood transfusion during or after treatment. AIM: To determine the influence of the allogeneic blood transfusion as a possible related factor to infection in patients with malignant neoplasms of the gastrointestina [...] l system. PATIENTS AND METHOD: Charts of 400 oncological patients were randomly selected and divided into two groups: group 1 (n = 200) - patients submitted to allogeneic blood transfusion and group 2 (n = 200) - non transfused patients. Both groups were evaluated and compared according to the presence and type of infection and a possible association with age, sex, types of tumors and therapeutics approach. RESULTS: The relation between infection and blood transfusion, as well as age, sex, management and type of presented tumors were not significant. There was no difference in the incidence of infection between the non transfused patients (28) and those submitted to allogeneic blood transfusion (31). CONCLUSIONS: In the present investigation allogeneic blood transfusion was apparently not related to development of infection in patients with malignant gastrointestinal tumors.

Luiz Ronaldo, Alberti; Leonardo de Souza, Vasconcellos; Andy, Petroianu.

2006-09-01

314

The Bethesda system for reporting thyroid fine needle aspirates: A cytologic study with histologic follow-up  

Science.gov (United States)

Background: The Bethesda system for reporting thyroid cytopathology represents a major step towards standardization, reproducibility, improved clinical significance, and greater predictive value of thyroid fine needle aspirates (FNAs). Aims: To elucidate the utility of the Bethesda system in reporting thyroid FNAs. Materials and Methods: We retrospectively reviewed thyroid FNAs between April 2009 and March 2012, classified them using the Bethesda system, found out the distribution of cases in each Bethesda category, and calculated the malignancy risk for each category by follow-up histopathology. Results: Of the 1020 FNAs, 1.2% were non-diagnostic, 87.5% were benign, 1% were atypical follicular lesion of undetermined significance (AFLUS), 4.2% were suspicious for follicular neoplasm (SFN), 1.4% were suspicious for malignancy (SM), and 4.7% malignant. Of 69 cases originally interpreted as non-diagnostic, 12 remained non-diagnostic after re-aspiration. In 323 cases, data of follow-up histopathologic examination (HPE) were available. Rates of malignancy reported on follow-up HPE were non-diagnostic 0%, benign 4.5%, AFLUS 20%, SFN 30.6%, SM 75%, and malignant 97.8%. Conclusions: Reviewing the thyroid FNAs with the Bethesda system allowed a more specific cytological diagnosis. In this study, the distribution of cases in the Bethesda categories differed from some studies, with the number of benign cases being higher and the number of non-diagnostic and AFLUS cases being lower. The malignancy risk for each category correlated well with other studies. The Bethesda system thus allows standardization in reporting, improves perceptions of diagnostic terminology between cytopathologists and clinicians, and leads to more consistent management approaches. PMID:23833397

Mondal, Santosh Kumar; Sinha, Simanti; Basak, Bijan; Roy, Dipanwita Nag; Sinha, Swapan Kumar

2013-01-01

315

Synchronous pancreatic solid pseudopapillary neoplasm and intraductal papillary mucinous neoplasm  

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Full Text Available Solid pseudopapillary neoplasm (SPN is a rare and low-grade malignant pancreatic neoplasm composed of poorly cohesive monomorphic neoplastic cells forming solid and pseudopapillary structures with frequent hemorrhagic-cystic degeneration. Intraductal papillary mucinous neoplasm (IPMN is a pancreatic exocrine tumor composed of intraductal papillary growth of mucin containing neoplastic cells in the main pancreatic duct or its major branches. In the case presented here, a 53-year-old, Japanese man was found to have multiple cystic lesions and dilatation of the main pancreatic duct in the neck of the pancreas. Histological examination revealed a main-duct and branch-duct type IPMN, of the gastric-type, involving the neck of the pancreas, associated with a 0.5 cm SPN in the caudal side of the IPMN. We diagnosed this case as synchronous SPN and IPMN. As far as we know, only one other case of synchronous SPN and IPMN has been reported. Both the present case and the previously reported case showed abnormal nuclear expression of ?-catenin in SPN, whereas IPMN showed no abnormal nuclear expression. These results suggest that ?-catenin abnormality is not a common pathogenetic factor of synchronous SPN and IPMN.

Kenichi Hirabayashi

2013-01-01

316

Stemness is derived from thyroid cancer cells  

OpenAIRE

Background: One hypothesis for thyroid cancer development is its derivation from thyroid cancer stem cells (CSCs). Such cells could arise via different paths including from mutated resident stem cells within the thyroid gland or via epithelial to mesenchymal transition (EMT) from malignant cells since EMT is known to confer stem-like characteristics. Methods: To examine the status of stemness in thyroid papillary cancer we employed a murine model of thyroid papillary carcinoma and exa...

RishengMa; SimonBonnefond

2014-01-01

317

Valor preditivo do exame clínico, cintilografia, ultra-sonografia, citologia aspirativa e tiroglobulina sérica no nódulo tiroideano único atóxico: estudo prospectivo de 110 pacientes tratados cirurgicamente Prediction of malignancy in the solitary thyroid nodule by physical exaination, thyroid scintigraphy, thyroid ultrasound, Fine-needle biopsy and serum thyroglobulin: a prospective study of 110 operated patients  

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Full Text Available Nódulos de tiróide são comuns na prática médica. Para estabelecer o valor preditivo dos diversos testes diagnósticos, estudamos prospectivamente os dados de exame clínico, cintilografia, ultra-sonografia, citologia aspirativa e tiroglobulina sérica pré-operatória de 110 pacientes com nódulos operados e os comparamos com o diagnóstico anátomo-patológico da cirurgia. Nos 110 pacientes encontramos à histologia 124 lesões distintas, sendo 106 (85% benignas e 18 (15% malignas. Entre as benignas havia 90 bócios colóides (73%, 8 adenomas foliculares (6%, 4 cistos tiroglossos (3% e outras 4 lesões; entre as malignas havia 16 (13% carcinomas primários da tiróide (9 papilíferos, 3 foliculares, 3 indiferenciados e 1 medular e 2 secundários. Entre os testes diagnósticos a citologia aspirativa apresentou os melhores resultados (sensibilidade: 94%, especificidade: 97%, em comparação com a cintilografia (sensibilidade: 89%, especificidade: 21%, ultra-sonografia (sensibilidades entre 60 e 100% e especificidades entre 25 e 69% e tiroglobulina pré-operatória (sensibilidade: 7% para qualquer valor discriminatório e elevada especificidade. Alguns dados clínicos também apresentaram elevada especificidade, mas baixa sensibilidade, como rouquidão, disfagia, aparecimento de nova lesão, adenomegalia cervical e antecedentes de radiação. Neste estudo prospectivo concluímos que a citologia aspirativa é o melhor método disponível para o diagnóstico dos nódulos de tiróide.Thyroid nodules are common in medical practice. To establish the predictive values of diagnostic tests we studied prospectively the results obtained from physical examination, aspiration cytology, scintigraphy, ultra-sonography and pre-operative serum thyroglobulin in 110 patients operated and compared them with the results obtained from surgical pathology specimens. We found 124 lesions in the 110 patients: 106 (85% benign and 18 (15% malignant. The benign were 90 simple goiters (73%, 8 follicular adenomas (6%, 4 thyroglossal cysts (3% and 4 other rare lesions; the malignant were 16 (13% primary thyroid carcinomas (9 papillary, 3 follicular, 3 undifferentiated and 1 medullary and 2 secondary thyroid carcinomas. Aspiration cytology presented the best results (sensitivity: 94%, specificity: 97%, compared with scintigraphy (sensitivity: 89%, specificity: 21%, ultra-sonography (sensitivities from 60 to 100%, specificities from 25 to 69% and pre-operative serum thyroglobulin (very low sensitivity and high specificity. Few clinical signs and symptoms also presented high specifity, but low sensitivity, as hoarseness, dysphagia, new lesion, cervical adenomegaly and previous local irradiation. We conclude that aspiration cytology is the best available method to diagnose thyroid nodules.

Maria Lúcia D. Alves

2002-12-01

318

Valor preditivo do exame clínico, cintilografia, ultra-sonografia, citologia aspirativa e tiroglobulina sérica no nódulo tiroideano único atóxico: estudo prospectivo de 110 pacientes tratados cirurgicamente / Prediction of malignancy in the solitary thyroid nodule by physical exaination, thyroid scintigraphy, thyroid ultrasound, Fine-needle biopsy and serum thyroglobulin: a prospective study of 110 operated patients  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Nódulos de tiróide são comuns na prática médica. Para estabelecer o valor preditivo dos diversos testes diagnósticos, estudamos prospectivamente os dados de exame clínico, cintilografia, ultra-sonografia, citologia aspirativa e tiroglobulina sérica pré-operatória de 110 pacientes com nódulos operado [...] s e os comparamos com o diagnóstico anátomo-patológico da cirurgia. Nos 110 pacientes encontramos à histologia 124 lesões distintas, sendo 106 (85%) benignas e 18 (15%) malignas. Entre as benignas havia 90 bócios colóides (73%), 8 adenomas foliculares (6%), 4 cistos tiroglossos (3%) e outras 4 lesões; entre as malignas havia 16 (13%) carcinomas primários da tiróide (9 papilíferos, 3 foliculares, 3 indiferenciados e 1 medular) e 2 secundários. Entre os testes diagnósticos a citologia aspirativa apresentou os melhores resultados (sensibilidade: 94%, especificidade: 97%), em comparação com a cintilografia (sensibilidade: 89%, especificidade: 21%), ultra-sonografia (sensibilidades entre 60 e 100% e especificidades entre 25 e 69%) e tiroglobulina pré-operatória (sensibilidade: 7% para qualquer valor discriminatório e elevada especificidade). Alguns dados clínicos também apresentaram elevada especificidade, mas baixa sensibilidade, como rouquidão, disfagia, aparecimento de nova lesão, adenomegalia cervical e antecedentes de radiação. Neste estudo prospectivo concluímos que a citologia aspirativa é o melhor método disponível para o diagnóstico dos nódulos de tiróide. Abstract in english Thyroid nodules are common in medical practice. To establish the predictive values of diagnostic tests we studied prospectively the results obtained from physical examination, aspiration cytology, scintigraphy, ultra-sonography and pre-operative serum thyroglobulin in 110 patients operated and compa [...] red them with the results obtained from surgical pathology specimens. We found 124 lesions in the 110 patients: 106 (85%) benign and 18 (15%) malignant. The benign were 90 simple goiters (73%), 8 follicular adenomas (6%), 4 thyroglossal cysts (3%) and 4 other rare lesions; the malignant were 16 (13%) primary thyroid carcinomas (9 papillary, 3 follicular, 3 undifferentiated and 1 medullary) and 2 secondary thyroid carcinomas. Aspiration cytology presented the best results (sensitivity: 94%, specificity: 97%), compared with scintigraphy (sensitivity: 89%, specificity: 21%), ultra-sonography (sensitivities from 60 to 100%, specificities from 25 to 69%) and pre-operative serum thyroglobulin (very low sensitivity and high specificity). Few clinical signs and symptoms also presented high specifity, but low sensitivity, as hoarseness, dysphagia, new lesion, cervical adenomegaly and previous local irradiation. We conclude that aspiration cytology is the best available method to diagnose thyroid nodules.

