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1

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

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.

3

Benign and malignant thyroid neoplasms after childhood irradiation for Tinea capitis  

International Nuclear Information System (INIS)

The incidence of all thyroid surgery was studied among 10,842 persons whose thyroid glands had been exposed in childhood to an average dose of 9 rads of x-radiation during treatment for tinea capitis and among 2 matched control groups. A statistically significant increased risk for both benign and malignant neoplasms was found in the exposed group. The excess risk was 8.3 cases/year/rad/million population. There were no differences in other surgical conditions between the irradiated and nonirradiated groups. Persons irradiated under age 6 years had the highest excess risk for developing carcinomas. The incidence of thyroid neoplasms was approximately threefold higher in women than in men among the irradiated persons and among the controls, but the relative risk for the irradiated group of women was greater than the addition of the relative risks of the other groups. Low-dose radiation is instrumental in the development of both benign and malignant thyroid neoplasms

4

[Thyroid malignant neoplasms. Therapeutic results in 305 patients].  

Science.gov (United States)

Between 1960 and 1972, 305 patients with malignomas of the thyroid gland were surgically treated, irradiated (megavoltage therapy and/or iodine-131), and treated with thyroid hormone according to principles formerly stated. Differentiated adenocarcinomas (34.4% of all the patients) were observed more frequently in women and younger patients, whereas dedifferentiated carcinomas (33.8%) are found relatively more often in men and in an advanced age. Only in 12% of the cases the tumor was discovered in an early stage; thus, an early diagnosis is much too rare so far. In almost two thirds of the patients a spread of metastases occurred. Of these, 11% grew manifest later than five years following the therapy. Distant metastases from differentiated adenocarcinomas accumulated I-131 in sixty per cent, those from undifferentiated carcinomas still in twenty per cent. Treatment results are influenced decisively by histology, tumor spread, age and sex, women less than forty years old with differentiated adenocarcinomas and a circumscribed extension of the tumor having the best prognosis. More prognostic importance is due to the extension of the primary tumor than to the presence of metastases to regionary lymph nodes. Patients with metastases accumulating I-131 have a better chance of survival than those whose metastases do not accumulate. By means of standardized therapeutic rules, utilizing modern therapeutic techniques and based on interdepartmental cooperation, it was possible to improve the results partly by the two- or threefold as compared to a previously treated group of patients. PMID:960130

Heinze, H G; Schineis, E

1976-08-01

5

Does Radioiodine Therapy in Patients with Differentiated Thyroid Cancer Increase the Frequency of Another Malignant Neoplasm?  

Science.gov (United States)

Objectives. To compare the frequency of another primary malignancy in patients with differentiated thyroid carcinoma (DTC) who received radioiodine therapy or not (131I). Material and Methods. 168 cases of DTC patients were retrospectively evaluated as to the frequency of another neoplasia by comparing patients with and without it, taking into account clinical, laboratory, and therapeutic parameters. Results. Another primary malignancy occurred in 8.9% of patients. Of these, 53.3% showed the malignancy before 131I and 46.7% after it. By comparing both groups, the age at the moment of diagnosis of another neoplasia was 46.1 ± 20.2 years for the group before 131I therapy and of 69.4 ± 11.4 years for the group after it (P = 0.02). Of the 148 patients treated with 131I, 4.7% developed another malignancy. The latter were older (61 ± 17 years) than those who did not show another cancer type (44.1 ± 14.2 years) (P < 0.05). Conclusion. The frequency of another neoplasia found after 131I was similar to that found before 131I. PMID:22084737

Hirosawa, Renata Midori; Marivo, Monica; Luengo, Juliana de Moura Leite; Tagliarini, Jose Vicente; Castilho, Emanuel Cellice; Marques, Mariangela de Alencar; Kiy, Yoshio; Marone, Marilia Martins Silveira; Silveira, Liciana Vaz de Arruda; Mazeto, Glaucia Maria Ferreira da Silva

2011-01-01

6

The surgical management of benign and malignant thyroid neoplasms in Marshall Islanders exposed to hydrogen bomb fallout.  

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On March 1, 1954, a serious fallout accident occurred during the United States atomic testing program at Bikini in the Trust Territory of the Pacific Islands. Following the detonation of a large thermonuclear device (known as Bravo) an unexpected shift in winds resulted in deposition of radioactive debris on several inhabited atolls in the Marshall Islands. During the early post-detonation period military, sea, and air surveys traced the hottest portion of the parabolic cloud as it drifted in an ever widening pattern of diminishing concentration eastward and southeast of Bikini. The center of the cloud passed North of the Rongelap Atoll, which was the nearest inhabited atoll. This report concerns the development of thyroid lesions, the special circumstances encountered during thyroid surgery, and the results of the surgical management of benign and malignant lesions that were subsequently encountered in this population. PMID:1290253

Dobyns, B M; Hyrmer, B A

1992-01-01

7

Second Malignant Neoplasms Following Radiotherapy  

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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 prevent...

Sanath Kumar

2012-01-01

8

Juvenile thyroid malignancy  

Directory of Open Access Journals (Sweden)

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

Parelkar Sandesh

2009-01-01

9

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

10

[Primary immunodeficiency syndromes and malignant neoplasms].  

Science.gov (United States)

Among 727 patients registered to the Japan Immunodeficiency Registry up to December 6, 1986 from 1975, 25 patients were reported to have developed malignant neoplasms. The incidence of malignant neoplasms in 649 childhood patients was 3.2%, which was approximately 400 times higher than general childhood populations. More than half of these patients were complicated with malignant limphomas. The patients with Chediak-Higashi syndrome and ataxia-telangiectasia showed the highest incidence of developing malignant neoplasms. PMID:3599459

Kobayashi, N; Naitoh, K; Kudo, H; Matsui, I; Hayakawa, H; Yada, J

1987-04-01

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Malignant lymphoma of the thyroid gland  

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Full Text Available Introduction Malignant lymphoma of the thyroid gland can be defined as a lymphoma arising from the thyroid gland. Lymphomas of the thyroid gland represent less than 5% of primary thyroid neoplasms and are two to three times more common in women than in men, whereas the median age is usually close to 60 years. Majority of thyroid lymphomas are diffuse, large-cell lymphomas. The incidence of thyroid lymphomas in patients with Hashimoto thyroiditis has markedly increased and this phenomenon is probably related to their pathogenesis. Clinical presentation Unlike most other thyroid neoplasms, lymphomas are usually rapidly enlarging masses and local symptoms are common: pain, hoarseness, dysphagia, and dyspnea or stridor. Diagnosis To evaluate the extent of disease, a chest x-ray and CT scans of the head and neck, chest, abdomen, and pelvis are necessary. An excisional or large-needle biopsy may also be necessary to make the correct diagnosis. Occasionally, these tumors can be confused with anaplastic thyroid carcinomas, which can lead to serious mistakes in management. A gallium scan or a positron emission tomography (PET scan can help later to establish whether any residual abnormality, observed on x-ray studies after treatment, contains active lymphoma or scar tissue. After diagnosis, patients are clinically staged (without surgery using appropriate computed tomography scans or magnetic resonance imaging. Therapy Assessment of the extent of thyroid lymphomas is crucial for prognosis and treatment. Total thyroidectomy may improve the prognosis in patients with intrathyroidal disease only. It is very important to identify patients with favorable prognostic factors and to treat them with standard chemotherapy (CHOP and radiotherapy protocols. Patients with diffuse large-cell primary thyroid lymphomas should not be treated with radiation therapy alone. Conclusion The best treatment results for malignant lymphomas of the thyroid gland are achieved using a combined-modality therapy.

?aparevi? Zorica

2002-01-01

12

Thermography in thyroid neoplasm diagnostics  

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Thermographic procedures were used in the examination of 70 patients suspected of bearing thyroid tumors in whom /sup 131/I scanning had revealed hypofunction of nodes (''cold'' nodes) as well as 38 patients who had been operated for thyroid tumors at different periods. Thermographic diagnosis of primary thyroid tumor was confirmed histologically in 49 cases. Pseudonegative results were established in 5 cases. Pseudopositive results were recorded in 6 out of 21 cases of benign legions of the thyroid. Recurrences were identified thermographically in 16 patients operated for thyroid tumors. No pseudonegative results were obtained.

Kuz' michev, A.S. (Leningradskij Pediatricheskij Meditsinskij Inst. (USSR))

1981-01-01

13

Thermography in thyroid neoplasm diagnostics  

International Nuclear Information System (INIS)

Thermographic procedures were used in the examination of 70 patients suspected of bearing thyroid tumors in whom 131I scanning had revealed hypofunction of nodes (''cold'' nodes) as well as 38 patients who had been operated for thyroid tumors at different periods. Thermographic diagnosis of primary thyroid tumor was confirmed histologically in 49 cases. Pseudonegative results were established in 5 cases. Pseudopositive results were recorded in 6 out of 21 cases of benign legions of the thyroid. Recurrences were identified thermographically in 16 patients operated for thyroid tumors. No pseudonegative results were obtained

14

Intensity and distribution of immunohistochemical expression of galectin-3 in thyroid neoplasms.  

Science.gov (United States)

The aim of the study was to assess the intensity and distribution of galectin-3 expression in benign and malignant thyroid neoplasms by immunohistochemical method. Immunohistochemical expression of galectin-3 was analyzed in surgical thyroid specimens from 82 patients with histopathologic diagnosis of follicular adenoma (n = 32), Hürthle cell adenoma (n = 10) and papillary carcinoma (n = 40). Results of intracytoplasmatic and intranuclear expression of galectin-3 were scored using a semi-quantitative scale for intensity. Intracytoplasmatic expression ofgalectin-3 was positive in 18 (43%) benign neoplasms and in all 40 malignant neoplasms. The accuracy, sensitivity and specificity of intracytoplasmatic expression of galectin-3 as a malignant marker in thyroid neoplasms were 78.1%, 100% and 57.1%, respectively. Intracytoplasmatic expression of galectin-3 was positive in 10 (31%) cases of follicular adenoma and 8 (80%) cases of Hürthle cell adenoma. The accuracy, sensitivity and specificity of intranuclear expression of galectin-3 as a malignant marker in thyroid neoplasms were 84.1%, 100% and 69%, respectively. There was no strong intensity of either intracytoplasmatic or intranuclear expression ofgalectin-3 in benign thyroid neoplasms, and no weak intensity of either intracytoplasmatic or intranuclear expression of galectin-3 in malignant neoplasms. There was no statistically significant difference between intracytoplasmatic and intranuclear expression of galectin-3 in benign thyroid neoplasms. The results of our study indicate that the immunohistochemical expression of galectin-3 is a highly sensitive marker of malignancy, with low specificity in differentiating malignant from benign thyroid neoplasms. The analysis of intensity and distribution ofgalectin-3 expression could improve the specificity of the method. PMID:23115948

Matesa-Ani?, Dubravka; Moslavac, Sandra; Matesa, Neven; Cupi?, Hrvoje; Kusi?, Zvonko

2012-06-01

15

Malignant intraperitoneal neoplasms of childhood  

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Objective. The purpose of this paper is to review and categorize the CT appearances of primary and secondary intraperitoneal neoplasms in children. Materials and methods. We retrospectively reviewed the CT images of 14 cases of intraperitoneal neoplasms. They were reviewed for bowel wall thickening, mesenteric nodules, ascites, calcification, peritoneal nodules, omental caking, and contrast enhancement. Results. Computed tomography images of 14 cases of intraperitoneal neoplasms were evaluated: rhabdomyosarcoma (5), lymphoma (3), neuroblastoma (2), germ cell tumor (1), mesothelioma (1), Wilms tumor (1), and hepatocellular carcinoma (1). Nodular enhancement was seen in all cases, ascites in most, significant bowel wall thickening only with lymphoma, and calcification only with germ cell tumors. Omental caking was present both with rhabdomyosarcoma and lymphoma. Conclusions. While rare in pediatrics, intraperitoneal neoplasms occur in children, and CT is useful in identifying these peritoneal neoplasms. (orig.) With 5 figs., 1 tab., 34 refs.

Chung, C.J.; Fordham, L.A. [Department of Radiology, UNC School of Medicine, Chapel Hill, NC (United States); Bui, V. [School of Medicine, University of North Carolina, Chapel Hill, NC (United States); Hill, J. [Department of Radiology, Medical University of South Carolina, Charleston, SC (United States); Bulas, D. [Department of Radiology, Children`s National Medical Center, Washington, DC (United States)

1998-05-01

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Functional activity of the thyroid gland in patients with malignant neoplasms of the head and neck following remote gamma-therapy  

International Nuclear Information System (INIS)

In 20 patients with malignant tumours of the head and neck the functional activity of the thyroid gland was investigated by the method of dynamic radioisotopic analysis. Test-sets ''Tri-Tab'' and ''Tetra-Tab'' enabled one to determine thyroxin-binding capacity, total thyroxin, index of free thyroxin. The studies were conducted before, immediately after, and (in 7 patients) 18 months following the completion of the radical course of remote gamma-therapy. Integral doses absorbed by the thyroid gland amounted to 9.000-45.000 rad. A decrease in the functional activity as low as the lower border of the normalcy was observed in all patients following the radiation therapy. No clinical symptoms of the hypofunction of the thyroid gland were noted. A statistically significant tendency to higher indices of the functional activity of the thyroid gland in the periods up to 18 months following the end of the remote gamma-therapy has been revealed

17

Thyroidal malignancy and scintigraphy  

International Nuclear Information System (INIS)

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'. 99mTc-MIBI-sctintigraphy (MIBI) and 18F-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.)

18

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.

Mehta, M.P.; Goetowski, P.G.; Kinsella, T.J.

1989-06-01

19

Chemoradiation therapy for malignant neoplasms  

International Nuclear Information System (INIS)

The experience of chemoradiation therapy of malignant tumors is reviewed. Methods and results of treating tumors of lungs, stomach, throat and urine bladder are presented in detail. The necessity of mutual investigations in the field of chemoradiation therapy of oncological patients according to a unified system is underlined

20

Multiple primary malignant neoplasms among atomic bomb survivors  

International Nuclear Information System (INIS)

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.)

 
 
 
 
21

Synchronous malignancies of breast and thyroid gland: A case report and review of literature  

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Full Text Available The relationship and coincidence of breast cancer with thyroid disorders is a subject of extensive debate and controversy. Many studies have shown that thyroid diseases are common among women with breast cancer. We present a case of concomitant malignancy of breast and thyroid with review of literature on the association of breast with thyroid neoplasm. The potential association and plausible mechanisms of breast carcinoma development after or before the thyroid carcinoma should be evaluated in larger cohorts of patients.

Agarwal Dwarka

2007-01-01

22

Radiotherapy of malignant thyroid tumours  

International Nuclear Information System (INIS)

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)

23

Controversies in the surgical management of thyroid follicular neoplasms. Retrospective analysis of 721 patients.  

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The most appropriate surgical management of "follicular neoplasm/suspicious for follicular neoplasm" lesions, is still controversial. Analysing and comparing the experience of two units for endocrine surgery, we retrospectively evaluated 721 patients, surgically treated after a follicular neoplasm diagnosis. Total thyroidectomy was routinely performed in one Institution, while in the other one it was selectively carried out. The main criteria leading to hemythyroidectomy were a single nodule, the age ?45 years, the absence of thyroiditis or clinical/intraoperative suspicion of malignancy. Total thyroidectomy was performed in 402/721 patients (55.7%), hemythyroidectomy in 319/721 cases (44.2%) and a completion thyroidectomy in 51/319 cases (15.9%). The overall malignancy rate was 24% (176/721 patients), respectively 16% (51/319 patients) following hemythyroidectomy, and 31% (125/402 patients) following total thyroidectomy. Definitive recurrent laryngeal nerve paralysis and permanent hypoparathyroidism were not reported in hemythyroidectomy patients in which lower mean hospitalization and costs were observed. Considering the low-risk of follicular neoplasm solitary lesions, hemythyroidectomy is still the safest standard of care with lower hospitalization and costs. In case of multiglandular disease or thyroiditis, that might be associated with a higher risk of cancer, total thyroidectomy should be recommended. Further investigation is warranted to achieve a better preoperative follicular neoplasm diagnostic accuracy in order to reduce the amount of unnecessary surgical operations with a diagnostic aim. PMID:24859409

Conzo, Giovanni; Calò, Pietro Giorgio; Gambardella, Claudio; Tartaglia, Ernesto; Mauriello, Claudio; Della Pietra, Cristina; Medas, Fabio; Santa Cruz, Rosa; Podda, Francesco; Santini, Luigi; Troncone, Giancarlo

2014-01-01

24

Impact of NRAS Mutations on the Diagnosis of Follicular Neoplasm of the Thyroid  

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Background. Most patients with a preoperative diagnosis of thyroid follicular neoplasm (FN) undergo diagnostic surgery to determine whether the nodule is benign or malignant. Point mutations at NRAS codon 61 are the most common mutations observed in FN. However, the clinical significance of NRAS mutation remains unclear. Methods. From 2012 to 2013, 123 consecutive patients undergoing thyroidectomy for FN were evaluated prospectively. Molecular analyses for NRAS codon 61 were performed with pyrosequencing. Results. The overall malignancy rate in FN was 48.8% (60/123). Of 123 FNs, 33 (26.8%) were positive for the NRAS mutation. The sensitivity, specificity, positive predictive value, and negative predictive value of a NRAS mutation-positive FN specimen to predict malignancy were 37%, 83%, 67%, and 58%, respectively. Patients with a NRAS-positive FN had a higher malignancy rate in additional thyroid nodules beyond the FN than patients with a NRAS-negative FN. The overall malignancy rate of patients with a NRAS-positive FN was significantly higher than that of patients with a NRAS-negative FN (79% versus 52%; P = 0.008). Conclusions. Determining NRAS mutation status in FN helps to improve the accuracy of thyroid cancer diagnosis and to predict cancer risk in accompanying thyroid nodules.

Bae, Ja-Seong; Jeon, Sora; Lee, Youn Soo

2014-01-01

25

Aftercare of malignant thyroid growth  

International Nuclear Information System (INIS)

The 'standard programme of aftercare for patients with malignant thyroid growths' practised in our department comprises the following measures: - Searching for residual tissues and recurrences in the neck/throat region and for metastases by means of physical examination, scintigraphy, x-ray diagnosis and laboratory tests (including determination of tumour markers); - monitoring and treatment of side effects by thyroidectomy (recurrent paresis, parathyroprival tetany); - prevention, detection and treatment of side effects of high-dosed radio-iodine therapy (on salivary glands and bone marrow) or those of cytostatic treatment (on heart muscle and bone marrow); - monitoring substitutive and suppressive treatment with thyroxines; - psychological guidance and genetic counselling. Corresponding to therapeutic approach, the overall aftercare programme is aimed primarily at papillary and follicular carcinoma and C-cell carcinoma. However, aftercare is hardly effective with anaplastic carcinoma owing to its persistently bad prognosis and its 50% survival time of some three months. (orig./MG)

26

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.)

27

Thyroid cancer: a lethal endocrine neoplasm  

International Nuclear Information System (INIS)

is 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

28

Thyroid neoplasms after radiation therapy for adolescent acne vulgaris  

International Nuclear Information System (INIS)

There is a potential hazard of thyroid cancer after exposure to external irradiation for the treatment of adolescent acne vulgaris. We noted a 60% incidence of thyroid carcinoma among 20 patients with such a history, who were operated on for thyroid nodules during a five-year period. Eighty-three percent of the patients with carcinoma had either a follicular or a mixed papillary-follicular carcinoma; 17% had a papillary carcinoma; 33% had regional node metastases; none had evidence of distant metastases. The interval between radiation exposure and thyroidectomy ranged from nine to 41 years. This association of thyroid neoplasms and a prior history of radiation for acne vulgaris may be coincidental and therefore remains to be proved by retrospective surveys of large numbers of treated patients with appropriate controls

29

Malignant pulmonary neoplasms causing airspace consolidation : CT findings  

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

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

1999-11-01

30

Malignant pulmonary neoplasms causing airspace consolidation : CT findings  

International Nuclear Information System (INIS)

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

31

The solitary thyroid nodule: diagnosis and management of malignant disease  

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While few solitary thyroid nodules are carcinomatous, it is essential to identify and preferentially select those that are for surgery. Clinical, biochemical, serologic, radiographic, scintigraphic, sonographic, biopsy, and even therapeutic evaluation may be necessary to choose those patients with the greatest probability of malignancy. The benefits and limitations of each diagnostic modality are discussed, and the importance of fine-needle aspiration is stressed. After the operative confirmation of malignancy, the prognosis in any given case depends on 1) the histologic type of the neoplasm, 2) its size and extent, 3) the presence of angioinvasiveness, 4) the tendency toward multicentricity of the lesion, 5) the age and sex of the patient, and 6) whether distant metastases are present. These factors influence the extent of surgery required for well-differentiated carcinomas. Meticulous dissection and preservation of the recurrent laryngeal nerves and the parathyroid glands along with their blood supply are important if total thyroidectomy for papillary carcinoma is to be employed with an acceptable operative morbidity to optimize survival. The value of the adjunctive use of thyroid hormone and radioactive iodine is also discussed. Finally, the clinical behaviors and treatments of undifferentiated carcinomas, sarcomas, lymphomas, and neoplasms metastatic to the thyroid gland are reviewed

32

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.

Penelope Korkolopoulou

2012-01-01

33

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.)

34

Intrapulmonary cystic teratoma mimicking malignant pulmonary neoplasm  

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Benign cystic teratoma of lung is an extremely rare tumour, which was first described in literature by Mohr in 1839. Intrapulmonary teratoma is thought to be a derivative of the third endo-dermal pharyngeal pouch, which is an anlage of the thymus. The authors present a rare case of mature cystic teratoma in a young male involving the right upper lobe of the lung. Diagnosis is often missed and patients are treated for various infectious conditions. Treatment is complete resection for both benign and malignant teratomas and carries excellent prognosis. Benign cystic teratoma, if not excised may cause grave complications like life-threatening haemoptysis or malignant transformation with metastatic disease. PMID:22892230

Sawant, Abhishek Chandrakant; Kandra, Ajay; Narra, Swapna Reddy

2012-01-01

35

Malignant neoplasms from radiotherapy of benign diseases  

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Radiation induced cancer from benign diseases are usually squamous cell carcinoma and found in skin, hypopharynx, larynx, esophagus, thyroid and then other part of sites followed. Many cases of radiation induced cancer have been reported since 1950, and current study of radiation induced cancer should include long term follow-up, exact diagnosis, radiation record, control group and statistical analysis. National Cancer Center had 11,133 radiation therapy patients between 1962 and 1972, 142 of them (1.3%) are benign diseases, and radiation associated cancer are found 3 of male and 2 of female patients. One hundred two cases of benign diseases radiotherapy in the National Cancer Center, 199 cases in Niigata University, and 344 cases in Keio University are statistically analyzed. Radiation cancer until 1951 and between 1952 to 1977 are also collected from 133 hospitals in Japan, and 48 cases of primary disease and radiation cancer are found and analyzed from 19,988 patients of benign diseases. (author)

36

Food habits in atomic bomb survivors suffering from malignant neoplasms  

International Nuclear Information System (INIS)

Food habits were surveyed in patients admitted to 13 hospitals in Nagasaki prefecture and other prefectures to compare the incidence of malignant neoplasms according to the food intake between atomic bomb exposed group and non-exposed group. The incidence of malignant neoplasms was significantly higher in male patients having the low intake of milk and salted fish than in those having the high intake of them in atomic bomb exposed group, while it was significantly higher in male patients having the low intake of potatoes and milk and in female patients having the low intake of boiled fish paste than in those having the high intake of them in non-exposed group. (Namekawa, K.)

37

Food habits in atomic bomb survivors suffering from malignant neoplasms  

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Food habits were surveyed in patients admitted to 13 hospitals in Nagasaki prefecture and other prefectures to compare the incidence of malignant neoplasms according to the food intake between atomic bomb exposed group and non-exposed group. The incidence of malignant neoplasms was significantly higher in male patients having the low intake of milk and salted fish than in those having the high intake of them in atomic bomb exposed group, while it was significantly higher in male patients having the low intake of potatoes and milk and in female patients having the low intake of boiled fish paste than in those having the high intake of them in non-exposed group. (Namekawa, K.).

Morimoto, Kazue; Inoue, Hisako; Uchino, Chito

1984-03-01

38

[Primary multiple malignant neoplasms in patients with skin melanoma].  

Science.gov (United States)

The problem of primary multiple malignant tumor (PMMT) of skin melanoma in Ukraine is analyzed. During the period from 2000 to 2006, 16760 cases of skin melanoma have been diagnosed, and in 873 patients from them PMMT has been registered. So, the part of the patients with multiple tumors among all patients with skin melanoma was 5.2%. Most often PMMT appears in the case of skin melanoma of head and neck (6.6 +/- 0.4%). Most commonly skin melanoma is accompanied by other skin malignant neoplasms (40.9 +/- 1.6% of all PMMT cases). Upon malignant skin melanoma, PMMT occurs more often in males (5.7 +/- 0.7%) than in females (4.9 +/- 0.7%). Most often the diagnosis of skin melanoma at PMMT is detected synchronously (48.3 +/- 1.6%), and simultaneous detection of PMMT predominates in all polyneoplasms and in all age groups. The most favourable course of skin melanoma is characteristic for metachronous cancer of II type when melanoma is diagnosed after manifestation of other malignant tumor. PMID:19145823

Korovin, S I; Gulak, L O; Fedorenko, Z P; Gordienko, T V; Kukushkina, M N

2008-01-01

39

Malignancy risk assessment in adenomatoid nodules and suspicious follicular lesions of the thyroid obtained by fine needle aspiration cytology.  

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Our aim was to assess malignancy risk in adenomatoid nodules and suspicious follicular lesions of the thyroid obtained by fine needle aspiration (FNA) cytology. Retrospective research was performed of 276 patients who underwent thyroid surgery after preoperative ultrasound-guided FNA diagnosis of either adenomatoid nodule, cellular follicular lesion, "suspicious for follicular neoplasm" or follicular neoplasm. Out of 276 patients, FNA reports showed 15 diagnoses (5%) of adenomatoid nodules, 73 (26%) cellular follicular lesions, 76 (28%) "suspicious for follicular neoplasm", and 112 diagnoses (41%) of follicular neoplasm. FNA reports were compared with pathohistological findings. In FNA reports of adenomatoid nodule (N = 15), there were seven (47%) pathohistological diagnoses (PHDs) of nodular goiter, and eight (53%) PHDs of follicular adenoma. In FNA reports of cellular follicular lesion (N = 73), there were 2 (3%) PHDs of thyroiditis, 32 (44%) PHDs of nodular goiter, 38 (52%) PHDs of follicular adenoma, and one (1%) PHD of papillary carcinoma. In FNA reports of "suspicious for follicular neoplasm" (N = 76), there was one (1%) PHD of thyroiditis, 24 (32%) PHDs of nodular goiter, 47 (62%) PHDs of follicular adenoma and four (5%) diagnoses of papillary carcinoma. In FNA reports of follicular neoplasm (N = 112), there were 25 (22%) PHDs of nodular goiter, 72 (64%) PHDs of follicular adenoma, and 15 (14%) PHDs of thyroid carcinoma. We found significant difference (p < 0.01) between investigated FNA report groups according to malignancy risk. Stratification of cytologic diagnoses of follicular thyroid lesions into different subcategories with various probabilities of malignancy allows more accurate estimation of malignancy risk and individualized patient treatment, when deciding between immediate operation and close follow-ups with repeat FNA. PMID:20698101

Dabeli?, Nina; Matesa, Neven; Matesa-Ani?, Dubravka; Kusi?, Zvonko

2010-06-01

40

Mucoepidermoid carcinoma of the thyroid gland arising from a papillary epithelial neoplasm.  

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We report a case of mucoepidermoid carcinoma of the thyroid gland. The simultaneous association of papillary and mucoepidermoid carcinoma in a Hashimoto's thyroiditis makes the present observation unusual. Surgery was limited due to local extension of the neoplasm. The patient consequently underwent external radiotherapy followed by radiometabolic therapy. The patient survived 11 months after diagnosis. As far as the histogenesis of the neoplasm is concerned, we believe that mucoepidermoid ar...

Arezzo, Alberto

1998-01-01

 
 
 
 
41

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

42

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

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

Havelka Marija J.

2003-01-01

43

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

Scientific Electronic Library Online (English)

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

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

44

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

Scientific Electronic Library Online (English)

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

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

2005-10-01

45

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

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

Marcos Emanuel de Alcântara Segura

2005-10-01

46

Galectin-3: A promising marker of thyroid malignancy  

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

Cveji? Dubravka S.

2003-01-01

47

Role of metallothioneins in benign and malignant thyroid lesions  

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

Pula Bartosz

2012-12-01

48

Meningioma as second malignant neoplasm after oncological treatment during childhood  

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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.)

Mueller, H.L.; Gebhardt, U. [Klinikum Oldenburg (Germany). Dept. of Pediatric Hematology and Oncology; Warmuth-Metz, M. [University Hospital Wuerzburg (Germany). Dept. of Neuroradiology; Pietsch, T. [Bonn Univ. (Germany). Dept. of Neuropathology; Soerensen, N. [Evangelisches Krankenhaus, Oldenburg (Germany). Dept. of Neurosurgery; Kortmann, R.D. [University Hospital Leipzig (Germany). Dept. of Radiooncology

2012-05-15

49

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.)

50

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

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

51

Solid state lasers for photodynamic therapy of malignant neoplasm  

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This work demonstrates the possibility of treating animals with malignant neoplasms using 608 nm of laser radiation by means of photodynamic therapy (PDT). The intracavity transformation of the Nd:YAP main radiation 1079 nm was Raman converted in barium nitrate crystal, and the Stokes frequency (1216 nm) was doubled using KTP or RTA crystals. The LiF or Cr:YAG crystals are used for the Q-switch. The radiation parameters were obtained at 100 Hz pump repetition frequency. The average power at 608-nm radiation with LiF and KTP was 700 mW at multimode generation. The 3-6 single 10-15 ns pulses were generated during one cycle of pumping. The doubling efficiency with RTA was two times more than with KTP. The cells of Ehrlich adenocarcinoma (0.1 ml) were implanted in hind thighs of ICR white non-imbred mice. Photosensitizer HpD was i.v. administered in a dose of 10 mg/kg. Ten animals were treated (2 as a control). There was a 9-30% decrease in the tumor growth depending on the irradiation dose. The better result (30%) was for the 200 J/cm2 dose radiation. These results show the possibility of using all solid state lasers with wavelength of 608 nm for PDT.

