WorldWideScience

Sample records for diagnostic thyroid pathology

  1. Diagnostic accuracy between fine needle aspiration biopsy (FNA and pathological examination of the thyroid

    Directory of Open Access Journals (Sweden)

    Jerso Menegassi

    2013-08-01

    Full Text Available INTRODUCTION: Despite the fact that the fine needle aspiration biopsy (FNA is commonly used in the initial evaluation and distinction of benign and malignant lesions of thyroid nodules, it may yield variable results, inasmuch as it is contingent on the pathologist's analysis and expertise in collecting appropriate samples. OBJECTIVE: To check the diagnostic accuracy between FNA and pathological examination of thyroid nodules, both performed in a diagnostic pathology service. METHODS: Retrospective study carried out in a diagnostic pathology service in Chapecó, Santa Catarina, Brazil. All patients who underwent FNA and pathological examination in the period from January 1st 2005 to December 31 2010 were included in this study. RESULTS: 1,172 FNA were conducted during this period and 265 patients underwent both FNA and pathological examination. Most patients were female (85%, with mean age 47.75 years (standard deviation [SD] = 14.93 years. Cytopathological examinations yielded the following results: benignity (43.77 %, suspected malignancy (23.77%, follicular neoplasm (5.28%, atypical follicular lesion of undetermined significance (1.51% and unsatisfactory sample (1.51%. In the pathological examination, the most predominant diagnoses were colloid goiter (38.87%, follicular adenoma (22.64% and classic papillary carcinoma (18.87%. In satisfactory samples (n = 261, the following results were obtained: diagnostic accuracy (89.66%, sensitivity (82.14%, specificity (93.22%, negative predictive value (91.67% and positive predictive value (75.19%. CONCLUSION: We concluded that FNA provides a good predictive value for benign thyroid, constituting a reliable and effective tool for diagnosis and surgical indication.

  2. Molecular pathology and thyroid FNA.

    Science.gov (United States)

    Poller, D N; Glaysher, S

    2017-12-01

    This review summarises molecular pathological techniques applicable to thyroid FNA. The molecular pathology of thyroid tumours is now fairly well understood. Molecular methods may be used as a rule-in test for diagnosis of malignancy in thyroid nodules, eg BRAF V600E point mutation, use of a seven-gene mutational panel (BRAF V600E, RAS genes, RET/PTC or PAX8/PPARG rearrangement), or as a comprehensive multigene next-generation sequencing panel, eg ThyroSeq v2. Molecular methods can also be applied as rule-out tests for malignancy in thyroid nodules, eg Afirma or ThyroSeq v2 or as markers of prognosis, eg TERT promoter mutation or other gene mutations including BRAF V600E, TP53 and AKT1, and as tests for newly defined tumour entities such as non-invasive follicular thyroid neoplasm with papillary like nuclei, or as a molecular marker(s) for targeted therapies. This review describes practical examples of molecular techniques as applied to thyroid FNA in routine clinical practice and the value of molecular diagnostics in thyroid FNA. It describes the range of molecular abnormalities identified in thyroid nodules and thyroid cancers with some practical applications of molecular methods to diagnosis and prognosis of thyroid nodules and thyroid cancer. © 2017 John Wiley & Sons Ltd.

  3. Diagnostic accuracy of fine needle biopsy in the management of thyroid pathology in the Hospital Mexico in 2011-2012

    International Nuclear Information System (INIS)

    Elizondo Herrera, Luis Guillermo

    2013-01-01

    The nodule has been a very common thyroid pathology; through palpation is located in a 5% of the population and through ultrasound this figure has increased by almost 50%. The thyroid nodule has been the shape of presentation of thyroid cancer; the majority of times asymptomatic and most recently has shown without relation to the size of the nodule, 5 to 15% of thyroid nodules are malignant. This requires to classify clinically, to decide which patient requires surgical management. In Costa Rica, and especially in the CCSS (Caja Costarricense de Seguro Social); It has had two tools for perform differentiation: ultrasound and FNA (fine needle aspiration biopsy). The diagnostic accuracy of these tests has allowed minimize thyroid surgeries in patients with benign nodules and sift patients with thyroid nodules into search for cancer of thyroid. Previous to routine use of FNA was resected only 14% of malignant nodules, now are resected more than 50%. The diagnostic accuracy of these tests is related to technical aspects and also with the structural and histological features of the lesions valued. The limitations and scope described have allowed to optimize the utilization of direct and indirect costs related to the management of patients with thyroid nodules and decrease morbidity in the management of thyroid pathology. The sensitivity and specificity of fine needle biopsy varies, as is noted in various publications, according to the reference center, has been quite reliable between 0.3 and 3 cm and is highly specific in the case of papillary carcinoma. The diagnostic accuracy of the test has never been studied in the Hospital Mexico. Of the total population for the period 2011-2012, it is documented that the FNA is a study of high specificity (95,5%), with value predictive negative and positive appropriate (>75%) and with an intermediate sensitivity (55,6%). The analysis of ultrasound and FNA as parallel testing has allowed greater sensitivity. The use of ultrasound

  4. DIAGNOSTIC CRITERIA FOR PROLIFERATIVE THYROID LESIONS IN BONY FISHES

    Science.gov (United States)

    Thyroid proliferative lesions are rather common in bony fishes but disagreement exists in the fish pathology community concerning diagnostic criteria for hyperplastic versus neoplastic lesions. To simplify the diagnosis of proliferative thyroid lesions and to reduce confusion reg...

  5. Ultrasound diagnostics of thyroid diseases

    Energy Technology Data Exchange (ETDEWEB)

    Kharchenko, Vladimir P. [Russian Radiology Research Center, Moscow (Russian Federation); Kotlyarov, Peter M. [Russian Center of Roentgenradiology, Moscow (Russian Federation); Mogutov, Mikhail S.; Sencha, Alexander N.; Patrunov, Yury N.; Belyaev, Denis V. [Yaroslavl Railway Clinic (Russian Federation); Alexandrov, Yury K. [State Medical Academy, Yaroslavl (Russian Federation)

    2010-07-01

    This book is based on the authors' extensive practical experience in the use of modern ultrasound, and other radiological methods, in the diagnosis of thyroid diseases. The authors have analyzed more than 100,000 ultrasound examinations performed between 1995 and 2008 in patients with thyroid and parathyroid disease, as well as many thousands of diagnostic and therapeutic ultrasound-guided minimally invasive procedures. The opening chapters include discussion of current ultrasound techniques, pitfalls, and the specifics of ultrasound examination of the thyroid in children. Detailed attention is then devoted to findings in the normal thyroid and in the presence of diffuse and focal changes. Further chapters focus on such topics as ultrasound examination after thyroid surgery and ultrasound diagnosis of parathyroid disease, recurrent goiter, and neck masses. Ultrasound-guided minimally invasive techniques, such as fine-needle aspiration biopsy, percutaneous laser ablation, and ethanol and glucocorticoid injections, are considered in depth. This up-to-date and richly illustrated book will interest and assist specialists in ultrasound diagnostics, radiologists, endocrinologists, and neck surgeons. (orig.)

  6. Ultrasound diagnostics of thyroid diseases

    International Nuclear Information System (INIS)

    Kharchenko, Vladimir P.; Kotlyarov, Peter M.; Mogutov, Mikhail S.; Sencha, Alexander N.; Patrunov, Yury N.; Belyaev, Denis V.; Alexandrov, Yury K.

    2010-01-01

    This book is based on the authors' extensive practical experience in the use of modern ultrasound, and other radiological methods, in the diagnosis of thyroid diseases. The authors have analyzed more than 100,000 ultrasound examinations performed between 1995 and 2008 in patients with thyroid and parathyroid disease, as well as many thousands of diagnostic and therapeutic ultrasound-guided minimally invasive procedures. The opening chapters include discussion of current ultrasound techniques, pitfalls, and the specifics of ultrasound examination of the thyroid in children. Detailed attention is then devoted to findings in the normal thyroid and in the presence of diffuse and focal changes. Further chapters focus on such topics as ultrasound examination after thyroid surgery and ultrasound diagnosis of parathyroid disease, recurrent goiter, and neck masses. Ultrasound-guided minimally invasive techniques, such as fine-needle aspiration biopsy, percutaneous laser ablation, and ethanol and glucocorticoid injections, are considered in depth. This up-to-date and richly illustrated book will interest and assist specialists in ultrasound diagnostics, radiologists, endocrinologists, and neck surgeons. (orig.)