Maria Lúcia D., Alves; Rui M.B., Maciel; Fabio V., Valeri; Magnus R. Dias da, Silva; José D., Contrera; Jurandyr M., Andrade; Maria A., Llorach-Velludo; Nassim, Iazigi.

2002-12-01

319

Canine thyroid carcinoma.  

Science.gov (United States)

Malignant thyroid carcinomas are relatively common in dogs. The majority of tumors are unilateral and nonfunctional. Before deciding on treatment options, it is important to determine whether the tumor is freely moveable or fixed and invasive into adjacent tissues. Thyroidectomy is recommended for unilateral, mobile thyroid carcinomas. Radiation therapy or radioactive iodine therapy are recommended for dogs with invasive or bilateral thyroid carcinomas. The role of adjunctive chemotherapy is poorly defined, but should be considered in dogs with high-risk tumors, such as large or bilateral thyroid carcinomas. The prognosis is good following surgical treatment of mobile thyroid tumors and irradiation of fixed thyroid carcinomas, with median survival times greater than 3 years. PMID:17591293

Liptak, Julius M

2007-05-01

320

Fine needle aspiration cytology of thyroid swellings: How useful and accurate is it?  

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Full Text Available Background: Fine needle aspiration cytology (FNAC is widely considered as the diagnostic technique of choice in the assessment of thyroid lesions. Aims: The aim of this study is to determine the utility and diagnostic accuracy of FNAC of thyroid lesions performed at our institution and to compare our experience with that of the experts from other regions of the world. Setting and Design: The present study is a five-year retrospective study of FNAC of thyroid lesions performed in the Pathology Department of our institute, during the period January 2004 to December 2008. The FNAC findings were correlated with the histopathological diagnosis, wherever available. Materials And Methods: 0 The records of 252 patients who had undergone FNAC during the study period were retrieved and information about age, sex, FNAC, and Histopathological diagnoses were extracted and the corresponding original slides were reviewed. The cytological results were classified as inadequate, benign, suspicious, and malignant. The histopathology diagnosis was classified as non-neoplastic (benign and neoplastic (malignant. Results: A total of 252 FNACs of thyroid lesions were done during the study period. The results of the FNA cytological diagnosis showed that four (1.6% of the patients had FNAs, which were inadequate for cytological assessment, 228 (90.5% patients had benign lesions, 17 (6.7% had lesions that were suspicious for malignancy, and three (1.2% had malignant neoplasms. The correlation of the FNAC findings with the histopathological diagnosis, showed that our FNAC diagnostic accuracy rate was 96.2%, with a sensitivity of 66%, and specificity of 100%. Conclusions: The results of our study are comparable with the current published data and demonstrate that FNA cytology is a sensitive, specific and accurate initial diagnostic test for the preoperative evaluation of patients with thyroid swellings in our setting as well. The clinicians should be encouraged to embrace this procedure in the initial management of such patients.

Bagga P

2010-01-01

321

Neoplasms in dogs receiving low-level gamma radiation during pre- and postnatal development  

International Nuclear Information System (INIS)

Beagle dogs were given whole-body exposure to 60Co gamma radiation at one of six ages of pre- or postnatal life. Four-hundred and eighty dogs, 120 for each age at exposure, received 20 R at 8, 28 or 55 days postcoitus (dpc) or at 2 days postpartum (dpp). Similarity 480 dogs, in groups of 120, were exposed to 100 R at these same ages. Exposures of 100 R were also given to 118 dogs at 70 dpp and 231 dogs at 365 dpp. An additional 359 dogs were sham-irradiated. Mean values for each age at exposure ranged from 15.6 to 17.5 rads for 20 R exposures and from 80.8 to 88.3 rads for exposure to 100 R. Mortality due to neoplasia during the initial ten years of the experiment was examined. Twenty dogs died or were killed because of neoplasia, 19 having been irradiated. Tumours in these 19 irradiated dogs included five malignant lymphomas, eight carcinomas (two of mammary origin, two of prostatic origin, and one each of oral mucosa, ovary, urinary bladder, and thyroid origin), four sarcomas (two haemangiosarcomas, one fibrosarcoma and one mast cell sarcoma), one astrocytoma, and one hepatocellular adenoma. Neoplasms occurred in all irradiated groups except 8 dpc (20 and 100 R) and 70 dpp (100 R). Eleven neoplasms developed in dogs irradiated perinatally (55 dpc or 2 dpp) with 20 or 100 R. Four of the tumours in the perinatally irradiated dogs were detected before two years of age. The earliest death was at three months, due to an astrocytoma. Preliminary analyses point n astrocytoma. Preliminary analyses point to findings of particular interest: (1) the preponderance of neoplasms causing death or euthanasia occurred in irradiated dogs; (2) the unusual finding of four deaths due to neoplasia before two years of age in perinatally irradiated dogs; and (3) the occurrence of five malignant lymphomas in this relatively small irradiated population

322

Diagnostic usefulness of computed tomography (CT) in thyroid tumors  

International Nuclear Information System (INIS)

We performed preoperative CT scan in 130 patients with various thyroid neoplasms using the whole body scanner, Somatom 2, Siemens. Both of the CT images and the correlation of the CT values between plain and contrast enhanced CT were compared with the gross and microscopic appearances of the each surgical specimen. The slice thickness of the scan was 4 mm. Sixty percent urografin was employed for the contrast enhancement study. The mean CT value was obtained from the region of interest (ROI) of the CT image. Both calcified parts and cystic lesions were excluded from the ROI. The majority of malignant tumors and adenomatous goiters revealed not only irregular contour but also heterogeneous structure. On the other hand, homogeneous structure with regular margin was generally seen in colloid adenoma and tubular adenoma, including some cases of follicular carcinoma. In the plain CT values, those of the malignant tumors were significantly lower than in the benign ones except tubular adenoma and cyst (p < 0.001). In the values of enhanced CT, however, there existed no significant differences between them except tubular adenoma. Therefore, in the effects of contrast enhancement of them, malignant tumors were much more significant than benign ones except tubular adenoma. The present studies indicate that the combination of the structural appearances of CT images and the value of plain and enhanced CT could make it possible to get even a histological diagnosis of thyroid tumors. (author)

323

Second Malignancy in Pediatric Patients: Imaging Findings and Differential Diagnosis  

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Full Text Available Therapeutic advances in the treatment of pediatric neoplasms have improved the prognosis but have also increased the risk of developing rare second malignancies."nPrimary neoplasms which are often associated with second malignancies include lymphoma, retinoblas-toma, medulloblastoma and leukemia. The most common second malignancies are central nervous system (CNS tumors, sarcomas, thyroid and parathyroid gland carcinoma and leukemia, particularly acute myeloblastic leukemia. Genetic predisposition, chemotherapy, and especially radiation therapy are included as pathogenic factors in second malignancies. We know all survivors of childhood cancer should have lifelong follow-up, preferably with US, magnetic resonance imaging and other procedures with no ionizing radiation. A new progressive lesion may represent recurrence of the primitive neoplastic process, late radiation injury, or more infrequently, a second malignancy. Differential diagnosis may be very difficult and the outcome is often fatal. "nTreatment protocols should be modified to reduce the risk of second malignancies without compromising the effectiveness of initial therapy. "nClinicians should individualize treatment for patients who are genetically predisposed. In addition, radiologists should be familiar with the long-term consequences of antineoplastic therapy."nIn a report of new England journal of medicine in 2007, 357:227-2284 by Dr. Brenner and Hall, 2% of all carcinomas in U.S.A are due to more use of CT exam and children are three to four times more sensitive to ionization radiation. "nSo all the radiologists and clinicians should be aware of the complications and should recommend follow up exams in children who have had previous treatments for such carcinomas.

N. Tayari

2010-05-01

324

Radiology of pancreatic neoplasms: An update.  

Science.gov (United States)

Diagnostic imaging is an important tool to evaluate pancreatic neoplasms. We describe the imaging features of pancreatic malignancies and their benign mimics. Accurate detection and staging are essential for ensuring appropriate selection of patients who will benefit from surgery and for preventing unnecessary surgeries in patients with unresectable disease. Ultrasound, multidetector computed tomography with multiplanar reconstruction and magnetic resonance imaging can help to do a correct diagnosis. Radiologists should be aware of the wide variety of anatomic variants and pathologic conditions that may mimic pancreatic neoplasms. The knowledge of the most important characteristic key findings may facilitate the right diagnosis. PMID:25232458

de la Santa, Luis Gijón; Retortillo, José Antonio Pérez; Miguel, Ainhoa Camarero; Klein, Lea Marie

2014-09-15

325

The Australian experience with the Bethesda classification system for thyroid fine needle aspiration biopsies.  