Khulugurov, Vitaliy M.; Ivanov, Nikolai; Kim, Byoung-Chul; Mayorov, Alexander; Bordzilovsky, Dnitri; Masycheva, Valentina; Danilenko, Elena; Chung, Moon-Kwan

2002-05-01

52

Microvessel and mast cell densities in malignant laryngeal neoplasm  

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Full Text Available Laryngeal neoplasm contributes to 30-40% of carcinomas of the head and neck. Mast cells are normal connective tissue residents, well represented in the respiratory tract. Experimental evidence suggests that the growth of a tumor beyond a certain size requires angiogenesis, which may also permit metastasis. The aim of this study was to evaluate the correlation between mast cell density, microvascular density, histopathological type and histological grade. Our study included 38 laryngeal carcinomas as follows: adenoid cystic carcinoma (2 cases, malignant papilloma (2 cases and squamous cell carcinoma (34 cases. The combined technique of CD 34-alcian blue safranin (ABS was used to identify microvessel and mast cell density, which was quantified by the hot spot method. A significant correlation was found between both mast cell and microvascular density, and G1/G2 histological grade (p=0.002 and p=0.004, respectively. Squamous cell carcinoma was significantly correlated with mast cell density (p=0.003, but not with microvascular density (p=0.454.

Balica Nicolae Constantin

2014-01-01

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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

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Geographical distribution for malignant neoplasm of the pancreas in relation to selected climatic factors in Japan  

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Full Text Available Abstract Background Malignant neoplasm of the pancreas has become one of the leading causes of death from malignant neoplasm in Japan (the 5th in 2003. Although smoking is believed to be a risk factor, other risk factors remain unclear. Mortality from malignant neoplasm of the pancreas tends to be higher in northern Japan and in northern European countries. A recent study reported that standardized mortality ratios (SMRs for malignant neoplasm of the pancreas were negatively correlated to global solar radiation level. People residing in regions with lower solar radiation and lower temperatures may be at higher risk of development of malignant neoplasm of the pancreas. Therefore, this study aimed to examine the relationship between SMRs for malignant neoplasm of the pancreas and climatic factors, such as the amount of global solar radiation and the daily maximum temperature in Japan. Results The study used multiple linear regression models. Number of deaths and demographic data from 1998 to 2002 were used for the calculation of SMR. We employed mesh climatic data for Japan published in 2006 by the Japan Meteorological Agency. Regression coefficients for the amount of global solar radiation and the daily maximum temperature in males were -4.35 (p = 0.00034 and -2.81 (p Conclusion This study suggested that low solar radiation and low temperature might relate to the increasing risk of malignant neoplasm of the pancreas. Use of group data has a limitation in the case of evaluating environmental factors affecting health, since the impact of climatic factors on the human body varies according to individual lifestyles and occupations. Use of geographical mesh climatic data, however, proved useful as an index of risk or beneficial factors in a small study area. Further research using individual data is necessary to elucidate the relationship between climatic factors and the development of malignant neoplasm of the pancreas.

Okada Masafumi

2007-07-01

55

Second malignant neoplasms and cardiovascular disease following radiotherapy.  

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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 (i.e., radiotherapy with or without chemotherapy and other therapies); type of radiation; and quantitative considerations (i.e., dose-response relationships). Major conclusions of the NCRP include: (1) the relevance of older technologies for current risk assessment when organ-specific absorbed dose and the appropriate relative biological effectiveness are taken into account and (2) the identification of critical research needs with regard to newer radiation modalities, dose-response relationships, and genetic susceptibility. Recommendation for research priorities and infrastructural requirements include (1) long-term large-scale follow-up of extant cancer survivors and prospectively treated patients to characterize risks of SMNs and CVD in terms of radiation dose and type; (2) biological sample collection to integrate epidemiological studies with molecular and genetic evaluations; (3) investigation of interactions between radiotherapy and other potential confounding factors, such as age, sex, race, tobacco and alcohol use, dietary intake, energy balance, and other cofactors, as well as genetic susceptibility; (4) focusing on adolescent and young adult cancer survivors, given the sparse research in this population; and (5) construction of comprehensive risk prediction models for SMNs and CVD to permit the development of follow-up guidelines and prevention and intervention strategies. PMID:24378498

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

2014-02-01

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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)

57

Profile of Hashimoto's Thyroiditis in Sri Lankans: Is There an Increased Risk of Ancillary Pathologies in Hashimoto's Thyroiditis?  

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Hashimoto's thyroiditis has been reported to be associated with many neoplastic and nonneoplastic thyroid pathologies. This retrospective study aims to determine the demographic profile of Hashimoto's thyroiditis in Sri Lankans, document ancillary pathologies in Hashimoto's thyroiditis, and determine whether there is an increased risk of occurrence of malignancies, benign neoplasms, and nonneoplastic benign lesions in Hashimoto's thyroiditis by comparing with thyroids showing multinodular goi...

Siriweera, Eranga Himalee; Ratnatunga, Neelakanthi Vajira Illangakoon

2010-01-01

58

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

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Acinic cell carcinoma of parotid with predominant follicular pattern mimicking follicular neoplasm of thyroid  

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Full Text Available Acinic Cell Carcinoma (ACC was previously called acinic cell tumor and it is a neoplasm demonstrating cytological differentiation towards serous acinar cells. The histological architecture of ACC is diverse and classification consists of various histological subtypes. This is a case of acinic cell carcinoma of parotid gland in a 45 years female patient which showed predominant follicular variant of ACC. It is a least frequent variant of ACC occurring in only 5% and it mimics follicular neoplasm of thyroid. [Int J Res Med Sci 2014; 2(3.000: 1217-1219

A. Bhagya Lakshmi

2014-06-01

60

[Occupational morbidity and mortality in malignant neoplasms among persons professionally exposed to asbestos dust].  

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Asbestos fibres discharged as a result of machine processing of brakes, are characterized by a lowered biological activity due to the fixation layer which covers them. This has been confirmed through occupational diseases' analysis and new data on malignant neoplasms epidemiology among workers engaged in machine processing of asbestos-moulded machine parts. General mortality caused by malignant neoplasms in these groups higher than in the control group, although statistically is not significant. This necessitates further epidemiologic studies to be performed at similar plants. PMID:2139623

Iatsenko, A S; Kogan, F M

1990-01-01

 
 
 
 
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Malignant intraductal oncocytic papillary neoplasm of the common bile duct  

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Recently, several cases of intraductal oncocytic papillary neoplasm (IOPN) of the liver and hepatic bile ducts have been reported. The author herein reports the first case of IOPN of the common bile duct (CBD). A 78-year-old man was admitted to our hospital because of jaundice. Imaging modalities including US, CT, MRI revealed an intraductal tumor of the middle CBD and biliary dilation distal to the tumor. A partial resection of the CBD was performed. Grossly, a papillary tumor measuring 20 ?...

Terada, Tadashi

2012-01-01

62

Primary malignant melanoma of female urethra: A rare neoplasm.  

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Primary malignant melanoma of urethra is an extremely rare entity. It has very poor prognosis. A 62-year-old post-menopausal female presented with complaints of voiding difficulty and a mass projecting from external urethral meatus. External genital examination revealed a growth arising from urethral meatus with blood-stained discharge from its surface. Biopsy from lesion confirmed the diagnosis to be malignant melanoma. Metastatic work up for the malignancy was negative. We describe the surgical management of this pathology at our tertiary care center and discuss the various treatment options possible in this scenario. PMID:25313778

Pandey, Praveen K; Vijay, Mukesh K; Goel, Hemant; Shukla, Suruchi

2014-01-01

63

The pattern and distribution of malignant neoplasms among Yemeni patients.  

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Gastrointestinal tract in general with breast in females, were the most frequent sites of malignancies in the Republic of Yemen. Adenocarcinoma and squamous cell carcinoma were the most frequent types.

A. K. Al-Thobhani

2001-10-01

64

CT-guided radioactive seed 125I implantation for the treatment of malignant adrenal neoplasms  

International Nuclear Information System (INIS)

Objective: To evaluate CT-guided radioactive seed 125I implantation in treating malignant adrenal neoplasms. Methods: CT-guided radioactive seed 125I implantation was performed in 9 cases of malignant adrenal neoplasms with a total of 9 lesions. The clinical data were retrospectively analyzed. Treatment plan system was used to design the distribution of 125I seeds for treatment. Under CT guidance, the 125I seeds of 29.6 MBq were implanted into the malignant adrenal neoplasms with an interval distance of 1.0-1.5 cm. A follow-up of 1-15 months was conducted. The postoperative efficacy was evaluated with enhanced CT scanning. Results: After the treatment, complete remission (CR) was obtained in 5 patients, partial remission (PR) in 3 patients and no change (NC) in 1 patients, with an overall effective rate of 88.9%. The main complication was slight bleeding (n=1). Conclusion: For the treatment of malignant adrenal neoplasms, CT-guided radioactive seed 125I implantation carries reliable short-term effectiveness, therefore, it is a safe, effective and minimally-invasive therapy. (authors)

65

[Electroglottography in patients operated for thyroid gland malignancies].  

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

Zagólski, Olaf

2004-01-01

66

Primary amyloid goiter mimicking rapid growing thyroid malignancy.  

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Amyloid accumulation in the thyroid gland leading to a clinically detectable mass, known as amyloid goiter, is a rare condition associated with primary amyloidosis. Moreover, a localized primary amyloid goiter involving only the thyroid gland is rarer still. Here, we report a patient with a localized primary amyloid goiter that had grown rapidly, causing dysphagia and dyspnea on exercise, and confused us with malignancy such as anaplastic carcinoma. After surgery, no further symptoms occurred. A diagnosis of amyloid goiter was established on microscopic examination. In patients with a rapidly enlarging thyroid gland presenting with dysphagia, dyspnea, or hoarseness, amyloid goiter and malignancy should both be suspected, even when systemic amyloidosis is not suspected. PMID:24150545

Joung, Kyong Hye; Park, Jae-Yong; Kim, Koon Soon; Koo, Bon Seok

2014-02-01

67

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

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Increased prevalence of thyroid cancer was noted in patients with previous history of radiotherapy of the head and neck region in childhood. According to previous research, radiotherapy for Ti nia capitis was using up to 30 years ago in Khorasan Province. This study tries to evaluate prevalence of benign and malignant thyroid nodules and detect and treat these patients earlier to prevent more complications and increased cost. Methods and patients: Using mass media, we recalled all patients with history of radiotherapy for Tinea capitis in childhood. A questionnaire was filled for each patient and thyroid examination, thyroid scan and thyroid sonography were performed. Fine needle aspiration biopsy (FNAB) was done if a thyroid nodule larger than 1 cm was palpable. Serum TSH was measured in all patients. Also thyroid surgery was recommended for all patients with thyroid nodules more than 1 cm. A control group was defined from a group of patients who referred for non thyroidal sonography to radiology department of Ghaem hospital. These patients also were evaluated by clinical examination and thyroid sonography. Results: We studied 180 patients with mean age of 47.7 years and 127 age and sex m etched controls. Thyroid nodules was palpated in 45.5% of patients and 7% of controls (P0.01). The mean largest diameter of nodules were 24.8 mm in patients and 10.8 mm in control group (P<0.001). 75% of patients were agreed with FNAB and 5% of them had suspicious cytology results. No suspicious or malignant results was noted in control group. Twenty seven patients (33.7%) were operated. Pathological results were benign in 89.9% and malignant in 1% of patients. His study showed that thyroid nodules and thyroid neo plasma were significantly more larger in the patients group. Thyroid neoplasm were more frequent in younger patients with latent thyroid (from radiotherapy) of less than 40 years, so aggressive evaluation is recommended in these group

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

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

69

Bone sarcoma as a second malignant neoplasm in children: influence of radiation and genetic predisposition  

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Osteosarcoma or chondrosarcoma developed as a second malignant neoplasm (SMN) in 40 of 188 individuals with SMN whose first neoplasm occurred in childhood. A genetic susceptibility to cancer was found in 23; the SMN developed in an irradiated field in 32; both factors were present in 16; neither in one. When a genetic predisposition was present, radiation shortened the interval to SMN. The intervals between tumors and the age at which the bone sarcomas developed in relation to genetic disease and therapy were analyzed by a two-mutation hypothesis

70

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)

71

Partially Cystic Thyroid Nodules: Ultrasound Findings of Malignancy  

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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.

Park, Jang Mi; Choi, Yoon Jung; Kwag, Hyon Joo [Dept. of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2012-09-15

72

Thyroid gland. TNM classification of malignant tunours  

International Nuclear Information System (INIS)

The Head and Neck sites were classified between 1954 and 1973, some of them being amended. The classifications now published will remain unchanged until at least 1986. The classifications for Oro-, Naso- and Hypo- pharynx are based on data developed and analysed by the Task Forces on Head and Neck Cancers of the American Joint Committee (AJC) and by the German-Austrian-Swiss Study Group on Maxillofacial tumours. The classification for Larynx has not changed since 1972. The proposed classification for Thyroid Gland is based on that recommended by the European Organisation for Research on Treatment of Cancer (EORTC)

73

Malignancy in solitary nodular lesions of thyroid : a review  

International Nuclear Information System (INIS)

Out of the cases seen for thyroid disorders, 150 cases with solitary nodule were studied to find out the correlation between the histopathological features and the functional status of the nodules. 35-45 ?Cs of sup(131)I was given orally and thyroid uptake was measured at 2,4,24 and 48 hours after administration and thyroid scan was done at the end of 24 hours. On the basis of sup(131)I concentration found in the nodules, single nodules were classified as hyperfunctioning, functioning, hypofunctioning and nonfunctioning. The incidence of malignancy was high in nonfunctioning and hypofunctioning nodules, while no malingnancy was found in the functioning types of nodules. These results are compared with those of other such studies. (M.G.B.)

74

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

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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

75

The undifferentiated malignant neoplasm. Identification of lymphoma arising in skeletal muscle by immunohistochemical analysis.  

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The undifferentiated malignant neoplasm presents a significant problem in the intelligent selection of therapy. Because of advances in chemotherapy, there are cancers that are effectively palliated, and sometimes cured if appropriately treated. Characterization of tumors by immunohistochemical stains drastically reduces the incidence of "undifferentiated" diagnoses and will optimize patient management, as illustrated by two cases of large-cell lymphoma arising in skeletal muscle. PMID:2414476

Berg, A R; Linder, J; Anderson, R W; Tempero, M A; Edney, J A; Armitage, J O

1985-11-01

76

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

77

Differential Nuclear and Cytoplasmic Expression of PTEN in Normal Thyroid Tissue, and Benign and Malignant Epithelial Thyroid Tumors  

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Germline mutations in PTEN (MMAC1/TEP1) are found in patients with Cowden syndrome, a familial cancer syndrome which is characterized by a high risk of breast and thyroid neoplasia. Although somatic intragenic PTEN mutations have rarely been found in benign and malignant sporadic thyroid tumors, loss of heterozygosity (LOH) has been reported in up to one fourth of follicular thyroid adenomas (FAs) and carcinomas. In this study, we examined PTEN expression in 139 sporadic nonmedullary thyroid ...

Gimm, Oliver; Perren, Aurel; Weng, Liang-ping; Marsh, Debbie J.; Yeh, Jen Jen; Ziebold, Ulrike; Gil, Elad; Hinze, Raoul; Delbridge, Leigh; Lees, Jacqueline A.; Mutter, George L.; Robinson, Bruce G.; Komminoth, Paul; Dralle, Henning; Eng, Charis

2000-01-01

78

Trends in mortality rate from malignant skin melanoma and other malignant skin neoplasms in Czechoslovakia during the period 1921--1970.  

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Mortality from malignant skin melanoma (172 ICD) has an ascending trend in Czechoslovakia (CSSR) the rate being higher after the year 1960 in Bohemia (CSR) than the Slovakia (SSR). Mortality from other malignant neoplasms of the skin (173 ICD) declines; this decline for the whole of Czechoslovakia has been statistically influenced mainly by the lower death rate from this cause in Bohemia, for in Slovakia this mortality rate has risen, although significantly only in women. The proportion of deaths from malignant skin melanoma (172 ICD) out of the total number of deaths from malignant skin neoplasms (172 + + 173 ICD) is relatively low in Czechoslovakia--lower in Slovakia than in Bohemia. PMID:1004663

Somogyi, J; Hostýnová, E; Simkovic, D

1976-01-01

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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, 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)

80

Accuracy of CT in predicting malignant potential of cystic pancreatic neoplasms  

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Background. Cystic lesions of the pancreas are being identified more frequently. Deciding which asymptomatic lesions can be safely followed with serial imaging and which require resection due to malignant potential is an increasingly common question. Current clinical practice is to rely on characteristics of the lesions on CT scan, and additional information from endoscopic ultrasound with fine-needle aspiration (EUS-FNA) and cyst fluid analysis or endoscopic retrograde pancreatography (ERCP) to assess malignant potential. Hypothesis. The malignant potential of pancreatic cystic lesions cannot be accurately predicted by CT scan. Methods. CT scans from 48 patients with cystic lesions of the pancreas were stripped of patient identifiers and retrospectively presented to two expert radiologists. The radiologists recorded specific characteristics of the lesions thought to be important in the differential diagnosis and their opinion of the likely diagnosis. Diagnostic accuracy was assessed by comparing the radiologists’ diagnoses to the final pathologic diagnosis after resection. To determine if clinical history, EUS-FNA or ERCP findings improved diagnostic accuracy, medical records were retrospectively reviewed and scored as either supporting or not supporting malignant potential of the lesion. Results. Specific diagnoses based on CT findings alone were correct in an average of 39% of the cases. Even when diagnoses were dichotomized as benign (43%) or potentially malignant (57%, papillary mucinous neoplasms, mucinous cystic neoplasms, cancer), determinations based on CT alone were accurate in an average of 61% of cases. Accuracy rates were 60.4 and 62.5% for the two radiologists, although there was only fair agreement between them (Kappa=0.28, 95% CI=(0.01–0.55), p=0.05). When all clinical information available was considered together as a single dichotomous indicator of malignant potential, the indicator was accurate in 90% of the cases (Kappa=0.73, 95% CI=(0.51–0.95, p<0.0001)). Conclusion. Specific preoperative diagnosis of pancreatic cystic neoplasms by CT alone is substantially inaccurate. Complementary tests such as EUS-FNA with fluid analysis and ERCP should be recommended to improve diagnosis especially if nonoperative treatment is planned. PMID:19088937

Hodges, Sally E.; Yagnik, Vivek; Moron, Fannie E.; Wu, Meng-Fen; Hilsenbeck, Susan G.; Raijman, Isaac L.; Charles Brunicardi, F.

2008-01-01

 
 
 
 
81

Diagnostic value of isotope scanning in thyroid disease  

International Nuclear Information System (INIS)

Scannograms of the thyroid in 138 patients were analysed. Scanning of the thyroid is a valuable diagnostic adjunct, but it should be performed on definite indications. The scannogram pattern in malignant neoplasms of the thyroid is dependent on morphological features of a tumor, size and localization of a tumor node in the gland thickness. But scanning is found to be of no decisive value in establishing the differetial diagnosis between benign and malignant neoplasms of the thyroid. Isotope scanning of the thyroid proves to be a largly informative method of examination in patients previously subjected to thyroid surgery. Scanning technique seems to be of importance in recognizing

82

Mortality on malignant neoplasms of lymphatic and haematopoietic tissue near nuclear power plant sites in Japan  

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Recently, there have been several reports of increases of leukemia, especially childhood leukemia, in populations resident in the vicinity of nuclear installations. However, there is no information on cancer mortality of the people living near nuclear power stations in Japan. Therefore, we have studied the standardized mortality ratio of malignant neoplasms of lymphatic and hematopoietic tissue near nuclear power plant sites in Japan. Data on the cancer mortality were obtained from the magnetic tapes of National Vital Statistics, Ministry of Health and Welfare, for years of 1973-1987. Standardized Mortality Ratio (SMR) of all leukemia, lymphoma, non-HODGKIN's lymphoma, multiple myeloma and acute non-lymphatic leukemia was calculated for various age groups (0-14, 0-24 years and all ages) and different period (1973-1977, 1978-1982, 1983-1987 and 1973-1987) for each nuclear power plant site. The results showed that some of the studied population had higher rates of certain malignant neoplasms, and some had lower rates, either before or after the facilities came into operation. Our statistical analysis provided no evidence of any association between particular sites and increased cancer mortality rates. (author).

Iwasaki, Tamiko; Nishizawa, Kanae; Matsudaira, Hiromichi (National Inst. of Radiological Sciences, Chiba (Japan)); Murata, Motoi

1993-09-01

83

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

84

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

85

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

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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

86

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

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The incidence of second malignant neoplasms (SMN) was assessed in 248 patient 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 (less than EF), extended field (EF) or total nodal irradiation (TNI). Chemotherapy was scored as single agent (SAC) or multiagent (MAC). MAC consisted primarily of either nitrogen mustard, vincristine, 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 to 10 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 itself. PMID:7296488

Nelson, D F; Cooper, S; Weston, M G; Rubin, P

1981-12-01

87

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 SciELO Brazil | Language: English Abstract in portuguese Tumores mesenquimais da glândula tireoide são extremamente raros. Os autores relatam um caso de osteossarcoma primário de tireoide em um paciente masculino que apresentou massa tumoral na região cervical. A tomografia computadorizada demonstrou um grande tumor no lobo tireoideano direito, com zonas [...] de calcificação. A peça cirúrgica consistia de um tumor marrom-acinzentado e firme, medindo 13 × 11 × 7,5 cm. À microscopia, foi encontrada neoplasia maligna de alto grau composta por células poligonais de tamanho intermédio, com um padrão condroide em algumas áreas e formação de osteoide. O processo revelou imunoexpressão negativa para AE1/AE3, proteína glial fibrilar ácida (GFAP), antígeno da membrana epitelial (EMA), p53 e fator de transcrição da tireoide (TTF-1) e imunopositividade para CD99 e S100. O diagnóstico de osteossarcoma primário da glândula tireoide foi, então, estabelecido. Abstract in english Primary mesenchymal tumors of the thyroid gland are extremely rare. The authors report a case of primary thyroid osteosarcoma in a male patient presenting a tumoral mass in the neck. CT scan demonstrated a large tumor in the right thyroid lobe with areas of calcification. The surgical specimen consi [...] sted 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.

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

88

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

89

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Tumores mesenquimais da glândula tireoide são extremamente raros. Os autores relatam um caso de osteossarcoma primário de tireoide em um paciente masculino que apresentou massa tumoral na região cervical. A tomografia computadorizada demonstrou um grande tumor no lobo tireoideano direito, com zonas [...] de calcificação. A peça cirúrgica consistia de um tumor marrom-acinzentado e firme, medindo 13 × 11 × 7,5 cm. À microscopia, foi encontrada neoplasia maligna de alto grau composta por células poligonais de tamanho intermédio, com um padrão condroide em algumas áreas e formação de osteoide. O processo revelou imunoexpressão negativa para AE1/AE3, proteína glial fibrilar ácida (GFAP), antígeno da membrana epitelial (EMA), p53 e fator de transcrição da tireoide (TTF-1) e imunopositividade para CD99 e S100. O diagnóstico de osteossarcoma primário da glândula tireoide foi, então, estabelecido. Abstract in english Primary mesenchymal tumors of the thyroid gland are extremely rare. The authors report a case of primary thyroid osteosarcoma in a male patient presenting a tumoral mass in the neck. CT scan demonstrated a large tumor in the right thyroid lobe with areas of calcification. The surgical specimen consi [...] sted 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.

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

2013-02-01

90

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

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

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

1998-05-01

91

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

International Nuclear Information System (INIS)

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

92

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

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

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

2005-12-01

93

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

International Nuclear Information System (INIS)

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

94

Visualization of lung malignant neoplasms with 99mTc-MIBI  

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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.)

95

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

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

96

Intraductal papillary mucinous neoplasms of the pancreas (IPMNs): new insights on clinical outcomes and malignant progression.  

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Intraductal papillary mucinous neoplasms (IPMNs) are cystic tumors of the pancreas that can progress into invasive carcinomas. Main duct IPMN is usually treated with surgery while branch duct IPMN is surgically resected if it is high risk based on certain features of the tumor (mostly radiographic) that do have some limitations. Predicting the risk of malignant progression has been lately the main focus of research especially that comprehending the molecular pathogenesis of the disease has emerged as a valuable means to better understand the disease and thus guide disease management. We will present two abstracts from the ASCO Annual Meeting. The first compares the clinical outcomes of pancreatic ductal carcinoma and IPMN associated cancer, and the second looks at the pathogenesis of the disease at the cellular and molecular levels to predict high risk disease. PMID:25076329

Khouri, Jack; Saif, Muhammad Wasif

2014-07-01

97

Multiple primary malignant neoplasms of the glottis, renal pelvis, urinary bladder, oral floor, prostate, and esophagus in a Japanese male patient: a case report.  

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Owing to recent advances in diagnostic and surgical techniques for cancer, a patient diagnosed with two or more neoplasms is not rare. We report on the case of a 58-year-old male with multiple primary malignant neoplasms, who suffered from three histological types of malignant neoplasm in six organs, namely the glottis, renal pelvis, urinary bladder, oral floor, prostate, and esophagus in chronological order. The first neoplasm was a squamous cell carcinoma of the glottis diagnosed in 2006. The second and third neoplasms were urothelial carcinomas of the right renal pelvis and urinary bladder, respectively, diagnosed in 2008. The remaining three neoplasms were diagnosed in 2010, namely a squamous cell carcinoma of the oral floor, an adenocarcinoma of the prostate, and a squamous cell carcinoma of the esophagus. The glottic cancer and esophageal cancer were treated by external radiation therapy. The malignant neoplasms of the oral floor and those which originated in the urinary tract were surgically resected. All neoplasms except the malignant neoplasm of the oral floor were well controlled. The patient died of cervical lymph node metastasis from the squamous cell carcinoma of the oral floor in January 2011. As far as we know, the present report is the first one on this combination of primary malignant neoplasms. PMID:25245383

Mukaiyama, Yoshihiro; Suzuki, Motofumi; Morikawa, Teppei; Mori, Yoshiyuki; Takeshima, Yuta; Fujimura, Tetsuya; Fukuhara, Hiroshi; Nakagawa, Tohru; Nishimatsu, Hiroaki; Kume, Haruki; Homma, Yukio

2014-01-01

98

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

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

Mousa A. Al-Abbadi

2013-01-01

99

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 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

100

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

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Full Text Available

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

 
 
 
 
101

Evaluation of peroxisome proliferator-activated receptor-gamma expression in benign and malignant thyroid pathologies.  

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Impairment of peroxisome proliferator-activated receptor-gamma (PPAR-gamma) function through a dominant negative PAX-8/PPAR-gamma fusion gene or other events resulting in wild-type PPAR-gamma downregulation has been implicated in malignant thyroid cell transformation. The aim of our study was to perform a systematic evaluation of PPAR-gamma mRNA and protein expression in normal thyroid tissue as opposed to benign thyroid pathologies of different functional status and thyroid malignancy, to gain further insights into a putative physiological role of PPAR-gamma in the thyroid and to define whether PPAR-gamma could serve as a marker of thyroid cell differentiation. Ten cold benign (CTN) and 10 toxic (TTN) thyroid nodules and corresponding normal thyroid tissues, 10 follicular thyroid cancers (FTC), 10 papillary thyroid cancers (PTC) and 8 Graves' disease (GD) thyroids were studied by real-time polymerase chain reaction (PCR), immunohistochemistry and reverse transcriptase (RT)-PCR (PAX-8/PPAR-gamma fusion gene). PPAR-gamma mRNA expression was demonstrated in all samples. When comparing benign nodular and normal thyroid tissue of the same patient no significant difference in PPAR-gamma mRNA expression was observed. PPAR-gamma mRNA levels were similar in CTN and FTC. In contrast, PPAR-gamma mRNA expression was downregulated in 9 of 10 PTC and all GD samples, whereby at least 4 fold downregulation (compared with normal and benign nodular thyroid tissues) was observed in the latter. Immunohistochemistry showed an increased, patchy PPAR-gamma nuclear staining in CTNs and TTNs and only faint staining in the corresponding normal thyroid tissues. A diffuse and weak PPAR-gamma staining pattern was observed in all GD samples. No PAX-8/PPAR-gamma rearrangements were detected in any of the 68 thyroid tissue samples. In conclusion PPAR-gamma mRNA and protein expression levels are not concordant in benign thyroid nodular disease. Furthermore there is no clear-cut association of PPAR-gamma mRNA expression with follicular thyroid tumorigenesis. Absence of a PAX-8/PPAR-gamma fusion gene in the series of 68 thyroid samples is in agreement with the suggestion of PAX-8/PPAR-gamma rearrangement being restricted to a subset of follicular thyroid cancers. The marked downregulation of PPAR-gamma in GD warrants further investigation and could be linked, for example, with changes in apoptosis. PMID:16187907

Karger, S; Berger, K; Eszlinger, M; Tannapfel, A; Dralle, H; Paschke, R; Führer, D

2005-09-01

102

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

International Nuclear Information System (INIS)

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

103

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

Science.gov (United States)

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

104

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, E-mail: ptaddei@mdanderson.or [Division of Radiation Oncology, Unit 1202, University of Texas M D Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030 (United States)

2010-12-07

105

Second malignant neoplasms complicating Hodgkin's disease: the National Cancer Institute experience  

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The medical records of all patients treated for Hodgkin's disease during the years 1964-1981 were reviewed. Four hundred seventy-three previously untreated patients were analyzed. Thirty-four subsequent second malignant neoplasms were observed in 33 patients among those treated for Hodgkin's disease. Eight cases of acute nonlymphocyctic leukemia, one case of chronic myeloid leukemia, three cases of non-Hodgkin's lymphoma, three cases of sarcoma, and 19 other tumors were identified. The ten-year estimated risk of leukemia by treatment was the following: radiotherapy only (0), chemotherapy only (0.02), initial combined radiotherapy-chemotherapy (0.06), and salvage combined radiotherapy-chemotherapy (0.09). The ten-year estimated risk of solid tumors was 0.07 overall, with all treatment groups associated with similar risks. Unlike some other reports, a greater risk of leukemia in patients who began treatment for Hodgkin's disease at age 40 or older was not found. However, a positive association was noted between increasing risk of solid tumors and increasing patient age.