  7. Hashimoto's Thyroiditis Pathology and Risk for Thyroid Cancer

    Science.gov (United States)

    Paparodis, Rodis; Imam, Shahnawaz; Todorova-Koteva, Kristina; Staii, Anca

    2014-01-01

    Background: Hashimoto's thyroiditis (HT) has been found to coexist with differentiated thyroid cancer (DTC) in surgical specimens, but an association between the two conditions has been discounted by the medical literature. Therefore, we performed this study to determine any potential relationship between HT and the risk of developing DTC. Methods: We collected data for thyrotropin (TSH), thyroxine (T4), thyroid peroxidase antibody (TPO-Ab) titers, surgical pathology, and weight-based levothyroxine (LT4) replacement dose for patients who were referred for thyroid surgery. Patients with HT at final pathology were studied further. To estimate thyroid function, patients with preoperative hypothyroid HT (Hypo-HT) were divided into three equal groups based on their LT4 replacement: LT4-Low (1.43 μg/kg). A group of preoperatively euthyroid (Euth-HT) patients but with HT by pathology was also studied. All subjects were also grouped based on their TPO-Ab titer in TPO-high (titer >1:1000) or TPO-low/negative (titer thyroid glands (LT4-Low) but not in fully hypothyroid HT (LT4-Mid and LT4-High). High TPO-Ab titers appear to protect against DTC in patients with HT. PMID:24708347

  8. Pathology Reporting of Thyroid Core Needle Biopsy: A Proposal of the Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Group

    OpenAIRE

    Jung, Chan Kwon; Min, Hye Sook; Park, Hyo Jin; Song, Dong Eun; Kim, Jang Hee; Park, So Yeon; Yoo, Hyunju; Shin, Mi Kyung

    2015-01-01

    In recent years throughout Korea, the use of ultrasound-guided core needle biopsy (CNB) has become common for the preoperative diagnosis of thyroid nodules. However, there is no consensus on the pathology reporting system for thyroid CNB. The Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Group held a conference on thyroid CNB pathology and developed guidelines through contributions from the participants. This article discusses the outcome of the discussions that led to a consens...

  9. Ultrasound elastography in the evaluation of thyroid pathology. Current status

    International Nuclear Information System (INIS)

    Cantisani, Vito; Lodise, Pietro; Grazhdani, Hektor; Mancuso, Ester; Maggini, Elena; Di Rocco, Giorgio; D’Ambrosio, Ferdinando; Calliada, Fabrizio; Redler, Adriano; Ricci, Paolo; Catalano, Carlo

    2014-01-01

    Thyroid pathology including thyroid nodules and diffuse thyroid diseases represents often a diagnosing challenge for clinicians. US, although highly accurate in identifying thyroid nodules and diffuse thyroid diseases, is still not sufficiently accurate to evaluate them. US-elastography has been introduced in order to further increase US accuracy in many fields and eventually for thyroid disease. The aim of the present paper it to provide an update of the literature on different available techniques and the results reported both for thyroid nodules differentiation and for diffuse thyroid disease evaluation. Advantages and limitations of elastography are also discussed

  10. Ultrasound elastography in the evaluation of thyroid pathology. Current status

    Energy Technology Data Exchange (ETDEWEB)

    Cantisani, Vito, E-mail: vito.cantisani@uniroma1.it [Department of Radiology, Oncology, and Anatomy Pathology, Sapienza University of Rome (Italy); Lodise, Pietro, E-mail: pietro.lodise@gmail.com [Department of Radiology, Oncology, and Anatomy Pathology, Sapienza University of Rome (Italy); Grazhdani, Hektor, E-mail: he1graz@gmail.com [Department of Radiology, Oncology, and Anatomy Pathology, Sapienza University of Rome (Italy); Mancuso, Ester, E-mail: ester.mancuso@libero.it [Department of Radiology, Oncology, and Anatomy Pathology, Sapienza University of Rome (Italy); Maggini, Elena, E-mail: elenamaggini@yahoo.it [Department of Radiology, Oncology, and Anatomy Pathology, Sapienza University of Rome (Italy); Di Rocco, Giorgio, E-mail: giorgiodirocco@virgilio.it [Department of Surgical Sciences, Sapienza University of Rome (Italy); D’Ambrosio, Ferdinando, E-mail: ferdinando.dambrosio@uniroma1.it [Department of Radiology, Oncology, and Anatomy Pathology, Sapienza University of Rome (Italy); Calliada, Fabrizio, E-mail: fabrizio.calliada@gmail.com [Policlinico San Matteo, University of Pavia (Italy); Redler, Adriano, E-mail: adriano.redler@uniroma1.it [Department of Surgical Sciences, Sapienza University of Rome (Italy); Ricci, Paolo, E-mail: paolo.ricci@uniroma1.it [Department of Radiology, Oncology, and Anatomy Pathology, Sapienza University of Rome (Italy); Catalano, Carlo [Department of Radiology, Oncology, and Anatomy Pathology, Sapienza University of Rome (Italy)

    2014-03-15

    Thyroid pathology including thyroid nodules and diffuse thyroid diseases represents often a diagnosing challenge for clinicians. US, although highly accurate in identifying thyroid nodules and diffuse thyroid diseases, is still not sufficiently accurate to evaluate them. US-elastography has been introduced in order to further increase US accuracy in many fields and eventually for thyroid disease. The aim of the present paper it to provide an update of the literature on different available techniques and the results reported both for thyroid nodules differentiation and for diffuse thyroid disease evaluation. Advantages and limitations of elastography are also discussed.

  11. The Role of Radiopharmaceuticals in Amiodarone-Induced Thyroid Pathology.

    Science.gov (United States)

    Irimie, Alexandru; Piciu, Doina

    2017-11-10

    The use of amiodarone for the treatment of ventricular and supraventricular dysrhythmias brings in organism an increased amount of iodine, interfering with thyroid function. If the treatment needs to be interrupted, iodine remains at abnormal levels for months or even years. The aim of the study was to review the literature regarding the optimal tests for early diagnostic and to analyze the role of nuclear medicine tests in the differential and correct assessment of the amiodarone-induced thyroid pathology. We made a review of available publications in PUBMED referring the amiodaroneinduced thyroid pathology, focusing on the differential diagnosis, made by nuclear medicine tests, of hypothyroidism (AIH) and hyperthyroidism expressed as: type I amiodarone induced thyrotoxicosis (AIT I), type II amiodarone induced thyrotoxicosis (AIT II), and less frequently as a mixt form, type III amiodarone induced thyrotoxicosis (AIT III). We presented cases from the database of a tertiary center in Cluj-Napoca, Romania. Despite the frequent complication of thyroid function, this pathology is underestimated and diagnosed. There is a limited number of studies and clear protocols, especially in the mixed forms cases. This increase in iodine uptake interferes seriously with thyroid hormone production and release. The nuclear medicine tests are essential in the correct assessment and differential diagnosis of different forms of induced thyroid dysfunction. The destruction of the follicular cells can result in the release of excessive thyroid hormone into the circulation, with potential development of atrial fibrillation, worsening the cardiac disease, so any benefic therapeutic procedure should be known; the use of radioiodine as therapy alternative, despite the known limitations induced by blockade was clear benefic in the case presented. A special attention needs to be addressed to those patients with differentiated thyroid cancer, which will be submitted to radioiodine therapy and

  12. Diffuse sclerosing variant of thyroid papillary carcinoma: Diagnostic challenges occur with Hashimoto's thyroiditis

    Directory of Open Access Journals (Sweden)

    Chien-Chin Chen

    2013-06-01

    Full Text Available Diffuse sclerosing papillary thyroid carcinoma (DSPTC is a relatively rare variant of papillary thyroid carcinoma with distinct histological features, radiological characteristics, and biological aggressiveness. Compared with conventional papillary thyroid carcinoma, DSPTC is characterized by scattered microscopic tumor islands, diffuse fibrosis, calcification, and abundant lymphocytic aggregation. A preoperative diagnosis is challenging in the absence of nodules and scanty fine needle aspiration cytology samples. We describe a unique DSPTC patient, an 18-year-old woman who presented with a neck mass that grew slowly for 2 years. The palpable neck mass was nontender, well defined, firm, and unmovable. Laboratory studies showed normal thyroid function and positive autoimmune markers: antithyroglobulin antibody = 1:1600 and antimicrosomal antibody = 1:1600. A neck ultrasound showed diffusely prominent microcalcifications with one small vague nodule. Hashimoto's thyroiditis with an accompanying malignancy was suspected. Based on the result of intraoperative pathology reports, the patient was given a total thyroidectomy. Lymph node dissection and histological analysis revealed bilateral DSPTC in addition to lymphocytic thyroiditis in nonmalignant areas of the thyroid. Clinical and histological diagnostic challenges usually occur when DSPTC presents with a diffuse thyroid enlargement, dispersed microscopic tumor islands (frequently without mass formation, extensive fibrosis, and abundant lymphocytic infiltration mimicking thyroiditis.