Science.gov (United States)

Fine needle aspiration biopsy (FNAB) is the initial investigation of choice for thyroid nodules. The Bethesda system, which classifies thyroid FNABs into different categories each linked to a risk of malignancy, has been widely adopted. However, the risk of malignancy implied by each Bethesda category is likely to vary due to population characteristics and inconsistency in the application of diagnostic criteria.We present our experience of the Bethesda system in 2076 thyroid nodules from 1410 patients. Categories were as follows: 266 (12.8%) were category 1 (B1) non-diagnostic, 1551 (74.7%) category 2 (B2) benign, 97 (4.7%) category 3 (B3) atypia of uncertain significance, 98 (4.7%) category 4 (B4) suspicious for follicular neoplasm, 16 (0.8%) category 5 (B5) suspicious for malignancy and 48 (2.3%) category 6 (B6) malignant.Surgery was performed on 425 nodules from 315 patients. Malignancy rates in the target nodules were B1 4.2%, B2 0.26%, B3 9.3%, B4 15.3%, B5 79% and B6 100%. Twelve patients with B3 nodules underwent repeat FNAB, with eight reclassified as B2, one as B3, one as B1 and two as B4. An incidental microcarcinoma separate to the target nodule was identified in 11.1%.As applied in our institution, and despite very sparing use of B3 and B5 categories, our audit has demonstrated risks of malignancy broadly in keeping with that predicted. Of note, the risk of malignancy in the clinically indeterminate categories of B1, B3 and B4 were all at the lower ranges of those predicted in the Bethesda atlas and mostly lower than those reported by other studies. PMID:25393248

Sarkis, L M; Norlen, O; Aniss, A; Watson, N; Delbridge, L W; Sidhu, S B; Sywak, M S; Gill, A J

2014-12-01

326

Incidental Thyroid Carcinoma Diagnosed after Total Thyroidectomy for Benign Thyroid Diseases: Incidence and Association with Thyroid Disease Type and Laboratory Markers  

OpenAIRE

Objective. Currently, total thyroidectomy (TT) is widely used to treat benign thyroid diseases and thyroid carcinoma. The differential diagnosis between benign and malignant thyroid disorders and the potential identification of thyroid microcarcinomas with biochemical markers remain controversial. This retrospective study aimed to estimate the prognostic validity of thyroid autoantibodies, thyroglobulin (Tg), and the thyroid disease type in diagnostic approaches regarding the co-existence of ...

Askitis, D.; Efremidou, E. I.; Karanikas, M.; Mitrakas, A.; Tripsianis, G.; Polychronidis, A.; Liratzopoulos, N.

2013-01-01

327

Emerging therapies for thyroid carcinoma.  

LENUS (Irish Health Repository)

Thyroid carcinoma is the most commonly diagnosed endocrine malignancy. Its incidence is currently rising worldwide. The discovery of genetic mutations associated with the development of thyroid cancer, such as BRAF and RET, has lead to the development of new drugs which target the pathways which they influence. Despite recent advances, the prognosis of anaplastic thyroid carcinoma is still unfavourable. In this review we look at emerging novel therapies for the treatment of well-differentiated and medullary thyroid carcinoma, and advances and future directions in the management of anaplastic thyroid carcinoma.

Walsh, S

2012-02-01

328

Papillary thyroid microcarcinoma in a thyroid pyramidal lobe  

Directory of Open Access Journals (Sweden)

Full Text Available

We report an extremely rare case of papillary thyroid microcarcinoma (PTMC in the thyroid Epub ahead of print pyramidal lobe (TPL. A 48-year-old woman underwent ultrasound-guided fine-needle aspiration for a small thyroid nodule in the right lobe in local clinic, and it revealed a malignant cytology. On preoperative ultrasonography for tumor staging in our hospital, another small suspiciously malignant hypoechoic nodule was detected in the left TPL. Total thyroidectomy and central nodal dissection were performed. Histopathology confirmed PTMCs in the left TPL and both thyroid lobes. Ultrasonography for TPL should be required for complete evaluation of possible multifocality of thyroid malignancy.

Tae Kwun Ha

2014-10-01

329

Surgeons overestimate the risk of malignancy in thyroid nodules. Evaluation of subjective estimates using a Bayesian analysis Los cirujanos sobreestiman el riesgo de malignidad de los nódulos tiroideos. Evaluación de los estimados subjetivos usando un análisis bayesiano  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction. Thyroid nodules are the most common endocrine condition treated by surgeons. The main purpose of the evaluation of a thyroid nodule is to rule out a carcinoma. Medical decisions concerning thyroid nodules are highly influenced by subjective beliefs.
Objective. To assess the subjective probabilities of malignancy that are as-signed to the clinical characteristics of a patient with a thyroid nodule in order to determine the degree of influence that these probabilities have on the final clini-cal suspicion of malignancy compared with objective data.
Material and methods. A Bayesian analysis was designed to predict the risk of malignancy of a thyroid nodule based on the causal relationship between the demographic and clinical risk factors that are detected during the first consulta-tion. A model with demographic and clinical variables using general surgeons as experts was developed.
Results. The highest probability of malignancy (94% was assigned to the pooled case of a male who was older than 60 years, with dysphonia, dysphagia, accelerated growth rate of the nodule and previous neck radiotherapy and who had a relative with thyroid cancer as well as multiple nodules that were larger than 1 cm and with hard consistency and palpable neck lymph nodes. For low risk cases in which the nodule characteristics are not suggestive of malignancy, the probability of malignancy assigned by clinicians was 33.59%; for high risk cases this was 75.54%.
Conclusion. Surgeons make diagnostic decisions based on subjective beliefs that do not necessarily correspond to the objective measures of the characteris-tics of the nodules.
Introducción. Los nódulos tiroideos son la condición endocrina más frecuente para los cirujanos. El principio de la evaluación de un nódulo tiroideo es determinar si este corresponde a un carcinoma. Las decisiones médicas sobre los nódulos tiroideos son influenciadas fuertemente por consideraciones subjetivas.
Objetivo. Determinar las probabilidades subjetivas asignadas a las característi-cas clínicas de un paciente con un nódulo tiroideo, para evaluar el grado de in-fluencia de estas probabilidades en la sospecha clínica final de malignidad en comparación con los datos objetivos.
Materiales y métodos. Se diseñó un análisis bayesiano para predecir el riesgo de malignidad en un nódulo tiroideo basado en la relación causal conocida de factores clínicos y demográficos durante la primera consulta. Se desarrolló un modelo con las variables clínicas y demográficas usando como expertos a los ci-rujanos.
Resultados. La mayor probabilidad de malignidad (94% se asignó al caso clíni-co de un hombre mayor de 60 años, con disfonía y disfagia, nódulo de creci-miento rápido, antecedentes de radioterapia cervical y familiar con cáncer de ti-roides, con nódulos múltiples, mayores de 1 cm de consistencia dura y con adenomegalias cervicales palpables. Para los casos de bajo riesgo, con nódulos sin características de malignidad, la probabilidad de malignidad asignada por los clínicos fue de 33,59%, para los de alto riesgo fue de 75,54%.
Conclusión. Los cirujanos toman decisiones diagnósticas basadas en creen-cias subjetivas que no necesariamente corresponden con los datos objetivos de las características de nódulos.

Alvaro Sanabria

2011-06-01

330

Surgeons overestimate the risk of malignancy in thyroid nodules, evaluation of subjective estimates using a bayesian analysis / Los cirujanos sobreestiman el riesgo de malignidad de los nódulos tiroideos, evaluación de los estimados subjetivos usando un análisis bayesiano  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: English Abstract in spanish Introducción. Los nódulos tiroideos son la condición endocrina más frecuente para los cirujanos. El principio de la evaluación de un nódulo tiroideo es determinar si éste corresponde a un carcinoma. Las decisiones médicas sobre los nódulos tiroideos son influenciadas fuertemente por consideraciones [...] subjetivas. Objetivo. Determinar las probabilidades subjetivas asignadas a las características clínicas de un paciente con un nódulo tiroideo, para evaluar el grado de influencia de estas probabilidades en la sospecha clínica final de un proceso maligno en comparación con los datos objetivos. Materiales y métodos. Se diseñó un análisis bayesiano para predecir el riesgo de un proceso maligno en un nódulo tiroideo, con base en la relación causal conocida de los factores clínicos y los demográficos durante la primera consulta. Se desarrolló un modelo con las variables clínicas y demográficas usando como expertos a los cirujanos. Resultados. La mayor probabilidad de un proceso maligno (94 %) se asignó al caso clínico de un hombre mayor de 60 años, con disfonía y disfagia, nódulo de crecimiento rápido, antecedentes de radioterapia cervical y familiar con cáncer de tiroides, con nódulos múltiples, mayores de 1 cm, de consistencia dura y con adenomegalias cervicales palpables. Para los casos de bajo riesgo, con nódulos sin características de un proceso maligno, la probabilidad de éste asignada por los clínicos fue de 33,59 % y para los de alto riesgo de 75,54 %. Conclusión. Los cirujanos toman decisiones diagnósticas basadas en creencias subjetivas que no necesariamente corresponden con los datos objetivos de las características de nódulos. Abstract in english Introduction: Thyroid nodules are the most common endocrine condition treated by surgeons. The mainpurpose of the evaluation of a thyroid nodule is to rule out a carcinoma. Medical decisions concerning thyroid nodules are highly influenced by subjective beliefs. Objective: To assess the subjective p [...] robabilities of malignancy that are assigned to the clinicalcharacteristics of a patient with a thyroid nodule in order to determine the degree of influence that these probabilities have on the final clinical suspicion of malignancy compared with objective data. Material and methods: A bayesian analysis was designed to predict the risk of malignancy of a thyroid nodule based on the causal relationship between the demographic and clinical risk factors that are detected during the first consultation. A model with demographic and clinical variables using general surgeons as experts was developed. Results: The highest probability of malignancy (94%) was assigned to the pooled case of a malewho was older than 60 years, with dysphonia, dysphagia, accelerated growth rate of the nodule and previous neck radiotherapy and who had a relative with thyroid cancer as well as multiple nodules that were larger than 1 cm and with hard consistency and palpable neck lymph nodes. For low risk cases in which the nodule characteristics are not suggestive of malignancy, the probability of malignancy assigned by clinicians was 33.59%; for high risk cases this was 75.54%. Conclusion: Surgeons make diagnostic decisions based on subjective beliefs that do not necessarily correspond to the objective measures of the characteristics of the nodules.