Tester, W.J.; Kinsella, T.J.; Waller, B.; Makuch, R.W.; Kelley, P.A.; Glatstein, E.; DeVita, V.T.

1984-07-01

106

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

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

2014-06-11

107

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.)

108

Isolated familial medullary thyroid carcinoma as part of multiple endocrine neoplasm (men-2a)  

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Medullary carcinoma of thyroid (MTC) is a distinct thyroid carcinoma that originates from the para follicular C cell of thyroid gland which produce calcitonin. MTC has a genetic association with multiple endocrine neoplasia (MEN) type 2A syndromes. Sporatic or isolated MTC occur in 75 % of patients. (author)

109

Dose-Dependent Effects of Focal Fractionated Irradiation on Secondary Malignant Neoplasms in Nf1 mutant mice  

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Secondary malignant neoplasms (SMNs) are increasingly common complications of cancer therapy that have proven difficult to model in mice. Clinical observations suggest that the development of SMN correlates with radiation dose; however, this relationship has not been investigated systematically. We developed a novel procedure for administering fractionated cranial irradiation (CI) and investigated the incidence and spectrum of cancer in control and heterozygous Nf1 mutant mice irradiated to a...

Nakamura, Jean L.; Phong, Connie; Pinarbasi, Emile; Kogan, Scott C.; Vandenberg, Scott; Horvai, Andrew E.; Faddegon, Bruce A.; Fiedler, Dorothea; Shokat, Kevan; Houseman, Benjamin T.; Chao, Richard; Pieper, Russell O.; Shannon, Kevin

2011-01-01

110

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

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

111

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

112

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

113

Thyroid suppression and medical ablation for differentiated thyroid cancer  

International Nuclear Information System (INIS)

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

114

Malignancy Risk Analysis in Patients with Inadequate Fine Needle Aspiration Cytology (FNAC) of the Thyroid  

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Background Thyroid fine needle aspiration cytology (FNAC) is the standard diagnostic modality for thyroid nodules. However, it has limitations among which is the incidence of non-diagnostic results (Thy1). Management of cases with repeatedly non-diagnostic FNAC ranges from simple observation to surgical intervention. We aim to evaluate the incidence of malignancy in non-diagnostic FNAC, and the success rate of repeated FNAC. We also aim to evaluate risk factors for malignancy in patients with non-diagnostic FNAC. Materials and Methods Retrospective analyses of consecutive cases with thyroid non diagnostic FNAC results were included. Results Out of total 1657 thyroid FNAC done during the study period, there were 264 (15.9%) non-diagnostic FNAC on the first attempt. On repeating those, the rate of a non-diagnostic result on second FNAC was 61.8% and on third FNAC was 47.2%. The overall malignancy rate in Thy1 FNAC was 4.5% (42% papillary, 42% follicular and 8% anaplastic), and the yield of malignancy decreased considerably with successive non-diagnostic FNAC. Ultrasound guidance by an experienced head neck radiologist produced the lowest non-diagnostic rate (38%) on repetition compared to US guidance by a generalist radiologist (65%) and by non US guidance (90%). Conclusions There is a low risk of malignancy in patients with a non-diagnostic FNAC result, commensurate to the risk of any nodule. The yield of malignancy decreased considerably with successive non-diagnostic FNAC. PMID:23185295

Al Maqbali, Talib; Tedla, Miroslav; Weickert, Martin O.; Mehanna, Hisham

2012-01-01

115

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 < 0.01). In a series of 256 soft tissue tumors of different histotypes NFC staining showed loss of 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

116

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)

117

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

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STAT3 protein phosphorylation is a frequent event in various hematologic malignancies and solid tumors. Acquired STAT3 mutations have been recently identified in 40% of patients with T-cell large granular lymphocytic leukemia, a rare T-cell disorder. In this study, we investigated the mutational status of STAT3 in a large series of patients with lymphoid and myeloid diseases. STAT3 mutations were identified in 1.6% (4 of 258) of patients with T-cell neoplasms, in 2.5% (2 of 79) of patients with diffuse large B-cell lymphoma but in no other B-cell lymphoma patients (0 of 104) or patients with myeloid malignancies (0 of 96). Functional in vitro assays indicated that the STAT3Y640F mutation leads to a constitutive phosphorylation of the protein. STA21, a STAT3 small molecule inhibitor, inhibited the proliferation of two distinct STAT3 mutated cell lines. Using a mouse bone marrow transplantation assay, we observed that STAT3Y640F expression leads to the development of myeloproliferative neoplasms with expansion of either myeloid cells or megakaryocytes. Together, these data indicate that the STAT3Y640F mutation leads to constitutive activation of STAT3, induces malignant hematopoiesis in vivo, and may represent a novel therapeutic target in some lymphoid malignancies. PMID:23872306

Couronné, Lucile; Scourzic, Laurianne; Pilati, Camilla; Della Valle, Véronique; Duffourd, Yannis; Solary, Eric; Vainchenker, William; Merlio, Jean-Philippe; Beylot-Barry, Marie; Damm, Frederik; Stern, Marc-Henri; Gaulard, Philippe; Lamant, Laurence; Delabesse, Eric; Merle-Beral, Hélène; Nguyen-Khac, Florence; Fontenay, Michaëla; Tilly, Hervé; Bastard, Christian; Zucman-Rossi, Jessica; Bernard, Olivier A; Mercher, Thomas

2013-11-01

118

Thyroid and associated polyglandular neoplasms in patients who received head and neck irradiation during childhood  

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One hundred fifty-one patients with a history of childhood irradiation to the head, neck, and thorax had neck explorations (142 for cold thyroid nodules and 9 for hypercalcemia). Fifty-nine of the patients had thyroid carcinoma, and associated glandular tumors were found in 20 others. In addition, 6 female patients developed breast carcinoma; 4 of these women also had thyroid carcinoma. In this series, 48.6% of the patients irradiated for acne and 36.4% with tonsil and adenoid irradiation developed thyroid carcinoma, but only 10.5% with thymic irradiation did so. It is suggested that the workup on these patients include not only complete thyroid and parathyroid testing, but also a careful examination of all salivary glands, both major and minor. Women should have thorough breast examinations and should perhaps be followed as if they were in the potentially high-risk breast group. When thyroid surgery is performed, a total thyroidectomy is recommended

119

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

International Nuclear Information System (INIS)

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

120

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 (0.59?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

 
 
 
 
121

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  

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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

122

Canine cutaneous neoplasms: prevalence and influence of age, sex and site on the presence and potential malignancy of cutaneous neoplasms in dogs from Zimbabwe  

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Full Text Available Histopathological examination was performed on cutaneous biopsies from 900 dogs with skin lesions from Zimbabwe, collected from 1996 to 2000. Clinical data were collected from medical records. Sixty per cent (540/900 of the cases were tumours and 40% (360/900 were non-neoplastic inflammatory or degenerative diseases. Thirty different histological types of tumour were diagnosed. The prevalence of epithelial, mesenchymal, lymphohistiocytic and melanocytic tumours was 39.4 %, 44.4 %, 7.4 % and 8.7 %, respectively. The 10 most common tumours, comprising 73.7% of all cutaneous neoplasms, were mast cell tumours, squamous cell carcinomas, perianal gland adenomas, lymphomas, benign melanomas, haemangiosarcomas, sebaceous gland adenomas, fibrosarcomas, lipomas and malignant melanomas. The prevalence of various neoplasms, age of affected dogs and sites of occurrence were similar to surveys in other countries, except that in Zimbabwe there was a greater prevalence of lymphomas and of tumours associated with increased exposure to ultraviolet light (squamous cell carcinomas, haemangiosarcomas and melanomas. For all classes of tumours the sex of the dog did not have any significant influence on the likelihood of developing a tumour. For a dog diagnosed with a tumour located on the trunk, the tumour was significantly more likely to be an epithelial tumour than a non-epithelial tumour. The occurrence of melanocytic tumours on the trunk was significantly lower than at other sites. Lymphohistiocytic tumours were 10 times more likely to occur at multiple locations as opposed to single locations.

S. Mukaratirwa

2012-06-01

123

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 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)

124

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

125

Evaluation of FAK and Src expression in human benign and malignant thyroid lesions.  

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Focal Adhesion Kinase (FAK) and Src have been reported to regulate tumor growth, invasion, metastasis and angiogenesis. The present study aimed to evaluate by immunohistochemistry the clinical significance of FAK and Src expression in 108 patients with benign and malignant thyroid lesions. Total FAK expression provided a distinct discrimination between malignant and benign (p = 0.00001), as well as between papillary carcinoma and hyperplastic nodules thyroid lesions (p = 0.00005), being also associated with follicular cells' proliferative capacity (p = 0.0003). In malignant thyroid lesions, total FAK expression was associated with tumor size (p = 0.0455), and presence of capsular (p = 0.0102) and lymphatic (p = 0.0173) invasion. Total Src expression was borderline increased in cases of papillary carcinoma compared to hyperplastic nodules (p = 0.0993), being also correlated with tumor size (p = 0.0169). FAK and Src expression was ascribed to a significant extent to the phosphorylated forms of the enzymes, which provided a better discrimination between malignant and benign thyroid lesions. The current data revealed that FAK and to a lesser extent Src expression could be considered of clinical utility in thyroid neoplasia with potential use as therapeutic targets. PMID:20405349

Michailidi, Christina; Giaginis, Costas; Stolakis, Vassilios; Alexandrou, Paraskevi; Klijanienko, Jerzy; Delladetsima, Ioanna; Chatzizacharias, Nicolaos; Tsourouflis, Gerasimos; Theocharis, Stamatios

2010-12-01

126

Tumores malignos en nuestro medio: Estudio de 10 años Malignant neoplasms in our environment: A ten-year study  

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Full Text Available Se estudian 616 pacientes con tumores malignos del aparato genital femenino, las que fueron intervenidas quirúrgicamente en el hospital ginecoobstétrico docente de Guanabacoa en el decenio 1984-1994. Como resultado de este trabajo se observó que el 2,9 % del total de biopsias correspondía a neoplasias malignas, y fue el carcinoma del cuello uterino el tumor más frecuente (423 casos para el 68,6 % del total de neoplasias. Los tumores de la mama y el endometrio ocuparon el 2do. y 3er. lugares en frecuencia, cuyas variedades histológicas se corresponden con lo reportado en la literatura. Se evidencia la importancia de redoblar la vigilancia e incrementar la labor y eficacia en la detección precoz del cáncer cervicouterino y de la glándula mamaria.616 patients with female genital malignant neoplasms, who had been operated on at the Teaching Gynecological and Obstetric Hospital in Guanabacoa from 1984-1994, were studied. As a result, it was observed that 2.9 % of biopsies corresponded to malignant neoplasms and the most frequent was the cervix-uteri carcinoma (423 cases accounting for 68,6 % of total number. Breast and endometriun neoplasms are the second and third causes. Whose histological varieties are similar to those reported in literature. The importance of strenghtening surveillance and increasing the effectiveness in the early detection of cervix uterine cancer and of breast cancer are evidenced.

Nancy Vasallo Pastor

1999-12-01

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Tumores malignos en nuestro medio: Estudio de 10 años / Malignant neoplasms in our environment: A ten-year study  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se estudian 616 pacientes con tumores malignos del aparato genital femenino, las que fueron intervenidas quirúrgicamente en el hospital ginecoobstétrico docente de Guanabacoa en el decenio 1984-1994. Como resultado de este trabajo se observó que el 2,9 % del total de biopsias correspondía a neoplasi [...] as malignas, y fue el carcinoma del cuello uterino el tumor más frecuente (423 casos para el 68,6 % del total de neoplasias). Los tumores de la mama y el endometrio ocuparon el 2do. y 3er. lugares en frecuencia, cuyas variedades histológicas se corresponden con lo reportado en la literatura. Se evidencia la importancia de redoblar la vigilancia e incrementar la labor y eficacia en la detección precoz del cáncer cervicouterino y de la glándula mamaria. Abstract in english 616 patients with female genital malignant neoplasms, who had been operated on at the Teaching Gynecological and Obstetric Hospital in Guanabacoa from 1984-1994, were studied. As a result, it was observed that 2.9 % of biopsies corresponded to malignant neoplasms and the most frequent was the cervix [...] -uteri carcinoma (423 cases accounting for 68,6 % of total number). Breast and endometriun neoplasms are the second and third causes. Whose histological varieties are similar to those reported in literature. The importance of strenghtening surveillance and increasing the effectiveness in the early detection of cervix uterine cancer and of breast cancer are evidenced.

Nancy, Vasallo Pastor; Adis L., Peña Cedeño; Alfredo, Rodríguez Pérez.

1999-12-01

128

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

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

Hai-ling Wang

2012-06-01

129

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

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

Barnwell John

2010-01-01

130

Study of Denosumab in the Treatment of Hypercalcemia of Malignancy in Subjects With Elevated Serum Calcium  

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Breast Cancer; Hypercalcemia of Malignancy; Colon Cancer; Endocrine Cancer; Head and Neck Cancer; Kidney Cancer; Lung Cancer; Lymphoma; Metastatic Cancer; Multiple Myeloma; Parathyroid Neoplasms; Renal Cancer; Thyroid Cancer; Hodgkin's Lymphoma; Non-Hodgkin's Lymphoma; Non-Small Cell Lung Cancer

2014-05-08

131

Local radiation dose and solid second malignant neoplasms after childhood cancer in Germany: a nested case-control study.  

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Radiotherapy (RT) has been associated with the development of solid second malignant neoplasms (SMNs) in childhood cancer survivors. The aim of this study was to analyse the effect of cumulative doses of previous RT received at the SMN body region, at all other body regions and at body regions adjacent to the SMN, on the risk of developing a solid SMN. A total of 190 cases diagnosed with a solid second malignant neoplasm in 1980-2002 were matched with 368 controls with single neoplasm from the database of the German Childhood Cancer Registry (GCCR) (33,809 patients at cut-off date). The GCCR registers approximately 97 % of all childhood malignancies which occur at an age of less than 15 years in Germany since 1980. It was found that 147 (77.4 %) cases had received RT compared to 208 (56.6 %) controls with cumulative focus doses from 8 to 110 Gy. Fifty per cent of the SMNs and 60 % of RT affected the head region. RT was shown to increase the risk of a solid second tumour within the body region of radiation by 5.3 % per Gy (odds ratio 1.053; 95 % confidence interval 1.036-1.071). With increasing age at diagnosis and with more recent treatment eras, this effect decreased. Cumulative RT doses received at all other body regions or only at body regions adjacent to the SMN did not show an additional effect on the risk of developing an SMN. It is thus concluded that RT is the main risk factor for the development of SMNs within the irradiated body region. Late effects surveillance of former patients should give special attention to the originally irradiated parts of the body. PMID:24859016

Hennewig, Ulrike; Kaatsch, Peter; Blettner, Maria; Spix, Claudia

2014-08-01

132

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  

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uracy 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.

133

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

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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)

134

Multiple primary malignant neoplasms in a fixed population of A-bomb survivors, 1  

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In a fixed population (7,564 A-bomb survivors) for Adult Health Study performed until December 1985, 28 A-bomb survivors (5 men and 23 women) were diagnosed as having thyroid cancer, and 79 (including one man) as breast cancer. There was an evident tendency among the group receiving 100 rad or more towards higher incidence of cancers of the thyroid and breast and synchronous or metachronous multiple primaries. The incidence of thyroid cancer tended to be higher in A-bomb survivors less than 20 years of age at the time of exposure; however, this tendency was not seen in the case of breast cancer. The incidence of thyroid cancer - in contrast to breast cancer - tended to decrease from year to year. Multiple primaries were associated with thyroid cancer in 5 A-bomb survivors and breast cancer in 9 A-bomb survivors. Three A-bomb survivors had both thyroid and breast cancers. Among the 11 A-bomb survivors with multiple primaries, nine had received 100 rad or more. (Namekawa, K.)

135

Impact of the serum thyroglobulin concentration on the diagnostics of benign and malignant thyroid diseases  

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Aim of this study is to evaluate new and controversially discussed indications for determining the thyroglobulin (Tg) level in different thyroid diseases to support routine diagnostics. Methods: The following groups were included: 250 healthy subjects without goiter, 50 persons with diffuse goiter, 161 patients with multinodular goiter devoid of functional disorder (108 of them underwent surgery, in 17 cases carcinomas were detected), 60 hyperthyroid patients with autonomously functioning nodular goiter, 150 patients with Hashimoto's thyroiditis and 30 hyperthyroid patients with Graves' disease. Results: The upper limit of the normal range of the Tg level was calculated as 30 ng Tg/ml. The evaluation of the collective with diffuse goiter showed that the figure of the Tg level can be expected in a similar magnitude as the thyroid volume in milliliters. Nodular tissue led to far higher Tg values then presumed when considering the respective thyroid volume, with a rather high variance. A formula for a rough prediction of the Tg levels in nodular goiters is described. In ten out of 17 cases with thyroid carcinoma, the Tg was lower than estimated with thyroid and nodular volumes, but two patients showed a Tg exceeding 1000 ng/ml. The collective with functional autonomy had a significantly higher average Tg level than a matched euthyroid group being under suppressive levothyroxine substitution. However, due to the high variance of the Tg values, the autonomy could not consistently be predicted with the Tg level in individual cases. The patients with Hashimoto's thyroiditis showed slightly decreased Tg levels. In Graves' disease, a significantly higher average Tg level was observed compared with a matched group with diffuse goiter, but 47% of all Tg values were still in the normal range (<30 ng/ml). Conclusion: Elevated Tg levels indicate a high probability of thyroid diseases, such as malignancy, autonomy or Graves' disease. However, as low Tg concentrations cannot exclude the respective disorder, a routine Tg determination seems not to be justified in benign thyroid diseases. (orig.)

136

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

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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

137

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

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The incidence of second malignant neoplasms (SMN) was assessed in 248 patient 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 (less than EF), extended field (EF) or total nodal irradiation (TNI). Chemotherapy was scored as single agent (SAC) or multiagent (MAC). MAC consisted primarily of either nitrogen mustard, vincristine, 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 to 10 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 itself.

Nelson, D.F.; Cooper, S.; Weston, M.G.; Rubin, P.

1981-12-01

138

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

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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 (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 itself.

Nelson, D.F. (Univ. of Pennsylvania, Philadelphia); Cooper, S.; Weston, M.G.; Rubin, P.

1981-12-01

139

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

140

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)

 
 
 
 
141

Metastatic vs primary malignant neoplasms affecting the umbilicus: clinicopathologic features of 77 tumors.  

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Periumbilical skin is unique due to its proximity to intra-abdominal and pelvic structures. In addition to primary skin malignancies, it is a site often involved with metastatic disease. We reviewed the clinical and pathologic features of 77 umbilical malignancies occurring at our institution since 1988. Seventy-seven patients were identified (female/male ratio, 4.1:1.0) with the average age for women being 63 years and 55 years for men. Eighty-eight percent of malignancies originated outside the umbilicus and 12% were primary skin tumors. Fifty-eight (85%) patients with metastatic tumors had umbilical involvement from a known primary vs 10 (15%) with unknown primaries. Nine patients with metastatic tumors to the umbilicus would present with solitary umbilical involvement. Of these patients, 56% would not have a primary site assigned to their metastatic disease. In women, the 3 most common primary sites were the ovary, endometrium, and pancreatobiliary tree, whereas for men, it was the genitourinary tract, pancreatobiliary tree, and the gastrointestinal tract. Of the primary umbilical malignancies, 44% of patients were male and 56% female. Malignant melanoma was the most common primary umbilical malignancy. In summary, women are more likely than men to have malignant tumors affecting the umbilicus. Overall, the most likely primary site of a metastatic tumor to the umbilicus is the genitourinary tract. Rarely, patients present with metastatic tumors to the umbilicus, and most of these patients will not have a primary site of tumor origin assigned. PMID:21419680

Papalas, John A; Selim, Maria A

2011-08-01

142

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

143

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

144

Integral Analysis of Blood Plasma Biochemical Parameters as an Optimizing Diagnostic Technique of Epithelial Tissue Malignant Neoplasms  

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Full Text Available The aim of the investigation was to assess the interaction of tumor marker level, the indices of protein and mineral metabolism, free radical oxidation in blood plasma and the tumor-forming stage in malignant processes in epithelial tissues. Materials and Methods. Blood plasma of 73 patients with epithelial tissue malignant neoplasms and 31 apparently healthy people were studied. Blood plasma biochemical parameters were assessed using the analyzers: free-radical activity — by induced biochemiluminescence; oxidative protein modification — by the level of carbonyl derivatives; elemental analysis — using atomic emission spectrometry. Results. Low diagnostic value of the determination of oncomarkers at early stage of the studied oncological diseases was shown. We observed the change of blood plasma biochemical parameters at early carcinogenesis stage: the albumin level reduction and the concentration increase of urea, alpha1- and gamma-globulin fractions. Cancer patients were found to have impaired element homeostasis: Na, Fe, Cu, Li level decrease, K, P, Sr increase. We revealed the activation of free-radical oxidation and oxidative protein modification, the correlation of the intensity of these processes with the content of some elements in blood plasma. Integral analysis of blood plasma biochemical parameters increases diagnostic value of the determination of tumor markers in the detection of malignant tumors of epithelial tissues.

?.I. Erlykina

2013-08-01

145

Non-traumatic myositis ossificans mimicking a malignant neoplasm in an 83-year-old woman: a case report  

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Full Text Available Abstract Introduction Myositis ossificans is a benign, self-limiting condition that usually affects young, athletically active men. To the best of our knowledge, this case report describes the oldest recorded patient with myositis ossificans. Case presentation Our patient was an 83-year-old Japanese woman who presented with a one week history of a palpable mass in the left thigh. She had a history of surgery for transverse colon cancer and lung cancer at the ages of 73 and 80, respectively. Clinical and radiological examinations suggested a malignant neoplasm such as metastatic carcinoma or extraskeletal osteosarcoma. A diagnosis of myositis ossificans was made by core needle biopsy. Our patient was asymptomatic and had no recurrence at one year follow-up. Conclusion Clinicians should consider myositis ossificans as a possible diagnosis for a soft tissue mass in the limb of an older patient, thereby avoiding unnecessarily aggressive therapy.

Nishio Jun

2010-08-01

146

Introducing the reporting system for thyroid fine-needle aspiration cytology according to the new guidelines of the Japan Thyroid Association.  

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The Japan Thyroid Association (JTA) recently published new guidelines for clinical management of thyroid nodules. This paper introduces their diagnostic system for reporting thyroid fine-needle aspiration cytology. There are two points where the new reporting system that differs from existing internationally-accepted ones. The first is the subclassification of the so-called indeterminate category, which is divided into 'follicular neoplasm' and 'others'. The second is the subclassification of follicular neoplasm into 'favor benign', 'borderline' and 'favor malignant'. It is characterized by self-explanatory terminologies as to histological type and probability of malignancy to establish further risk stratification as well as to facilitate communication between clinicians and cytopathologists. The different treatment strategies adopted for thyroid nodules is deeply influenced by the particular diagnostic system used for thyroid cytology. In Western countries all patients with follicular neoplasms are advised to have immediate diagnostic surgery while patients in Japan often undergo further risk stratification without immediate surgery. The JTA diagnostic system of reporting thyroid cytology is designed for further risk stratification of patients with indeterminate cytology. If a surgeon applies diagnostic lobectomy to all patients with follicular neoplasm unselectively, this subclassification of follicular neoplasm has no practical meaning and is unnecessary. Cytological risk stratification of follicular neoplasms is optional and cytopathologists can choose either a simple 6-tier system without stratification of follicular neoplasm or a complicated 8-tier system depending on their experience in thyroid cytology and clinical management. PMID:24727657

Kakudo, Kennichi; Kameyama, Kaori; Miyauchi, Akira; Nakamura, Hirotoshi

2014-06-29

147

Ultrasoundelastography: Can it provide valid information for differentiation of benign and malignant thyroid nodules?  

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Ultrasoundelastography (USE) is a new imaging technique that is performed with a normal ultrasound transducer. It provides improved characterization of a tissue or nodule based on the latter's elasticity and stiffness. The aim of the present, prospective study was to assess the validity of USE in characterizing thyroid nodules. USE patterns were analyzed in light of nodule cytology (British Thyroid Association classification) to determine whether these patterns can be used to decide whether or not fine-needle aspiration cytology (FNAC) is indicated. We examined a consecutive series of 617 thyroid nodules in patients referred for the first time to the Endocrinology Unit of Atri Hospital (Atri, [TE]). Patients underwent ultrasonographic and USE examinations of their thyroid nodules, which were then subjected to FNAC. All nodules with Thy 1 cytology were excluded, leaving 567 nodules for analysis. USE findings were classified on the basis of the degree and distribution of elasticity within the lesion: four patterns were identified (1, 2, 3a, 3b, or 4).None of the nodules with Thy 4 cytology (malignant) had USE pattern 1 or 2; patterns 3 and 4 were associated with higher cytologic grades. In conclusion, USE provides additional information on thyroid nodules, which can be used with ultrasound features of the nodules, to decide whether FNAC is indicated. In fact, patterns 1 and 2 do not seem to be associated with Thy 4 cytology. PMID:23396629

Raggiunti, B; Capone, F; Franchi, A; Fiore, G; Filipponi, S; Colagrande, V; Di Nicola, M; Mangifesta, R; Ballone, E

2011-09-01

148

Thyroid metastasis from breast cancer presenting with diffuse microcalcifications on sonography: a case report.  

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Microcalcifications are frequently associated with papillary thyroid cancers. Metastatic nodules from extrathyroid malignancies may mimic primary thyroid neoplasm on sonography, but do not present with microcalcifications. We report the case of a 45-year-old woman with a history of invasive ductal carcinomas of bilateral breasts, status post surgery and neoadjuvant chemotherapy. Four years after surgery, thyroid sonography revealed diffuse microcalcifications without nodular component. Core needle biopsy confirmed thyroid metastasis from primary breast cancer. PMID:24752943

Liu, Yi-Pei; Tiu, Chui-Mei; Chou, Yi-Hong; Hsu, Chih-Yi; King, Kuang-Liang; Lai, Yi-Chen; Wang, Hsin-Kai; Chiou, Hong-Jen; Chang, Cheng-Yen

2014-09-01

149

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

International Nuclear Information System (INIS)

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

150

Somatic mutations in 33 benign and malignant hot thyroid nodules in children and adolescents.  

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Hot thyroid nodules (HTNs) in children are rare. Their reported malignancy rate is higher than in adults. However molecular data are rare. We present clinical and molecular data for 33 consecutive (29 benign and 4 malignant) HTNs. 17/29 Benign HTNs (59%) harbored somatic TSHR mutations. The most commonly observed mutation was M453T (in 8/29 samples). T632I and D633Y mutations were each detected twice. All other TSHR mutations were each found in one sample, including the new A538T mutation. One NRAS mutation was detected in a benign HTN with a M453T mutation. A PAX8/PPARG rearrangement was found in one malignant HTN. A T632I mutation was detected in one hot papillary thyroid carcinoma. The percentage of TSHR mutation positive HTNs in children and adolescents is within the range observed in adults. Contrary to adults, the M453T mutation is the predominant TSHR mutation in HTNs of children and adolescents. The increased malignancy rate of HTNs of children does not appear to be associated with RAS, BRAF, PAX8/PPARG and RET/PTC mutations. PMID:24915144

Eszlinger, Markus; Niedziela, Marek; Typlt, Eva; Jaeschke, Holger; Huth, Sandra; Schaarschmidt, Jörg; Aigner, Thomas; Trejster, Ewa; Krohn, Knut; Bösenberg, Eileen; Paschke, Ralf

2014-08-01

151

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

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

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

2013-01-01

152

Thyroiditis  

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

153

[Malignant non-epithelial neoplasms of the uterine body--clinical analysis].  

Science.gov (United States)

Twenty six cases of primary uterine sarcomas treated between 1980-1990 are analyzed. There were 16 cases (62%) of endometrial stromal sarcoma, 8 cases (31%) of leiomyosarcoma and 2 cases (7%) of botryoid rhabdomyosarcoma. Symptoms of uterine sarcoma are presented. In 19 patients (73%) pathological diagnosis was obtained by endometrial curettage before surgery. Stage of disease was classified according to intraoperative scale of Lewis. Median survival for the whole group treated surgically, by radiotherapy and chemotherapy was 22.2 months. Five patients (19%) in whom the disease was limited to the endometrium survived more than 5 years. Recurrences of the neoplasm and their treatment by secondary cytoreductive surgery are described. PMID:9686471

Emerich, J; Konefka, T; Dudziak, M

1997-12-01

154

Clinical evaluation of 24 cases of primary thyroid malignant lymphoma  

International Nuclear Information System (INIS)

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 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)

155

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

International Nuclear Information System (INIS)

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

156

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

Energy Technology Data Exchange (ETDEWEB)

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

157

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.

158

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

International Nuclear Information System (INIS)

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

159

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2012-03-01

160

Predictive value of galactographic patterns for benign and malignant neoplasms of the breast in patients with nipple discharge.  