  13. Hashimoto thyroiditis: clinical and diagnostic criteria.

    Science.gov (United States)

    Caturegli, P; De Remigis, A; Rose, N R

    2014-01-01

    Hashimoto thyroiditis (HT), now considered the most common autoimmune disease, was described over a century ago as a pronounced lymphoid goiter affecting predominantly women. In addition to this classic form, several other clinico-pathologic entities are now included under the term HT: fibrous variant, IgG4-related variant, juvenile form, Hashitoxicosis, and painless thyroiditis (sporadic or post-partum). All forms are characterized pathologically by the infiltration of hematopoietic mononuclear cells, mainly lymphocytes, in the interstitium among the thyroid follicles, although specific features can be recognized in each variant. Thyroid cells undergo atrophy or transform into a bolder type of follicular cell rich in mitochondria called Hürthle cell. Most HT forms ultimately evolve into hypothyroidism, although at presentation patients can be euthyroid or even hyperthyroid. The diagnosis of HT relies on the demonstration of circulating antibodies to thyroid antigens (mainly thyroperoxidase and thyroglobulin) and reduced echogenicity on thyroid sonogram in a patient with proper clinical features. The treatment remains symptomatic and based on the administration of synthetic thyroid hormones to correct the hypothyroidism as needed. Surgery is performed when the goiter is large enough to cause significant compression of the surrounding cervical structures, or when some areas of the thyroid gland mimic the features of a nodule whose cytology cannot be ascertained as benign. HT remains a complex and ever expanding disease of unknown pathogenesis that awaits prevention or novel forms of treatment. Copyright © 2014 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2010-01-01

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

  15. Thyroid nodular disease: their usefulness of diagnostic methods

    International Nuclear Information System (INIS)

    Mendez Ayala, Irene Maria; Sanchez Luthard, Maria de los Angeles; Martins Schmitz; Gomez, Silvia

    2009-01-01

    The thyroid nodular disease is defined by the presence of nodules of thyroid of solid, liquid or mixed consistency, they are or non concrete. Solitary nodule thyroid, diffuse and multinodular goiter forms can be presented in. The thyroid nodule is a frequent clinical problem, the clinical prevalence in adult population is of 4%. Objective: to make a bibliographical revision to near the utility of the different methods available for the thyroid nodular pathology diagnosis and determining which of them turns out more specific to differentiate benignancy from malignancy in the found nodules. Materials and Methods: the bibliographical search was made in the data base Medline (Pubmed), in scientific magazines of the region and text books. Criteria of inclusion: bibliographical references pertaining to medical magazines and free full text with an antiquity nongreater to 8 years were included. Conclusion: the presence of thyroid nodules constitutes a reason for frequent consultation, the main diagnostic method at the moment is the fine needle aspiration cytology, due to its simple accomplishment, low cost, not requiring the hospitalization of the patient, and being fundamental in the decision making of the doctor. This diagnostic method is, in addition, the one that with greater certainty allows to differentiate benign from malignant nodules. (authors) [es

  16. Communication skills in diagnostic pathology.

    Science.gov (United States)

    Lehr, Hans-Anton; Bosman, Fred T

    2016-01-01

    Communication is an essential element of good medical practice also in pathology. In contrast to technical or diagnostic skills, communication skills are not easy to define, teach, or assess. Rules almost do not exist. In this paper, which has a rather personal character and cannot be taken as a set of guidelines, important aspects of communication in pathology are explored. This includes what should be communicated to the pathologist on the pathology request form, communication between pathologists during internal (interpathologist) consultation, communication around frozen section diagnoses, modalities of communication of a final diagnosis, with whom and how critical and unexpected findings should be communicated, (in-)adequate routes of communication for pathology diagnoses, who will (or might) receive pathology reports, and what should be communicated and how in case of an error or a technical problem. An earlier more formal description of what the responsibilities are of a pathologist as communicator and as collaborator in a medical team is added in separate tables. The intention of the paper is to stimulate reflection and discussion rather than to formulate strict rules.

  17. Pathological evaluation of thyroid glands in Graves' disease after thyroid arteries embolization

    International Nuclear Information System (INIS)

    Zhuang Wenquan; Xiao Haipeng; Cheng Wei; Yang Jianyong; Chen Guorui; Ling Qibo

    2003-01-01

    Objective: To study the pathological morphology of thyroid specimen after thyroid arteries embolization. In order to select appropriate size of embolizing granules, the diameters of thyroid arteries in Graves' disease were measured. Methods: Multiple slides of embolized thyroid tissues from superior pole, body and inferior pole of the resected thyroid glands were made. After being embedded and stained, pathological morphology was observed and diameters of arteries in various parts of thyroid glands were measured under microscopy. Results: Pathological examination of thyroid glands showed that superior and inferior thyroid arteries and most of their branches were embolized with ischemic necrosis and fibrosis in the embolized thyroid tissue. Follicular epithelium appeared as flat or cubic shapes with colloid reduction. Average diameter of main branches of superior artery was 440-550 μm and that of inferior artery was 300-375 μm. The diameters of capillary network in the thyroid body was 120-250 μm, and the non-embolized ones was 40-110 μm. The diameter of isthmus was 130-150 μm. Conclusions: Pathological morphology of Graves' disease after thyroid arteries embolization showed that the excretion of thyroid glands would be decreased and equivalents to subtotal thyroidectomy

  18. Thyroid Nodules Individual Pathologic Assessment in Imam Reza Hospital Tabriz

    Directory of Open Access Journals (Sweden)

    Saeed Judi

    2017-02-01

    Full Text Available Background and Objectives: Single thyroid nodule is a common clinical finding in patients with thyroid gland enlargment or with palpable mass in anterior neck. Because of various pathologic kinds and wide spectrum of nodules from inflammatory disease to benign and malignan tumors, pathologically diagnosis of disease is very important because treatment, prognosiss and approach will differ with respect to diagnosis. Because of importance and high incidence of disease, we decided to investigate records of patients in pathology department of Imam Reza hospital of Tabriz between 2011-14. Our goals were determination of pathologic incidence of single thyroid nodules and investigation of them by sex and age. After extracting results from records, we presented them in the form of tables and figure. Material and Methods: In total, 17349 patients referred to pathology department of Imam Reza hospital between 2011-14. In 191 cases the first clinical diagnosiss was single thyroid nodule. Thyroids specimes were sent to pathology department. Results: The most common pathologic report was multinodular goiter in 90 patients (47%. Other kinds were follicular adenoma 28%, papillary carcinoma 15%, follicular carcinoma and diffuse goiter 3%, lymphocytic thyroiditis, medulary carcinoma 1%, granuloma, lymphoma and abscess each one 0.5%, respectively. Conclusion: Most cases of thyroid nodules are nodular goiter and it is prevalent among females.

  19. Thyroid cancer following diagnostic iodine-131 administration

    International Nuclear Information System (INIS)

    Hall, P.; Holm, L.-E.; Boice, J.D.