Edgar, Alfonso; Álvaro, Sanabria; Mario, Castillo.

2011-12-01

331

Thyroid cancer cell lines: Critical models to study thyroid cancer biology and new therapeutic targets  

OpenAIRE

Thyroid cancer is the most common endocrine malignancy and the incidence is rising. Currently, there are no effective treatments for patients with advanced forms of thyroid cancer. Anaplastic thyroid represents the most severe form of the disease with 95% mortality at 6 months. It is therefore critical to better understand the mechanisms involved in thyroid cancer development and progression in order to develop more effective therapeutic strategies. Cell lines derived from thyroid tumors ...

RebeccaESchweppe

2012-01-01

332

Behind the scenes of thyroid tumors : Underlying genetic mechanisms  

OpenAIRE

Thyroid cancer is the most frequently observed malignancy involving endocrine tissues. This group of diseases is also the major cause of death related to neoplasia of the endocrine system. Tumors in the thyroid gland are common in the general population and the majority represents benign follicular adenoma (FTA). Thyroid follicular cell derived tumors encompass FTA, follicular thyroid carcinoma (FTC), papillary thyroid carcinoma (PTC), and poorly-differentiated thyroid carci...

Lee, Jia Jing

2007-01-01

333

Case of concurrent Riedel's thyroiditis, acute suppurative thyroiditis, and micropapillary carcinoma.  

Science.gov (United States)

Riedel's thyroiditis (RT) is a rare chronic inflammatory disease of the thyroid gland. It is characterized by a fibroinflammatory process that partially destroys the gland and extends into adjacent neck structures. Its clinical manifestation can mask an accompanying thyroid neoplasm and can mimic invasive thyroid carcinoma. Therefore, diagnosis can be difficult prior to surgical removal of the thyroid, and histopathologic examination of the thyroid is necessary for a definite diagnosis. The concurrent presence of RT and other thyroid diseases has been reported. However, to our knowledge, the association of RT with acute suppurative thyroiditis and micropapillary carcinoma has not been reported. We report a rare case of concurrent RT, acute suppurative thyroiditis, and micropapillary carcinoma in a 48-year-old patient. PMID:23526581

Hong, Ji Taek; Lee, Jung Hwan; Kim, So Hun; Hong, Seong Bin; Nam, Moonsuk; Kim, Yong Seong; Chu, Young Chae

2013-03-01

334

Anaplastic Transformation of Differentiated Thyroid Carcinoma  

OpenAIRE

Anaplastic thyroid cancer (ATC) is one of the most aggressive malignancies that arise from transformation of pre-existing differentiated thyroid cancer (DTC). However, the carcinogenic mechanism of anaplastic transformation remains unclear. We describe a case for huge goiter diagnosed as papillary thyroid carcinoma, which underwent thyroidectomy. The final histology showed anaplastic transformation. The clinical and possible etiological aspects are discussed.

Khairy, Gamal

2009-01-01

335

Airway emergency from spontaneous haemorrhagic thyroid cancer.  

Science.gov (United States)

Spontaneous thyroid haemorrhages are rare. There are reported cases occurring in thyroid nodules and cysts but none in thyroid malignancies. We describe a 48 year old who presented to the on-call ENT team with a rapidly progressing neck swelling that was interfering with his airway. After resuscitation, the patient underwent a right lobectomy to stop the bleeding. Histology showed a thyroid follicular carcinoma. As per the regional multidisciplinary team discussion, he underwent a completion thyroidectomy followed by radioactive iodine treatment. We conclude that spontaneous haemorrhages of the thyroid gland can occur in malignancies and stress the importance of early histological diagnosis. PMID:25500848

Vijendren, A; Ladha, N; Hilger, A W

2014-08-01

336

Concordancia de la citología por punción con aguja fina para la detección de cáncer de tiroides en pediatría / Diagnostic yield of fine-needle aspiration cytology for the detection of thyroid cancer in pediatric patients  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish [...] Abstract in english Background: Despite the low frequency of thyroid nodules (TN) in children, one of every four is malignant. Fine-needle aspiration cytology (FNAC) has a high accuracy detecting thyroid cancer. Aim: To evaluate the performance of FNAC in TN in Chilean children to detect thyroid cancer. Patients and Me [...] thods: The pathological reports of 77 thyroidectomies and 103 FNAC carried out in patients aged less than 18 years, between 2002 and 2013 were reviewed. In 36 patients aged 15 ± 2 years (77% women), both the reports of the thyroidectomy and FNAC were available. The cytological specimens were reclassified based on Bethesda 2010. The histology was classified as benign (nodular hyperplasia and follicular adenoma, n = 18), or malignant (papillary, follicular and medullar carcinoma, n = 18). The concordance of the cytology with the final biopsy report was calculated. Results: FNAC classified 13 specimens as definitively benign and 13 as definitively malignant. Among these, these concordances with the pathological study of the biopsy was 100%. Of six cytology tests considered "suspicious for follicular neoplasm" by FNAC, four were benign (67%), and two malignant (33%). Of four cytology tests considered "suggestive of carcinoma" by FNAC, one was benign (25%), and three malignant (75%). Conclusions: Among the studied children, there was a good concordance between FNAC and surgical biopsies. Therefore a FNAC should be carried out when malignancy is suspected in pediatric patients with a TN.

Francisca, Grob; Diego, Carrillo; Alejandro, Martínez-Aguayo; Pablo, Zoroquain; Antonieta, Solar; Irini, Nicolaides; Hernán, González.

2014-03-01

337

A molecular computational model improves the preoperative diagnosis of thyroid nodules  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Thyroid nodules with indeterminate cytological features on fine needle aspiration (FNA cytology have a 20% risk of thyroid cancer. The aim of the current study was to determine the diagnostic utility of an 8-gene assay to distinguish benign from malignant thyroid neoplasm. Methods The mRNA expression level of 9 genes (KIT, SYNGR2, C21orf4, Hs.296031, DDI2, CDH1, LSM7, TC1, NATH was analysed by quantitative PCR (q-PCR in 93 FNA cytological samples. To evaluate the diagnostic utility of all the genes analysed, we assessed the area under the curve (AUC for each gene individually and in combination. BRAF exon 15 status was determined by pyrosequencing. An 8-gene computational model (Neural Network Bayesian Classifier was built and a multiple-variable analysis was then performed to assess the correlation between the markers. Results The AUC for each significant marker ranged between 0.625 and 0.900, thus all the significant markers, alone and in combination, can be used to distinguish between malignant and benign FNA samples. The classifier made up of KIT, CDH1, LSM7, C21orf4, DDI2, TC1, Hs.296031 and BRAF had a predictive power of 88.8%. It proved to be useful for risk stratification of the most critical cytological group of the indeterminate lesions for which there is the greatest need of accurate diagnostic markers. Conclusion The genetic classification obtained with this model is highly accurate at differentiating malignant from benign thyroid lesions and might be a useful adjunct in the preoperative management of patients with thyroid nodules.

Tomei Sara

2012-09-01

338

Thyroid Surgery  

Medline Plus

Full Text Available ... treatment options including medications and surgery. Thyroid Gland Anatomy and Function The thyroid gland is a butterfly- ... Diagnosing thyroid problems includes examining the patients’ medical history, as well as family history. Some thyroid problems ...

339

Thyroid Surgery  

Medline Plus

Full Text Available ... metabolism. The thyroid gland uses iodine from the blood to make the thyroid hormone. A small gland ... the levels of the thyroid hormone in the blood. It secretes a hormone known as Thyroid Stimulating ...

340

Horner syndrome as a manifestation of thyroid carcinoma: a rare association / Síndrome de Horner como manifestação clínica de carcinoma da tireoide: uma associação rara  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Paciente de 82 anos apresentando-se com nódulo tireoidiano de crescimento progressivo e ptose palpebral esquerda. O exame oftalmológico revelou ainda miose ipsilateral e achados diagnósticos de síndrome de Horner. A tomografia computadorizada mostrou massa tireoidiana de 7,5 cm infiltrando os grande [...] s vasos do pescoço. Apesar dos dados clínicos e imagiológicos sugestivos de um carcinoma pouco diferenciado da tireoide, a citologia aspirativa foi diagnóstica de carcinoma papilar. Em função do estádio avançado da neoplasia e das comorbilidades significativas, foi proposta para terapêutica paliativa. A síndrome de Horner é uma manifestação clínica infrequente em tumores tireoidianos, estando as condições benignas maioritariamente implicadas. As neoplasias malignas da tireoide representam uma causa rara de síndrome de Horner. Contudo, um diagnóstico adequado e expedito é fundamental para o tratamento atempado nos raros casos de malignidade da tireoide. Abstract in english 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. Altho [...] ugh 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.

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

2013-08-01

341

Hematologic malignancies of the pancreas.  

Science.gov (United States)

Hematologic malignancies are relatively uncommon neoplasms of abdominal soft tissue. This article discusses the clinical and imaging features of pancreatic lymphoma, pancreatic extraosseous multiple myeloma, granulocytic sarcoma (chloroma), posttransplant lymphoproliferative disorder, and Castleman disease. The combination of imaging findings and the appropriate clinical presentation should allow the radiologist to raise a provisional diagnosis of hematologic malignancy. PMID:25120155

Sandrasegaran, Kumar; Tomasian, Anderanik; Elsayes, Khaled M; Nageswaran, Harris; Shaaban, Akram; Shanbhogue, Alampady; Menias, Christine O

2015-02-01

342

Primary de novo malignant giant cell tumor of kidney: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Osteoclast-like giant cell tumors are usually observed in osseous tissue or as tumors of tendon sheath, characterized by the presence of multinucleated giant cells and mononuclear stromal cells. It has been reported in various extraosseous sites including breast, skin, soft tissue, salivary glands, lung, pancreas, female genital tract, thyroid, larynx and heart. However, extraosseus occurrence of such giant cell tumors in the kidney is extremely rare and is usually found in combination with a conventional malignancy. De-novo primary malignant giant cell tumors of the kidney are unusual lesions and to our knowledge this is the second such case. Case Presentation We report a rare case of extraosseous primary denovo malignant giant cell tumor of the renal parenchyma in a 39-year-old Caucasian female to determine the histogenesis of this neoplasm with a detailed literature review. Conclusion Primary denovo malignant giant cell tumor of the kidney is extremely rare. The cellular origin of this tumor is favored to be a pluripotential mesenchymal stromal cell of the mononuclear/phagocytic cellular lineage. Awareness of this neoplasm is important in the pathological interpretation of unusual findings at either fine needle aspiration or frozen section of solid renal masses.