Science.gov (United States)

The purpose was to identify features of malignant and non-malignant neoplastic breast disease on galactography and to estimate their predictive value. This is the largest reported study correlating galactographic morphological patterns with histopathology and the only blinded study. The study included 351 consecutive galactograms and 161 breast biopsies performed in patients with nipple discharge over a 10-year period. Three radiologists, blinded to clinical data and histological results, re-evaluated 158 previously performed galactograms of patients who had undergone excision biopsy. Extravasation or incomplete filling precluded reading in 9.5% of examinations. Among the remaining 143 examinations there were 11 cancers (7.7%), 56 papillomas (39.2%), 19 cases of intraductal papillomatous proliferation (13.3%), 55 cases of fibrocystic or secretory disease (38.5%) and two normals. A "filling defect/cut-off" pattern (n = 90) was found in 6 cancers (6.7%) and 58 cases of papilloma or papillomatous proliferation (64.4%). A "leafless tree" pattern was found only in benign cases (n = 12; 8.4%). In 32 of 143 cases (22.4%) a "ductal ectasia" pattern was present, in one case of which (3.1%) cancer was found. Cancer was identified in two of four cases with an "architectural distortion" pattern. Cancer is rare in patients with nipple discharge. A tendency towards a lower incidence of cancer associated with the "ductal ectasia" and "leafless tree" patterns was found. No statistical evidence was found to indicate that galactography provides an effective prospective diagnosis of malignancy. However, an abnormal galactogram strongly correlated (p galactography is in the localization of breast neoplasms and in the choice of appropriate surgical therapy. PMID:11089460

Dinkel, H P; Trusen, A; Gassel, A M; Rominger, M; Lourens, S; Müller, T; Tschammler, A

2000-07-01

 
 
 
 
161

Proliferative potential of canine oral epulides and malignant neoplasms assessed by bromodeoxyuridine labeling.  

Science.gov (United States)

The proliferative potential of canine oral lesions, including epulides, squamous cell carcinomas, a malignant melanoma, and a fibrosarcoma, was examined using a monoclonal antibody to bromodeoxyuridine (BrdU). Twenty-three dogs with oral masses were administered BrdU intravenously at a dose of 8 mg/kg 1 hour before surgery, and the BrdU labeling index (LI) of each lesion was determined immunohistochemically. The average BrdU LIs for the main proliferating elements in the fibromatous epulis (4 cases), ossifying epulis (2 cases), and acanthomatous epulis (10 cases) were 4.9, 3.0, and 8.8%, respectively. The squamous cell carcinomas (5 cases) had an average LI of 15.9%, and the LIs of the malignant melanoma and fibrosarcoma were 7.5 and 10.3%, respectively. All cases of acanthomatous epulides and squamous cell carcinoma treated with simple marginal surgical resection recurred within a short time. The higher LIs in the acanthomatous epulides, squamous cell carcinomas, and fibrosarcoma correlate well with their poor prognoses, reflected by rapid growth and frequent recurrence. Acanthomatous epulis is clearly distinguished from other epulides by its aggressive clinical behavior and high proliferative potential, which is equivalent to that of malignant tumors, despite a lack of cell atypia. The BrdU LI is a useful marker for evaluating the proliferative potential and prognosis of canine oral tumors. PMID:9921754

Yoshida, K; Yanai, T; Iwasaki, T; Sakai, H; Ohta, J; Kati, S; Ishikawa, K; Lackner, A A; Masegi, T

1999-01-01

162

[The use of Cardioxane in chemotherapy of malignant neoplasms in children].  

Science.gov (United States)

Treatment with anthracycline antibiotics may have a toxic effect on the myocardium. The report deals with the results of application of a cardioprotector--cardioxan--in 38 children, aged 2-13 years, with malignant tumors treated, among other drugs, with doxorubicin. These data were compared with those on 33 pediatric patients who had received anthracycline antibiotics until 1994. No cardioxan-related complications were recorded whenever the instructions on the use were followed. The results are inconclusive because of the short duration of the study and examination being still incomplete. PMID:9381706

Safonova, S A; Punanov, Iu A; Dedukh, V M; Kolygin, B A

1997-01-01

163

Interobserver Agreement for Detection of Malignant Features of Intraductal Papillary Mucinous Neoplasms of the Pancreas on MDCT.  

Science.gov (United States)

OBJECTIVE. The purpose of this retrospective study was to measure interobserver agreement in the assessment of malignant imaging features of intraductal papillary mucinous neoplasms (IPMNs) on MDCT. MATERIALS AND METHODS. Pancreatic protocol CT studies were reviewed for 84 patients with resected IPMNs. Maximal diameter of the dominant cyst, presence of a mural nodule, presence of a solid component, and diameters of the main pancreatic duct (MPD) and common bile duct (CBD) were measured by four radiologists independently. In each patient, the IPMN was classified into one of three types: main duct, branch duct, or mixed IPMN. Interobserver agreement of lesion features was examined using the intraclass correlation coefficient (ICC) for continuous features and Fleiss kappa for categorical features. RESULTS. The final dataset included 55 branch duct IPMNs, nine main duct IPMNs, and 20 mixed IPMNs. Moderate agreement (? = 0.458; 95% CI, 0.345-0.564) was observed in assigning branch duct, main duct, or mixed IPMN subtypes. Measurement agreement was substantial to excellent for dominant cyst (ICC = 0.852; 95% CI, 0.777-0.907), MPD (0.753, 0.655-0.837), and CBD (0.608, 0.463-0.724) but only fair to moderate for the detection of the presence of mural nodule (? = 0.284, 0.125-0.432) or solid component (? = 0.405, 0211-0.577). CONCLUSION. Substantial to excellent interobserver agreement in the measurement of cyst diameter, MPD, and CBD support their use for characterizing malignant features of IPMN on MDCT. However, the subjective interpretation of the presence of solid components and mural nodules by individual radiologists was more variable. PMID:25341134

Do, Richard K G; Katz, Seth S; Gollub, Marc J; Li, Jian; LaFemina, Jennifer; Zabor, Emily C; Moskowitz, Chaya S; Klimstra, David S; Allen, Peter J

2014-11-01

164

Pattern of recurrence in children with midline posterior fossa malignant neoplasms  

Energy Technology Data Exchange (ETDEWEB)

Background. Surveillance imaging of the brain and spinal neuraxis in patients with posterior fossa malignant tumors is commonly performed, with the assumption that early detection of tumor recurrence will improve outcome. However, the benefit of this imaging has not been proven. To evaluate the usefulness of spinal surveillance imaging in children with nonmetastatic (at diagnosis, M0) posterior fossa ependymoma and medulloblastoma. Materials and methods. This retrospective study included 65 children (3 months to 16 years, mean 5.7 years) treated between 1985 and 1997 for ependymoma (22) and medulloblastoma (43). Medical records were reviewed for pathology and treatment data. Serial imaging of the head and spine was reviewed for evidence of tumor recurrence. Results. Twenty-four patients (37 %) had tumor recurrence, including 13 with ependymoma and 11 with medulloblastoma. Of the 17/24 recurrent patients initially diagnosed as M0 (6 medulloblastoma and 11 ependymoma), 13 (76 %) had a cranial recurrence only, and 4 (24 %) presented with concomitant cranial and spinal recurrence. No M0 patient presented solely with spinal metastases at recurrence. Conclusion. This study suggests that spinal surveillance imaging in patients with posterior fossa ependymoma or medulloblastoma initially staged as M0 may not be useful, as these patients initially recur intracranially. Thus, until an intracranial recurrence is detected, these patients may be spared the time, expense and sedation risk necessary for spinal imaging. (orig.)

Wootton-Gorges, S.L.; Foreman, N.K.; Albano, E.A.; Dertina, D.M.; Nein, P.K.; Shukert, B.; Cesario, K.B.; Gage, S.; Rumack, C.M.; Strain, J.D. [Children' s Hospital, Department of Radiology, Denver, CO (United States)

2000-02-01

165

Second primitive malignant neoplasm after radiotherapy; Deuxieme cancer primitif survenant apres radiotherapie  

Energy Technology Data Exchange (ETDEWEB)

Since the prolongation of survival for patients treated by radiotherapy second primary cancers are not rare. Cumulative incidence of second primary malignancy after radiotherapy (SPMAR) 40 years after treatment can reach 20 % when patients were 40 years old at treatment time. Among SPMAR some of them can be promoted by irradiation. Relative risk (RR) analysis is the most common method used to estimate the proportion of such second cancers. Most of studies reported a RR around 1.1 in adult patients. In young patients RR is about 6, meaning that SPMAR attributable to irradiation is more elevated in this subgroup. Quantification of these events, bio-molecular mechanisms, risk factors are complex and not yet fully understood. Information given to patients must be adapted and the cost/benefit ratio has to be justified regarding SPMAR risk. Irradiation technique optimisation is an important point especially in young patient and adults, in order to reduce at maximum the volume of organ at risk exposed while not compromising optimal dose given to the tumour volume, although no standard rules of irradiation are definitively established at the present time. (authors)

Doyen, J.; Courdi, A.; Gerard, J.P. [Service d' oncologie-radiotherapie, Cyclotron biomedical, centre Antoine-Lacassagne, 06 - Nice (France)

2010-07-15

166

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

Scientific Electronic Library Online (English)

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

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

167

Synchronous Hurthle Cell Carcinoma and Papillary Carcinoma in a Patient with Hashimoto’s Thyroiditis: A Rare Case Report  

Directory of Open Access Journals (Sweden)

Full Text Available Hashimoto’s thyroiditis, the most common autoimmune thyroid disease, is due to destruction of the thyroid gland by autoantibodies. Various types of thyroid malignancies may arise in Hashimoto’s thyroiditis. Follicular carcinomas, papillary carcinomas, lymphomas, medullary carcinomas and hurthle cell neoplasms may develop in Hashimoto’s thyroiditis. We present a rare case report of a 35-year-old female who presented with hypothyroidism of a two-year duration. A diagnosis of Hashimoto’s thyroiditis was made for which she was under treatment. Due to the recent increase in size of the thyroid, a fine needle aspiration cytology was done. A preoperative diagnosis of Hurthle cell neoplasm was made based on fine needle aspiration cytology findings. The total thyroidectomy specimen revealed Hashimoto’s thyroiditis with synchronous papillary carcinoma and Hurthle cell carcinoma, which is a very rare occurrence.

Narayanan O. Navya

2014-10-01

168

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

169

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

Science.gov (United States)

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. PMID:25047205

Eszlinger, Markus; Hegedüs, László; Paschke, Ralf

2014-08-01

170

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

171

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

International Nuclear Information System (INIS)

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

172

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2011-10-15

173

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)

174

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

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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

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

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

Saleh Husain

2009-01-01

176

{sup 131}I - MIBG Therapy in Malignant Pheochromocytoma and Medullary Thyroid Carcinoma  

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{sup 131}I-metaiodobenzylguanidine(MIBG) has been used for the diagnosis and treatment of neural crest tumors. We report our experience with this agent in 8 patients[l multiple endocrine neoplasia(MEN) type IIb; 2 malignant pheochromocytoma; 5 medullary thyroid carcinoma(MTC)]. The therapeutic procedure consisted of 30-200 mCi of {sup 131}I-MIBG administered by slow I.V. infusion, given at 3-6 months intervals. Cumulative activity ranged from 150 mCi to 410 mCi, in 1 to 4 courses. {sup 131}I-MIBG therapy resulted in significant disease free interval in 1 malignant pheochromocytoma(no measurable lesion)after surgery; complete hormonal and tumoral response in 2 MTC(1 MEN IIb); stable disease in 1 recurred pheochromocytoma(MEN IIb); stable disease but symptomatic improvement in 1 MTC; progressive disease in 1 malignant pheochromocytoma and 2 MTC. The patients who showed progression appeared to have large inoperable tumors or postoperative remnant tumors.

Yoon, Jong Kil; Ryoo, Baek Yeol; Lee, Chang Hee; Jeong, Sang Hoon; Cheon, Young Kug; Choi, Chang Woon; Lim, Sang Moo; Hong, Sung Woon [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

1995-06-15

177

131I - MIBG Therapy in Malignant Pheochromocytoma and Medullary Thyroid Carcinoma  

International Nuclear Information System (INIS)

131I-metaiodobenzylguanidine(MIBG) has been used for the diagnosis and treatment of neural crest tumors. We report our experience with this agent in 8 patients[l multiple endocrine neoplasia(MEN) type IIb; 2 malignant pheochromocytoma; 5 medullary thyroid carcinoma(MTC)]. The therapeutic procedure consisted of 30-200 mCi of 131I-MIBG administered by slow I.V. infusion, given at 3-6 months intervals. Cumulative activity ranged from 150 mCi to 410 mCi, in 1 to 4 courses. 131I-MIBG therapy resulted in significant disease free interval in 1 malignant pheochromocytoma(no measurable lesion)after surgery; complete hormonal and tumoral response in 2 MTC(1 MEN IIb); stable disease in 1 recurred pheochromocytoma(MEN IIb); stable disease but symptomatic improvement in 1 MTC; progressive disease in 1 malignant pheochromocytoma and 2 MTC. The patients who showed progression appeared to have large inoperable tumors or postoperative remnant tumors.

178

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

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

Kabayegit Ozlem

2008-07-01

179

Power Doppler US patterns of vascularity and spectral Doppler US parameters in predicting malignancy in thyroid nodules  

International Nuclear Information System (INIS)

Aim: The purpose of this study was to determine whether spectral Doppler ultrasound (US) parameters, including resistive index (RI) and maximal systolic velocity (MSV), or vascular pattern can be used to distinguish malignant from benign thyroid nodules. Materials and methods: We prospectively examined 169 thyroid nodules in 134 patients undergoing sonographically guided fine-needle aspiration biopsy (FNAB). Vascularity as determined by power Doppler US imaging was defined as absent, perinodular alone, or intranodular. For each nodule, the RI and MSV values were recorded as the average of the recordings obtained. Results of the FNAB and surgical pathological examination, if available, were used as a proof of final diagnosis to categorize all nodules as benign or malignant. Results: Seven nodules were excluded from study because of non-diagnostic FNAB results due to hypocellular or insufficient cytological material. Of the remaining nodules, nine were malignant (all confirmed at surgery) and 153 were benign. Of the 145 nodules with intranodular vascularity, nine (6.2%) were malignant and the remaining 136 (93.8%) were benign. The malignant nodules had a mean RI of 0.60 on intranodular and 0.58 on perinodular arteries. These values were not significantly higher than those associated with benign nodules (RI = 0.57 and RI = 0.56, respectively). Malignant nodules had a mean MSV of 20.4 cm/s on intranodular and 35.3 cm/s on perinodular arteries that were also not significantly different from those associated with benign nodules (p > 0.05). Conclusion: The results of this study indicate that Doppler US characteristics including vascular pattern, RI and MSV are not useful parameters for distinguishing malignant from benign thyroid nodules. Therefore, Doppler US characteristics including vascular pattern, RI and MSV values of thyroid nodules can not be used as a diagnostic method to determine which nodules should undergo FNAB

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

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

International Nuclear Information System (INIS)

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

182

Doxorubicin-induced myocardial failure in rats with malignant neoplasm: Protective role of fullerenol C60(OH24  

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Full Text Available The therapeutic utility of the anthracycline antibiotic doxorubicin is limited due to its cardiotoxicity. Our aim was to investigate the efficacy of fullerenol C60(OH24 in preventing single, high-dose doxorubicin-induced cardiotoxicity in rats with malignant neoplasm. In vitro and in vivo studies have shown that fullerenol C60(OH24, has strong antioxidative potential. Experiment was performed on adult female Sprague Dawley rats with chemically induced mammary carcinomas. All 32 rats (2-5 groups received i.p. applications of 1-methyl-l-nitrosourea (MNU; 50 mg/kg body weight on the 50th and 113th day of age. Animals were randomly divided into five groups as follows: (1 Untreated control group - rats received saline only; (2 Cancer control group - rats received MNU and saline; (3 Dox group - rats received MNU and Dox 8 mg/kg; (4 Full/Dox group -rats received MNU and Full 100 mg/kg 30 min before Dox 8 mg/kg; (5 Full group - rats received MNU and Full 100 mg/kg. Tumor incidence was 4.94 +- 0.576 per rat. The animals were sacrificed 2 days after the application of doxorubicin and/or fullerenol, and the serum activities of CK, LDH and ?-HBDH, as well as the levels of MDA, GSH, GSSG, GSH-Px, SOD, CAT, GR and TAS in the heart, were determined. The results obtained from the enzymatic activity in the serum show that the administration of a single dose of 8 mg/kg in all treated groups induces statistically significant damage. There are significant changes in the enzymes of LDH and CK (p < 0.05, after an i.p. administration of doxorubicin/fullerenol and fullerenol. Comparing all groups with untreated control group, point to the conclusion that in the case of a lower oc-HBDH/LDH ratio, results in more serious the liver parenchymal damage. The results revealed that doxorubicin induced oxidative damage and that the fullerenol antioxidative influence caused significant changes in MDA, GSH, GSSG, GSH-Px, SOD, CAT, GR and TAS level in the heart (p < 0.05. Ultra structural analysis of heart tissues from rats treated with doxorubicin and indicated that the hearts of the rats were protected from doxorubicin-induced subcellular damage. Doxorubicin/fullerenol rats did not appear to show significant cardiac damage although occasional focal loss of cristae in the mitochondria was observed. Therefore, it is suggested that fullerenol might be a potential cardioprotector in doxorubicin-treated individuals.

Injac Rade

2008-01-01

183

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  

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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

184

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

185

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

International Nuclear Information System (INIS)

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

186

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

187

Delayed results of combined treatment of malignant neoplasms of nasal cavity and accessory basal sinuses with the use of remote neutron therapy  

International Nuclear Information System (INIS)

Analysis of results of combined treatment of 24 patients with locally spread forms of malignant neoplasms in nasal cavity and accessory nasal sinuses, subjected to preoperational remote neutron therapy, was carried out. Mean neutron energy was 6.5 MeV, total focus dose - 38-40 Gy. It is shown that combined method of treatment features high efficiency, ensuring 5-year survival rate of 67.8% of the patients. However, the treatment is accompanied by grave complications, formation of face tissue-defects and radiation-induced cataract. The necessity of improving the methods of eye protection in the course of radiotherapy is emphasized. 1 ref

188

Malignant epithelioid peripheral nerve sheath tumor with prominent reticular/microcystic pattern in a child: a low-grade neoplasm with 18-years follow-up.  

Science.gov (United States)

Malignant peripheral nerve sheath tumors (MPNSTs) constitute neuron-specific enolase, with negativity for perineurial cell markers (claudin-1, epithelial membrane antigen, and glucose transporter-1) and other lineage-specific mesenchymal and epithelial antigens. This unusual variant of low-grade MPNST must be differentiated from a variety of other entities, in particular benign perineurioma, myxoid neurofibroma, and benign reticular/microcystic schwannoma. Confinement of the recurrent disease to the abdominal cavity emphasizes the necessity of primary curative wide excision of this highly recurring but nonmetastasizing low-grade neoplasm. PMID:21768875

Agaimy, Abbas; Stachel, Klaus-Daniel; Jüngert, Jörg; Radkow, Tanja; Carbon, Roman; Metzler, Markus; Holter, Wolfgang

2014-09-01

189

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

Science.gov (United States)

Increasing interest in the treatment of locally advanced and already metastasized thyroid cancer is reflected in the high number of submitted and accepted conference papers at the annual meeting of the American Society of Clinical Oncology (ASCO Congress) 2011. Many patients suffering from differentiated, undifferentiated and medullary thyroid cancer do not respond to established therapeutic procedures, so that new strategies have to be developed. Targeted biological agents are a new and promising therapeutic method that selectively affects complex signaling cascades, especially angiogenesis, of the malignant cells. Clinicians and researchers should understand the potential of these therapeutic strategies and be aware of the typical side effects. PMID:22570003

Uecker, F C; Laban, S; Knecht, R

2012-05-01

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

Radiation-induced thyroid disease  

International Nuclear Information System (INIS)

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

192

Breast tumor resembling the tall cell variant of papillary thyroid carcinoma: report of 4 cases with evidence of malignant potential.  

Science.gov (United States)

A new type of breast carcinoma resembling the tall cell variant of papillary thyroid carcinoma has recently been described. To date, rare cases are on record. Here, 4 new cases of the tall cell variant of papillary thyroid carcinoma of the breast are described in women aged from 45 to 80 years old. All patients presented with palpable breast nodules and were treated with quadrantectomy. One patient presented with a long clinical history and a metastatic intramammary lymph node. The patient is alive and well 3 months after surgery. The remaining 3 patients are disease free at mean 7.5 months (range, 5 to 10 months) after surgery. These data suggest that papillary thyroid-like carcinomas of the breast show malignant potential. PMID:17172492

Tosi, Anna L; Ragazzi, Moira; Asioli, Sofia; Del Vecchio, Marina; Cavalieri, Monica; Eusebi, Leonardo H U; Foschini, Maria P

2007-01-01

193

HER2 expression in thyroid tumors.  

Science.gov (United States)

Similarities exist in hormone receptors of breast, prostate, and thyroid tumors. HER2 oncogene expression is known to be present in breast and prostate tumors, but conflicting data have been published about its presence in thyroid tumors. This uncertainty prompted us to examine the incidence of HER2 overexpression in normal and malignant thyroid tissue. Normal and neoplastic thyroid tissue samples from 46 female and 9 male patients were assayed for HER2 expression by immunohistochemical assay. Of the 55 total samples, 36 were from neoplasms and 19 were from benign tissues. Significant HER2 overexpression was not found in any benign or malignant thyroid tissue. Two of 6 thyroid carcinomas from male patients showed 1+ reactivity for HER2 expression on immunohistochemistry assay, but remained negative on fluorescene in sito hybridization confirmatory testing. No significant expression of HER2 was noted in benign or malignant thyroid tissue. These results cast doubt on the value of HER2 as a prognostic factor or possible target for specific antitumor therapy for thyroid cancer. PMID:14700299

Mondi, Matthew M; Rich, Ryan; Ituarte, Phillip; Wong, Mariwil; Bergman, Simon; Clark, Orlo H; Perrier, Nancy D

2003-12-01

194

Evidence for Transcriptional and Posttranscriptional Alterations of the Sodium/Iodide Symporter Expression in Hypofunctioning Benign and Malignant Thyroid Tumors  

Science.gov (United States)

The uptake of iodide by epithelial thyroid cells requires the expression of a specific transporter, the Na+/I? symporter, NIS. Benign and malignant thyroid tumors of epithelial origin show a decrease up to a loss of iodide uptake activity. Previous studies of the human NIS (hNIS) gene expression in these tumors, based on the amplification of transcripts and/or immunohistochemical detection of the protein, have yielded divergent data; hNIS expression was found either increased or decreased. To get a new and integrated view of the alterations of hNIS expression in hypofunctioning thyroid tumors, we performed investigations of hNIS transcript and hNIS protein levels on the same tumors and paired normal tissue samples. HNIS, identified as a 75- to 80-kd species, was present in all normal tissue samples from euthyroid patients, but was undetectable, even at high membrane protein input, in all benign and malignant hypofunctioning thyroid tumors. By contrast, ?50% of tumors contained hNIS transcripts. This dissociation between transcript and protein levels was not found for the transcript and protein encoded by the PDS gene assayed in the same tumors. The hNIS transcript-positive tumors contained small amounts of low-molecular mass hNIS-immunoreactive species identified as nonglycosylated hNIS. Tumors containing the nonmature form of hNIS exhibited a predominant intracellular immunolabeling. In conclusion, our data show that benign and malignant hypofunctioning thyroid tumors either no longer express hNIS protein or express only a very low amount of nonglycosylated hNIS and indicate that the impairment of hNIS gene expression might result from alterations at both transcriptional and posttranscriptional levels. PMID:15215159

Trouttet-Masson, Severine; Selmi-Ruby, Samia; Bernier-Valentin, Francoise; Porra, Valerie; Berger-Dutrieux, Nicole; Decaussin, Myriam; Peix, Jean-Louis; Perrin, Agnes; Bournaud, Claire; Orgiazzi, Jacques; Borson-Chazot, Francoise; Franc, Brigitte; Rousset, Bernard

2004-01-01

195

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)

196

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

197

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

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

Gopinath, Balasubramanian; Shanthi, Natesan

2013-06-01

198

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

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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

199

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)

200

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. 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

 
 
 
 
201

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

202

Prospective evaluation of multiparametric ultrasound and quantitative elastosonography in the differential diagnosis of benign and malignant thyroid nodules: Preliminary experience  

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Purpose: To assess the clinical value of quantitative elastosonography compared with multiparametric ultrasound in differentiating the nature of thyroid nodules. Methods and materials: Ninety-seven consecutive patients (32 males, 65 females, mean age, 54 years, range 20–81 years) with thyroid nodules previously detected at color-Doppler ultrasound (CDUS), were prospectively examined with elastosonography with dedicated quantitative software (Elasto-Q, Toshiba) before surgery. Ultrasound examination and elastosonography were evaluated by two investigators in consensus. US features, color-Doppler pattern, and strain ratio value were evaluated. Sensitivity and specificity of CDUS and sono-elastography were compared using X{sup 2} test and ROC curves. Results: Sensitivity and specificity of hypoechogenicity, irregular margins or suspicious halo features, CDUS blood flow pattern, and strain ratio in the diagnosis of malignant nodules were 56.8%, 62.2%, 54.1% and 97.3% and 71.7%, 93.3%, 28.3%, and 91.7%, respectively. Elastosonography was more sensitive and specific than all ultrasonographic features in predicting malignancy of the thyroid nodules (p < 0.0001). According to elastosonographic features the lesions characterized by strain ratio ?2 were highly likely to be of malignant nature (p < 0.0001, O.R. 396, 95%, CI: 44–3530). Conclusions: The results of the present study suggest that elastosonography with Q system is a valuable tool in the characterization of thyroid nodules and it seems to be far more accurate than CDUS. These findings as well as those of previous studies support its use in selecting patients who are candidates for surgery.

Cantisani, Vito, E-mail: vito.cantisani@uniroma1.it [Department of Radiology, Oncology, and Anatomy Pathology, University “La Sapienza”, Policlinico Umberto I, Rome, Itlay (Italy); D’Andrea, Vito [Department of Surgical Sciences, University “La Sapienza”, Rome (Italy); Biancari, Fausto [Department of Surgery, Oulu University Hospital, Oulu (Finland); Medvedyeva, Olena; Di Segni, Mattia; Olive, Matteo [Department of Radiology, Oncology, and Anatomy Pathology, University “La Sapienza”, Policlinico Umberto I, Rome, Itlay (Italy); Patrizi, Gregorio; Redler, Adriano; De Antoni E, Enrico [Department of Surgical Sciences, University “La Sapienza”, Rome (Italy); Masciangelo, Raffaele [Department of Hygiene and Infectious Disease, University “La Sapienza”, Rome (Italy); Frezzotti, Francesca [Department of Surgical Sciences, University “La Sapienza”, Rome (Italy); Ricci, Paolo [Department of Radiology, Oncology, and Anatomy Pathology, University “La Sapienza”, Policlinico Umberto I, Rome, Itlay (Italy)

2012-10-15

203

Prospective evaluation of multiparametric ultrasound and quantitative elastosonography in the differential diagnosis of benign and malignant thyroid nodules: Preliminary experience  

International Nuclear Information System (INIS)

Purpose: To assess the clinical value of quantitative elastosonography compared with multiparametric ultrasound in differentiating the nature of thyroid nodules. Methods and materials: Ninety-seven consecutive patients (32 males, 65 females, mean age, 54 years, range 20–81 years) with thyroid nodules previously detected at color-Doppler ultrasound (CDUS), were prospectively examined with elastosonography with dedicated quantitative software (Elasto-Q, Toshiba) before surgery. Ultrasound examination and elastosonography were evaluated by two investigators in consensus. US features, color-Doppler pattern, and strain ratio value were evaluated. Sensitivity and specificity of CDUS and sono-elastography were compared using X2 test and ROC curves. Results: Sensitivity and specificity of hypoechogenicity, irregular margins or suspicious halo features, CDUS blood flow pattern, and strain ratio in the diagnosis of malignant nodules were 56.8%, 62.2%, 54.1% and 97.3% and 71.7%, 93.3%, 28.3%, and 91.7%, respectively. Elastosonography was more sensitive and specific than all ultrasonographic features in predicting malignancy of the thyroid nodules (p < 0.0001). According to elastosonographic features the lesions characterized by strain ratio ?2 were highly likely to be of malignant nature (p < 0.0001, O.R. 396, 95%, CI: 44–3530). Conclusions: The results of the present study suggest that elastosonography with Q system is a valuable tool in the characterization of thyroid nodules and it seems to be far more accurate than CDUS. These findings as well as those of previous studies support its use in selecting patients who are candidates for surgery

204

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

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Histone deacetylases (HDACs) have been associated with human malignant tumor development and progression, and HDAC inhibitors are currently being explored as anticancer agents in clinical trials. The present study aimed to evaluate the clinical significance of HDAC-1, HDAC-2, HDAC-4, and HDAC-6 proteins' expression in human malignant and benign thyroid lesions. HDAC-1, HDAC-2, HDAC-4, and HDAC-6 proteins' expression was assessed immunohistochemically on paraffin-embedded thyroid tissues obtained from 74 patients with benign and malignant thyroid lesions. Enhanced HDAC-2 and HDAC-6 expression was significantly more frequently observed in malignant, compared to benign, thyroid lesions (p?=?0.0042 and p?=?0.0069, respectively). Enhanced HDAC-2, HDAC-4, and HDAC-6 expression was significantly more frequently observed in cases with papillary carcinoma compared to hyperplastic nodules (p?=?0.0065, p?=?0.0394, and p?=?0.0061, respectively). In malignant thyroid lesions, HDAC-1, HDAC-4, and HDAC-6 expression was significantly associated with tumor size (p?=?0.0169, p?=?0.0056, and p?=?0.0234, respectively); HDAC-2 expression with lymphatic and vascular invasion (p?=?0.0299 and p?=?0.0391, respectively); and HDAC-4 expression with capsular invasion (p?=?0.0464). The cellular pattern of HDAC-1 and HDAC-2 distribution (nuclear vs. nuclear and cytoplasmic) presented a distinct discrimination between malignant and benign thyroid lesions (p?=?0.0030 and p?=?0.0028, respectively) as well as between papillary carcinoma and hyperplastic nodules (p?=?0.0036 and p?=?0.0028, respectively). HDAC-1, HDAC-2, HDAC-4, and HDAC-6 may be associated with the malignant thyroid transformation and could be considered as useful biomarkers and possible therapeutic targets in this neoplasia. PMID:23873102

Giaginis, Constantinos; Alexandrou, Paraskevi; Delladetsima, Ioanna; Giannopoulou, Ioanna; Patsouris, Efstratios; Theocharis, Stamatios

2014-01-01

205

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)

206

Malignant solitary fibrous tumor of the thyroid: a case-report and review of the literature / Tumor fibroso solitário maligno da tiroide: relato de caso e revisão da literatura  

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Full Text Available SciELO Brazil | Language: English Abstract in portuguese O tumor fibroso solitário (SFT) é uma neoplasia rara de células fusiformes que mais frequentemente envolve a pleura, raramente ocorrendo em áreas extratorácicas. Já foram descritos 26 casos de SFT da tiroide. Relatamos o caso de uma paciente de 60 anos de idade com um histórico de 8 meses de aumento [...] do pescoço associado à disfagia. A paciente foi submetida a uma hemitiroidectomia direita e foi diagnosticado um SFT de tiroide. A imuno-histoquímica mostrou resultados positivos para o marcador CD34, e o grande número de mitoses e a presença de atipia celular sugerem que o tumor era maligno. Em nosso conhecimento, este é o segundo caso de STF da tiroide maligno já relatado. Dada a rara ocorrência desses tumores, a indicação de tratamento adjuvante e o prognóstico são incertos. Recomenda-se o acompanhamento de longo prazo depois da ressecção cirúrgica. Abstract in english Solitary fibrous tumor (SFT) is an uncommon spindle-cell neoplasm that most often involves the pleura, rarely occurring in extra-thoracic locations. Twenty-six cases of SFT arising in the thyroid gland have been described. We report a case of a 60-year-old woman presenting an 8-month history of enla [...] rgement of the neck associated with dysphagia. The patient underwent a right hemithyroidectomy and SFT of the thyroid was diagnosed. Immunohistochemistry showed positivity for CD34 marker, and the high number of mitoses and the presence of cellular atypia suggested that the tumor was malignant. To our knowledge, this is the second case of malignant SFT of the thyroid gland ever reported. Due to the rarity of these tumors, the indication of adjuvant therapy and prognosis are uncertain. Long-term follow-up after surgical resection seems to be advisable.