    1996-01-01

    To provide quantitative data on the risk of thyroid cancer following 131 I exposure, 34104 patients administered 131 I for diagnostic purposes were followed for up to 40 years. Mean thyroid dose was estimated as 1.1 Gy, and 67 thyroid cancers occurred in contrast to 49.7 expected [standardized incidence ratio (SIR)=1.35; 95% confidence interval (CI) 1.05-1.71]. Excess cancers were apparent only among patients referred because of a suspected thyroid tumor and no increased risk was seen among those referred for other reasons. Further, risk was not related to radiation dose to the thyroid gland, time since exposure, or age at exposure. The slight excess of thyroid cancer, then appeared due to the underlying thyroid condition and not radiation exposure. Among those under age 20 years when 131 I was administered, a small excess risk (3 cancers vs 1.8 expected) was about 2-10 times lower than that predicted from A-bomb data. These data suggest that protraction of dose may result in a lower risk than acute x-ray exposure of the same total dose

  20. Impact of lymphocytic thyroiditis on incidence of pathological incidental thyroid carcinoma.

    Science.gov (United States)

    Farrell, Eric; Heffron, Cynthia; Murphy, Matthew; O'Leary, Gerard; Sheahan, Patrick

    2017-01-01

    The purpose of this study was to investigate the impact of lymphocytic thyroiditis on incidence of incidental thyroid cancers. We conducted a retrospective review of 713 consecutive patients who underwent thyroidectomies. Incidental thyroid cancer was defined as an unexpected cancer discovered on pathological examination outside the index nodule undergoing preoperative cytology. We excluded 65 cases because of preoperative diagnosis of thyroid cancer, and 68 because of nonincidental cancer within the index nodule. Among the remaining 580 cases, there were 43 cases (7.4%) of incidental thyroid cancers. Incidental thyroid cancers were significantly associated with moderate/severe lymphocytic thyroiditis (relative risk = 2.5; p = .03). Sixteen of 56 patients with moderate/severe lymphocytic thyroiditis had Graves' disease, none of whom had incidental thyroid cancer. The risk of incidental thyroid cancer associated with moderate/severe lymphocytic thyroiditis was significantly higher in non-Graves' than patients with Graves' disease (p = .05). The risk of incidental thyroid cancer is significantly increased in patients with moderate/severe lymphocytic thyroiditis. Moderate/severe lymphocytic thyroiditis associated with Graves' disease seems to have a lower risk of incidental thyroid cancer. © 2016 Wiley Periodicals, Inc. Head Neck 39: 122-127, 2017. © 2016 Wiley Periodicals, Inc.

  1. Morphological, diagnostic and surgical features of ectopic thyroid gland: a review of literature.

    Science.gov (United States)

    Guerra, Germano; Cinelli, Mariapia; Mesolella, Massimo; Tafuri, Domenico; Rocca, Aldo; Amato, Bruno; Rengo, Sandro; Testa, Domenico

    2014-01-01

    Ectopic thyroid tissue remains a rare developmental abnormality involving defective or aberrant embryogenesis of the thyroid gland during its passage from the floor of the primitive foregut to its usual final position in pre-tracheal region of the neck. Its specific prevalence accounts about 1 case per 100.000-300.000 persons and one in 4.000-8.000 patients with thyroid disease show this condition. The cause of this defect is not fully known. Despite genetic factors have been associated with thyroid gland morphogenesis and differentiation, just recently some mutation has been associated with human thyroid ectopy. Lingual region in the most common site of thyroid ectopy but ectopic thyroid tissue were found in other head and neck locations. Nevertheless, aberrant ectopic thyroid tissue has been found in other places distant from the neck region. Ectopic tissue is affected by different pathological changes that occur in the normal eutopic thyroid. Patients may present insidiously or as an emergency. Diagnostic management of thyroid ectopy is performed by radionuclide thyroid imaging, ultrasonography, CT scan, MRI, biopsy and thyroid function tests. Asymptomatic euthyroid patients with ectopic thyroid do not usually require therapy but are kept under observation. For those with symptoms, treatment depends on size of the gland, nature of symptoms, thyroid function status and histological findings. Surgical excision is often required as treatment for this condition. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  2. Clinical characteristics and molecular pathology of skull ectopic thyroid cancer

    Science.gov (United States)

    Cao, Longxing; Wang, Zhongyong; Ma, Jiawei; Chen, Jinsheng; Zhu, Haojiang; Zhou, Xiaohua; Zhu, Qing; Dong, Jun; Huang, Qiang

    2016-01-01

    Thyroid cancer is very common, but skull ectopic thyroid cancer has not been reported in 50 years of literatures in foreign countries. There are only four cases of the skull ectopic thyroid cancer reported in more than 30 years of domestic literature including the cases in this report. This paper aims to investigate the clinical characteristics and possible molecular mechanisms of this rare disease. Five keywords of “thyroid gland”, “ectopic thyroid”, “thyroid cancer”, “ectopic thyroid cancer” and “metastatic thyroid cancer” were included and 50 years of literatures in the PubMed-MEDLINE and Wanfang database were reviewed. By combining the test data of 2 cases of surgical patient tissue microarray specimens-molecular immunology pathology, the possible molecular mechanisms were analyzed and molecular regulation network diagram was drawn. The skull ectopic thyroid cancer has not been reported in 50 years of literatures in foreign countries and there are only four cases of the skull ectopic thyroid cancer reported in more than 30 years of domestic literature including the cases in this report. The molecular expressions of skull ectopic thyroid cancer, orthotopic thyroid cancer, and metastatic thyroid cancer were not the same: (I) AKT (P=0.012, 0.002) and mTOR (P=0.002, 0.004) were highly expressed in the skull ectopic thyroid cancer; (II) BRAF (P=0.029, 0.014) and ERK (P=0.002, 0.001) were highly expressed in orthotopic thyroid cancer; (III) MMP-9 (P=0.023, 0.016) was highly expressed in metastatic thyroid cancer. According to the molecular information base, the PI3K is predicted to be a key crossing gene of the above three signaling pathways, which showed no significant differences in these three thyroid cancers (P=0.692, 0.388, 0.227), but PI3K has regulation roles in the three signaling pathways of Akt/mTOR, MAPK, and NF-κB. PI3K gene is an important starting gene of thyroid cancers. After the canceration starts, due to the fact that the local

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

    International Nuclear Information System (INIS)

    Marrero Rodriguez, Maria Teresa

    2007-01-01

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

  4. Overview of surgical pathology of the thyroid gland.

    Science.gov (United States)

    Nishiyama, R H

    2000-08-01

    The purpose of this overview is to provide timely information on selected topics on the surgical pathology of the thyroid gland. Selected publications of the author and his colleagues at the University of Michigan and the Maine Medical Center form the basis of this review. Information provided in our reports is updated by perusal of recent, pertinent publications. The following questions summarize the contents of the overview. What is a "lateral aberrant thyroid"? Does it always represent metastatic carcinoma? What are dyshormogenetic goiters? Can "focal thyroiditis" in thyroid glands removed for the treatment of Graves' disease and toxic nodular goiters be predictive of the development of postoperative hypothyroidism? What is the pathology of autonomously functioning (hot) nodules? Do tall-cell, columnar-cell, and diffuse sclerosing types of papillary carcinomas forbode bad prognoses? What is the controversy over Hurthle cell tumors? Does the presence of a better differentiated component in an anaplastic thyroid carcinoma modify its biologic behavior? Are poorly differentiated carcinomas unique histologic variants? Does their histology affect prognosis? What is the most common small-cell tumor of the thyroid gland? Has the Chernobyl nuclear disaster affected the incidence of childhood thyroid carcinoma? Are these radiation-induced tumors more aggressive? The answers, some of which are controversial, are found in this overview. The aims here were to provide information to surgeons and pathologists and to improve the care of patients with thyroid disease.