Torkian Bahman

2004-06-01

343

Malignant tumors of childhood  

International Nuclear Information System (INIS)

This book contains 34 papers about malignant tumors. some of the titles are: Invasive Cogenital Mesoblastic Nephroma, Leukemia Update, Unusual Perinatal Neoplasms, Lymphoma Update, Gonadal Germ Cell Tumors in Children, Nutritional Status and Cancer of Childhood, and Chemotherapy of Brain tumors in Children

344

Molecular biology of Philadelphia-negative myeloproliferative neoplasms  

OpenAIRE

Myeloproliferative neoplasms are clonal diseases of hematopoietic stem cells characterized by myeloid hyperplasia and increased risk of developing acute myeloid leukemia. Myeloproliferative neoplasms are caused, as any other malignancy, by genetic defects that culminate in the neoplastic phenotype. In the past six years, since the identification of JAK2V617F, we have experienced a substantial increase in our knowledge about the genetic mechanisms involved in the genesis of myeloproliferative ...

Paulo Vidal Campregher; Fábio Pires de Souza Santos; Guilherme Fleury Perini; Nelson Hamerschlak

2012-01-01

345

Epigenetic modifications in human thyroid cancer  

OpenAIRE

Thyroid carcinoma is the most common endocrine malignancy of the endocrine organs, and its incidence rate has steadily increased over the last decade. Over 95% of thyroid carcinoma is derived from follicular cells that have a spectrum of differentiation to the most invasive malignancy. The molecular pathogenesis of thyroid cancer remains to be clarified, although activating the RET, RAS and BRAF oncogenes have been well characterized. Increasing evidence from previous studies demonstrates tha...

Faam, Bita; Ghaffari, Mohammad Ali; Ghadiri, Ata; Azizi, Fereidoun

2014-01-01

346

Correlation between CT perfusion and vascular endothelial growth factor in neoplasm of head and neck  

International Nuclear Information System (INIS)

Objective: To investigate the correlation between the CT perfusion and microvessel density (MVD), expression of vascular endothelial growth factor (VEGF) in neoplasm of head and neck. Methods: Eighty-eight lesions of head and neck were scanned by spiral CT. The largest axial surface of the mass was searched on unenhanced imaging, and at this level the dynamic contrast enhanced scan series was acquired. Time-density curves (TDC) were created from circular or oval regions of the interest drawn over the mass, target artery by Toshiba Xpress/SX spiral CT with perfusion functional software. The parameters were measured including: peak height (PH), peak time (PT), mean transit time (MTT), contrast enhancement ratio (RPH), and perfusion flow (PF). Histopathological slides of 35 masses were carefully prepared for the anti-CD34 and VEGF immunohistochemical staining and tumor microvessel density and calculation of VEGF expression scores. The parameters of CT perfusion were correlatively study with MVD and VEGF. Results: (1) The TDC of CT perfusion imaging could be classified into 3 types. The TDC of 53/77 (68.9%) malignant tumors presented the type with rapid ascending and rapid descending after injecting contrast. The TDC of 6/9 malignant lymphomas showed low platform curve o (2)The PF median of thyroid carcinoma was 82. 2(41.0,183.4)ml·min-1·100 g-1. There was significantly difference in the parameters of CT perfusion among thyroid carcinoma and squamousion among thyroid carcinoma and squamous cell cancer (Median 23.8 (7.0, 108.4) ml·min-1·100 g-1) and lymphomas (Median 24.5 (13.2, 78.6) ml·min-1·100 g-1). (3) MVD in benign tumors was (44.7±3.4), and in malignant tumors, it is (49.6±14.8). There was no significantly difference in MVD between benign and malignant tumors. High VEGF expression was found in 15 malignant tumors and 1 benign tumors, low VEGF expression was found in 9 malignant tumors and 10 benign tumors. (4)There were no significantly difference in VEGF expression and MVD. There was good correlation between MVD (M 40.0) and PH (M 26.9), RPH (M 14.5), PF (M 46.8) (r=0.35, 45.49, 0.41). There was correlation between VEGF (M 4.0) and MTT (M 16.7) (r=-0.41). Conclusion: The TDC and CT perfusion could be helpful to differentiate benign from malignant tumors. CT perfusion in neoplasm of head and neck is correlated with MVD and VEGF, and may reflect MVD and expression of VEGF. (authors)

347

Cystic neoplasms of the pancreas  

International Nuclear Information System (INIS)

Cystic neoplasms of pancreas are rare lesions. Following the Compagno-Oertel classification, we differenciate serous microcystic adenomas (SMA) from mucinous macrocystic adenomas/adenocarcinomas (MMA). The former are benign tumors with slow growth, composed by innumerable small and tiny cystic with centra calcifications, resulting in a ''honeycomb'' pattern. They have a mixed US structure while CT densitometric values reflect a mixture of connective tissue and proteinaceous fluid. Postcontrast enhancement is frequently seen. MMA are potential (adenoma) or frankly (adenocarcinoma) malignant tumors. They appears as moltilocular cystic masses containing septa and/or papillary bulgings, with thickened walls. Both US and CT demonstrate their predominantly cystic character, and the eventual presence of excrescences. WE report a series of 23 cases (6 SMA, 17 MMA) of cystic neoplasms of the pancreas studied during the past five years. A correct diagnosis of SMA was possible in all 6 cases, while MMA was correctly diagnosed in 17 out of 18 cases. There were no false negatives, and 1 falsa positive. All differential diagnoses are also discussed

348

Vascular encasement by pancreatobiliary neoplasms  

International Nuclear Information System (INIS)

This paper reports that vascular encasement is common with pancreatobiliary malignancy. This study was performed to determine the value of gradient-echo (GRE) MR imaging in the detection of mesenteric vessel encasement. Fifteen patients with known pancreatobiliary tumors underwent dynamic CT and gradient-echo and spin-echo MR imaging. Imaging findings were correlated with clinical/surgical follow-up. GRE MR imaging provides useful adjunctive information to dynamic CT and conventional spin-echo (SE) MR imaging in patients with pancreatobiliary neoplasms. It excels at diagnosing mesenteric venous compression and occlusion. It does not, however, significantly add information regarding celiac arterial abnormalities to that available with dynamic CT. Dyamic Ct, SE Mr imaging, and GRE MR imaging all fall short of enabling diagnosis of pancreatobiliary tumor adherence to the abdominal vasculature

349

Thyroid lesions diagnosis by Fourier transformed infrared absorption spectroscopy (FTIR)  

International Nuclear Information System (INIS)

Thyroid nodules are a common disorder, with 4-7% of incidence in the Brazilian population. Although the fine needle aspiration (FNA) is an accurate method for thyroid tumors diagnosis, the discrimination between benign and malignant neoplasm is currently not possible in some cases with high incidence of false negative diagnosis, leading to a surgical intervention due to the risk of carcinomas. The aim of this study was to verify if the Fourier Transform infrared spectroscopy (FTIR) can contribute to the diagnosis of thyroid carcinomas and goiters, using samples of tissue and aspirates. Samples of FNA, homogenates and tissues of thyroid nodules with histopathological diagnosis were obtained and prepared for FTIR spectroscopy analysis. The FNA and homogenates samples were measured by ?-FTIR (between 950 . 1750 cm-1), at a nominal resolution of 4 cm-1 and 120 scans). Tissue samples were analyzed directly by ATR-FTIR technique, at a resolution 2 cm-1, with 60 scans in the same region. All spectra were corrected by the baseline and normalized by amides area (1550-1640 cm-1) in order to minimize variations of sample homogeneity. Then, spectra were converted into second derivatives using the Savitzk-Golay algorithm with a 13 points window. The Ward's minimum variance algorithm and Euclidean distances among the points were used for cluster analysis. Some FNA samples showed complex spectral pattern. All samples showed some cell pellets and large amount of hormone, represented by the bands of 1545 and 1655 cm-1. Bands in 1409, 1412, 1414, 1578 and 1579 cm-1 were also found, indicating possible presence of sugar, DNA, citric acid or metabolic products. In this study, it was obtained an excellent separation between goiter and malign lesion for the samples of tissues, with 100% of specificity in specific cluster and 67% sensibility and 50 of specificity. In homogenate and FNA samples this sensibility and specificity were lower, because among these samples, it were included many types of thyroid lesions. To obtain a more precise diagnosis for FNA of follicular thyroid the sample size should be increased. The results of this study suggest that FTIR spectroscopy may be useful for discriminate thyroid carcinomas from goiters in tissue samples. (author)

350

Pediatric choroid plexus neoplasms  

International Nuclear Information System (INIS)