Wellington, Alves Filho; Renata Regina da Graça Lorencetti, Mahmoud; Daniel Marin, Ramos; Vergilius José Furtado de, Araujo-Filho; Patricia Picciarelli de, Lima; Claudio Roberto, Cernea; Lenine Garcia, Brandão.

2014-06-01

207

The Usefulness of Standardized Uptake Value in Differentiation between Benign and Malignant Thyroid Lesions Detected Incidentally in 18F-FDG PET/CT Examination  

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Introduction In the last decade, (18)F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET and PET/CT) has become one of the major diagnostic tools used in oncology. A significant number of patients who undergo this procedure, due to non-thyroidal reasons, present incidental uptake of (18F-FDG) in the thyroid. The aim of the study was to compare the SUVmax (standardized uptake value) of thyroid focal lesions, which were incidentally found on PET/CT, in relation to the results of thyroid fine-needle aspiration biopsy (FNAB) and/or histopathological evaluation. Materials and Methods Patients referred for PET/CT examination, due to non-thyroidal illness, presented focal 18F-FDG uptake in the thyroid and were advised to undergo ultrasonography (US), hormonal evaluation, FNAB and/or total thyroidectomy at our institution. Results 6614 PET/CT examinations performed in 5520 patients were analyzed. Of the 122 patients with focal thyroid 18F-FDG activity, 82 patients (67.2%) underwent further thyroid evaluation using FNAB. Benign lesions were diagnosed in 46 patients, malignant - in 19 patients (confirmed by post-surgical histopathology), while 17 patients had inconclusive results of cytological assessment. Mean SUVmax of benign lesions was 3.2±2.8 (median?=?2.4), while the mean SUVmax value for malignant lesions was 7.1±8.2 (median?=?3.5). The risk of malignancy was 16.7% for lesions with a SUVmax under 3, 43.8% for lesions with a SUVmax between 3 and 6, and 54.6% for lesions with a SUVmax over 6. In the group of malignant lesions, a positive correlation between the lesion’s diameter and SUVmax was observed (p?=?0.03, r?=?0.57). Conclusions Subjects with incidental focal uptake of 18F-FDG in thyroid are at a high risk of thyroid malignancy. A high value of SUVmax further increases the risk of malignancy, indicating the necessity for further cytological or histological evaluation. However, as SUVmax correlated with the diameter of malignant lesions, small lesions with focal uptake of 18F-FDG should be interpreted cautiously. PMID:25296297

Czarnywojtek, Agata; Lodyga, Martha; Wyszomirska, Anna; Janicka-Jedynska, Malgorzata; Baczyk, Maciej; Ruchala, Marek

2014-01-01

208

Changes in expression of human serine protease HtrA1, HtrA2 and HtrA3 genes in benign and malignant thyroid tumors.  

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Human HtrA proteins are serine proteases involved in essential physiological processes. HtrA1 and HtrA3 function as tumor suppressors and inhibitors of the TGF-? signaling pathway. HtrA2 regulates mitochondrial homeostasis and plays a pivotal role in the induction of apoptosis. The aim of the study was to determine whether the HtrA proteins are involved in thyroid carcinogenesis. We used the immunoblotting technique to estimate protein levels of HtrA1, HtrA2, long and short variants of HtrA3 (HtrA3-L and HtrA3-S) and TGF-?1 in tissues of benign and malignant thyroid lesions, and control groups. We found that the levels of HtrA2 and HtrA3-S were higher in thyroid malignant tumors compared to normal tissues and benign tumors. The HtrA3-L level was increased in malignant tumor tissues compared to benign tumor tissues and control tissues from patients with benign lesions, and elevated in normal tissues from patients with thyroid carcinoma compared to normal tissues from patients with benign lesions. We also compared levels of HtrA proteins in follicular thyroid carcinoma (FTC) and papillary thyroid carcinoma (PTC) and found that these types of carcinoma differed in the expression of HtrA3-S and HtrA1. These results indicate the implication of HtrA proteins in thyroid carcinogenesis suggest that HtrA3 variants may play different roles in cancer development, and that the increased HtrA3-L levels in thyroid tissue could be correlated with the development of malignant lesions. The TGF-?1 levels in tumor tissues were not significantly altered compared to control tissues. PMID:22923201

Zurawa-Janicka, Dorota; Kobiela, Jaros?aw; Galczynska, Natalia; Stefaniak, Tomasz; Lipinska, Barbara; Lachinski, Andrzej; Skorko-Glonek, Joanna; Narkiewicz, Joanna; Proczko-Markuszewska, Monika; Sledzinski, Zbigniew

2012-11-01

209

Neoplasms HIV associated Kaposi sarcoma not  

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Abstract - The incidence of malignancies in virus carriers acquired immunodeficiency (HIV) has increased in conjunction with the disease during the past decade. 40% of all AIDS patients develop cancer during the course of HIV infection. Kaposi's sarcoma (KS), Non-Hodgkin lymphoma (NHL) and cervical cancer have an impact extremely high in HIV infected patients, and they are considered as disease AIDS-defining stage. Many reports suggest that other neoplasms they can have a high impact on the population of HIV carrier, including head and neck carcinoma, rectal cancer - anal, plasma cytomas, and melanoma lung cancer. Methods - We examined the spectrum of cancer in HIV-infected patients, specifically neoplasms except Kaposi sarcoma diagnosed between 1/1998 - 6/2004. Information on age, sex, factors was gathered risk for AIDS, neoplasms and mortality rate. Results: The total number of patients in our study was 21 patients, what 15 were male (71%) and 6 females (29%); the median age was 36 (29-70). Tumors were reported: 11 Non-Hodgkin lymphomas (52%), 2 Hodgkin's lymphoma (6.6%), 1 medullary thyroid cancer (6.6%), 1 melanoma (6.6%), 1 rectal cancer (5%) and three head and neck cancers (14%), 1 cancer 1 lung and breast cancer. Five of the patients were intravenous drug abusers (24%); 4 patients were homosexual, bisexual March 8 straight, on 6 patients know the data. Conclusions - The spectrum of malignancies associated with infection HIV in our study was similar to that described in other populations. ratio between the immune system and the epidemiology of the virus-induced tumors is to importance to identify new therapeutic approaches in the treatment and / or prevention of these neoplasms

210

Impact of the serum thyroglobulin concentration on the diagnostics of benign and malignant thyroid diseases; Stellenwert des Serum-Thyreoglobulinspiegels bei der Diagnostik benigner und maligner Schilddruesenerkrankungen  

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Aim of this study is to evaluate new and controversially discussed indications for determining the thyroglobulin (Tg) level in different thyroid diseases to support routine diagnostics. Methods: The following groups were included: 250 healthy subjects without goiter, 50 persons with diffuse goiter, 161 patients with multinodular goiter devoid of functional disorder (108 of them underwent surgery, in 17 cases carcinomas were detected), 60 hyperthyroid patients with autonomously functioning nodular goiter, 150 patients with Hashimoto's thyroiditis and 30 hyperthyroid patients with Graves' disease. Results: The upper limit of the normal range of the Tg level was calculated as 30 ng Tg/ml. The evaluation of the collective with diffuse goiter showed that the figure of the Tg level can be expected in a similar magnitude as the thyroid volume in milliliters. Nodular tissue led to far higher Tg values then presumed when considering the respective thyroidvolume, with a rather high variance. A formula for a rough prediction of the Tg levels in nodular goiters is described. In ten out of 17 cases with thyroid carcinoma, the Tg was lower than estimated with thyroid and nodular volumes, but two patients showed a Tg exceeding 1000 ng/ml. The collective with functional autonomy had a significantly higher average Tg level than a matched euthyroid group being under suppressive levothyroxine substitution. However, due to the high variance of the Tg values, the autonomy could not consistently be predicted with the Tg level in individual cases. The patients with Hashimoto's thyroiditis showed slightly decreased Tg levels. In Graves' disease, a significantly higher average Tg level was observed compared with a matched group with diffuse goiter, but 47% of all Tg values were still in the normal range (<30 ng/ml). Conclusion: Elevated Tg levels indicate a high probability of thyroid diseases, such as malignancy, autonomy or Graves' disease. However, as low Tg concentrations cannot exclude the respective disorder, a routine Tg determination seems not to be justified in benign thyroid diseases. (orig.) [German] Ziel dieser Studie ist es, neue und bislang zum Teil kontrovers diskutierte Indikationen zur Bestimmung des Thyreoglobulins (Tg) bei unterschiedlichen Schilddruesenerkrankungen in der klinischen Routine zu ueberpruefen. Methoden: Die Studie umfasst folgende Kollektive: 250 gesunde Probanden, 50 Patienten mit euthyreoter Struma diffusa, 161 Patienten mit euthyreoter Knotenstruma (davon 108 operierte Faelle, wobei sich 17 Karzinome fanden), 60 hyperthyreote Patienten mit autonomer Knotenstruma, 150 Patienten mit Thyreoiditis Hashimoto und 30 hyperthyreote Patienten mit M. Basedow. Ergebnisse: Die Grenze des Referenzbereichs errechnete sich zu 30 ng Tg/ml. Die Analyse der diffusen Strumen zeigte eine lineare Abhaengigkeit des Tg-Spiegels von der Schilddruesengroesse, wobei der Erwartungswert in etwa dem Organvolumen in ml entsprach. Knotige Veraenderungen fuehrten zu einem ueberproportionalen Tg-Anstieg, der allerdings einer grossen Varianz unterlag und daher im Einzelfall nur schwer abzuschaetzen war. Von den 17 Patienten mit Schilddruesenkarzinom lag der Tg-Spiegel in 10 Faellen unterhalb des Erwartungswertes, 2 Patienten zeigten einen Tg-Wert von >1000 ng/ml. Bei Autonomien fand sich bezogen auf eine durch Substitution extrem supprimierte Vergleichsgruppe ein signifikant hoeherer mittlerer Tg-Spiegel. Aufgrund der hohen Varianz der Tg-Werte beider Kollektive war die Diagnose der Autonomie anhand der Tg-Bestimmung jedoch kaum moeglich. In der Gruppe mit Thyreoiditis Hashimoto zeigte sich im Vergleich zum Normalkollektiv ein erniedrigter Tg-Spiegel. Bei M. Basedow war die mittlere Tg-Konzentration signifikant hoeher als in der Vergleichsgruppe mit Struma diffusa, dennoch lagen 47% aller Werte noch im Referenzbereich. Schlussfolgerung: Hohe Tg-Werte fuehren bei Verdacht auf Malignitaet, Autonomie oder M. Basedow zu einer hoeheren Krankheitswahrscheinlichkeit. Da niedrige Tg-Spiegel die entsprechende Erkrankung

Rink, T.; Schroth, H.J. [Abt. fuer Nuklearmedizin, Staedtisches Klinikum, Hanau (Germany); Dembowski, W.; Klinger, K. [Medizinische Klinik, St. Vinzenz Krankenhaus, Hanau (Germany)

2000-08-01

211

Second neoplasms following radiotherapy or chemotherapy for cancer  

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

Penn, I.

1982-02-01

212

Second neoplasms following radiotherapy or chemotherapy for cancer  

International Nuclear Information System (INIS)

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

213

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

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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

214

Potential value of elasto sonography in the diagnosis of malignancy in thyroid nodules  

International Nuclear Information System (INIS)

uded from the US elasto graphic evaluation. Another limitation is that the nodule to be examined must be clearly distinguishable from other nodules present in the thyroid. Thus, multi nodular goiters with coalescent nodules are not suitable for this analysis. US elasto sonography seems to have a great potential as a new tool for the diagnosis of thyroid cancer, especially in nodules with indeterminate cytology.

215

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

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A 63-year-old woman was admitted to our hospital with serious headache and vomiting. Five months before admission, she had undergone surgery for a primary advanced gastric cancer. Neuroradiological examinations revealed subdural fluid collection. We twice performed evacuation of the subdural fluid collection. However, aggravation of her state of consciousness progressed and she passed away. Histological examinations demonstrated that the dural veins were infiltrated by numerous tumor cells that produced mucus; however, ruptured vessels were not found. Furthermore, the subdural fluid collection increased shortly after the initial operation. We infer that the cause of the collection, which was associated with the dural metastasis of malignant tumors, was not only mucin secretion by tumor cells but also a rapid increase in perfusion pressure in the vessels of the dura mater, resulting in extravasation of plasma components into the subdural space. Our case demonstrates that the pathogenetic mechanism that is specific for subdural fluid collection caused by dural metastasis of malignant tumors differs from the mechanism of production of subdural hematoma associated with dural metastasis. PMID:24036578

Kimura, Shigeyoshi; Kotani, Akio; Takimoto, Toshiro; Yoshino, Atsuo; Katayama, Yoichi

2014-10-01

216

Thyroid  

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In vivo thyroid function testing is conducted with isotopes of iodine, the rate-limiting substrate for thyroid hormonogenesis, or with pertechnetate, an anion which the thyroidal follicular cells will concentrate or trap similarly to iodide, but will not organify. The physical characteristics of these isotopes, their advantages or indications, their disadvantages, and the average radiation dose to the thyroid in the infant, child, and adult are reviewed. The latter is expressed as estimated dose in rads per microcurie administered assuming an uptake of 27 percent and a biological half-life of 68 days. For many years the standard isotope for thyroid studies has been 131I. This isotope, however, has the disadvantage of a high radiation dose to the gland, especially in infants and children. Furthermore the high-energy gamma ray (364 keV) requires low-efficiency, thick septal collimators for scanning. More recently 125I, 123I, and 99/sup m/Tc-pertechnetate have been used. (auth)

217

Fine Needle Aspiration Cytology of Pediatric Thyroid Nodules  

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

Ayper KAÇAR

2010-05-01

218

Probability of malignancy in non-palpable thyroid nodules. Predictive value of color Doppler ultrasound and cytological correlation  

International Nuclear Information System (INIS)

Objective: To evaluate the diagnostic accuracy of ultrasound and Doppler criteria in the differentiation of malignant nodules, using cytological diagnosis as standard reference. Material and Method: Prospective observational study in 200 patients, between March-September 2008, assessed for known thyroid nodular disease using FNA. The probability of malignancy was categorized as low (0-3), intermediate (4-7) or high (greater than 7). The procedures were performed using Medison Sonoline ultrasound equipment, with a linear transducer (7.5 MHz), and the aspiration was performed with a 25 G needle and sent to cytology immediately. A single sample was needed in 88% of cases. Results: Approximately 96% of the nodules that went to cytology were categorized as low-grade, 3% as intermediate and 1% as high, without significant differences (p>0.5) when compared with the ultrasound score. Sonographic features indicating a high probability of malignancy were found in 2% (n=5) of cases, and the diagnosis was confirmed by cytology in 2 cases. Malignancy criteria such as size (>1 cm), irregular contours, solid echo structure, calcifications, and intranodal Doppler showed variable sensitivity and specificity (S: 32-44% and E: 28-55%) with overlapping confidence intervals within lesions of intermediate and low probability. Low probability lesions showed isoechogenicity, regular contours, lack of calcifications and intralesional Doppler, for a negative predictive value of 62-77%. Conclusion: Our results suggest that overlapping sonographic features between benign and malignant nodules requires final cytological diagnosis in most cases, given the safety of the cytological technique and the short waiting time.

219

Development of a clinical decision model for thyroid nodules  

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Full Text Available Abstract Background Thyroid nodules represent a common problem brought to medical attention. Four to seven percent of the United States adult population (10–18 million people has a palpable thyroid nodule, however the majority (>95% of thyroid nodules are benign. While, fine needle aspiration remains the most cost effective and accurate diagnostic tool for thyroid nodules in current practice, over 20% of patients undergoing FNA of a thyroid nodule have indeterminate cytology (follicular neoplasm with associated malignancy risk prevalence of 20–30%. These patients require thyroid lobectomy/isthmusectomy purely for the purpose of attaining a definitive diagnosis. Given that the majority (70–80% of these patients have benign surgical pathology, thyroidectomy in these patients is conducted principally with diagnostic intent. Clinical models predictive of malignancy risk are needed to support treatment decisions in patients with thyroid nodules in order to reduce morbidity associated with unnecessary diagnostic surgery. Methods Data were analyzed from a completed prospective cohort trial conducted over a 4-year period involving 216 patients with thyroid nodules undergoing ultrasound (US, electrical impedance scanning (EIS and fine needle aspiration cytology (FNA prior to thyroidectomy. A Bayesian model was designed to predict malignancy in thyroid nodules based on multivariate dependence relationships between independent covariates. Ten-fold cross-validation was performed to estimate classifier error wherein the data set was randomized into ten separate and unique train and test sets consisting of a training set (90% of records and a test set (10% of records. A receiver-operating-characteristics (ROC curve of these predictions and area under the curve (AUC were calculated to determine model robustness for predicting malignancy in thyroid nodules. Results Thyroid nodule size, FNA cytology, US and EIS characteristics were highly predictive of malignancy. Cross validation of the model created with Bayesian Network Analysis effectively predicted malignancy [AUC = 0.88 (95%CI: 0.82–0.94] in thyroid nodules. The positive and negative predictive values of the model are 83% (95%CI: 76%–91% and 79% (95%CI: 72%–86%, respectively. Conclusion An integrated predictive decision model using Bayesian inference incorporating readily obtainable thyroid nodule measures is clinically relevant, as it effectively predicts malignancy in thyroid nodules. This model warrants further validation testing in prospective clinical trials.

Eberhardt John

2009-08-01

220

Methodological extensions of meta-analysis with excess relative risk estimates: application to risk of second malignant neoplasms among childhood cancer survivors treated with radiotherapy.  

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Although radiotherapy is recognized as an established risk factor for second malignant neoplasms (SMNs), the dose response of SMNs following radiotherapy has not been well characterized. In our previous meta-analysis of the risks of SMNs occurring among children who have received radiotherapy, the small number of eligible studies precluded a detailed evaluation. Therefore, to increase the number of eligible studies, we developed a method of calculating excess relative risk (ERR) per Gy estimates from studies for which the relative risk estimates for several dose categories were available. Comparing the calculated ERR with that described in several original papers validated the proposed method. This enabled us to increase the number of studies, which we used to conduct a meta-analysis. The overall ERR per Gy estimate of radiotherapy over 26 relevant studies was 0.60 (95%CI: 0.30-1.20), which is smaller than the corresponding estimate for atomic bomb survivors exposed to radiation as young children (1.7; 95% CI: 1.1-2.5). A significant decrease in ERR per Gy with increase in age at exposure (0.85 times per annual increase) was observed in the meta-regression. Heterogeneity was suggested by Cochran's Q statistic (P < 0.001), which may be partly accounted for by age at exposure. PMID:25037101

Doi, Kazutaka; Mieno, Makiko N; Shimada, Yoshiya; Yonehara, Hidenori; Yoshinaga, Shinji

2014-09-01

 
 
 
 
221

Estimating regional cancer burden in countries with partial registration coverage: an application to all malignant neoplasms in Italy over the period 1970-2010.  

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Regional epidemiological indicators of cancer burden are essential information for cancer surveillance and health resources planning, especially in countries with partial registration coverage and geographically variable risk patterns, such as Italy. This paper presents a methodology to derive cancer incidence and prevalence at the regional and national scale and illustrates its application to all malignant neoplasms in Italy for the period 1970-2010. The method, denoted as MIAMOD, is based on a back-calculation approach and derives cancer-specific morbidity measures by using official mortality data and model-based relative survival from local Cancer Registries data. The output includes time-trends and projections of a complete set of epidemiological indicators, i.e. mortality, incidence and prevalence. Results for all cancers in Italy show different incidence patterns by gender and a pronounced regional variability among men: male incidence is estimated to decrease in almost all northern-central regions, while more stable or even rising trends are estimated in the southern regions. No incidence reduction is expected for women. Prevalence increases country-wide in both sexes. The proposed approach can be applied to derive regional up-to-date time trends of cancer burden indicators in countries with local and sparse cancer registration systems. These estimates are useful for planning health services on a national and regional basis and for highlighting regional differences. PMID:17055719

Grande, E; Inghelmann, R; Francisci, S; Verdecchia, A; Micheli, A; Capocaccia, R; De Angelis, R

2006-12-01

222

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.

223

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

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

Taddei, Phillip J; Mirkovic, Dragan; Zhang Rui; Giebeler, Annelise; Harvey, Mark; Newhauser, Wayne D [Department of Radiation Physics, University of Texas M D Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030 (United States); Mahajan, Anita; Kornguth, David; Woo, Shiao, E-mail: ptaddei@mdanderson.or [Department of Radiation Oncology, University of Texas M D Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030 (United States)

2010-12-07

224

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

Science.gov (United States)

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

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

2010-12-01

225

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.

226

Comparison of metallothionein (MT) and Ki-67 antigen expression in benign and malignant thyroid tumours.  

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Thyroid carcinomas are the most frequently occurring tumours in the endocrine system. Metallothioneins (MT) and Ki-67 proteins are present in intensely proliferating cells, and their expression has been observed in numerous tumours, including thyroid tumours. The purpose of this study was to analyse the relationship between intensity of MT expression and Ki-67 antigen on one hand and histological features of the examined thyroid tumours on the other. The investigated material included 186 archival paraffin blocks with samples of various thyroid tissues, obtained from the Chair and Department of Pathomorphology, Medical University of Wroclaw. In paraffin sections, immunohistochemical reactions were performed with the use of monoclonal anti-MT (I/II) and anti-Ki-67 antibodies. Intensity of MT and Ki-67 antigen expression was evaluated using a light microscope using the semi-quantitative method of Remmele. A significant difference in MT expression was noted between different tumours of the thyroid: the highest expression was detected in follicular carcinoma and the lowest was detected in medullary carcinoma. Expression of MT was also significantly elevated in follicular carcinoma as compared to follicular adenoma. On the other hand, no significant differences were seen between expression of Ki-67 antigen in follicular adenoma and follicular carcinoma. Moreover, these investigations detected no correlation between the expression of MT and Ki-67 antigen in follicular adenoma and follicular carcinoma. In view of the obtained results, the expression of MT can be considered as a potential marker of differentiation between the two types of thyroid tumours, which are otherwise difficult to differentiate. PMID:21187474

Królicka, Anna; Kobierzycki, Christopher; Pu?a, Bartosz; Podhorska-Oko?ów, Marzena; Piotrowska, Aleksandra; Rzeszutko, Marta; Rzeszutko, Wojciech; Rabczy?ski, Jerzy; Domos?awski, Pawe?; Wojtczak, Beata; Dawiskiba, Janusz; Dzi?giel, Piotr

2010-12-01

227

Malignant mesenteric perivascular epithelioid cell neoplasm presenting as an intra-abdominal fistula in a 49-year-old female.  

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Perivascular epithelioid cell tumors are rare mesenchymal tumors arising from histologically and immunohistochemically distinctive perivascular epithelioid cells that express both myogenic and melanocytic markers. These tumors are known to arise from different organs in the body and usually have an unpredictable clinical course. We report a case of a 49-year-old female who presented with diffuse abdominal pain, fever, chills, and nonbilious vomiting for a day. Work-up revealed a mesenteric mass measuring 13.5 × 7.7 × 9.5?cm, arising in the mesentery of the hepatic flexure, with adjacent gas suggestive of fistularization into the right colon. An exploratory laparotomy with resection of the mesenteric mass was performed, and the initial histopathology results were compatible with either an adenocarcinoma or a sarcoma; however, because of poor differentiation it was difficult to make a definitive diagnosis. However, final histopathology results revealed a malignant perivascular epithelioid cell tumor (with reservation that a S100 negative metastatic melanoma must be excluded clinically). Following surgery the patient was started on everolimus, an m-TOR inhibitor, and has shown good response to this medication. PMID:25114821

Kapur, Sakshi; Patel, Napoleon K; Levin, Miles B; Huang, Richard

2014-01-01

228

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

229

Clinical value of virtual bronchoscopy in early diagnosis of central malignant lung neoplasm in high risk patients  

International Nuclear Information System (INIS)

Virtual bronchoscopy (CT-VB) is a recently developed 3D visualization technique that employs thin-section spiral computed tomographic data of the thorax for non-invasive evaluation of the tracheo-bronchial tree. The purpose of this study was to compare the efficacy of multislice-CT virtual bronchoscopy in detecting early endobronchial manifestation of central lung cancer with that of flexible fiberoptic bronchoscopy. For this purpose, a group of 50 high risk patients (cigarette pack-years, long standing history of COLD) underwent both FOB and CT-VB investigation. Multislice CT was performed using the following parameters: collimation, 1 mm; pitch factor, 0.937-1.375; reconstruction interval, 0.8 mm and postprocessing was based on volume rendering technique. Images of eight standard tracheo-bronchial sections were obtained from each patient both during FOB and CT-VB and were independently interpreted respectively by a pneumologist and a bronchiseptica. Airway evaluation was based on the analysis of changes in the mucosal architecture, the shape of the ostia and of the carinae and on the presence of secretion deposits as early signs of tumor onset. The sensitivity of virtual bronchoscopy in discriminating diseased from healthy patients was 94 % and its specificity 65 %. Its positive predictive value 56 % and its negative predictive value 96 %. According to the ROC analysis, except for the assessment of the secretion deposits, the other three criteria evaluated separatele other three criteria evaluated separately during virtual bronchoscopic assessment of the airways contributed equally in discriminating diseased from disease-free patients (areas under curve ranging between 0,797 and 0,845). The best AUC was associated with the evaluation of the sum of all three parameters together (0,858). Nevertheless, FOB and CT-VB results in the evaluation of the shape of the ostia resulted to agree moderately while just a fair agreement was observed with respect to the evaluation of the mucosal architecture and of the shape of the carinae (Kappa values ranging between 0,310 and 0,520). As to the evaluation of the secretion deposits, for example, the two diagnostic tests showed very poor agreement (negative Kappa value) concluding, this preliminary evaluation indicates that virtual bronchoscopy combined with the evaluation of MS-CT axial scans may be a promising and non-invasive diagnostic method for evaluation of patients at high risk of developing central lung neoplasm and can add important information about an intraluminal tumor and its relation to surrounding structures. Further studies should be undertaken to evaluate the potentials of this promising method as a tool to evaluate endoluminal growth in tumorous lung lesions. Even though it showed just fair agreement with flexible fiberoptic bronchoscopy, the evaluation of changes in the form of the carinae, in the shape of the ostia and the accurate analysis of modifications in the mucosal architecture as early signs of tumor growth, showed to be three valid separate diagnostic criteria for airway assessment by means of virtual bronchoscopy. From a technical point of view, multislice-CT allowed the optimization of examination parameters such as acquisition time and primary collimation resulting not only in a reduction of respiratory and pulsation artefacts but also in a dramatic improvement of the z-axis and hence a much better resolution of the 3-dimensional reconstructions. As a consequence, MS-CT virtual bronchoscopy provides enhanced detail fidelity and represents a valid diagnostic tool for the evaluation of the whole tracheo-bronchial tree up to its third generation bronchi. (author)

230

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

231

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.

232

"Evaluation of single cold Thyroid nodule with 99mTc-Sestamibi "  

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Full Text Available In 30 patient with single cold thyroid nodule and normal thyroid function tests, 99mTc-MIBI scan is performed. The nodules are divided to hot (10, Warm (12 and cold (8. FNA reported papillary Ca in 4, suspicious follicular neoplasm in 3 and 23 benign lesions. 7 patients were operated on and had final pathology reports (4 papillary Ca and 3 benign lesions. All the nodules with no MIBI uptake were benign in this study. Warm nodules were benign for the most part (Only 1 papillary Ca was reported. Hot nodules revealed 3 malignant neoplasm but 7 benign lesions were also observed. In this study 99mTc-MIBI did not show an acceptible specificity for diagnosis of malignant thyroid tumors. However lack of MIBI uptake (Cold nodule or evidence of some activity in the nodules (Warm nodule is mostly seen in benign lesions.