  5. Clinical surgical and pathological characterization of nodular thyroid disease

    International Nuclear Information System (INIS)

    Gonzalez Mendoza, Dayanis Ceila; Rodriguez Valdes, Adriana; Bejerano Garcia, Ramiro Julio

    2012-01-01

    Nodular thyroid disease is a worrisome endocrine problem due to its association with cancer. To characterize patients hospitalized with this condition according to clinical surgical and pathological aspects, as well as to determine the effectiveness of the cytology by fine-needle aspiration biopsy for diagnosis

  6. Punction methods of diagnostics and treatment of thyroid diseases

    Directory of Open Access Journals (Sweden)

    A.S. Tolstokorov

    2010-06-01

    Full Text Available The object of this research is to study the punction methods role under diagnostics and treatment of different thyroid diseases. The authors of this article present treatment methods of 121 patients with different thyroid diseases. The received results allow to draw a conclusion, that punction methods of diagnostics and treatment of thyroid disease can be used as independent methods of treatment and in a complex with other medication remedies

  7. Clinical relevance of nuclear medicine in diagnostics and therapy of the thyroid

    International Nuclear Information System (INIS)

    1982-01-01

    50 papers divided into 7 interrelated topics including the corresponding discussions are reported. The papers deal with diagnostics and therapy of thyroid diseases by means of radiopharmaceuticals. Carcinomas and functional disorders of the thyroid are discussed in the same way as problems of thyroiditis and thyroid immunology as well as morphological diagnostics of the thyroid and thyroid function related to other internal diseases

  8. Color-coded duplex sonography in the study of thyroid pathologic conditions

    International Nuclear Information System (INIS)

    Anguissola, R.; Bozzini, A.; Campani, R.; Bottinelli, O.; Genovese, E.; Guglielmoni, B.; Fulle, I.; Bandi, G.

    1991-01-01

    The authors examined 110 patients with suspected pathologic conditions of the thyroid by means of color-coded duplex US. In addition to the information yielded by conventional US, this technique allows organ vascularization to be demonstrated. Five normal patients were considered as a control group: no tissue vascularization was demonstrated in these cases. In 8 patients presenting with carcinoma or recurrences, vascularization was markedly increased both peripheral and central to the nodule. A few doubts are still to be solved as to the diagnostic value of color-coded duplex US in the evaluation of non-carcinomas nodular pathologic conditions. As a matter of fact, non-functioning avascular adenomas can be demonstrated only in a very low percentage of cases (66%). Color-coded duplex US proved extremely sensitive and specific in depicting malignant neoplasms. Moreover, the use of fine.needle biopsy could be optimized and subsequently reduced. Color-coded duplex US proved to be markedly superior to othe rmethods and techniques in the study of thyroid diseases, especially thyroiditis and multiple pathologic conditions. The simultaneous presence of hypocapture at scintigraphy and peripheral and central vascularization in a single nodule or within multinodular struma at color-Doppler was highly suggestive of malignant thyroid neoplasm. Color-coded duplex US is a low-cost technique, which can be performed on an outpatient basis. Moreover, it is not invasive, nor does it damage the thyroid. That is why its use is almost mandatory in the study of pathologic conditions of the thyroid

  9. Uptodate view on diagnostics and treatment of medullary thyroid cancer

    Directory of Open Access Journals (Sweden)

    D O Gazizova

    2013-09-01

    Full Text Available During last 4 years leading endocrine societies of the world published clinical recommendations on diag nostics and treatment of medullary thyroid cancer. The article covers most aspects of following patients with this pathology.

  10. Amiodarone-Induced Thyrotoxic Thyroiditis: A Diagnostic and Therapeutic Challenge

    Directory of Open Access Journals (Sweden)

    Umang Barvalia

    2014-01-01

    Full Text Available Amiodarone is an iodine-based, potent antiarrhythmic drug bearing a structural resemblance to thyroxine (T4. It is known to produce thyroid abnormalities ranging from abnormal thyroid function testing to overt hypothyroidism or hyperthyroidism. These adverse effects may occur in patients with or without preexisting thyroid disease. Amiodarone-induced thyrotoxicosis (AIT is a clinically recognized condition commonly due to iodine-induced excessive synthesis of thyroid, also known as type 1 AIT. In rare instances, AIT is caused by amiodarone-induced inflammation of thyroid tissue, resulting in release of preformed thyroid hormones and a hyperthyroid state, known as type 2 AIT. Distinguishing between the two states is important, as both conditions have different treatment implications; however, a mixed presentation is not uncommon, posing diagnostic and treatment challenges. We describe a case of a patient with amiodarone-induced type 2 hyperthyroidism and review the current literature on the best practices for diagnostic and treatment approaches.

  11. Amiodarone-Induced Thyrotoxic Thyroiditis: A Diagnostic and Therapeutic Challenge

    Science.gov (United States)

    Barvalia, Umang; Amlani, Barkha; Pathak, Ram

    2014-01-01

    Amiodarone is an iodine-based, potent antiarrhythmic drug bearing a structural resemblance to thyroxine (T4). It is known to produce thyroid abnormalities ranging from abnormal thyroid function testing to overt hypothyroidism or hyperthyroidism. These adverse effects may occur in patients with or without preexisting thyroid disease. Amiodarone-induced thyrotoxicosis (AIT) is a clinically recognized condition commonly due to iodine-induced excessive synthesis of thyroid, also known as type 1 AIT. In rare instances, AIT is caused by amiodarone-induced inflammation of thyroid tissue, resulting in release of preformed thyroid hormones and a hyperthyroid state, known as type 2 AIT. Distinguishing between the two states is important, as both conditions have different treatment implications; however, a mixed presentation is not uncommon, posing diagnostic and treatment challenges. We describe a case of a patient with amiodarone-induced type 2 hyperthyroidism and review the current literature on the best practices for diagnostic and treatment approaches. PMID:25477968

  12. Errors and mistakes in ultrasound diagnostics of the thyroid gland

    Science.gov (United States)

    Jędrzejowski, Maciej; Jakubowski, Wiesław; Trzebińska, Anna

    2014-01-01

    Ultrasound examination of the thyroid gland permits to evaluate its size, echogenicity, margins, and stroma. An abnormal ultrasound image of the thyroid, accompanied by other diagnostic investigations, facilitates therapeutic decision-making. The ultrasound image of a normal thyroid gland does not change substantially with patient's age. Nevertheless, erroneous impressions in thyroid imaging reports are sometimes encountered. These are due to diagnostic pitfalls which cannot be prevented by either the continuing development of the imaging equipment, or the growing experience and skill of the practitioners. Our article discusses the most common mistakes encountered in US diagnostics of the thyroid, the elimination of which should improve the quality of both the ultrasound examination itself and its interpretation. We have outlined errors resulting from a faulty examination technique, the similarity of the neighboring anatomical structures, and anomalies present in the proximity of the thyroid gland. We have also pointed out the reasons for inaccurate assessment of a thyroid lesion image, such as having no access to clinical data or not taking them into account, as well as faulty qualification for a fine needle aspiration biopsy. We have presented guidelines aimed at limiting the number of misdiagnoses in thyroid diseases, and provided sonograms exemplifying diagnostic mistakes. PMID:26672970

  13. Explanation of diagnostic criteria for radiation thyroid diseases

    International Nuclear Information System (INIS)

    Liu Libo; Luo Yunxiao; Wang Jianfeng; Chen Dawei; Cheng Guanghui; Jin Yuke

    2012-01-01

    National occupational health standard-Diagnostic Criteria for Radiation Thyroid Diseases has been approved and issued by the Ministry of Health. Based on the extensive research of literature, this standard was enacted according to the relevant laws and regulations. It is mainly used for diagnosis of thyroid diseases caused by occupational radiation, and it also can serve as a guide to diagnose thyroid disease induced by medical radiation. To implement this standard, and to diagnose and treat the radiation thyroid diseases patient correctly and timely, the contents of this standard were interpreted in this article. (authors)

  14. Pathological changes in the thyroid gland in crush asphyxia.

    Science.gov (United States)

    Byard, Roger W

    2013-12-01

    To determine whether crush asphyxia may be associated with macro- and microscopic changes in the thyroid gland, four cases of death due to crush asphyxia were evaluated where the decedents (males aged 36, 37, 45, and 65 years respectively) suffered lethal chest compressions. The diagnosis of crush asphyxia in each case was suggested by the death scene description and confirmed by the finding of injuries to the torso, with marked congestion of the face, neck, and upper body associated with petechial and subconjunctival hemorrhages. In addition to other pathological findings, each decedent had intense congestion of their thyroid gland resulting in a dark/black appearance. Microscopically, stromal capillaries were engorged, with bulging of capillaries into the follicles. Rupture of these small vessels had created focal intrafollicular aggregates of erythrocytes within the colloid. As intense suffusion of the thyroid gland with blood in cases of crush asphyxia may impart an appearance of "black thyroid" this may be another feature of this condition to look for at autopsy, in addition to intrafollicular blood lakes on histology.