Purpose: Choroid plexus tumors (CPT) are rare childhood neoplasms. The relatively small number of reported cases and the controversies surrounding the clinical and pathological classification of these tumors have made it difficult to define a standard of care for these patients. Our intention is to contribute to the body of knowledge of these tumors and further define the role of adjuvant therapy. Methods and Materials: We performed a retrospective review of 14 children with choroid plexus neoplasms referred to St. Jude Children's Research Hospital between October 1985 and December 1987. Ten patients had choroid plexus carcinoma (CPC) based on pathologic criteria and evidence of brain invasion at surgery or leptomeningeal disease (M+); 4 patients had choroid plexus papilloma (CPP). Patients with CPP were initially treated with surgery alone whereas patients with CPC were generally treated with postoperative therapy that included chemotherapy (CT) and/or craniospinal irradiation (CSI) with a focal boost to the primary site. For most patients CT consisted of combinations of cyclophosphamide, etoposide, vincristine, and a platinum agent. The median CSI dose was 35.2 Gy (range 24-46.2 Gy). The median primary site dose was 55.2 Gy (range 49.6-64 Gy). Results: Seven of the 10 CPC cases presented with leptomeningeal dissemination; two of these patients have succumbed to disease. Of the 3 patients with M0 status, all are alive with no evidence of disease (NED). The medial tim evidence of disease (NED). The medial time to relapse from the time of surgery was 5.3 mo (range 3-25 mo). Seven CPC patients were treated with gross total resection (GTR). Three of these patients (2 M0, 1 M+) received CT without CSI and are currently NED (27, 69, and 60 mo respectively). One M+ patient progressed on CT and has stable disease after CSI (6 mo), one (M0) received CT and CSI and is NED (120 mo), one (M+) is currently on CT with objective response (3 mo) and one (M+) died of progressive disease (24.5 mo) despite CT and CSI. Three patients with CPC had subtotal resection (STR). One of these patients (M+) received CT and CSI and is NED (23 mo), one (M0) had an elective second resection GTR alone and is currently NED (153 mo), and one (M+) developed progressive disease (13.5 mo) while on CT and died despite CSI. Among the 4 CPP patients, GTR was performed in two; both were NED at 54 and 81 mo. Two patients with CPP (one with focal atypia) were treated with STR initially; both transformed to CPC at 7 and 27 mo, respectively. Both were currently NED following salvage with (1) GTR and CSI alone (98 mo) or (2) STR, CT, and CSI (62 mo). Six of the 12 survivors in this series had significant neuropsychological sequelae. Conclusion: The prognosis of CPP is good for patients treated with GTR. Malignant transformation occurred in 2 CPP patients with less than GTR. Patients with localized CPC who undergo GTR have had a favorable outcome with the addition of chemotherapy or irradiation. CSI may not be routinely indicated in M0 children following GTR. There is evidence that salvage with radiation therapy may be successful following progression on chemotherapy. For patients treated with STR, the use of CT and CSI appears to be necessary

351

Correlation between iodine concentration and pathology of thyroid nodules and residual thyroids  

International Nuclear Information System (INIS)

Using a new computed tomography (CT) software, we measured the volume and iodine concentration of each thyroid nodule and its residual thyroid in 87 patients with 110 thyroid nodules before partial or total thyroidectomy. 123I thyroid uptake was measured in 46/87 patients. The relation between these iodine data and histological findings from the nodule and residual thyroid was analyzed. Variability of iodine concentrations in a thyroid nodule was higher in malignant nodules than in benign nodules. Follicular adenomas were lower in mean of iodine concentrations than other types of nodules. All nodules with an iodine concentration of 3 were follicular adenomas. However, there was no significant difference in 123I thyroid uptake per volume among all pathological types of nodules. Pathologically, chronic thyroiditis was evident in 8 of 16 residual thyroids with a papillary carcinoma. In 5 residual thyroids with a follicular carcinoma, there was no evidence of chronic thyroiditis. Conversely, none of the 16 residual thyroids with a papillary carcinoma showed evidence of hypoplasia but 2 of the 5 residual thyroids with a follicular carcinoma showed evidence of hypoplasia. Of 72 residual thyroids with a benign nodule, 21 demonstrated chronic thyroiditis and 9 revealed hypoplasia. The residual thyroids with hypoplasia and severe chronic thyroiditis were lower in mean of iodine concentrations than those with a histologically normaons than those with a histologically normal thyroid although there was no significant difference in 123I thyroid uptake per volume among all pathological types of residual thyroids. However, all of 3 residual thyroids with 123I thyroid uptake per volume of 3 demonstrated hypoplasia. The pathological type of thyroid carcinoma and the co-existence of chronic thyroiditis in the residual thyroid are major prognostic factors. (K.H.)

352

Fine-needle aspiration cytology of amyloid associated with nonneoplastic and malignant lesions.  

Science.gov (United States)

To assess the value of fine-needle aspiration (FNA) cytology for the diagnosis of amyloid, we retrospectively studied all FNA cases diagnosed as having amyloid during a 6-yr period (1990-1996). FNA was performed on both superficial and deep locations. A total of 6 cases containing amyloid was studied, including primary medullary thyroid carcinoma, metastatic medullary thyroid carcinoma to a vertebrae, multiple myeloma, squamous-cell carcinoma of the lung metastatic to a hilar lymph node, primary pulmonary amyloid, and amyloid tumor in a vertebral body in a patient with primary systemic amyloidosis. Despite the location or disease association, the cytologic appearance of amyloid in all cases was similar. On Diff-Quik stain, amyloid appeared as amorphous, irregular, waxy basophilic to metachromatic clumps of material. Papanicolaou stain revealed cyanophilic to organophilic clumps of material with occasional prominent fissures. In all 6 cases, amyloid was confirmed by Congo red stain and in 3 cases by a thioflavin T stain. In 4 of the 6 cases (67%), amyloid was associated with an underlying malignancy. In 3 cases malignant cells were admixed with the amyloid, and in another case malignancy was present at a distant site. We conclude that FNA biopsy is a helpful initial procedure for the evaluation of patients with amyloid deposits. The clinical implications of amyloid found in any particular body site include both benign and malignant conditions. The presence of an associated neoplasm must be especially considered in the differential diagnosis of amyloid deposits. PMID:9557261

Halliday, B E; Silverman, J F; Finley, J L

1998-04-01

353

Advanced medullary thyroid cancer: pathophysiology and management  

OpenAIRE

Carla Vaz Ferreira, Débora Rodrigues Siqueira, Lucieli Ceolin, Ana Luiza MaiaThyroid Section, Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, BrazilAbstract: Medullary thyroid carcinoma (MTC) is a rare malignant tumor originating from thyroid parafollicular C cells. This tumor accounts for 3%–4% of thyroid gland neoplasias. MTC may occur sporadically or be inherited. Hereditary MTC appears as part of the multiple endocrine neoplasia syndrome type 2A...

Cv, Ferreira; Dr, Siqueira; Ceolin L; Al, Maia

2013-01-01

354

Imaging strategy in differentiated thyroid cancer  

OpenAIRE

This thesis focuses on clinical dilemmas, which the clinician faces in the management of patients with differentiated thyroid cancer (DTC) with a specific emphasis on the role of current and new diagnostic imaging. Thyroid cancer is a rare disease, but it is the most common endocrine malignancy of an endocrine organ. Approximately 300 new cases are diagnosed in the Netherlands yearly. Thyroid epithelial tumors can be derived from follicular cells, represent differentiated thyroid carcinoma...

Phan, Thi Thanh Ha

2007-01-01

355

A rare case of thyroid metastasis from pancreatic adenocarcinoma.  

LENUS (Irish Health Repository)

CONTEXT: Thyroid metastasis from pancreatic adenocarcinoma is extremely rare, with only two previous cases in the literature. We report a case of pancreatic adenocarcinoma metastasising to the thyroid. We review the incidence, diagnosis, and management of this rare occurrence. CASE REPORT: A 38-year-old man with a synchronous 6-month history of thyroid swelling, presented with epigastric pain and signs of obstructive jaundice. He was investigated by abdominal computerised tomography and endoscopic retrograde cholangiopancreatography. The diagnosis of pancreatic neoplasm was made. His thyroid neoplasm was investigated at another tertiary centre and thought to be a papillary neoplasm. He underwent a pancreaticoduodenectomy and recovered well post-operatively. Eight weeks later he had a total thyroidectomy. Histology confirmed that the thyroid mass was both morphologically and immunophenotypically similar to the pancreatic neoplasm. CONCLUSION: This case demonstrates the importance of a full investigation when a patient with suspected neoplastic history presents with a thyroid nodule. We outline the crucial role that immunohistochemistry plays in detecting and classifying primary and secondary thyroid neoplasms. The detection of a solitary thyroid metastasis from pancreatic adenocarcinoma may indicate a poor prognosis, and it is debatable whether resection of the primary should be undertaken when it presents with a solitary metastasis.

Kelly, Michael E

2012-02-01

356

Granular cell tumor of the thyroid: Clinical and pathological characteristics of a rare case in a 14-year-old girl  

Science.gov (United States)

Granular cell tumors (GCTs) are soft tissue neoplasms that originate in the nervous system, which may arise anywhere in the body. However, GCTs are extremely uncommon in thyroid tumors, with a favorable prognosis. The diagnosis of GCTs is dependent on pathological and immunohistochemical analysis and at present, surgical resection is considered the only suitable treatment. Regular follow-up after surgery is an important way to monitor treatment outcome and recurrence. The present study describes a new pathological type of thyroid GCTs diagnosed by pathology and immunohistochemistry. A 14-year-old female was referred to the West China Hospital of Sichuan University (Chengdu, China), for thyroid incidentaloma. Laboratory examinations were within the normal range. Thyroid sonography demonstrated a solid hypoechoic mass in the right lobe of the thyroid. Fine needle aspiration cytology showed a suspicious malignant tumor and subsequently a total thyroidectomy was performed. Analysis of frozen sections, from obtained samples, did not facilitate a definite diagnosis. Finally, a thyroid benign granular tumor with atypical changes was diagnosed by postoperative pathology and immunohistochemistry. A 14-month post-operative follow-up showed that the patient experienced a stable recovery and had no signs of recurrence or metastasis. The case emphasizes that the diagnosis of thyroid granular cell tumors is predominantly based on postoperative morphology and immunophenotype. The clinical routine for the differential diagnosis may be due to: (i) neoplasms displaying a granular appearance mimicking granular cell tumors, or (ii) differential diagnosis in the pathological category of granular cell tumors. Further accumulation of such rare cases may be of clinical significance in aiding the diagnosis and treatment of GCTs.