"Dabiri Oskoi Sh "

1999-06-01

233

Spontaneous endomyometrial neoplasms in aging Chinese hamsters  

Energy Technology Data Exchange (ETDEWEB)

Twenty-one endomyometrial neoplasms among 93 nulliparous noninbred Chinese hamsters were evaluated. The median survival time of the 93 females was 1040 days. The median age of hamsters with endomyometrial neoplasms was 1200 days. Neoplasms were classified as carcinomas or malignant mixed muellerian tumors of the endometrium and benign or malignant myometrial neoplasms. There were 13 endometrial adenocarcinomas. Three tumors were mixed adenosquamous carcinomas, which occurred in significantly older Chinese hamsters than did adenocarcinomas. Three malignant mixed muellerian tumors consisted of 2 carcinosarcomas and 1 mixed mesodermal tumor. The 2 myometrial neoplasms were a lelomyoma and a lelomyosarcoma. The classification and relative frequency of these neoplasms were similar to endomyometrial neoplasms of women, which makes Chinese hamsters useful subjects for studies of spontaneous endomyometrial cancers.

Brownstein, D.G.; Brooks, A.L.

1980-05-01

234

Thyroid-specific ablation of the Carney complex gene, PRKAR1A, results in hyperthyroidism and follicular thyroid cancer.  

Science.gov (United States)

Thyroid cancer is the most common endocrine malignancy in the population, and the incidence of this cancer is increasing at a rapid rate. Although genetic analysis of papillary thyroid cancer (PTC) has identified mutations in a large percentage of patients, the genetic basis of follicular thyroid cancer (FTC) is less certain. Thyroid cancer, including both PTC and FTC, has been observed in patients with the inherited tumor predisposition Carney complex, caused by mutations in PRKAR1A. In order to investigate the role of loss of PRKAR1A in thyroid cancer, we generated a tissue-specific knockout of Prkar1a in the thyroid. We report that the resulting mice are hyperthyroid and developed follicular thyroid neoplasms by 1 year of age, including FTC in over 40% of animals. These thyroid tumors showed a signature of pathway activation different from that observed in other models of thyroid cancer. In vitro cultures of the tumor cells indicated that Prkar1a-null thyrocytes exhibited growth factor independence and suggested possible new therapeutic targets. Overall, this work represents the first report of a genetic mutation known to cause human FTC that exhibits a similar phenotype when modeled in the mouse. In addition to our knowledge of the mechanisms of human follicular thyroid tumorigenesis, this model is highly reproducible and may provide a viable mechanism for the further clinical development of therapies aimed at FTC. PMID:22514108

Pringle, Daphne R; Yin, Zhirong; Lee, Audrey A; Manchanda, Parmeet K; Yu, Lianbo; Parlow, Alfred F; Jarjoura, David; La Perle, Krista M D; Kirschner, Lawrence S

2012-06-01

235

A molecular computational model improves the preoperative diagnosis of thyroid nodules  

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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 ...

Tomei Sara; Marchetti Ivo; Zavaglia Katia; Lessi Francesca; Apollo Alessandro; Aretini Paolo; Di Coscio Giancarlo; Bevilacqua Generoso; Mazzanti Chiara

2012-01-01

236

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

237

Expressão de galectina-3 e citoqueratina 19 nas neoplasias epiteliais da glândula tireóidea e correlação histopatológica / Expression of galectin-3 and cytokeratin 19 in the epithelial neoplasm of the thyroid gland and histopathological correlation  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese INTRODUÇÃO: O câncer da glândula tireóidea é caracterizado pela sua variedade clínica e patológica. O difícil diagnóstico pré-operatório das lesões foliculares induz a mais procedimentos cirúrgicos de caráter diagnóstico do que propriamente terapêutico. A proposta deste estudo foi identificar a expr [...] essão imuno-histoquímica das neoplasias epiteliais tireóideas utilizando anticorpos monoclonais para galectina-3 e citoqueratina 19 e correlacioná-la com variáveis histopatológicas. MATERIAL E MÉTODO: A expressão da galectina-3 e da citoqueratina 19 foi estudada imuno-histoquimicamente em 84 casos com diagnóstico de tecido normal (n = 10), bócio adenomatoso (n = 8), adenoma folicular (n = 12), adenoma de célula de Hürthle (n = 3), carcinoma papilífero (n = 29), carcinoma folicular (n = 8), carcinoma insular (n = 4), carcinoma de células de Hürthle (n = 4) e carcinoma indiferenciado (n = 6), selecionados a partir de pacientes operados no Serviço de Cirurgia de Cabeça e Pescoço do Hospital Heliópolis (HOSPHEL), no período de 1984 a 1995. RESULTADOS: A expressão da galectina-3 foi observada em bócio adenomatoso (12,5%), adenoma folicular (16,7%), carcinoma papilífero (96,6%), carcinoma folicular (12,5%), carcinoma insular (50%), carcinoma de célula de Hürthle (100%) e carcinoma indiferenciado (50%). Nossos resultados confirmaram a expressão significativa da galectina-3 no grupo das neoplasias malignas, principalmente no carcinoma papilífero. O padrão de expressão da citoqueratina 19 foi diferente entre os tipos de lesão: enquanto nos bócios e adenomas mostrou-se fraco, nos carcinomas papilíferos foi forte e difuso. CONCLUSÃO: Associadas, a galectina-3 e a citoqueratina 19 auxiliam o diagnóstico histopatológico, principalmente nas lesões de interpretação duvidosa, além de evidenciarem atipias e, com isso, determinarem uma lesão suspeita. Abstract in english BACKGROUND: The cancer of the thyroid gland is characterized by its clinical and pathological variety. The difficult preoperative diagnosis of the follicular lesions lead to more surgical procedures of diagnostic characteristic than therapeutic. The aim of this study was to identify the immunohistoc [...] hemical expression of the thyroid epithelial neoplams using monoclonal antibodies for galectin-3 and cytokeratin 19, and correlate them with pathological variables. MATERIAL AND METHODS: The expression of galectin-3 and cytokeratin 19, was immunohistochemically studied in 84 cases with diagnosis of normal tissue (n = 10), adenomatoid goiter (n = 8), follicular adenoma (n = 12), Hürthle cell adenoma (n = 3), papillary carcinoma (n = 29), follicular carcinoma (n = 8), poorly differentiated carcinoma (n = 4), Hürthle cell carcinoma (n = 4), anaplastic carcinoma (n = 6), which were selected from patients treated at the Head and Neck Surgery Department of Hospital Heliópolis, from 1984 to 1995. RESULTS: The expression of galectin-3 was observed in the cases of adenomatoid goiter (12.5%), follicular adenoma (16.7%), papillary carcinoma (96.6%), follicular carcinoma (50%), Hürthle cell carcinoma (100%) and anaplastic carcinoma (50%). Our results confirmed the significant expression of galectin-3 in the group of the malignant neoplasms, mainly in the papillary carcinoma. The expression pattern of cytokeratin 19 was different among the types of lesions; whereas in the goiters and adenomas it was weak, in the papillary carcinomas it was strong and diffuse. CONCLUSIONS: Galectin-3 and cytokeratin 19, associated, help the histopathological diagnosis, mainly in the lesions of difficult interpretation; besides they highlight atypical conditions and, thus, determine a suspicious lesion.

Marilene Paladino, Rosa; Cristina T., Kanamura; Marcos Brasilino de, Carvalho.

238

Expressão de galectina-3 e citoqueratina 19 nas neoplasias epiteliais da glândula tireóidea e correlação histopatológica Expression of galectin-3 and cytokeratin 19 in the epithelial neoplasm of the thyroid gland and histopathological correlation  

Directory of Open Access Journals (Sweden)

Full Text Available INTRODUÇÃO: O câncer da glândula tireóidea é caracterizado pela sua variedade clínica e patológica. O difícil diagnóstico pré-operatório das lesões foliculares induz a mais procedimentos cirúrgicos de caráter diagnóstico do que propriamente terapêutico. A proposta deste estudo foi identificar a expressão imuno-histoquímica das neoplasias epiteliais tireóideas utilizando anticorpos monoclonais para galectina-3 e citoqueratina 19 e correlacioná-la com variáveis histopatológicas. MATERIAL E MÉTODO: A expressão da galectina-3 e da citoqueratina 19 foi estudada imuno-histoquimicamente em 84 casos com diagnóstico de tecido normal (n = 10, bócio adenomatoso (n = 8, adenoma folicular (n = 12, adenoma de célula de Hürthle (n = 3, carcinoma papilífero (n = 29, carcinoma folicular (n = 8, carcinoma insular (n = 4, carcinoma de células de Hürthle (n = 4 e carcinoma indiferenciado (n = 6, selecionados a partir de pacientes operados no Serviço de Cirurgia de Cabeça e Pescoço do Hospital Heliópolis (HOSPHEL, no período de 1984 a 1995. RESULTADOS: A expressão da galectina-3 foi observada em bócio adenomatoso (12,5%, adenoma folicular (16,7%, carcinoma papilífero (96,6%, carcinoma folicular (12,5%, carcinoma insular (50%, carcinoma de célula de Hürthle (100% e carcinoma indiferenciado (50%. Nossos resultados confirmaram a expressão significativa da galectina-3 no grupo das neoplasias malignas, principalmente no carcinoma papilífero. O padrão de expressão da citoqueratina 19 foi diferente entre os tipos de lesão: enquanto nos bócios e adenomas mostrou-se fraco, nos carcinomas papilíferos foi forte e difuso. CONCLUSÃO: Associadas, a galectina-3 e a citoqueratina 19 auxiliam o diagnóstico histopatológico, principalmente nas lesões de interpretação duvidosa, além de evidenciarem atipias e, com isso, determinarem uma lesão suspeita.BACKGROUND: The cancer of the thyroid gland is characterized by its clinical and pathological variety. The difficult preoperative diagnosis of the follicular lesions lead to more surgical procedures of diagnostic characteristic than therapeutic. The aim of this study was to identify the immunohistochemical expression of the thyroid epithelial neoplams using monoclonal antibodies for galectin-3 and cytokeratin 19, and correlate them with pathological variables. MATERIAL AND METHODS: The expression of galectin-3 and cytokeratin 19, was immunohistochemically studied in 84 cases with diagnosis of normal tissue (n = 10, adenomatoid goiter (n = 8, follicular adenoma (n = 12, Hürthle cell adenoma (n = 3, papillary carcinoma (n = 29, follicular carcinoma (n = 8, poorly differentiated carcinoma (n = 4, Hürthle cell carcinoma (n = 4, anaplastic carcinoma (n = 6, which were selected from patients treated at the Head and Neck Surgery Department of Hospital Heliópolis, from 1984 to 1995. RESULTS: The expression of galectin-3 was observed in the cases of adenomatoid goiter (12.5%, follicular adenoma (16.7%, papillary carcinoma (96.6%, follicular carcinoma (50%, Hürthle cell carcinoma (100% and anaplastic carcinoma (50%. Our results confirmed the significant expression of galectin-3 in the group of the malignant neoplasms, mainly in the papillary carcinoma. The expression pattern of cytokeratin 19 was different among the types of lesions; whereas in the goiters and adenomas it was weak, in the papillary carcinomas it was strong and diffuse. CONCLUSIONS: Galectin-3 and cytokeratin 19, associated, help the histopathological diagnosis, mainly in the lesions of difficult interpretation; besides they highlight atypical conditions and, thus, determine a suspicious lesion.

Marilene Paladino Rosa

2005-02-01

239

Expressão de galectina-3 e citoqueratina 19 nas neoplasias epiteliais da glândula tireóidea e correlação histopatológica / Expression of galectin-3 and cytokeratin 19 in the epithelial neoplasm of the thyroid gland and histopathological correlation  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese INTRODUÇÃO: O câncer da glândula tireóidea é caracterizado pela sua variedade clínica e patológica. O difícil diagnóstico pré-operatório das lesões foliculares induz a mais procedimentos cirúrgicos de caráter diagnóstico do que propriamente terapêutico. A proposta deste estudo foi identificar a expr [...] essão imuno-histoquímica das neoplasias epiteliais tireóideas utilizando anticorpos monoclonais para galectina-3 e citoqueratina 19 e correlacioná-la com variáveis histopatológicas. MATERIAL E MÉTODO: A expressão da galectina-3 e da citoqueratina 19 foi estudada imuno-histoquimicamente em 84 casos com diagnóstico de tecido normal (n = 10), bócio adenomatoso (n = 8), adenoma folicular (n = 12), adenoma de célula de Hürthle (n = 3), carcinoma papilífero (n = 29), carcinoma folicular (n = 8), carcinoma insular (n = 4), carcinoma de células de Hürthle (n = 4) e carcinoma indiferenciado (n = 6), selecionados a partir de pacientes operados no Serviço de Cirurgia de Cabeça e Pescoço do Hospital Heliópolis (HOSPHEL), no período de 1984 a 1995. RESULTADOS: A expressão da galectina-3 foi observada em bócio adenomatoso (12,5%), adenoma folicular (16,7%), carcinoma papilífero (96,6%), carcinoma folicular (12,5%), carcinoma insular (50%), carcinoma de célula de Hürthle (100%) e carcinoma indiferenciado (50%). Nossos resultados confirmaram a expressão significativa da galectina-3 no grupo das neoplasias malignas, principalmente no carcinoma papilífero. O padrão de expressão da citoqueratina 19 foi diferente entre os tipos de lesão: enquanto nos bócios e adenomas mostrou-se fraco, nos carcinomas papilíferos foi forte e difuso. CONCLUSÃO: Associadas, a galectina-3 e a citoqueratina 19 auxiliam o diagnóstico histopatológico, principalmente nas lesões de interpretação duvidosa, além de evidenciarem atipias e, com isso, determinarem uma lesão suspeita. Abstract in english BACKGROUND: The cancer of the thyroid gland is characterized by its clinical and pathological variety. The difficult preoperative diagnosis of the follicular lesions lead to more surgical procedures of diagnostic characteristic than therapeutic. The aim of this study was to identify the immunohistoc [...] hemical expression of the thyroid epithelial neoplams using monoclonal antibodies for galectin-3 and cytokeratin 19, and correlate them with pathological variables. MATERIAL AND METHODS: The expression of galectin-3 and cytokeratin 19, was immunohistochemically studied in 84 cases with diagnosis of normal tissue (n = 10), adenomatoid goiter (n = 8), follicular adenoma (n = 12), Hürthle cell adenoma (n = 3), papillary carcinoma (n = 29), follicular carcinoma (n = 8), poorly differentiated carcinoma (n = 4), Hürthle cell carcinoma (n = 4), anaplastic carcinoma (n = 6), which were selected from patients treated at the Head and Neck Surgery Department of Hospital Heliópolis, from 1984 to 1995. RESULTS: The expression of galectin-3 was observed in the cases of adenomatoid goiter (12.5%), follicular adenoma (16.7%), papillary carcinoma (96.6%), follicular carcinoma (50%), Hürthle cell carcinoma (100%) and anaplastic carcinoma (50%). Our results confirmed the significant expression of galectin-3 in the group of the malignant neoplasms, mainly in the papillary carcinoma. The expression pattern of cytokeratin 19 was different among the types of lesions; whereas in the goiters and adenomas it was weak, in the papillary carcinomas it was strong and diffuse. CONCLUSIONS: Galectin-3 and cytokeratin 19, associated, help the histopathological diagnosis, mainly in the lesions of difficult interpretation; besides they highlight atypical conditions and, thus, determine a suspicious lesion.

Marilene Paladino, Rosa; Cristina T., Kanamura; Marcos Brasilino de, Carvalho.

2005-02-01

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

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

International Nuclear Information System (INIS)

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)

242

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

243

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

Scientific Electronic Library Online (English)

Full Text Available 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.

244

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 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.)

245

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

Energy Technology Data Exchange (ETDEWEB)

The aim of this study was to evaluate the use of {sup 124}I 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 {sup 124}I. Patient dosimetry was derived from PET data obtained 1-13 days after simultaneous oral administration of a therapeutic dose of {sup 131}I and a diagnostic dose of {sup 124}I. The obtained data were compared with findings from intratherapeutic probe measurements and clinical outcome. The phantom studies confirmed that {sup 124}I can be quantitated by PET (imprecision {<=}10%), and volumetry is feasible for nodules <13 mm (imprecision {<=}20%). Any influence of contamination with {sup 123}I or the simultaneous administration of {sup 131}I on the accuracy of the PET quantification and the probe measurements was ruled out by phantom measurements with solutions of {sup 131}I, {sup 124}I and{sup 123}I 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 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 {sup 124}I 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.)

Eschmann, Susanne M.; Bilger, Kilian; Kupferschlaeger, Juergen; Thelen, Marcel H.; Dohmen, Bernhard M.; Besenfelder, Hariolf; Bares, Roland [Department of Nuclear Medicine, University of Tuebingen (Germany); Reischl, Gerald [Division of Radiopharmacy, University of Tuebingen (Germany)

2002-06-01

246

When to repeat thyroid fine needle aspiration cytology?  

Science.gov (United States)

The aim of of the study was to investigate the possible changes of primary fine needle aspiration (FNA) diagnoses after subsequent check ups. We investigated 948 thyroid nodules and the main indications for repeat FNAs were inadequate/indeterminate FNA findings and growing nodules at ultrasound check up. FNA findings were subdivided into inadequate, benign, low-risk lesion (includes cellular follicular lesion, suspicious of follicular/Hürthle cell neoplasm, atypical Hürthle cell hyperplasia), follicular/Hürthle cell neoplasm, high-risk lesion (includes lesions suspicious of malignancy), and malignant. Of the total of 948 nodules, repeat FNA diagnoses remained within the same category in 709 (75%) nodules. Out of 38 primary inadequate FNAs, 7 (18%) remained inadequate, 24 (63%) were benign, and 3 (8%) were categorized as high-risk/malignant. Out of 659 primary benign FNAs, 587 (89%) remained benign, and 11 (2%) were categorized as high-risk/malignant. Out of 169 primary low-risk lesion FNAs, 66 (39%) remained low-risk, 65 (38%) were benign, and 10 (6%) were categorized as high-risk/malignant. Out of 43 primary high-risk lesion FNAs, 20 (46%) remained high-risk, 2 (5%) were benign, 3 (7%) were categorized as a low-risk lesion, and 13 (30%) were categorized as malignant. Out of 35 FNAs that were primary follicular/Hürthle cell neoplasm, 27 (77%) remained follicular/Hürthle cell neoplasm, 1 (3%) was categorized as benign, 4 (11%) were categorized as a low-risk lesion, and 3 (8%) as high-risk/malignant. In conclusion, repeat thyroid FNA is useful in most cases of primary inadequate/indeterminate FNA findings, as well as in the evaluation of growing nodules. PMID:23540162

Moslavac, Sandra; Matesa-Ani?, Dubravka; Matesa, Neven; Kusi?, Zvonko

2012-12-01

247

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

248

Cancer of the thyroid and salivary glands  

International Nuclear Information System (INIS)

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

249

Oxyphilic carcinoma of the thyroid gland  

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Full Text Available Oxyphilic tumors of the thyroid gland are rare tumors characterized by the presence of Hürthle cells - mitochondrion-rich, eosinophilic epithelial cells. Hürthle cell carcinomas (HCC of the thyroid behave in a more aggressive fashion as compared to other well-differentiated thyroid cancers. Many recent studies have been focused on the further elucidation of pathogenesis and the role of mitochondrial hyperplasia in carcinogenesis of these neoplasms. The importance of combining morphological and genetic approaches in the study of HCC has been emphasized by the difficulties encountered in establishing adequate differential diagnostic criteria between benign and malignant forms, as well as by the resistance of HCC to radio and chemotherapy. It has been well documented that the Hürthle cells are characterized by profound aberrations in the nuclear and mitochondrial genome and by alterations in oncogenes, tumor suppressor genes and other key genes involved in energy metabolism, proliferation and apoptosis.

Stankov Karmen

2003-01-01

250

Incidence of malignant neoplasi in single nodules of the thyroid gland  

International Nuclear Information System (INIS)

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)

251

Diagnostic markers and prognostic factors in thyroid cancer.  

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There has been considerable progress identifying biomarkers in thyroid tumors that improve the accuracy of fine-needle aspiration biopsy and also help predict tumor aggressiveness or behavior. In this review we address both the clinical potential of molecular biomarkers and their usefulness, based on the most recent literature. We describe the current best clinical staging systems and the common somatic mutations in thyroid cancer. The BRAF mutation is the most common mutation in papillary thyroid cancer and has recently been reported to be associated with disease aggressiveness; it is also an independent predictor of tumor behavior. Combined testing of RET/PTC, NTRK, RAS and PAX8-PPARgamma, which are mutually exclusive mutations, helps improve the accuracy of fine-needle aspiration biopsy. Gene-expression profiling studies have identified a variety of potential molecular markers to help distinguish benign from malignant thyroid neoplasms. Expression analysis of differentially expressed microRNAs also appears to be a promising diagnostic approach for distinguishing benign from malignant thyroid neoplasm. It is especially useful for indeterminate nodules by fine-needle aspiration biopsy. PMID:19852742

Vriens, Menno R; Schreinemakers, Jennifer Mj; Suh, Insoo; Guerrero, Marlon A; Clark, Orlo H

2009-10-01

252

Thyroid fine needle aspiration cytology in children and adolescents.  

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Thyroid fine needle aspiration cytology (FNAC) is the most accurate and cost effective method in the evaluation of the thyroid nodule and has been commonly used in adults. Thyroid nodules are uncommon in younger patients (1-2%). Our aim was to determine some relevant clinical and cytological parameters in this demographic group. Ultrasound-guided thyroid FNACs performed from May 1995 to June 2008 in patients under 18 years of age were retrospectively reviewed. The following clinical parameters were retrieved: age and gender, number of nodules, and nodule size. Cytological parameters included cytologic diagnosis and cyto-pathohistological correlation. Total of 236 cases, representing 206 patients under 18 years of age, were retrieved from a total of 11748 thyroid FNAC cases (2.0%). The patient's age ranged from 2 to 18 years (mean 14). There were 180 (87.4%) females and 26 (12.6%) males with a female/male ratio 4:1. For 56 patients data concerning the number of nodules were recorded. 20 (35.7%) patients did not have any nodules, 20 (35.7%) patients had solitary thyroid nodule and 16 (28.6%) patients had multiple nodules. The size of nodules ranged from 0.4-5.4 cm (mean 1.4 cm). The cytologic diagnoses were: unsatisfactory (9), cyst fluid (7), benign (204), cellular follicular lesion/follicular neoplasm (9) and papillary thyroid carcinoma (7). The prevalence of malignancy among cytologic diagnoses was 3.4%. 21 patients had surgical follow up. 5 patients (23.8%) had thyroid malignancies (all papillary carcinomas). The remainder had benign thyroid lesions; follicular adenomas (8), multinodular goiters (5), diffuse goiters (2) and Hashimoto thyreoiditis (1). There were no false negative or false positive cytologic diagnoses. The prevalence of thyroid malignancies among cytologic diagnoses was similar to those reported in adults. In limited number of patients with surgical follow up there were no false negative or false positive cytologic diagnoses. PMID:20432751

Moslavac, Sandra; Matesa, Neven; Kusi?, Zvonko

2010-03-01

253

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.

254

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

Energy Technology Data Exchange (ETDEWEB)

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

255

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

256

Diagnostic imaging and therapy of neuroectodermal neoplasms  

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Computed tomography (CT) and /sup 123/I- or /sup 131/I-meta-iodo-benzyl-guanidine (MIBG) scintigraphy were compared for accuracy in tumor detection in 47 patients with neuroectodermal neoplasms. MIBG concentration was found in 12 of 13 pheochromocytomas, 12 of 12 neuroblastomas, 5 of 9 carcinoids, and 1 of 4 glomus tumors. MIBG uptake was not observed in medullary thyroid carcinomas, oat-cell carcinomas, Merkel tumors, 1 gastrinoma, and 2 unclassified neuroectodermal neoplasms. With regard to the different tumor manifestations, the sensitivity in detecting pheochromocytomas, neuroblastomas, and carcinoids was 87%, 77%, and 100% for CT, and 83%, 100% and 71% for MIBG scintigraphy. MIBG scintiscan was superior in the detection of small adrenal pheochromocytomas (< 1 cm diameter) and in the depiction of small bone metastases and bone marrow infiltration from neuroblastoma. In all, 25 cycles of high-dose MIBG therapy were performed in eight patients with surgically incurable tumors (4 malignant pheochromocytomas, 1 neuroblastoma, 3 carcinoids). The total therapeutic activity applied was 3.55-43.29 GBq /sup 131/I-MIBG. Tumor kinetics of MIBG were investigated before and during treatment. One patient with metastatic pheochromocytoma has been in complete remission for a follow-up period of 36 months since completion of treatment, and another patient is in partial remission. Tumor reduction or no change was observed in four patients. Two patients died of nonconcentrating recurrence and metastases.

Adolph, J.; Kimmig, B.

1989-01-01

257

The influence of various amounts of 131-iodine on the proliferation of benign and malignant thyroid cells  

International Nuclear Information System (INIS)

The aim of our work was to find a method to predict the sensitivity of different thyroid diseases towards 131-iodine individually for each patient who is going to have a 131-iodine treatment. We tried to determine the 131-iodine-uptake of benign primary thyroid cells and malignant thyroid (carcinoma) cell-lines (follicular -UCLA RO 82 W-1 and papillary -NPA'87). The following culture dishes were used: 75 cm2-flasks, 24-well plates and Palladium-covered dishes. We incubated 350000 cells per well with 3,7; 9,25; 18,5; 37; and 185 mbq 131-iodine/500 ?l Hanks Balanced Salt Solution and 10 (5; 100; 0,1 and 0) ?M non-active sodium-iodide for 2 minutes up to 72 hours. The amount of 131-iodine stored by the cells was measured with a Gamma-counter. The ability of the tested two cell-lines to take up 131-iodine was pretty low (about 0,02 % - 0,9 % of the added 131-iodine doses). In addition to that we controlled and determined the cell proliferation by staining them with Trypan-blue and counting using a phase-contrast-microscope. From the cell numbers we collected during 8 days control a growth curve could be prepared. There was a remarkable difference in the growth rate between 131-iodine-incubated (3,7 mbq) and non-incubated cells. The number of the irradiated cells was about 30 % lower. Furthermore we added 10 ?M 13-cis retinoic acid to the nutrition media to attempt to rise the extent of the cells differentiation and therefor also the 131-iodine-uptake. Four defor also the 131-iodine-uptake. Four days preparation with retinoic acid in the media caused a slight increase (10 %) of the 131-iodine-uptake in the RO 82 W-1-cells, 28 days incubation decreased the 131-iodine-uptake significantly (about 30 % - 70 %) and the cells died. After 10 days preparation with retinoic acid the NPA'87-cells also showed a decrease in the 131-iodine-uptake (?40-50 %) and the cells died. (author)

258

Primary pancreatic cystic neoplasms revisited: part II. Mucinous cystic neoplasms.  

Science.gov (United States)

Mucinous cystic neoplasms (MCNs) of the pancreas represent one of the most common primary pancreatic cystic neoplasms, accounting for approximately half of these cases. MCNs are observed almost exclusively in women, and most commonly are located in the body/tail of the pancreas. In contrast to SCNs, MCNs have malignant potential. Proliferative changes (hyperplasia with or without atypia, borderline changes, non-invasive or carcinomas in-situ, and invasive carcinomas) can often be observed within the same neoplasm. Several risk factors for the presence of underlying malignancy within an MCN have recently been recognized. Cross-sectional imaging is of key importance for the diagnostic evaluation of patients with a cystic pancreatic lesion. Cyst fluid examination (cytology, biochemical/genetic analysis) is possible by using fine needle aspiration of the MCN, usually under endoscopic guidance, and may provide useful information for the differential diagnosis. Since MCNs have malignant potential, surgical resection is the treatment of choice. PMID:21251815

Sakorafas, George H; Smyrniotis, Vasileios; Reid-Lombardo, Kaye M; Sarr, Michael G

2011-06-01

259

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

260

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

 
 
 
 
261

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

262

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)

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Phyllodes tumor metastatic to thyroid Hürthle cell adenoma.  

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We present a case of a malignant phyllodes tumor metastasizing to a Hürthle cell adenoma of the thyroid. A 55-year-old woman underwent mastectomy for a malignant phyllodes tumor. Two years later, she presented with a left thyroid mass, which was a single, circumscribed, soft, deep red-brown nodular lesion with an eccentric area of firmer consistency. Histologically, the thyroid tumor was composed of 2 distinct types of cellular proliferation. Atypical spindle cells were infiltrating between the Hürthle cell cords and follicles in a fibrosarcomatous pattern. A battery of immunohistochemical stains was applied to both the thyroid and breast tumors for comparison. Based on the histologic and immunophenotypic features of the fibrosarcomatous components of both the breast and thyroid tumors, we rendered a diagnosis of cystosarcoma phyllodes metastatic to Hürthle cell adenoma. To the best of our knowledge, this unusual case is a first report of tumor-to-tumor metastasis of a sarcoma to a primary thyroid neoplasm. PMID:12296767

Giorgadze, Tamar; Ward, Richard M; Baloch, Zubair W; LiVolsi, Virginia A

2002-10-01

264

Percutaneous alcohol injection (PAI) of thyroid nodule  

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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

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Accuracy of fine needle aspiration biopsy with and without the use of tumor markers in cytologically indeterminate thyroid lesions.  