  15. Shear wave elastography in medullary thyroid carcinoma diagnostics

    Directory of Open Access Journals (Sweden)

    Katarzyna Dobruch-Sobczak

    2015-12-01

    Full Text Available Shear wave elastography (SWE is a modern method for the assessment of tissue stiffness. There has been a growing interest in the use of this technique for characterizing thyroid focal lesions, including preoperative diagnostics. Aim: The aim of the study was to assess the clinical usefulness of SWE in medullary thyroid carcinoma (MTC diagnostics. Materials and methods: A total of 169 focal lesions were identifi ed in the study group (139 patients, including 6 MTCs in 4 patients (mean age: 45 years. B-mode ultrasound and SWE were performed using Aixplorer (SuperSonic, Aix-en-Provence, with a 4–15 MHz linear probe. The ultrasound was performed to assess the echogenicity and echostructure of the lesions, their margin, the halo sign, the height/width ratio (H/W ratio, the presence of calcifi cations and the vascularization pattern. This was followed by an analysis of maximum and mean Young’s (E modulus values for MTC (EmaxLR, EmeanLR and the surrounding thyroid tissues (EmaxSR, EmeanSR, as well as mean E-values (EmeanLRz for 2 mm region of interest in the stiffest zone of the lesion. The lesions were subject to pathological and/or cytological evaluation. Results: The B-mode assessment showed that all MTCs were hypoechogenic, with no halo sign, and they contained micro- and/ or macrocalcifi cations. Ill-defi ned lesion margin were found in 4 out of 6 cancers; 4 out of 6 cancers had a H/W ratio > 1. Heterogeneous echostructure and type III vascularity were found in 5 out of 6 lesions. In the SWE, the mean value of EmaxLR for all of the MTCs was 89.5 kPa and (the mean value of EmaxSR for all surrounding tissues was 39.7 kPa Mean values of EmeanLR and EmeanSR were 34.7 kPa and 24.4 kPa, respectively. The mean value of EmeanLRz was 49.2 kPa. Conclusions: SWE showed MTCs as stiffer lesions compared to the surrounding tissues. The lesions were qualifi ed for fi ne needle aspiration biopsy based on B-mode assessment. However, the diagnostic algorithm

  16. The diagnostic value of Th1/Th2 cell cytokine and thyroid autoantibody on autoimmune thyroid diseases

    International Nuclear Information System (INIS)

    Feng Xuemin; Qin Mingxiu; Zhao Yan

    2008-01-01

    To study the diagnostic value of Th1/Th2 cell cytokine and thyroid autoantibody in autoimmune thyroid diseases (AITD), 28 patients with Graves' disease (GD), 15 patients with hyperthyroidism and thyroiditis (GDIII), 13 patients with Hashimoto's hyperthyroidism (HTL), 21 patients with Hashimoto's thyroiditis(HT)and 20 healthy subjects were enrolled in this study. The serum concentrations of Th1 cytokine (IFN-γ) and Th2 cytokine (IL-4) were determined by ELISA. The serum levels of thyrotropin receptor antibodies (TRAb), thyroglobulin antibodies (TGAb) and thyroid peroxidase antibodies (TPOAb) were measured by RIA. The relationship between the serum levels of IFN-γ, IL-4 and TRAb, TGAb and TPOAb were analyzed. The results showed that IFN-γ levels from higher to lower in different groups were in the order of HT, HTL, GDIII, GD and the IL-4 were GD, GDIII, HTL, HT, respectively. There was significant difference in the IFN-γ (P<0.05) and IL-4 levels (P<0.01) between GDIII and HTL groups. There was no significant difference in TGAb and TPOAb between GDIII and HTL groups. In HT group, IFN-γ levels was positively correlated with TGAb and TPOAb (r=0.67,0.54,P<0.01). In GD group, IL-4 was positively correlated with TRAb (r =0.71,P<0.01). The imbalance of Th1/Th2 cell cytokine reflects pathologic change and abnormality of immune function in AITD patients. The detection of Th1/Th2 cell cytokine combined with thyroid autoantibody may be regarded as an indicator in the diagnosis of autoimmune thyroid diseases. (authors)

  17. The special features of response on the disease and victim behavior in women with thyroid pathologies

    Directory of Open Access Journals (Sweden)

    Олена Вікторівна Варібрус

    2015-12-01

    Full Text Available Thyroid pathologies are characterized with an expressed somatic distress and transformations of psychic sphere. Elimination of hormonal imbalance as pathogenetic mechanism levels the clinic symptomatology to a great extent. That is why the problem of inclination to treatment in endocrinological patients becomes particularly topical.The aim of research was the study of the special features of response on treatment and manifestations of victim behavior connected with chronic somatic pathology in women with the different types of thyroid pathologies.Contingent and methods of research. There were used the clinical methodology of diagnostics of the type of an attitude to disease (TAD and the Andronnikova modified questionnaire of inclination to victim behavior.Results. Most of all interrogated patients with thyroid pathologies had intrapsychic (49,6 % against 32,0 % and combined maladjustment (18,6 % against 8,0 %, the lesser part of them had adaptive types of response on disease comparing with healthy women (9,7 % against 40,0 %. The intragroup differences were expressed in prevalence of types with intrapsychic maladjustment in women with hypothyroidism (57,4 % against 42,4 %, and interpsychic and combined at hyperthyroidism (27,1 % against 16,7 % and 22,0 % against 14,8 %. The main types of response on disease in persons with thyroid pathologies were anxious and sensitive (10,6 %, anxious (8,8 %, sensitive (8,8 % and anosognosic (8,8 %, in healthy women – ergopathic (16,0 %, anosognosic (14,0 %, energopathic and sensitive (12,0 % and harmonic types (10,0 %.An intensity of the victim behavior was higher in patients with thyroid pathologies, in women with hyperthyroidism took place aggressive, self-destructive and hypersocial ones, in patients with hypothyroidism – dependent and uncritical types of victimhood that indicated the presence of somatogenic victimhood as a factor of psychological and psychosocial maladjustment.Conclusions. The

  18. Human Telomerase Reverse Transcriptase (hTERT) Gene Expression in Thyroid Carcinoma: Diagnostic and Prognostic Role

    International Nuclear Information System (INIS)

    Asaad, N.Y.; Abdel Wahed, M.M.; Mohammed, A.G.

    2006-01-01

    Background: The catalytic component of telomerase, human telomerase reverse transcriptase (hTERT) has been found to be reactivated in immortalized cell lines and considered as a diagnostic marker for malignancy in different body tissues. Aim of Work: Therefore we thought to determine whether hTERT gene detection could serve as an adjunct in the diagnosis of thyroid lesions together with evaluation of its prognostic value. Patients and Methods: The study included 50 cases of primary thyroid carcinoma including; 28 papillary carcinoma, 14 follicular carcinoma,S anaplastic carcinoma and 3 medullary carcinoma in addition to 5 cases of nodular hyperplasia and 5 cases of follicular adenoma. RNA was extracted from paraffin sections of those patients and hTERT gene expression was identified by Reverse Transcription - Polymerase Chain Reaction (RT-PCR). Results: RT-PCR of hTERT gene revealed expression in 43/50 (86%) malignant thyroid cases; including 25 papillary, 11 follicular, 4 anaplastic and 3 medullary carcinoma cases. On the other hand, hTERT gene expression could not be detected in either hyperplastic nodule or in follicular adenoma cases. The diagnostic validity of hTERT gene detection in benign and malignant thyroid lesions was in the form of 88.3% accuracy, 86% sensitivity, 100% specificity, 100% positive predictive value and 90% negative predictive value. No significant association has been found between hTERT gene expression and any clinico pathologic parameters concerned in this study. In thyroid carcinoma cases, hTERT gene detection was the most independent predictor of poor survival by multivariate survival analysis. Conclusion: Detection of hTERT gene expression should be considered in confirmation of malignant thyroid lesions. Moreover it could be one of the helpful tools in addition to grade, tumor type, and age to stratify patients with thyroid carcinoma into different prognostic categories. Hence, inhibition of hTERT could be of use prospectively in the