DU, ZHEN-HONG; QIU, HONG-YAN; WEI, TAO; ZHU, JING-QIANG

2015-01-01

357

Malignant pleural disease  

Energy Technology Data Exchange (ETDEWEB)

The vast majority of pleural neoplasms invade the pleura secondarily and can be seen in patients with bronchogenic carcinoma, breast cancer, lymphoma, and ovarian or gastric carcinoma. Primary pleural neoplasms are less common, although they have developed notoriety since the up-surge of malignant mesothelioma and the knowledge of its connection to asbestos exposure. Other malignant primary tumors include localized fibrous tumor and pleural liposarcoma. In most patients with diffuse malignant pleural disease the chest radiograph shows pleural effusion with or without pleural thickening. Computed tomography (CT) usually provides precise localization and extent of the disease and may be of value in assessing chest wall and mediastinal involvement. In specific situations, magnetic resonance (MR) may be useful as a problem-solving tool when CT findings of chest wall or diaphragmatic invasion are equivocal or in patients with contraindication to intravenous administration of ionic contrast material.

Bonomo, Lorenzo E-mail: l.bonomo@radiol.unich.it; Feragalli, Beatrice; Sacco, Rocco; Merlino, Biagio; Storto, Maria Luigia

2000-05-01

358

Sweet syndrome and its association with hematopoietic neoplasms.  

Science.gov (United States)

The Sweet syndrome, or acute febrile neutrophilic dermatosis, is rare and has characteristic clinical, physical, and pathologic findings: abrupt onset of pyrexia, elevated neutrophil count, tender erythematous skin lesions, and a diffuse infiltrate of mature neutrophils in the reticular dermis with edema in the papillary dermis. The Sweet syndrome can be further classified based on the clinical setting: classical, malignancy-associated, and drug-induced. Diagnosis can alert the clinician to the presence of an underlying malignancy or the recurrence of a malignancy. The most commonly associated malignancy is acute myelogenous leukemia. We present three cases of Sweet syndrome associated with hematopoietic neoplasms. PMID:25552802

Soto, Rodrigo; Levy, Yair; Krause, John R

2015-01-01

359

OCT4 expression on a case of poorly differentiated (insular) carcinoma of the thyroid gland and minireview.  

Science.gov (United States)

Poorly differentiated (insular) carcinoma of the thyroid gland is rare and defined as follicular-cell neoplasms that show limited evidence of structural follicular cell differentiation and occupy both morphologically and behaviourally an intermediate position between differentiated (follicular and papillary carcinomas) and undifferentiated (anaplastic) carcinomas. The authors report a case of a 37-year-old Thai woman who presented with a prolonged left thyroid nodule. Final pathological diagnoses of her mass were poorly differentiated (insular) carcinoma with lymphovascular invasion and nodular goiter. The tumor cell arrangements were nest (insular) and trabecular patterns with some follicular formations. Immunohistochemistry of the tumor cells revealed negative immunostaining for OCT4. Expression of OCT4 gene is involved in the regulation and maintenance of pluripotency of embryonic stem cells, germ cells, and in tumor cells. The authors believe that poorly differentiated (insular) carcinoma of the thyroid gland probably develops from the remnant of thyroid stem cells and is not associated with dedifferentiation (anaplasia or loss of cellular differentiation) from nodular goiter or cells of other thyroid carcinomas. Although there was negative immunostain for OCT4 in the presented case, the authors assumed that the tumor cells behave with an intermediate position between thyroid stem cells and prothyrocytes Also they do not behave with thyroblasts. Additionally, the tumor may be associated with new cellular dedifferentiation. However, there is only one case of immunohistochemistry of OCT4 in poorly differentiated (insular) carcinoma of the thyroid gland. Thus, prognosis of the presented still is mainly correlated with clinical and histological findings. Further research on expression of OCT4 gene on thyroid cancers and other malignant tumors relating to tumorigenic cancer cells (cancer stem cells) may be useful to prognostic evaluation and administration of a new chemotherapy and/or radiotherapy that is specific for tumor-initiating cells. PMID:16858970

Ruangpratheep, Chetana; Lohachittranond, Chanida; Poonpracha, Tara; Punyarit, Phaibul

2005-11-01

360

Diagnostic value of fine needle aspiration biopsy in 'cold' thyroid nodules  

International Nuclear Information System (INIS)

In this study fined needle aspiration (FNA) was performed to ascertain a preoperative diagnosis in patients with cold thyroid nodules. A brief clinical history comprising of general physical and local examination was recorded on a proforma. Fine needle aspiration of thyroid nodules were performed with 5 ml disposable syringe (22g needle). Local anesthesia was not used. Four slides were prepared in each case, two were fixed in 95% alcohol for Pananicolau's stain and the Haematoxylin and Eosin while other two slides were air dried for May Grunwald Giemsa stains. Surgical specimens were received at the Department of Pathology and processed as per routine. Cytological and histological reporting was done separately and independently. Special stains were performed when required. A total of 91 patients were studied, in 14 cases aspirate was unsatisfactory and in 21 cases surgery was not performed. In 56 patient, histological correlation was available. Forty were reported benign, out of which 37 proved correct on histological examination. Of the eleven smears reported as follicular neoplasm, 9 proved correct and 2 reported as 'suspicious' and 3 as 'malignant' also proved malignant on histological examination. Sensitivity was 86.36% and specificity was 100%. Efficiency of the test was 94.9%. Fine needle aspiration biopsy was found to be simple and valuable technique for a reliable preoperative diagnosis of thyroid nodules. (author)

361

The risk factor of thyroid  

International Nuclear Information System (INIS)

For the purposes of radiation protection, the noteworthy risk of thyroid is carcinogenesis. The risk factor which ICRP presented in the publication-26 is 5 x 10-6 rem-1. This numerical value is based upon the estimated likelihood of inducing fatal thyroid cancer. On the other hand, the risk factor presented by the BEIR report is 4 x 10-6 yr-1. This value was decided after consideration of the risks of both fatal and non-fatal cancer of thyroid. The following features distinguished thyroid cancer from malignancy of other tissue from medical point of view. 1) A large difference between incidence and mortality in case of thyroid cancer is recognized, because the thyroid cancer could be successfully treated by surgical or radiological treatment. 2) The high prevalence of clinically silent tumor in thyroid gland has been reported. The incidence of thyroid cancer, therefore, is very dependent on methods of medical inspection. The prevalence of radiation induced thyroid cancer is modified by various factors such as age, sex, latency, dose and dose rate. The latent period is very important factors such as ave, sex, latency, dose and dose rate. The latent period is a very important factor in the estimation of accumulated total risk of thyroid malignancy. What is included in the risk caused by thyroid irradiation must be investigated. The risk of non-fatal cancer should be considered in the -fatal cancer should be considered in the same way as that of fatal cancer. The dose-equivalent limit of thyroid in non-uniform irradiation caused by radioactive iodine is decided by the limit for non-stochastic effects. Therefore the further consideration of non-stochastic effects of thyroid is necessary. (author)

362

Thyroglobulin determinations in the serum of patients with benign and malignant thyroid diseases by means of a commercial human thyroglobulin (hTg) radioimmunoassay  

International Nuclear Information System (INIS)

Radioimmunological thyroglobulin determination in the serum as a post-operative progress control with patients suffering from different thyroid carcinomas using commercial test instruments was proven as correct. It was found that with all patients with differentiated thyroid carcinomas there was pre-operatively an increased hTg serum concentration. After thyroidectomy the serum level of metastases-free patients fell within the normal range. Also with radioiodine resectioning there was a definite fall in the hTg level. With only a minimal number of observations medullary carcinoma (C-cell carcinoma) showed no serum hTg concentration increases, and non-differentiated tumors showed no safely interpretable increases. Thyroglobulin determination proved itself as a reliable control parameter for follicular and papillary thyroid carcinoma with regard to tumor, metastatic and recidivistic progression or regression, but not for medullary and undifferentiated tumors. Furthermore, thyroglobulin determination with benign tumors of the thyroid and with the various forms of thyroiditis does not provide any reliable diagnostic information. (MBC)

363

Criterios ecográficos diagnósticos de neoplasia maligna en el nódulo tiroideo: correlación con la punción por aspiración con aguja fina y la anatomía patológica Ultrasound diagnostic criteria of malignancy in a thyroid nodule: correlation with fine needle aspiration and pathology  

Directory of Open Access Journals (Sweden)