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We investigated if the use of two tumor markers, galectin-3 and CD44v6, could improve diagnostic accuracy of thyroid fine needle aspiration biopsy (FNAB) in cytologically indeterminate lesions (CIL). 351 patients with CIL [cellular follicular lesion/suspicious follicular neoplasm/suspicious Hürthle cell neoplasm (CFL/sFN/sHCN), Hürthle cell neoplasm (HCN), and follicular neoplasm (FN)] and surgical follow-up were investigated. 251 patients had FNAB diagnoses made without help of tumor markers and the rest of 100 patients had FNAB diagnoses made with a known expression of tumor markers determined by the reverse transcription (RT)-PCR. Risk of malignancy in all 351 patients with CIL was 6.8%. In the group with FNAB made without RT-PCR, there were 140 CFL/sFN/sHCN with the risk of malignancy of 4.2%, 92 FN with the risk of malignancy of 13.0%, and 19 HCN with the risk of malignancy of 5.2%. In the group with FNAB made with RT-PCR, there were 49 CFL/sFN/sHCN with the risk of malignancy of 2.0%, 40 FN with the risk of malignancy of 7.5%, and 11 HCN with the risk of malignancy of 9.0%. In the group with at least one positive tumor marker (N = 69), the risk of malignancy was 3.1% for CFL/sFN/sHCN, 11.1% for FN, and 10.0% for HCN. In the group with negative tumor markers (N = 31) there were no malignancies. The use of tumor markers, galectin-3 and CD44v6, determined by RT-PCR improves only sensitivity of thyroid FNAB in CIL. In most patients with CIL, and negative both tumor markers, conservative approach is advisable. PMID:20432733

Matesa, Neven; Samija, Ivan; Kusi?, Zvonko

2010-03-01

266

Thyroid disease in the pediatric patient: emphasizing imaging with sonography  

International Nuclear Information System (INIS)

Thyroid disease does occur in the pediatric patient, and imaging plays an important role in its evaluation. A review is presented of normal development of the thyroid gland, the technique and indications for thyroid sonography, and key imaging features of congenital thyroid disorders (ectopic or absent thyroid, infantile goiter, thyroglossal duct remnants), benign thyroid masses (follicular adenoma, degenerative nodules, colloid and thyroid cysts), malignant masses (follicular, papillary and medullary carcinoma) and diffuse thyroid disease (acute bacterial thyroiditis, Hashimoto's thyroiditis, Grave's disease). (orig.)

267

Pediatric Thyroid Cancer  

Science.gov (United States)

... to help establish a diagnosis and plan for management. Treatments for thyroid cancer: If the tumor is found to be malignant, ... outcomes are seen in teenage girls, papillary type cancer, and tumors localized to the thyroid gland. Updated 1/12 Thyroid

268

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

269

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

270

[Pulmonary neuroendocrine neoplasms].  

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The pulmonary neuroendocrine neoplasms originate from the enterochromaffin cells which are diffusely distributed in the body. The incidence of these tumors has increased significantly in recent decades due to the available diagnostics. They make up about 1-2% of all lung tumors and 20-30% of all neuroendocrine neoplasms. The current WHO classification from 2004 divides them into typical carcinoids (TC), atypical carcinoids (AC), large cell neuroendocrine carcinomas (LCNEC) and small cell carcinomas (SCLC). The major neuroendocrine biomarkers are chromogranin A, synaptophysin and CD56. TC have a low mitotic rate of tumor-associated acromegaly are rare. Surgical resection with radical lymph node dissection is the treatment of choice for achieving long-term survival. Endoscopic resection of the endobronchial tumor growth is a good alternative for inoperable endobronchially localized tumors. Peptide receptor radionuclide therapy (PRRT) is a promising treatment option for patients with metastatic or unresectable pulmonary neuroendocrine tumors. New targeted therapies using angiogenesis inhibitors, mTOR inhibitors, and tyrosine kinase inhibitors are being tested for their effectiveness in many previous studies. Typical carcinoid tumors metastasize less frequently than AC, the 5-year survival rate of patients with TC being over 90%. Patients with AC have a 5-year survival rate between 35% and 87%. The highly malignant LCNEC and SCLC, on the other hand, have a 5-year survival rate between 15% and 57%, and tumor conferences to ensure a personalized treatment approach. Therefore patients with a neuroendocrine neoplasm of the lung should be treated in specialized centers. PMID:25006841

Sayeg, Y; Sayeg, M; Baum, R P; Kulkarni, H R; Presselt, N; Mäder, I; Kunze, A; Sänger, J; Hörsch, D; Bonnet, R

2014-07-01

271

Myopathy following postoperative ablative radioiodine for follicular carcinoma of the thyroid  

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Full Text Available Hermione C Price, Vijay JayagopalCentre for Diabetes and Endocrinology, York Hospital, York, UKAbstract: We highlight a case of disabling myopathy following radioablative iodine treatment for follicular carcinoma of the thyroid. A 34-year-old man presented with a tender neck swelling, ultrasound and biopsy were suggestive of thyroid malignancy. Thyroidectomy was undertaken and histology confirmed follicular carcinoma of the thyroid. Treatment with ablative radioiodine followed and within days the patient developed disabling myopathy. Investigations to date do not reveal any other cause for the myopathy and there is no evidence to suggest that this is a paraneoplastic phenomenon. We believe this is the first reported case of ablative radioiodine-induced mypoathy.Keywords: thyroid neoplasms, muscular diseases, iodine radioisotopes

Hermione C Price

2009-03-01

272

Expression of S100A4 in renal epithelial neoplasms.  

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Expression of S100A4 has been associated with progression and poor clinical outcome in a variety of malignancies including those of the breast, pancreas, bladder, and thyroid. To date, the expression of S100A4 protein in renal epithelial neoplasms is poorly understood. In this study, we evaluated the expression of S100A4 protein and mRNA in the nontumoral kidney and renal epithelial neoplasms of different types and correlated its expression with patient outcome. The study population included 155 clear cell renal cell carcinomas (cRCC), 22 papillary renal cell carcinomas (pRCC), 13 chromophobe renal cell carcinomas and 13 oncocytomas. In nontumoral kidney, nuclear and cytoplasmic S100A4 staining was detected in the glomerular epithelium and endothelium, distal tubules and collecting ducts, and loops of Henle. A different expression pattern was noted in the various neoplasms. S100A4 expression was significantly increased in the stromal cells in cRCC (83%) and pRCC (73%) compared with paired nontumoral kidney tissue (P<0.001). There was no increased stromal cell expression of S100A4 in oncocytomas and chromophobe carcinomas. Positive epithelial staining was more common in pRCC (58%) than cRCC (11%) (P=0.01). The level of mRNA detected by reverse transcription-polymerase chain reaction was significantly higher in the tumor as opposed to normal tissue in cRCC but not in the other neoplasms (P=0.03). Multivariate analysis revealed that epithelial S100A4 protein expression is an independent poor prognostic factor along with grade and stage only in cRCC (P<0.01). Although S100A4 protein was expressed in a minority of cRCC, its expression was associated with shorter overall patient survival. PMID:21691200

Wang, Li J; Matoso, Andres; Sciandra, Katherine T; Yakirevich, Evgeny; Sabo, Edmond; Zhang, Ying; Meitner, Patricia A; Tavares, Rosemarie; Noble, Lelia; Pareek, Gyan; DeLellis, Ronald A; Resnick, Murray B

2012-01-01

273

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)  

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Full Text Available SciELO Chile | Language: Spanish Abstract in spanish [...] Abstract in english 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 papillar [...] y thyroid carcinoma. Aim: To detect mRNA from specific malignancy markers in thyroid nodules and to evaluate their potential correlation with cytological and pathological diagnosis. Patients and methods: In 20 patients with thyroid nodules FNAB was performed prior to surgery. The main part of the FNAB sample was used to perform classical cytology. In the remaining of the sample were detected MUC-1, CD26, galectin-3 and TSH receptor mRNAs by RT-PCR technique. Results: Eight patients had positive cytology for papillary cancer; which was confirmed by pathology. Nine had suspicious or non conclusive cytological findings and 3 were negative for neoplastic cells; all 12 were pathologically benign. We detected TSH receptor and galectin-3 mRNA in almost all benign and malignant nodules. MUC-1 was present in 5/8 papillary carcinoma (62.5%), and 1/12 benign nodules (8.3%). CD26 was detected in 7/8 papillary carcinomas but also in 8/12 benign nodules. Conclusions: RT-PCR can be performed in very small samples of thyroid tissue to detect several mRNA markers. MUC-1 can be a potentially useful marker of malignancy in thyroid nodules. It can be detected by RT-PCR as a complementary technique in the diagnostic evaluation of thyroid nodules

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

274

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)  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish [...] Abstract in english 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 papillar [...] y thyroid carcinoma. Aim: To detect mRNA from specific malignancy markers in thyroid nodules and to evaluate their potential correlation with cytological and pathological diagnosis. Patients and methods: In 20 patients with thyroid nodules FNAB was performed prior to surgery. The main part of the FNAB sample was used to perform classical cytology. In the remaining of the sample were detected MUC-1, CD26, galectin-3 and TSH receptor mRNAs by RT-PCR technique. Results: Eight patients had positive cytology for papillary cancer; which was confirmed by pathology. Nine had suspicious or non conclusive cytological findings and 3 were negative for neoplastic cells; all 12 were pathologically benign. We detected TSH receptor and galectin-3 mRNA in almost all benign and malignant nodules. MUC-1 was present in 5/8 papillary carcinoma (62.5%), and 1/12 benign nodules (8.3%). CD26 was detected in 7/8 papillary carcinomas but also in 8/12 benign nodules. Conclusions: RT-PCR can be performed in very small samples of thyroid tissue to detect several mRNA markers. MUC-1 can be a potentially useful marker of malignancy in thyroid nodules. It can be detected by RT-PCR as a complementary technique in the diagnostic evaluation of thyroid nodules

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

2003-09-01

275

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  

Directory of Open Access Journals (Sweden)

Full Text Available 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 diagnosis. Patients and methods: In 20 patients with thyroid nodules FNAB was performed prior to surgery. The main part of the FNAB sample was used to perform classical cytology. In the remaining of the sample were detected MUC-1, CD26, galectin-3 and TSH receptor mRNAs by RT-PCR technique. Results: Eight patients had positive cytology for papillary cancer; which was confirmed by pathology. Nine had suspicious or non conclusive cytological findings and 3 were negative for neoplastic cells; all 12 were pathologically benign. We detected TSH receptor and galectin-3 mRNA in almost all benign and malignant nodules. MUC-1 was present in 5/8 papillary carcinoma (62.5%, and 1/12 benign nodules (8.3%. CD26 was detected in 7/8 papillary carcinomas but also in 8/12 benign nodules. Conclusions: RT-PCR can be performed in very small samples of thyroid tissue to detect several mRNA markers. MUC-1 can be a potentially useful marker of malignancy in thyroid nodules. It can be detected by RT-PCR as a complementary technique in the diagnostic evaluation of thyroid nodules

Pedro Pineda B

2003-09-01

276

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 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. PMID:25116459

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

2014-10-01

277

Role of Ki-67 as a proliferative marker in lesions of thyroid  

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Full Text Available Background: Specific criteria are used to diagnose thyroid neoplasms; however, the distinction between certain neoplasms, such as follicular adenoma and carcinoma, could be difficult. Thus, additional diagnostic features that can assist in this distinction would have great clinical usefulness. Aims: To evaluate the role of the proliferative marker Ki-67 in nonneoplastic and neoplastic lesions of the thyroid, with a special emphasis on the distinction between follicular adenoma and follicular carcinoma. Settings and Design: A retrospective study from a tertiary care center. Materials and Methods: One hundred cases of thyroid lesions, including 50 nonneoplastic and 50 neoplastic lesions, were retrieved from the archives of the Department of Pathology, Pt. BD Sharma PGIMS, Rohtak, Ki-67 immunostaining was performed by peroxidase-antiperoxidase method and compared with mitotic counts. Results: Ki-67 labeling index (LI showed a progressive rise from multinodular goiter to benign to malignant neoplasms. A statistically significant difference was observed in Ki-67 counts between multinodular goiter vs papillary carcinoma (P < 0.05 and follicular adenoma vs follicular carcinoma (P < 0.05. The correlation between mitotic counts and Ki-67 LI was found to be significant. Conclusions: In the present study, Ki-67 was found to be useful in differentiating between follicular adenoma and follicular carcinoma, but since the sample size of our study was small, larger studies are needed to confirm this observation as well as to assign a cutoff value for differentiating benign from malignant tumors.

Pujani M

2010-01-01

278

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 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.

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

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  

Scientific Electronic Library Online (English)

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.

 
 
 
 
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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

282

The thyroid  

International Nuclear Information System (INIS)

Thyroid imaging no longer has a predominant role in nuclear medicine, although it still is commonly performed. The introduction of in vitro assays for assessment of glandular function has decreased the need for administration of radionuclides to patients. The introduction of 123I has been a major step forward. The need now is for a tumor-specific agent that can help to determine the benignancy or malignancy of thyroid nodules. Perhaps immunologic techniques, which are not being intensively investigated, will provide an answer to this perplexing problem. Three-dimensional imaging, especially for larger organs, is beginning to be widely utilized. For the thyroid, techniques such as seven pinhole tomography or coded aperature methods can offer some improvement in detection of abnormalities but add little in the way of improved specificity. Resolution will improve with the development of new types of cameras. With the realization of the carcinogenic properties of radiation, especially related to the thyroid, perhaps the problem of radiation-associated thyroid cancer will lessen with time. Nonetheless, the frequency of diseases of the thyroid will require that thyroid imaging continue to be an important activity in nuclear medicine

283

Histochemical study of fibrillar proteins of the extracellular matrix in benign and malignant mammary neoplasms in dogs / Estudo histoquímico de proteínas fibrilares da matriz extracelular em neoplasias mamárias benignas e malignas na espécie canina  

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Full Text Available SciELO Brazil | Language: English Abstract in portuguese A finalidade do presente trabalho foi estudar algumas das proteínas fibrilares da matriz extracelular de 54 neoplasias mamárias benignas e malignas na espécie canina, utilizando métodos histoquímicos: Picrosirius associado à polarização para fibras colágenas , método de Gordon - Sweats para fibras r [...] eticulares e método de Weigert com e sem oxidação para fibras elásticas. Evidenciou-se na matriz uma grande variabilidade na quantidade, distribuição e características dos componentes matriciais presentes nos diferentes tipos de neoplasias. Detectou-se, assim, colágeno I, III e elementos do sistema elástico, distribuídos diferentemente nas neoplasias benignas e malignas. O método Picrosirius simples e associado à polarização permitiu a visualização do colágeno sob a forma de fibras espessas distribuídas irregularmente no estroma dos carcinomas e de modo mais ordenado e regular nas neoplasias benignas e, fibras mais finas, em menor quantidade, irregularmente e aleatoriamente dispostas nos carcinomas e regularmente nas neoplasias benigna. Sob luz polarizada os feixes de fibras colágenas , apresentaram diferentes comprimentos, avermelhados ou amarelados e fortemente birrefringentes, sugerindo serem colágeno tipo I e, entremeando as fibras, algumas mais finas ,pálidas, esverdeadas e fracamente birrefringentes, presumivelmente colágeno tipo III. Em áreas condrometaplásicas, tanto nos carcinomas como nas neoplasias benignas notou-se que os feixes colágenos apresentavam-se com fibras finas, paralelas, limitando regiões estreitas onde os condrócitos se aninhavam, e, rodeando esta área, feixes de fibras espessas, anastomosadas, dispostas irregularmente nos carcinomas e ordenadamente e paralelas nas neoplasias benignas. Sob luz polarizada, essa população entre condrócitos era formada por fibras pálidas e amareladas, sugerindo padrão tipo II e na faixa circundante, feixes fortemente birrefringentes, sugerindo o padrão do colágeno tipo I.. O uso do método - Gordon & Sweats, permitiu a visualização do colágeno sob a forma de fibras finas, dispostas tanto nos estromas densos como nos frouxos, com densidade variada mas, principalmente , margeando os ácinos e túbulos. Quanto à presença do sistema elástico em tumores benignos e malignos, verificou-se que há predomínio dessas fibras nos malignos, principalmente na pseudocápsula e ao redor de ácinos e túbulos. Elementos do sistema elástico não foram observados em espécimes submetidos à coloração de Weigert sem oxidação. Neste mesmo material, com oxidação, as fibras oxitalâmicas foram mais evidentes principalmente ao redor de ácinos, túbulos e pseudocápsula. Elementos do sistema elástico na (MEC) foram raros, tanto em amostras com e sem oxidação. Isto pode ser observado de maneira semelhante tanto em tumores benignos e malignos. Os resultados deste estudo enfatizam as profundas alterações estruturais dos componentes colagenosos e fibras do sistema elástico na matriz extracelular de neoplasias mamárias da espécie canina. Abstract in english The aim of the present study was to study some of the proteins that form the extracellular matrix of 54 benign and malignant mammary neoplasms in dogs, using histochemical methods: Picrosirius and polarization microscopy for collagenous fibers, Gordon -Sweats's method for reticular fibers and Weiger [...] t's fucsine-resorcine method for elastic fibers. A large variability in quantity, distribution and characteristics of the matrix components was observed in the different types of neoplasms. Collagen type I, III and elements of the elastic system had different distribution in benign and malignant neoplasms. The simple Picrossirius method and under polarization enabled visualization of collagen as thick fibers irregularly distributed in the stroma of carcinomas and in a more orderly and regular fashion in benign neoplasms. A smaller amount of thin fibers was observed in an irregular and random dispos

Ana Maria Cristina Rabello Pinto da Fonseca, Martins; Elia, Tamaso; José Luiz, Guerra.

284

Riedel's thyroiditis masquerading as anaplastic thyroid carcinoma: a case report  

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Full Text Available Abstract Introduction Riedel's thyroiditis is a rare thyroid disease characterized by dense fibrous tissues that replace the thyroid gland and invade the adjacent structures that can mimic thyroid malignancy. We discuss the presentation, investigation and management of this very rare condition. Case presentation We present a case of a 59-year-old African-Caribbean man who presented with a rapidly growing hard neck mass, a hoarse voice, dysphagia and breathing difficulty that clinically suggested thyroid malignancy. Biopsy, however, revealed dense fibrous tissues suggestive of Riedel's thyroiditis. This was successfully treated with very high dose steroids, with no relapse in the symptoms. Conclusion It is important for clinicians to be aware of this diagnosis when managing patients with thyroid disease, because Riedel's thyroiditis can mimic malignancy. In addition, our case demonstrates that this condition should be treated with very high dose steroids to prevent relapse.

Jindall Mudit

2010-01-01

285

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

286

A perfusion study of malignant lymph nodes in the neck with multi-slice spiral CT  

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Objective: To study the imaging features of various malignant lymph nodes in the neck space by using time-attenuation curves (TAC) and CT perfusion parameters, and to explore their values in the differential diagnosis. Methods: Dynamic enhanced CT scanning was performed in 50 patients with neoplasm in neck space, 33 of which were pathologically-proved malignant lymph nodes, including squamous carcinoma (n=16), thyroid carcinoma (n=8), and lymphoma (n=9). The data of TAC and perfusion parameters (BF, BV, MTT, and PS) of the neoplasms were recorded and analyzed statistically. Results: Significant difference in BF, BV, MTT and PS existed between the malignant lymph nodes (319.26 ml·min-1·100 g-1, 7.68 ml·100 g-1, 2.91 s, and 44.69 ml·min-1·100 g-1) and normal tissue (P-1·100 g-1, and 25.82 ml·100 g-1) were statistically higher than those of squamous carcinoma and lymphoma ( P-1·100 g-1) was higher statistically than that of lymphoma (231.14 ml·min-1·100 g-1) (P<0.05). Conclusion: The TAC and perfusion parameters of malignant lymph nodes in s of malignant lymph nodes in squamous carcinoma, thyroid carcinoma, and lymphoma have different characteristics, and they are helpful in the differential diagnoses. (author)

287

Pleomorphic dermal neoplasms: a review.  

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Pleomorphic neoplasms are typically associated with high-grade malignant behavior, but this does not readily apply to primary cutaneous tumors. Despite morphologic features suggestive of malignancy, atypical fibroxanthoma, the classic example of a pleomorphic dermal neoplasm, is characterized by indolent clinical behavior. Atypical fibroxanthoma is a distinctive clinicopathologic disease affecting sun-damaged skin of elderly males. Histologically, it is often ulcerated and dermal based with pushing growth, characterized by a sheet-like and fascicular growth of pleomorphic epithelioid, spindled, and multinucleated tumor cells with brisk and atypical mitotic activity. However, no positive discriminatory histologic or immunohistochemical features exist. Its diagnosis is one exclusion with a wide differential diagnosis, mainly including other mesenchymal, melanocytic, and epithelial neoplasms. Particular considerations are pleomorphic dermal sarcoma, invasive melanoma, squamous cell carcinoma, metaplastic carcinoma, poorly differentiated cutaneous angiosarcoma, cutaneous leiomyosarcoma, myxofibrosarcoma, variants of fibrous histiocytoma (FH), pleomorphic fibroma, and non-neural granular cell tumor. The behavior of these tumors is varied and ranges from outright malignant to entirely benign, requiring confident diagnosis to reliably predict behavior and guide treatment. Although challenging, because of significant clinical and pathologic overlap, it is usually possible to establish a definitive diagnosis when attention is paid to the often subtle differentiating features. This requires careful tumor sampling, recognition of the subtle distinguishing morphologic features, judicious use and analysis of immunohistochemistry, and interpretation of the findings in the appropriate clinical setting. PMID:24508694

Brenn, Thomas

2014-03-01

288

Malignant inflammatory myofibroblastic tumor of the maxillary sinus.  

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Inflammatory myofibroblastic tumors (IMTs) are extremely rare neoplasms with a variable natural history and biologic behavior, ranging from completely benign to malignant tumors with fatal outcome. They have no common identifiable cause, although some authors have assumed that any inflammatory stimulus may cause these pseudotumors. They are most commonly found in the lungs. Extrapulmonary sites include abdomen, retroperitoneum and extremities. IMTs rarely affect the head and neck, but the most common subsites in this region include the orbit, larynx, mouth, tonsils, parapharyngeal space, thyroid, parotid and lacrimal glands. There are few reports of inflammatory pseudotumors in the paranasal sinuses. In the maxillary sinus, the initial presenting sign is usually a nonspecific sinonasal mass, which has been growing over a period of weeks or months. On rare occasions, IMT may exhibit malignant transformation. Herein we present a rare case of pathologically proved IMT with malignant transformation which originated in the maxillary sinus of a 29-year-old male. PMID:24250100

Salehinejad, Jahanshah; Pazouki, Mahdi; Gerayeli, Mohammad Ali

2013-05-01

289

Silent thyroiditis  

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Lymphocytic thyroiditis; Subacute lymphocytic thyroiditis; Painless thyroiditis; Postpartum thyroiditis; Thyroiditis - silent ... The cause of this type of thyroiditis is unknown, but it is ... the thyroid. The disease affects women more often than men. The ...

290

Axillary node metastasis from differentiated thyroid carcinoma with hürthle and signet ring cell differentiation. A case of disseminated thyroid cancer with peculiar histologic findings  

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Full Text Available Abstract Background Differentiated thyroid cancer is usually associated with an excellent prognosis and indolent course. Distant metastases are rare events at the onset of thyroid cancer. Among these presentations, metastasis to the axillary lymph nodes is even more unusual: only few cases were previously reported in the literature; there has been no report of axillary lymph node metastasis from follicular thyroid carcinoma. Axillary lymph node metastasis generally arises in the context of disseminated disease and carries an ominous prognosis. Case presentation Here we present a case of axillary lymph node metastasis in the context of disseminated differentiated thyroid cancer. The patient underwent near total thyroidectomy and neck and axillary lymph node dissection. A histopathological diagnosis of poorly differentiated follicular carcinoma with "signet ring cells" and Hürthle cell features was established. The patient received radioactive iodine therapy and TSH suppression therapy. Subsequently his serum thyroglobulin level decreased to 44.000 ng/ml from over 100.000 ng/ml. Discussion and Conclusion Currently there are only few reported cases of axillary node metastases from thyroid cancer, and to our knowledge, this is the first report on axillary lymph node metastasis from follicular thyroid carcinoma. "Signet ring cell" is a morphologic feature shared by both benign and, more rarely, malignant follicular thyroid neoplasm, and it generally correlates with an arrest in folliculogenesis. Our case is one of the rare "signet ring cells" carcinomas so far described.

Chiofalo Maria

2012-02-01

291

Burkitts primary thyroid lymphoma coexistence with Hashimoto's thyroiditis  

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Th primary thyroid lymphoma is a rare neoplasm, above all in children. We present a case of a child with Burkitt's thyroid lymphoma as the only manifestation of this disease, associated to lymphocytic thyroiditis. Clinically, it initiated as a rapidly growing goiter with compressive symptomatology. The X-ray findings are described: hypoechoic and hypodense multiple nodes that affect the right thyroid lobe and isthmus, with extraglandular extension to the vascular space and to the mediastinum. The differential diagnosis is considered with other more frequent thyroid pathologies in this age group. (Author) 14 refs

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

Follicular thyroid carcinoma  

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Full Text Available Follicular thyroid cancer is the second most common thyroid malignancy. This tumor has a predisposition for hematogenous dissemination an extrathyroid spread. Accurate cytological diagnosis of follicular thyroid cancer is not possible and this fact highlights the necessity for surgical treatment of any suspicious thyroid nodule. Aggressiveness of this tumor is greater than in the case of papillary thyroid cancer and it is the reason for radical surgical treatment of follicular thyroid cancer. Total thyroidectomy facilitates later adjuvant therapy with thyroid hormones and radioiodine. This procedure improves the outcome and the risk of relapse. Results of our study clearly demonstrate that diagnosis of follicular thyroid cancer in us is established in the early phase of the disease (78.57%, but the significant number of the patients (21.43% is still in the advanced phase of the disease.

Boži? Vesna D.

2003-01-01

294

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

295

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

296

Immunohistochemical Reactivity of the 14F7 Monoclonal Antibody Raised against N-Glycolyl GM3 Ganglioside in Some Benign and Malignant Skin Neoplasms.  

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The evaluation of 14F7 Mab (anti-N-glycolyl GM3 ganglioside) immunorecognition in normal skin, cutaneous malignant melanoma (CMM), and in lymph node metastases (LNM) has been previously reported. In this work we extended the study to benign (BMN) and dysplastic (DMN) melanocytic nevi, basal (BCC), and squamous cell carcinoma (SCC). Immunohistochemical assays with 14F7 followed by a biotinylated link universal and streptavidin-AP in normal and pathological tissues were made. No reaction of 14F7 in normal skin (0/10) as well as a low reactivity in BMN (2/11) and DMN (1/7) was detected. A limited staining in BCC (2/13) and in SCC (4/8) was also evidenced, while 14F7 Mab were mostly reactive in CMM (28/28) and in LNM (6/7). These results suggest that 14F7 reactivity could be closely related with the more aggressive biological behavior of CMM and also support the use of NeuGcGM3 as target for both passive and active melanoma immunotherapy. PMID:22363862

Blanco, Rancés; Rengifo, Enrique; Rengifo, Charles E; Cedeño, Mercedes; Frómeta, Milagros; Carr, Adriana

2011-01-01

297

Multikinase inhibitors in the treatment of thyroid cancer: specific role of lenvatinib  

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Full Text Available Neda Stjepanovic, Jaume CapdevilaDepartment of Medical Oncology, Vall d'Hebron University Hospital, Barcelona, SpainAbstract: Thyroid cancers are the most frequent neoplasms of the endocrine system and in the initial stages their prognosis is excellent. However, few therapeutic options are available for advanced or metastatic disease. In the last decade, a better understanding of the molecular events involved in the tumorigenesis of thyroid cancers has led to development of new targeted agents for the management of advanced and refractory disease. Multikinase inhibitors that are able to block pathways involved in the proliferation, invasion, and neoangiogenesis of thyroid cancer have been the most widely studied. After an international effort to identify and recruit sufficient patients, four placebo-controlled studies of multikinase inhibitors have been completed. These trials have led to the approval of the first agents with activity in advanced medullary thyroid cancers, which will probably change the landscape of treatment for iodine-refractory differentiated thyroid cancer in the near future. The purpose of this paper is to review the development of targeted agents for thyroid malignancy, with a special focus on lenvatinib, a multikinase inhibitor.Keywords: thyroid cancer, lenvatinib, tyrosine kinase inhibitors, multikinase inhibitors, targeted therapies

Stjepanovic N

2014-04-01

298

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

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usion 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)

299

Follicular lesion of undetermined significance in thyroid FNA revisited.  

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Controversy exists regarding the validity of follicular lesion of undetermined significance (FLUS), an indeterminate diagnostic category of The Bethesda System for Reporting Thyroid Cytopathology (BSRTC). According to BSRTC, FLUS carries a 5-15% risk of cancer. This study was designed to determine if cytomorphology could stratify FLUS into subgroups with different risks of malignancy. Reports of 127 consecutive FNAs reported as FLUS with subsequent tissue diagnoses were evaluated for the presence of various cytologic features and the results were correlated with histological diagnoses. FLUS cases with focal nuclear atypia (nuclear overlap/crowding, nuclear grooves/membrane irregularities, nuclear enlargement, and/or nuclear pseudoinclusions) were more frequently malignant on excision whereas those with architectural atypia (microfollicles) were more often benign on excision (P < 0.05). The presence of any one or more of these nuclear features increased the risk of carcinoma in subsequent thyroid resection. Papillary carcinomas predominated in excised FLUS cases with focal nuclear atypia whereas most FLUS with architectural atypia were adenomas or hyperplastic nodules on histological evaluation. BSRTC recommends that thyroid aspirates containing follicular cell nuclear and/or architectural atypia insufficient for a diagnosis of suspicious for follicular neoplasm, suspicious for malignancy or malignant be classified as FLUS. Our findings indicate that FLUS cases with focal nuclear atypia carry a risk for malignancy that is substantially higher than that assigned to FLUS and are best classified as suspicious. FLUS cases lacking these atypical nuclear features have a risk for malignancy that approximates the risk BSRTC has assigned to FLUS. PMID:23894017

Walts, Ann E; Mirocha, James; Bose, Shikha

2014-01-01

300

Salivary gland neoplasms: an analysis of 74 cases.  