  19. Magnetic resonance spectroscopy as a diagnostic modality for carcinoma thyroid

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, Nikhil [Department of Surgery, Maulana Azad Medical College, Lok Nayak Hospital, New Delhi (India)], E-mail: nikhil_ms26@yahoo.co.in; Kakar, Arun K. [Department of Surgery, Maulana Azad Medical College, Lok Nayak Hospital, New Delhi (India); Chowdhury, Veena [Department of Radiodiagnosis, Maulana Azad Medical College, Lok Nayak Hospital, New Delhi (India); Gulati, Praveen [MR Centre, A-23 Green Park, New Delhi (India); Shankar, L. Ravi [Department of Radioiodine Uptake and Imaging, Institute of Nucler Medicine and Allied Sciences (INMAS), Timarpur, New Delhi (India); Vindal, Anubhav [Department of Surgery, Maulana Azad Medical College, Lok Nayak Hospital, New Delhi (India)

    2007-12-15

    Aim: The aim of this study was to observe the findings of magnetic resonance spectroscopy of solitary thyroid nodules and its correlation with histopathology. Materials and methods: In this study, magnetic resonance spectroscopy was carried out on 26 patients having solitary thyroid nodules. Magnetic resonance spectroscopy (MRS) was performed on a 1.5 T super conductive system with gradient strength of 33 mTs. Fine needle aspiration cytology was done after MRS. All 26 patients underwent surgery either because of cytopathologically proven malignancy or because of cosmetic reasons. Findings of magnetic resonance spectroscopy were compared with histopathology of thyroid specimens. Results and conclusion: It was seen that presence or absence of choline peak correlates very well with presence or absence of malignant foci with in the nodule (sensitivity = 100%; specificity = 88.88%). These results indicate that magnetic resonance spectroscopy may prove to be an useful diagnostic modality for carcinoma thyroid.

  20. Diagnostic accuracy of gray-scale and colour doppler ultrasonography in diagnosing malignant thyroid nodules

    International Nuclear Information System (INIS)

    Muhammad, D.; Khan, S.

    2016-01-01

    Objective: To determine diagnostic accuracy of gray-scale and colour doppler ultrasonography in diagnosing malignant thyroid nodules. Study Design: Validation study. Place and Duration of Study: Radiology department Combined Military Hospital (CMH) and Military Hospital (MH) Rawalpindi from July 2007 to July 2008. Subjects and Methods: Fifty cases of solitary/multinodular goitre with clinical suspicion of malignancy were included in the study by non-probability purposive sampling. Gray-scale and colour doppler ultrasonography of neck/thyroid gland was done and results were compared with histo-pathological findings from Armed Forces Institute of Pathology (AFIP) and Army Medical College keeping histopathology as gold standard. Results: In 50 patients, 10 cases found to have ultrasound findings suspicious of malignancy. Out of these 10 cases, 6 cases confirmed as malignant on histopathology. In 40 patients with benign ultrasound findings, one had malignancy on histo-pathological examination. Out of these 7 patients with confirmed malignancy, four had papillary carcinoma; two had follicular carcinomas and one anaplastic carcinoma. Diagnostic parameters calculated and found to be: sensitivity 85.7 percent; specificity 90.6 percent; PPV 60 percent; NPP 97.5 percent and accuracy of 90 percent. Conclusion: Gray-scale and colour doppler ultrasonography is a good technique in diagnosing malignant thyroid nodules. Entirely solid nodule with no cystic element having spiculated margins, micro-calcifications and central flow are helpful sonographic findings pointing towards malignancy. Associated cervical lymphadenopathy with calcification or degeneration is a significant finding favouring malignancy. (author)

  1. Papillary thyroid carcinoma: comparison between CT features and pathologic findings

    International Nuclear Information System (INIS)

    Tan Hongna; Gu Yajia; Peng Weijun; Yang Wentao; Huang Dan

    2009-01-01

    Objective: To evaluate the relationship between the CT imaging features and pathologic findings of papillary thyroid carcinoma (PTC) and papillary thyroid microcarcinoma (PTMC), as well as the CT appearances of Non-papillary thyroid carcinoma(N-PTC). Methods: CT features of 229 PTC, 42 PTMC and 36 N-PTC patients with 264, 57 and 41 lesions respectively were analyzed retrospectively, and comparison was made with the pathologic findings. All data were analyzed by X 2 test. Results: (1) Of PTC lesions, 25.4% (67/264)of the lesions and 2.9% (24/828) of metastatic lymph nodes showed cystic changes. Cyst formation with intracystic high density papillary-like nodules were found in 31.3% (21/67)of the PTC lesions and 37.5% (9/24) of metastatic lymph nodes. The histologic appearances of these tumors demonstrated fibrous tissue forming the wall of cyst, and papillary-like tumor tissue. (2) 75.2% (112/149) of PTC and 33.3% (5/15) of PTMC showed multiple small granular and fine calcifications, and there was statiscally significant difference between the two (P 0.05). However, the degree of enhancement in PTC lesions were less than that of N-PTC, 36.6% (94/257) of PTC and 54.1% (20/37)of N-PTC lesions showed significant enhancement, and there was statistically significant difference (P<0.05). 75.1% of PTC (172/229) and 52.8% of (19/36)N-PTC had cervical lymph node metastases, with a propensity fbr PTC to have more VI region metastatic lymph nodes, 80.8% (139/172)vs 57.9% (11/19), which was statistically significant (both P<0.05). (4)Distant metastases to bone or lung were rare, but N-PTC (5/36) were more likely to produce distant metastases than PTC (5/229), and there was statistically significant difference (P<0.01). Conclusion Multiple, small granular and fine calcifications were found more frequently in PTC than PTMC. Compared with N-PTC, the papillary-like mural nodules of PTC showed less enhancement on post-contrast CT and cervical lymph node metastases were more

  2. European Thyroid Association Guidelines regarding Thyroid Nodule Molecular Fine-Needle Aspiration Cytology Diagnostics.

    Science.gov (United States)

    Paschke, Ralf; Cantara, Silvia; Crescenzi, Anna; Jarzab, Barbara; Musholt, Thomas J; Sobrinho Simoes, Manuel

    2017-07-01

    Molecular fine-needle aspiration (FNA) cytology diagnostics has the potential to address the inherent limitation of FNA cytology which is an indeterminate (atypia of undetermined significance/follicular lesion of undetermined significance follicular neoplasm) cytology. Because of the emerging role of molecular FNA cytology diagnostics, the European Thyroid Association convened a panel of international experts to review methodological aspects, indications, results, and limitations of molecular FNA cytology diagnostics. The panel reviewed the evidence for the diagnostic value of mutation panel assessment (including at least BRAF , NRAS , HRAS , KRAS , PAX8/PPARG , RET/PTC ) of targeted next generation sequencing and of a microarray gene expression classifier (GEC) test in the diagnostic assessment of an indeterminate cytology thyroid nodule. Moreover, possible surgical consequences of molecular FNA diagnostic results of thyroid nodules and the evidence that analysis of a molecular FNA diagnostic panel of somatic mutations or a microarray GEC test can alter the follow-up were reviewed. Molecular tests may help clinicians to drive patient care and the surgical decision if the analysis is performed in specialized laboratories. These molecular tests require standardization of performance characteristics and appropriate calibration as well as analytic validation before clinical interpretation.

  3. Ultrasound Evaluation of Thyroid Gland Pathologies After Radiation Therapy and Chemotherapy to Treat Malignancy During Childhood.

    Science.gov (United States)

    Lollert, André; Gies, Christina; Laudemann, Katharina; Faber, Jörg; Jacob-Heutmann, Dorothee; König, Jochem; Düber, Christoph; Staatz, Gundula

    2016-01-01

    The purpose of this study was to evaluate correlations between treatment of malignancy by radiation therapy during childhood and the occurrence of thyroid gland pathologies detected by ultrasonography in follow-up examinations. Reductions of thyroid gland volume below 2 standard deviations of the weight-specific mean value, occurrence of ultrasonographically detectable thyroid gland pathologies, and hypothyroidism were retrospectively assessed in 103 children and adolescents 7 months to 20 years of age (median: 7 years of age) at baseline (1997-2013) treated with chemoradiation therapy (with the thyroid gland dose assessable) or with chemotherapy alone and followed by ultrasonography and laboratory examinations through 2014 (median follow-up time: 48 months). A relevant reduction of thyroid gland volume was significantly correlated with thyroid gland dose in univariate (P25 Gy). Thyroid gland dose was significantly higher in patients with thyroid gland pathologies during follow-up (P=.03). Univariate analysis revealed significant correlations between hypothyroidism and thyroid gland dose (Ppathologies, and hypothyroidism, after malignancy treatment during childhood are associated with thyroid gland dose. Both ultrasonography and laboratory follow-up examinations should be performed regularly after tumor therapy during childhood, especially if the treatment included radiation therapy. Copyright © 2016. Published by Elsevier Inc.