Full Text Available Introducción. La ecografía de tiroides ha mejorado la certeza diagnóstica para neoplasia maligna del nódulo tiroideo. Es importante definir qué nódulos requieren biopsia por aspiración con aguja fina (BACAF para disminuir el costo de un procedimiento innecesario y evitar que pase inadvertido el diagnóstico de neoplasia maligna. Objetivo. Validar los criterios ecográficos de neoplasia maligna que indican la punción por aspiración con aguja fina de tiroides. Materiales y métodos. Se diseñó un estudio prospectivo a tres años para evaluar la concordancia entre los hallazgos ecográficos y la punción por aspiración con aguja fina de tiroides comparada con el estudio final de histopatología. Se evaluó la sensibilidad, la especificidad, el valor diagnóstico positivo y negativo, la concordancia medida por el coeficiente kappa y el coeficiente de correlación. Resultados. Se estudiaron 1.467 pacientes, 10,2 % hombres y 89,8 % mujeres, con edades entre los 10 y los 95 años; el tamaño promedio del nódulo fue de 16 mm. Un total de 623 requirieron tiroidectomía; al resto se les hizo seguimiento por ecografía. Se presentaron 269 carcinomas papilares, 14 foliculares, 4 indiferenciados, 159 bocios, 74 adenomas y 101 tiroiditis. Se obtuvo sensibilidad de 86,4 %, especificidad de 89,4 %, valor diagnóstico de un resultado positivo de 87,5 % y uno negativo de 84,1 %. Los hallazgos ecográficos relacionados con cáncer fueron: hipoecogenicidad, microcalcificaciones, papilas y flujo intranodular. Individualmente, la concordancia fue baja, pero con la combinación de hipoecogenicidad, microcalcificaciones y papilas fue media y, con la adición de aumento del flujo intranodular, resultó alta. Conclusiones. La combinación de hipoecogenicidad, microcalcificaciones, papilas y alto flujo intranodular tiene alta concordancia con neoplasia maligna; sin embargo, cada criterio por separado no la tiene, y no pueden usarse individualmente para predecir o descartar neoplasia maligna.Introduction. Thyroid ultrasound has improved the diagnostic accuracy in the diagnosis of malignant neoplasia in thyroid nodules. It is important to define which nodules require fine needle aspiration so as to diminish the costs of unnecessary procedures and at the same time avoid unnoticed malignancy. Objective. To validate the echographic criteria of malignant neoplasia that validate fine needle aspiration of the thyroid nodule. Material and methods. Three-year prospective study to assess correlation between the ultrasound findings and fine needle aspiration with pathology findings, including sensibility, specificity, positive predictive value, negative predictive value, and concordance measured by Kappa coefficient, and correlation coefficient. Results. The study included 1,467 patients, 10,2% males and 89,8% females, with ages ranging from 10 years to 95 years; average size of the nodule was 16 mm; 623 patients required thyroidectomy, while the remainder were followed by ultrasound. There were 269 papillary carcinomas, 14 follicular carcinomas, 4 anaplastic carcinomas, 159 goiters, 74 adenomas, and 101 thyroiditis. Sensibility was 86,4%, specificity was 89,4%, positive predictive value 87,5%, and negative predictive value 84,1%. Ultrasound findings related with cancer were hypoechogenicity, microcalcifications, papillae, and intranodal flow; when adding intranodal flow, concordance was high. Conclusions. The combination of hypoechogenicity, microcalcifications, papillae and high intranodal flow exhibit high concordance with malignancy; however, echographic criteria considered individually does not, and those individual criteria cannot be used to predict or rule out malignant neoplasia.

Andrés Ignacio Chala

2013-03-01

364

Paraganglioma of the thyroid gland: A case report  

OpenAIRE

Introduction. Thyroid paraganglioma is a very rare malignant neuroendocrine tumor. Immunohistochemical features of thyroid paraganglioma are helpful for the diagnosis. Case report. A 69-year-old female came to hospital with the presence of a growing thyroid nodule of the left lobe. Ultrasonic neck examination showed 5 cm hypoechoic nodule in the left thyroid lobe. Thyroid scintigraphy showed a big cold nodule in the left lobe. Computed tomography (CT) scan ...

Filipovi? Aleksandar; Vu?kovi? Ljiljana; Pejakov Ljubica

2014-01-01

365

A solitary hyperfunctioning thyroid nodule harboring thyroid carcinoma: review of the literature  

OpenAIRE

Hyperfunctioning nodules of the thyroid are thought to only rarely harbor thyroid cancer, and thus are infrequently biopsied. Here, we present the case of a patient with a hyperfunctioning thyroid nodule harboring thyroid carcinoma and, using MEDLINE literature searches, set out to determine the prevalence of and characteristics of malignant “hot” nodules as a group. Historical, biochemical and radiologic characteristics of the case subjects and their nodules were compared to those in cas...

Mirfakhraee, Sasan; Mathews, Dana; Peng, Lan; Woodruff, Stacey; Zigman, Jeffrey M.

2013-01-01

366

Thyroid Surgery  

Medline Plus

Full Text Available Thyroid Surgery Introduction The thyroid gland is an important gland that helps regulate the way the body works. Different diseases can affect the thyroid gland. These diseases are common and affect many people. Most of these diseases ...

367

Thyroid Disease  

Science.gov (United States)

... include having: An autoimmune disease , like type 1 diabetes A personal history or family history of thyroid disorders Having had postpartum thyroiditis after a previous pregnancy Silent or painless thyroiditis ...

368

Thyroid Surgery  

Medline Plus

Full Text Available ... is known as metabolism. The thyroid gland uses iodine from the blood to make the thyroid hormone. ... Hypothyroidism can be caused by a lack of iodine, which can cause the thyroid gland to swell ...

369

Thyroid Surgery  

Medline Plus

Full Text Available Thyroid Surgery Introduction The thyroid gland is an important gland that helps regulate the way the body works. Different ... be treated with medications or radioactive iodine therapy. Surgery Thyroid surgery is done under general anesthesia. The ...

370

Thyroid Surgery  

Medline Plus

Full Text Available ... the thyroid are other small glands known as parathyroid glands. Two important nerves pass through the thyroid ... reviewed: 04/25/2013 1 thyroid hormone. The parathyroid glands produce the parathyroid hormone or PTH, which ...

371

Thyroid Surgery  

Science.gov (United States)

... small amount of thyroid tissue bilaterally or near-total thyroidectomy – leaving about one gm or cm of thyroid tissue on one side); or total thyroidectomy, which removes all identifiable thyroid tissue. There are ...

372

Thyroid carcinoma in children  

International Nuclear Information System (INIS)

Thyroid cancer is rare in children, with only 3-6% of thyroid malignancies occurring in children, and constitutes but 6% of head and neck tumors. Over 95% thyroid cancer are differentiated, and 10% of these occur in children of adolescents. Any of the histologic types that occur in adults may be in children, but they are most often differentiated thyroid carcinomas. The etiologies of thyroid carcinoma are unknown, but factors considered in pathogenesis include irradiation, sex and age. The incandesce of thyroid carcinoma in a solitary coddle in a child has been described as high as 70%. History and /or physical examination alone are unlikely to advance the diagnosis, and with exception of plasma CT in medullary thyroid carcinoma, blood studies are unhelpful in the diagnosis of thyroid carcinoma. Radiographs and ultrasound imaging are helpful in planning treatment and follow-up, but are unlikely to be needed for initial diagnosis. One of the main indication of thyroid scan in the pediatric group is thyroid nodule. FNAB is established as the most effective method of diagnosis in adults, although in children it may be less reliable. While radionuclide scintigraphy may be considered for initial screening, FNAB is well established and its specificity allows it to negate the need for a substantial number of operation. Treatment of differentiated thyroid carcinoma in children is more controversial. Some authors maintain that modified or subtotal thyroidectomy is appropriatio or subtotal thyroidectomy is appropriation this disease, others maintain that total thyroidectomy is required Nevertheless, radioiodine therapy is considered to be standard in the treatment of iodine-avid thyroid carcinomas for ablation of the thyroid remnant following surgery and for treatment of iodine-avid distant diseases. The front-line treatment of medullary thyroid carcinoma is aggressive surgery. Total thyroidectomy is indicated, In general treatment with chemotherapy, extemal radiation and I-131 are not helpful, however radioactive idiom therapy may be helpful in patients with normal postoperative calcitonin levels in preventing recurrence. At this time, the concomitant use of I-131 whole body scintigraphy, serum thyroglobulin. and neck ultrasonography appears to be the most practical and efficacious methods of long-term follow-up. Ultrasound and or are being added to the armament atrium as it becomes clear that patient with a negative whole body iodine image and measurable serum T g may have recurrent disease that is amenable to surgical removal and/or further radiotherapy

373

Criterios ecográficos diagnósticos de neoplasia maligna en el nódulo tiroideo: correlación con la punción por aspiración con aguja fina y la anatomía patológica / Ultrasound diagnostic criteria of malignancy in a thyroid nodule: correlation with fine needle aspiration and pathology  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish Introducción. La ecografía de tiroides ha mejorado la certeza diagnóstica para neoplasia maligna del nódulo tiroideo. Es importante definir qué nódulos requieren biopsia por aspiración con aguja fina (BACAF) para disminuir el costo de un procedimiento innecesario y evitar que pase inadvertido el dia [...] gnóstico de neoplasia maligna. Objetivo. Validar los criterios ecográficos de neoplasia maligna que indican la punción por aspiración con aguja fina de tiroides. Materiales y métodos. Se diseñó un estudio prospectivo a tres años para evaluar la concordancia entre los hallazgos ecográficos y la punción por aspiración con aguja fina de tiroides comparada con el estudio final de histopatología. Se evaluó la sensibilidad, la especificidad, el valor diagnóstico positivo y negativo, la concordancia medida por el coeficiente kappa y el coeficiente de correlación. Resultados. Se estudiaron 1.467 pacientes, 10,2 % hombres y 89,8 % mujeres, con edades entre los 10 y los 95 años; el tamaño promedio del nódulo fue de 16 mm. Un total de 623 requirieron tiroidectomía; al resto se les hizo seguimiento por ecografía. Se presentaron 269 carcinomas papilares, 14 foliculares, 4 indiferenciados, 159 bocios, 74 adenomas y 101 tiroiditis. Se obtuvo sensibilidad de 86,4 %, especificidad de 89,4 %, valor diagnóstico de un resultado positivo de 87,5 % y uno negativo de 84,1 %. Los hallazgos ecográficos relacionados con cáncer fueron: hipoecogenicidad, microcalcificaciones, papilas y flujo intranodular. Individualmente, la concordancia fue baja, pero con la combinación de hipoecogenicidad, microcalcificaciones y papilas fue media y, con la adición de aumento del flujo intranodular, resultó alta. Conclusiones. La combinación de hipoecogenicidad, microcalcificaciones, papilas y alto flujo intranodular tiene alta concordancia con neoplasia maligna; sin embargo, cada criterio por separado no la tiene, y no pueden usarse individualmente para predecir o descartar neoplasia maligna. Abstract in english Introduction. Thyroid ultrasound has improved the diagnostic accuracy in the diagnosis of malignant neoplasia in thyroid nodules. It is important to define which nodules require fine needle aspiration so as to diminish the costs of unnecessary procedures and at the same time avoid unnoticed malignan [...] cy. Objective. To validate the echographic criteria of malignant neoplasia that validate fine needle aspiration of the thyroid nodule. Material and methods. Three-year prospective study to assess correlation between the ultrasound findings and fine needle aspiration with pathology findings, including sensibility, specificity, positive predictive value, negative predictive value, and concordance measured by Kappa coefficient, and correlation coefficient. Results. The study i