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Between 2006 and 2009, 74 cases of salivary gland neoplasms were analyzed retrospectively, of which 44 (60%) were benign and 30 (40%) malignant. 61 % percent of neoplasms were in the parotid gland, 22% in the minor salivary glands including sublingual salivary glands, and 17% in the submandibular glands. The most common benign neoplasm was pleomorphic adenoma (64%), and the most common malignant neoplasm were adenoid cystic carcinoma (17%) and mucoepidermoid carcinoma (23%). We analyze the incidence and distribution of all types of salivary gland neoplasms in our series, and provide data for comparison with other epidemiological studies from different geographical sites and races. Demographic data from these studies help us to a better understanding of the biological and clinical characteristics of the disease. Further epidemiological surveys should be encouraged for better understanding of the disease and to provide early and better treatment of salivary gland neoplasms. PMID:23139498

Sirohi, Deepika; Sharma, Rohit; Sinha, Ramen; Suresh Menon, P

2009-06-01

 
 
 
 
301

Carcinossarcoma tireoidiano em um cão / Thyroid carcinosarcoma in a dog  

Scientific Electronic Library Online (English)

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.

302

Intrathoracic lymph node metastases from extrathoracic neoplasms.  

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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

303

Magnesium versus lead in dietary induction of rat neoplasms  

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A synthetic diet with permutations of concentrations of Mg and Pb was fed to 793 postweanling male Sprague-Dawley rats. When the diet was low in content of Mg and Pb, they often developed, in the following sequence: a threefold leukocytosis; a marked reduction in cell-mediated immunocompetence; a lethal malignant lymphoma (47/71) in 8 to 24 weeks; and, finally, a lethal myelogenous leukemia (5/52) in 24 to 62 weeks. If the low-Mg diet was supplemented with excess Pb, malignant lymphoma was prevented (0/35) in 8 to 24 weeks and the usual neoplastic action of Pb was inhibited. A dietary excess of Mg alone had no epithelial neoplastic action (0/284) and little lymphoid leukemogenic action (2/84) in 8 to 62 weeks. When the diet had an excess of Mg and Pb, it favored occurrence in 41 to 62 weeks of large renal adenomas (54/92) and carcinomas (19/92) as well as thyroid adenomas (7/92) and carcinomas (4/92). If the diet high in Mg and Pb was prepared with crude rather than purified casein, leukemoid reactions with atypical lymphoid leukemia (8/102), myeloid leukemia (3/102), and cerebral gliomas (4/102) developed in 34 to 62 weeks along with renal tumors (74/102), but no thyroid tumors (0/102) were seen. The means by which these dietary permutations of concentrations of Mg and Pb mediate induction of some rat neoplasms is unknown. It is suggested that the effects are due to mutual displacement or other influences of these ions in activation of key enzymes involved in neoplastic transformation.

McCreary, P.A. (McGraw Medical Centers, Chicago); Laing, G.H.; Coogan, P.S.; Hass, G.M.

1977-02-01

304

Histopathological audit of salivary gland neoplasms  

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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)

305

A case of quadruple primary malignancies including breast, tongue, and thyroid cancers and osteosarcoma in a young female without karyotype abnormality.  

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The patient was a 41-year-old, premenopausal woman with a chief complaint of well-circumscribed palpable, right breast mass without nipple discharge. Although she noticed the lump 3 months previously, the size of the tumor (1.1 × 0.9 cm(2)) had been stable. The patient's mother suffered from gastric cancer. Her previous history of the triple different malignancies was as follows: (1) left osteosarcoma [amputation of left lower leg at 15 years old (y/o)]. After the operation, she was treated with various kinds of anticancer drugs including a total of 45 g ifosphamide and 342 g methotrexate; (2) tongue cancer (right radical neck resection; 23 y/o); and (3) thyroid cancer (right lobectomy; 40 y/o). There was no evidence of recurrence of these malignancies at the present consultation. At the time of tongue cancer operation, chromosome abnormality was investigated, but the results were normal. Physical examination showed a well-delimited, elastic-firm, mobile tumor in the central outer right breast. Regional lymph nodes were not palpable. Mammography showed a focal asymmetry in the right upper breast on the mediolateral oblique view. Ultrasonography revealed a hypoechoic mass with irregular margins. Distant metastases could not be detected by whole-body computed tomography scan. The histology of the Mammotome(®) (vacuum-assisted core needle biopsy) specimen revealed that this tumor was low-grade ductal carcinoma in situ (DCIS). She underwent breast-conserving surgery with sentinel lymph node biopsy. On permanent histopathological examination, the diagnosis of the tumor was intracystic papilloma with low-grade DCIS. Surgical margin was negative, and sentinel lymph node metastases could not be observed. Estrogen and progesterone receptor (ER/PR) were strongly positive, but human epidermal growth factor receptor-2 (HER-2) overexpression was not tested because the lesion was DCIS. She has received no adjuvant therapy and is currently disease free 3 months after surgery. PMID:21562838

Kousaka, Junko; Fujii, Kimihito; Yorozuya, Kyoko; Mouri, Yukako; Yoshida, Miwa; Nakano, Shogo; Fukutomi, Takashi; Takahashi, Emiko; Yokoi, Toyoharu

2014-07-01

306

Clinicopathological and molecular characterization of nine cases of columnar cell variant of papillary thyroid carcinoma.  

Science.gov (United States)

The majority of papillary thyroid carcinoma is indolent and associated with long-term survival. The columnar cell variant, however, is a rare subtype that is variable in biological behavior; some are clinically aggressive, whereas others are more clinically indolent. Tumor size, tumor circumscription, and encapsulation may influence the behavior of columnar cell carcinomas. Other variables including genetic changes and putative biomarkers associated with malignant growth have not been thoroughly examined in these neoplasms. In this study, nine cases of columnar cell variant of papillary thyroid carcinoma from three institutions were classified as clinically indolent or aggressive based on pathological features, clinical history, and outcome. Indolent tumors were typically small, circumscribed or encapsulated, and from younger female patients, whereas aggressive tumors were large, locally aggressive, associated with regional and distant metastasis, and from older male patients. The missense mutation, V600E in the BRAF oncogene (BRAF(V600E)), was detected in three of nine of cases, of which two were clinically aggressive. Immunohistochemical evaluation of neoplasia-associated markers showed increased nuclear cyclin D1 expression, elevated Ki-67 proliferation indices, and predominantly weak nuclear p53 staining in both indolent and aggressive tumors. Expression of ?-catenin was largely restricted to a membranous pattern in both tumor types. Cytoplasmic expression of bcl-2 was overall mildly reduced in indolent neoplasms. Nuclear expression of estrogen and progesterone receptors was increased in both indolent and aggressive neoplasms, but was without sex- or age-related differences; however, whereas progesterone receptor expression was diffuse and strong in clinically indolent carcinomas, its expression was diminished in aggressive neoplasms. Recognition of the clinicopathological characteristics and the molecular and immunophenotypic features of the columnar cell variant of papillary thyroid carcinoma may aid in characterizing neoplasms that behave indolently or aggressively. PMID:21358618

Chen, Jey-Hsin; Faquin, William C; Lloyd, Ricardo V; Nosé, Vânia

2011-05-01

307

Unusual Presentation of Cystic Papillary Thyroid Carcinoma  

Science.gov (United States)

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 which is presented as subcutaneous swelling with sinus formation. PMID:23133761

Patil, Vijayraj S.; Vijayakumar, Abhishek; Natikar, Neelamma

2012-01-01

308

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

309

Thyroid disease in the pediatric patient: emphasizing imaging with sonography  

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Thyroid disease does occur in the pediatric patient, and imaging plays an important role in its evaluation. A review is presented of normal development of the thyroid gland, the technique and indications for thyroid sonography, and key imaging features of congenital thyroid disorders (ectopic or absent thyroid, infantile goiter, thyroglossal duct remnants), benign thyroid masses (follicular adenoma, degenerative nodules, colloid and thyroid cysts), malignant masses (follicular, papillary and medullary carcinoma) and diffuse thyroid disease (acute bacterial thyroiditis, Hashimoto's thyroiditis, Grave's disease). (orig.)

Babcock, Diane S. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

2006-04-15

310

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.

311

Subacute thyroiditis  

Science.gov (United States)

De Quervain's thyroiditis; Subacute nonsuppurative thyroiditis; Giant cell thyroiditis; Subacute granulomatous thyroiditis ... Subacute thyroiditis is a rare condition. It is thought to be caused by a viral infection. The condition often ...

312

Immunohistochemistry of germ cell and trophoblastic neoplasms.  

Science.gov (United States)

The immunoprofiles of 121 germ cell and trophoblastic neoplasms were defined, using a battery of antibodies against cytokeratin (CK), vimentin (VIM), epithelial membrane antigen (EMA), placental alkaline phosphatase (PLAP), S-100 protein, leukocyte common antigen (LCA), UCHL-1, LN-2, carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), chromogranin A, Leu-7, alpha-fetoprotein (AFP), alpha-1-antitrypsin (AAT), and the beta subunit of human chorionic gonadotropin (BHCG). In addition to 85 neoplasms of testicular origin, the cases included eight ovarian germ cell tumors and 28 extragonadal neoplasms. All tissues had been subjected to formalin fixation and paraffin embedding. Similar immunoreactivity patterns were seen in gonadal and extragonadal neoplasms, gestational and nongestational choriocarcinomas, components of mixed germ cell tumors and their pure counterparts, and metastatic and primary lesions. Placental alkaline phosphatase was a sensitive marker of germ cell differentiation, and expression of this marker in the absence of EMA appeared to be a staining pattern unique to germ cell tumors. Both LCA and S100 were absent in neoplastic germ cells, and thus were useful in differentiating these tumors from malignant lymphoma and malignant melanoma, respectively. Cytokeratin was helpful in distinguishing seminomas/dysgerminomas from nonseminomatous germ cell tumors, although 10% of seminomas showed focal or diffuse cytokeratin reactivity. Finally, 75% of all germ cell neoplasms displayed NSE, calling the specificity of this determinant into question. PMID:2457424

Niehans, G A; Manivel, J C; Copland, G T; Scheithauer, B W; Wick, M R

1988-09-15

313

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

314

Fine needle aspiration biopsy diagnosis of metastatic neoplasms of the breast. A three-case report  

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Abstract Metastases to the breast are unusual lesions that make up approximately 2% of all malignant mammary neoplasms and may mimic both benign and malignant primary neoplasms from a clinical point of view, as well as in imaging studies. Arriving at a correct diagnosis is therefore essential in order to establish appropriate management. We present three cases of metastatic neoplasms diagnosed through fine needle aspiration biopsy and immunocytochemistry. The cytological diag...

Raquel Garza-Guajardo; Nora Mendez-Olvera; Pablo Flores-Gutierrez; Silvia Hernandez-Martinez; Michelle Candanosa-Mc; Jesús Ancer-Rodriguez; Oralia Barboza-Quintana

2005-01-01

315

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.

de la Santa, Luis Gijon; Retortillo, Jose Antonio Perez; Miguel, Ainhoa Camarero; Klein, Lea Marie

2014-01-01

316

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)

317

Ultrasonographic Findings of Papillary Thyroid Cancer with or without Hashimoto's Thyroiditis  

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This study was designed to compare the ultrasonographic features of papillary thyroid carcinoma with and without Hashimoto's thyroiditis. This retrospective study included 190 patients with papillary thyroid carcinoma which was proven by neck surgery. The difference in the ultrasonographic findings between papillary thyroid carcinoma with Hashimoto's thyroiditis and papillary thyroid carcinoma without Hashimoto's thyroiditis were calculated statistically. Hashimoto's thyroiditis was diagnosed in 61 of 190 patients following neck surgery. The incidence of coexisting papillary thyroid carcinoma with Hashimoto's thyroiditis was significantly higher in women (p=0.0026). In addition, the frequency of macrocalcification in patients with Hashimoto's thyroiditis was also significantly higher (p=0.0009). Conversely,other ultrasonographic findings including the shape, margin, echogenicity and calcifications, for patients with papillary thyroid carcinoma with Hashimoto's thyroiditis and papillary thyroid carcinoma without Hashimoto's thyroiditis, were not statistically significant. We also found that patients with Hashimoto's thyroiditis who showed no calcification on ultrasonography tended not to detect the papillary carcinoma at a higher frequency. On ultrasonography, macrocalcifications occurred more frequently in patients with Hashimoto's thyroiditis than those without Hashimoto's thyroiditis. Malignant thyroid nodules without calcifications in patients with Hashimoto's thyroiditis more often could not be detected. Therefore, it is important carefully examine patients with Hashimoto's thyroiditis

Park, Jun Young; Lee, Tae Hyun; Park, Dong Hee [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

2010-04-15

318

Ultrasonographic Findings of Papillary Thyroid Cancer with or without Hashimoto's Thyroiditis  

International Nuclear Information System (INIS)

This study was designed to compare the ultrasonographic features of papillary thyroid carcinoma with and without Hashimoto's thyroiditis. This retrospective study included 190 patients with papillary thyroid carcinoma which was proven by neck surgery. The difference in the ultrasonographic findings between papillary thyroid carcinoma with Hashimoto's thyroiditis and papillary thyroid carcinoma without Hashimoto's thyroiditis were calculated statistically. Hashimoto's thyroiditis was diagnosed in 61 of 190 patients following neck surgery. The incidence of coexisting papillary thyroid carcinoma with Hashimoto's thyroiditis was significantly higher in women (p=0.0026). In addition, the frequency of macrocalcification in patients with Hashimoto's thyroiditis was also significantly higher (p=0.0009). Conversely,other ultrasonographic findings including the shape, margin, echogenicity and calcifications, for patients with papillary thyroid carcinoma with Hashimoto's thyroiditis and papillary thyroid carcinoma without Hashimoto's thyroiditis, were not statistically significant. We also found that patients with Hashimoto's thyroiditis who showed no calcification on ultrasonography tended not to detect the papillary carcinoma at a higher frequency. On ultrasonography, macrocalcifications occurred more frequently in patients with Hashimoto's thyroiditis than those without Hashimoto's thyroiditis. Malignant thyroid nodules without calcifications in patients with Hashimoto's thyrications in patients with Hashimoto's thyroiditis more often could not be detected. Therefore, it is important carefully examine patients with Hashimoto's thyroiditis

319

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

320

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 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

 
 
 
 
321

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  

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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 assigned 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 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 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 characteristics 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 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.

Mario Castillo

2011-06-01

322

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.

323

Skin metastasis as the initial manifestation of poorly differentiated thyroid carcinoma.  

Science.gov (United States)

Poorly differentiated thyroid carcinoma (PDTC) is a rare and clinically aggressive thyroid cancer of follicular cell origin. This thyroid tumor can also arise from Hürthle cell or papillary thyroid carcinoma (1). PDTC accounts for 4-7% of all thyroid cancers and it is twice as common in men of a mean age of 55.7 years (1,2). According to the World Health Organization (WHO) definition, PDTC has 2 histomorphologic subtypes: insular and noninsular (1). However, based on clinical features, PDTC has a morphologically and behaviorally intermediate position between well differentiated (follicular and papillary) and undifferentiated (anaplastic) thyroid carcinoma (3,4). Notably, PDTC often presents in an advanced stage and has a propensity for local recurrence, tending to metastasize to regional lymph nodes, the lungs, and bone (1). Accordingly, this thyroid tumor has a rapid and fatal outcome despite appropriate treatment (3). Skin metastases are a rare phenomenon in PDTC, representing 0.7-2.0% of all cutaneous malignant neoplasms (5). Skin metastasis from thyroid carcinoma is rare and occasionally represents the initial manifestation of an occult thyroid carcinoma (5,6). To the best of our knowledge, only a few cases of cutaneous metastasis from PDTC have been reported in the English-language literature until 2012. Herein, we report on an additional case of PDTC with metastasis to the skin as a presenting sign of thyroid cancer. A 78-year-old man presented with multiple skin nodules on the scalp, forehead, and chin. The patient presented with a progressive mass on the right side of the thyroid lobe that had developed 3 months previously. The patient had a history of odinophagia, weight loss, and decreased appetite. He had been a smoker for 40 years, but had no familial history of thyroid disease or exposure to radiation. On examination, multiple erythematous and tender nodules were found on the scalp, forehead, and chin (Figure 1). Thyroid examination revealed both sides of the thyroid gland were enlarged, as well as fixed and firm nodules in the right thyroid lobe without any evidence of thyrotoxicosis or hypothyroidism. Additionally, there was a palpable cervical lymphadenopathy on the right side. Routine hematological and biochemical thyroid hormones profile tests were within normal ranges. X-ray of the chest showed multiple foci of calcification on both lungs, but skull X-ray, abdomen ultrasonography, and brain computered tomography (CT) were normal. A thyroid scan revealed a cold nodule in the right lobe of the thyroid gland. A fine needle aspiration of the thyroid nodule was performed, and stained with Papanicolaou stain. Cytology smears revealed a mainly bloody background with few atypical cells indicating a neoplastic process. One of the scalp lesions was excised due to the clinical diagnosis of metastatic skin tumor and adenexal tumor, and submitted for histopathological examination. Histology of the lesion showed normal epidermis with presence of grenz zone between tumoral cells (Figure 2), as well as neoplastic cells arranged in nests within the delicate vascular stroma with minimal nuclear pleomorphic and small, but distinct nucleoli and clear cytoplasms. Additionally, solid nests, trabeculae, and a cribriform arrangement of cells with micro follicle formation and a wide area of necrosis were seen. These findings were consistent with poorly differentiated carcinoma (insular carcinoma). On the other hand, immunohistochemical tests were positive for thyroid transcription factor 1 (TTF-1) and thyroglobulin staining. Although the surgery was a difficult task because of the extensive thyroid metastases of tumor cells, a right-sided thyroid lobectomy and modified radical neck dissection was performed. The patient was discharged from the hospital and referred to the oncology department for palliative treatment. Follow-up was continued for 4 months after the primary diagnosis of skin metastases, but he died due to the widespread metastases of tumor cells. Thyroid carcinoma metastases to the skin are a rare clinical entity

Yaghoobi, Reza; Ranjbari, Nastaran; Derakhshandeh, Vita; Poostchi Bonab, Hamed; Pazyar, Nader

2014-09-01

324

Follicular thyroid carcinoma masquerading as subacute thyroiditis diagnosis using ultrasonography and radionuclide thyroid angiography  

International Nuclear Information System (INIS)

The rare presentation of a follicular thyroid carcinoma mimicking the clinical and radionuclide features of subacute thyroiditis is described. Granulomatous thyroiditis was initially suspected on the clinical basis. Repeat fine needle aspiration cytology was suggestive of acinar proliferation with hyperfunction. Ultrasonography revealed a solid nodule with a peripheral sonolucent halo. Radionuclide angiography showed intense arterial flow of Tc-99m pertechnetate through the right lobe thyroid enlargement suggestive of malignant thyroid pathology. Surgical excision and histopathological examination revealed a follicular carcinoma involving the right lobe. 31 refs., 4 figs

325

Usefulness of fine-needle aspiration in the diagnosis of thyroid lesions: an institutional experience of 340 patients  

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Full Text Available Objective: To evaluate the results of fine needle aspiration cytology (FNAC in the diagnosis, its correlation with histology, to highlight its limitations and diagnostic pitfalls as well as the impact of FNAC on the decreased rate of surgery in clinically suspect thyroid lesions.Study design: FNAC was performed on 340 patients with thyroid enlargement over a period of six years. The cytological results were correlated with clinical features, thyroid function tests and histopathological examination.Results: Among non- neoplastic group, the most frequently encountered lesion was colloid goiter in 231 (67.94% cases followed by thyroiditis in 68 (20% cases, five (1.47% adenomatous goiter and four (1.17% thyroglossal cysts. Among the neoplasticgroup, twelve (3.52% cases were reported as follicular neoplasm, seven (2.05% cases as Hürthle cell neoplasm and four (1.17% as malignant tumors. The cytological and histological concordance was determined. A false positive cytologic diagnosis of neoplasms was made in five cases. Presence of Hürthle cell metaplasia, hyperplastic nodules and papillary hyperplasia were responsible for the false positive diagnoses. For the entire series, the false negative rate was 8.57% and the false positive rate was 7.14%. FNA revealed a sensitivity of 62.5%, a specificity of 90.74%, a positive predictive value of 66.66% and a negative predictive value of 89.09%.Conclusion: FNAC is thus an accurate, cost- effective, minimally invasive and reliable diagnostic tool for assessment of patients with thyroid lesions and their management.

Pinki Pandey

2013-12-01

326

Late morphological and functional changes in thyroid gland following radioiodine damage and associated with external radiation  

International Nuclear Information System (INIS)

The late morphologic and functional changes in the thyroid gland after iodine-131 injury alone and in combination with external irradiation were studied. Different activities of the radionuclide were introduced in groups of experimental animals for 30 days, in the form of nuclear division products. External irradiation was applied with a single dose of 300 r. The kinetics of the radioisotope in the gland showed a decrease in the iodine-fixing function, under the influence of the radiation factor. In the later terms the impairement in the functional activity of the thyroid gland was demonstrated by changes in the gas exchange level, the changes being more pronounced after combined external and internal radiation treatment. The morphologic investigations showed increased hazard of development of tumors after irradiation of the gland with 1000 rad from incorporated iodine-131 and 300 rad external irradiation. Malignant neoplasms may equally develop after isolated external treatment with the afore-mentioned radionuclide doses. (author)

327

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 ...

328

Thyroid Antibodies  

Science.gov (United States)

... proteins, leading to chronic inflammation of the thyroid (thyroiditis), tissue damage, and/or disruption of thyroid function. ... or hyperthyroidism , such as Graves disease or Hashimoto thyroiditis . One or more of the following tests may ...

329

Thyroid Tests  

Science.gov (United States)

... 4 TSI Radioactive Iodine Uptake Test Graves' disease ? ? + ? Thyroiditis (with hyperthyroidism) ? ? - ? Thyroid nodules (hot, or toxic) ? ? - ? or ... T 3 /T 4 Antithyroid Antibody Hashimoto’s disease (thyroiditis, early stage) ? ? or Normal + Hashimoto’s disease (thyroiditis, later ...

330

Challenging epithelioid mesenchymal neoplasms: mimics and traps.  

Science.gov (United States)

Epithelioid mesenchymal malignancies represent a major diagnostic challenge. Epithelioid morphology can be observed in a variety of soft tissue neoplasms, however there exist specific subtypes in which an epithelioid apperance constitutes the most distinctive morphological feature. Moving from epithelioid sarcoma of Enzinger (the prototype of sarcoma with epithelioid morphology), this review will focus on the most relevant entities: namely epithelioid haemangioendothelioma and angiosarcoma, pseudomyogenic haemangioendothelioma, epithelioid malignant peripheral nerve sheath tumour, epithelioid sclerosing fibrosarcoma, epithelioid pleomorphic liposarcoma, alveolar soft part sarcoma, and undifferentiated soft tissue sarcoma with epithelioid morphology. Differential diagnoses and major pitfalls will be discussed in detail. PMID:24384587

Cacciatore, Matilde; Dei Tos, Angelo P

2014-02-01

331

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

332

A molecular computational model improves the preoperative diagnosis of thyroid nodules  

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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

333

Pancreatic Cystic Neoplasms  

Science.gov (United States)

Background: Cystic neoplasms of the pancreas are rare and constitute approximately 0.5% of all pancreatic neoplasms. Aims: The study was to describe clinicopathological features of pancreatic cystic tumors. Patients and Methods: In our retrospective study, we reviewed 10 cases of pancreatic cystic neoplasms that were diagnosed at the pathology department of Mongi Slim hospital over a 14-year period (2000-2013). We adopted the latest World Health Organization (WHO) classification (2010) in grouping all tumors. Results: There were one male and nine female patients (sex ratio M/F = 1:9) aged between 21 and 68 years (mean = 37.5 years). The most common clinical presentation was epigastric and abdominal pain (n = 6) followed by vomiting (n = 3). Abdominal computed tomography (CT) scan disclosed a cystic lesion of the pancreas ranging in size between 2 and 10 cm (mean = 6.75 cm). All patients underwent surgical treatment. Histopathological examination of the surgical specimen established the diagnosis of solid pseudopapillary neoplasm (n = 2), serous cystic neoplasm (n = 2), mucinous cystadenoma (n = 4), mucinous cystadenocarcinoma (n = 1), and intraductal papillary mucinous neoplasm with invasive carcinoma (n = 1). Conclusion: Better understanding of pancreatic cystic neoplasms is essential for clinicians to make accurate diagnosis and to provide the best management for patients.

Limaiem, Faten; Khalfallah, Tahar; Farhat, Leila Ben; Bouraoui, Saadia; Lahmar, Ahlem; Mzabi, Sabeh

2014-01-01

334

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

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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

335

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.

336

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

337

Gallium-67 uptake by the thyroid associated with progressive systemic sclerosis  

International Nuclear Information System (INIS)

Although thyroidal uptake of gallium-67 has been described in several thyroid disorders, gallium-67 scanning is not commonly used in the evaluation of thyroid disease. Thyroidal gallium-67 uptake has been reported to occur frequently with subacute thyroiditis, anaplastic thyroid carcinoma, and thyroid lymphoma, and occasionally with Hashimoto's thyroiditis and follicular thyroid carcinoma. A patient is described with progressive systemic sclerosis who, while being scanned for possible active pulmonary involvement, was found incidentally to have abnormal gallium-67 uptake only in the thyroid gland. Fine needle aspiration cytology of the thyroid revealed Hashimoto's thyroiditis. Although Hashimoto's thyroiditis occurs with increased frequency in patients with progressive systemic sclerosis, thyroidal uptake of gallium-67 associated with progressive systemic sclerosis has not, to our knowledge, been previously described. Since aggressive thyroid malignancies frequently are imaged by gallium-67 scintigraphy, fine needle aspiration cytology of the thyroid often is essential in the evaluation of thyroidal gallium-67 uptake

338

Characteristics of thyroid carcinoma in Graves' disease, chronic lymphocitic thyroiditis and nodular goiter  

Directory of Open Access Journals (Sweden)

Full Text Available The biology of thyroid cancer represents a spectrum of behavior ranging from well - differentiated lesions with an excellent prognosis to anaplastic carcinoma, wich is almost fatal. For this reason, it is important that clinicians have methods at their disposal to asses the characteristics of patient's thyroid malignancy. In this work we discuss the behavior of differentiated thyroid cancer in associated diseases of thyroid as : Graves’ disease, chronic lymphocitic thyroiditis - Hashimoto and nodular goiter. This is retrospectively reviewing of 50 patients treated for differentiated thyroid carcinoma at Department of surgery, Clinical Centre of Montenegro in Podgorica from 1998 until 2003. We evaluated occurrence, as well as the role of this diseases in patients with thyroid cancer.We found a more favorable course of thyroid cancer in the presence of chronic lymphocitic thyroiditis and nodular goiter, a contrary Graves’ disease. In associated diseases of thyroid, a significantly greater proportion of patients with thyroid cancer, have modular goiter.

Paunovi? Ivan R.

2003-01-01

339

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

340

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)

 
 
 
 
341

Mucoepidermoid carcinoma of the thyroid with concomitant papillary carcinoma: comparison of findings on fine-needle aspiration biopsy and histology.  

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We report two cases of mucoepidermoid carcinoma (MEC) of the thyroid gland coexisting with, and possibly arising in, papillary thyroid carcinoma (PTC). In the first case, CT-guided fine-needle aspiration (FNA) was performed on a paratracheal mass representing extrathyroidal invasion of a right thyroid lobe tumor. The aspirate showed papillary fronds and cells in honeycombed arrangements with fine chromatin, enlarged nuclei, nuclear grooves, and intranuclear inclusions in a background of mucus and blood; a diagnosis of PTC was rendered initially. However, examination of histologic sections of the mass showed nests of malignant squamous cells with interspersed mucous cells and extracellular mucin, concordant with MEC, as well as PTC. A retrospective review of the FNA specimen identified MEC. In the second case, ultrasound-guided FNA was performed on a right thyroid lobe nodule. The aspirate contained two populations of epithelial cells: larger cells showing foci of both squamous and glandular differentiation that were interpreted as MEC and smaller follicular cells with nuclear changes characteristic of PTC; both were addressed in the diagnostic report. Primary MEC of the thyroid is a rare neoplasm typically exhibiting indolent clinical behavior, although our first case demonstrated extensive local invasion. It is thought to arise from squamous metaplasia associated with PTC, Hashimoto thyroiditis, or other inflammatory or neoplastic processes. In thyroid FNAs, the presence of neoplastic mucous cells and extracellular mucin plus malignant squamous cells is diagnostic of MEC. As MEC is thought to arise in PTC, the finding of the latter in these aspiration specimens is not unexpected. PMID:25307114

Nath, Vikas; Parks, Graham E; Baliga, Mithra; Hartle, Edgar O; Geisinger, Kim R; Shenoy, Veena

2014-12-01

342

Intraductal papillary mucinous neoplasm: clinical surveillance and management decisions.  

Science.gov (United States)

Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is a relatively rare cystic neoplasm. Although most IPMNs appear to be benign and may be managed by surveillance, all IPMNs are considered premalignant lesions with malignant potential. As such, current efforts are focused on identifying those neoplasms that are at high risk for malignancy to optimize treatment strategy and outcome. IPMNs with invasive carcinoma have clinical outcomes that approach those of conventional pancreatic ductal adenocarcinoma. Management guidelines recommend surgical resection for IPMNs with high-risk imaging or cytologic features. The role of adjuvant therapy is unclear, and we review the evidence for chemoradiation here. Some studies suggest adjuvant chemoradiation may have the greatest impact in malignant IPMNs with adverse histologic features, that is, lymph node metastasis at the time of diagnosis or positive surgical margins. As more IPMNs are recognized and treated, more evidence will accumulate to guide clinicians regarding appropriate use of radiotherapy in the management of IPMN. PMID:24635864

Chin, Joanna Y; Pitman, Martha B; Hong, Theodore S

2014-04-01

343

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

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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. {sup 123}I 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 <0.00054 mg/cm{sup 3} were follicular adenomas. However, there was no significant difference in {sup 123}I 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 thyro