  4. Interrelation specific autoimmune pathologies of a thyroid gland with inorganic autoimmune rheumatic diseases

    Directory of Open Access Journals (Sweden)

    O V Paramonova

    2012-03-01

    Full Text Available The problem of a pathology of a thyroid gland at rheumatic diseases, in particular at rheumatoid arthritis, remains actual and to this day. The work purpose was studying antitelogenesis to thyroid hormones at patients with mixt autoimmune pathology. In whey of blood of patients with RA and autothyroid pathology are found out antibodies (AB to Т3 and Т4, their concentration correlates with activity of pathological process. It is shown, that level AB to Т3 and Т4 authentically differs from the maintenance of the given antibodies in whey of blood of healthy faces. Level of antibodies to thyroid hormones can be considered as the criterion predicting development of pathology of a thyroid gland at patients with RA.

  5. Interaction of pathology and molecular characterization of thyroid cancers

    International Nuclear Information System (INIS)

    Williams, E.D.; Cherstvoy, E.; Egloff, B.; Hoefler, H.; Vecchio, G.; Bogdanova, T.; Bragarnik, M.; Tronko, N.D.

    1996-01-01

    This paper presents the results of joint studies of thyroid cancer in children under 15 years of age between departments in Cambridge, Brussels, Naples and Munich in the European Union, and departments in Minsk, Kiev and Obninsk in the newly independent states of Eastern Europe. The pathology of 264 cases of childhood thyroid cancer out of 430 that have occurred since 1990 in the 3 countries in which high levels of fallout from the Chernobyl accident occurred has been restudied by NIS and EU pathologists. The overall level of agreement reached was about 97%. The diagnosis was supported by immunocytochemistry and ISH for the differentiation markers, thyroglobulin and calcitonin, and the tumors were classified according to the WHO, with papillary carcinomas being further subclassified. 99% of the 134 Belarussian cases were papillary carcinomas, as were 94% of the 114 Ukrainian tumors. All 9 of the Russian cases available for study were papillary in type. 76 of 154 cases of childhood thyroid cancer reviewed over a 30 year period in England and Wales and were also studied, 68% of these were papillary carcinoma. Histological study showed that a subtype of papillary carcinoma, rarely found in adults, with a solid/follicular architecture occurred in children. It was found in 72% of the Belarussian papillary carcinomas, 76% of the Ukrainian cases, but only 40% of the England and Wales cases. Molecular biological studies showed that the proportion of cases of papillary carcinoma expressing the ret gene was not significantly different in the exposed and the unexposed tumors, studies of the type of translocation leading to ret gene expression are not yet conclusive. Ras gene mutations were found as expected in follicular carcinoma, but were absent from any papillary carcinoma, whether from exposed or unexposed cases. TSH receptor mutations, normally found in follicular tumors were not found in any papillary carcinomas, nor were any p53 mutations identified. All these results

  6. Comparative Study of US Features, US-guided Fine Needle Aspiration Cytology, and Pathology Results for Eggshell Calcified Thyroid Nodules

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Yoon Nae; Kim, Dong Wook [Dept. of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2011-06-15

    The aim of this study was to investigate ultrasound (US) findings of eggshell calcified thyroid nodules associated with thyroid malignancy and the diagnostic usefulness for US-guided fine-needle aspiration cytology (US-FNAC) of eggshell calcified thyroid nodules. We analyzed 36 eggshell calcified thyroid nodules in 35 patients who underwent thyroid US and US-FNAC from January to December of 2009. We compared the US findings and US-FNAC results with the pathologic results confirmed by surgery. Twenty eggshell calcified nodules were surgically removed in 19 patients, from which 8 papillary thyroid carcinomas and 12 hyperplasia nodules were confirmed. The sensitivity, specificity, positive, and negative predictive values, as well as accuracy for US diagnosis and US-FNAC of eggshell calcified nodules were 100% and 20%, 25% and 100%, 43.8% and 100%, 100% and 63.6%, and 55% and 66.7%, respectively. The results of this study indicate that thick peripheral hypoechoic rim and thickening of eggshell calcified nodules are significantly related to malignancy, but focal disruption of eggshell calcification is not.

  7. [Diagnostic significance of pathologic synkinesis for detection of pyramidal pathology].

    Science.gov (United States)

    Baliasnyĭ, M M

    1991-01-01

    Five types of pathological synkinesis (++blepharo-ocular, ++blepharo-facial, ++bucco-manual, ++digito-digital on the hands, ++pedo-digital) are described. They are of definite importance for revealing pyramidal pathology including its early stages as well as for objective evaluation and observation of the time-course of changes in the illness.

  8. The assessment of the prevalence of associated benign pathology of thyroid and mammary glands

    OpenAIRE

    VASIUKHINA I.A.; DANILOVA L.I.

    2012-01-01

    Objective: to assess the prevalence of associated benign pathology of thyroid and mammary glands in women with unsuppressed menstrual cycle. Materials and methods: 265 women with unsuppressed menstrual cycle (MC) were examined by the sample method. The examination of the women included ultrasonography of thyroid and mammary glands with the detector-frequency of 7.5 MHz. The thyroid status and clinicolaboratory indicators of the reproductive system were estimated. Results. The prevalence of th...

  9. Thyroid gland involvement in advanced laryngeal cancer: association with clinical and pathologic characteristics.

    Science.gov (United States)

    Hilly, Ohad; Raz, Raanan; Vaisbuch, Yona; Strenov, Yulia; Segal, Karl; Koren, Rumelia; Shvero, Jacob

    2012-11-01

    Indications for thyroidectomy during laryngectomy are controversial. We examined whether clinicopathologic features can predict thyroid gland involvement, and the prognostic effect of thyroid gland involvement in patients undergoing total laryngectomy. The study set out to review preoperative assessment, operation findings, pathologic findings, and follow-up data. Thyroid gland involvement was found in 11 of 53 patients (21%) undergoing total laryngectomy and thyroidectomy. Preoperative work-up failed to predict thyroid gland involvement. Thyroid gland involvement was associated with salvage procedures (p = .025), paratracheal metastases (p = .003), and poor overall survival (hazard ratio = 2.74, p = .008). Thyroid gland involvement in patients undergoing total laryngectomy is frequent and is associated with poor prognosis. Preoperative assessment failed to predict thyroid gland involvement. We believe that thyroidectomy should be considered in cases with paratracheal lymphatic spread irrespective of tumor location within the larynx. Copyright © 2011 Wiley Periodicals, Inc.

  10. Thyroid disease

    International Nuclear Information System (INIS)

    Falk, S.

    1990-01-01

    Presenting a multidisciplinary approach to the diagnosis and treatment of thyroid disease, this volume provides a comprehensive picture of current thyroid medicine and surgery. The book integrates the perspectives of the many disciplines that deal with the clinical manifestations of thyroid disorders. Adding to the clinical usefulness of the book is the state-of-the-art coverage of many recent developments in thyroidology, including the use of highly sensitive two-site TSH immunoradionetric measurements to diagnose thyroid activity; thyroglobulin assays in thyroid cancer and other diseases; new diagnostic applications of MRI and CT; treatment with radionuclides and chemotherapy; new developments in thyroid immunology, pathology, and management of hyperthyroidism; suppressive treatment with thyroid hormone; and management of Graves' ophthalmopathy. The book also covers all aspects of thyroid surgery, including surgical treatment of hyperthyroidism; papillary, follicular, and other carcinomas; thyroidectomy; and prevention and management of complications

  11. Laryngeal chondrosarcoma mimicking medullary thyroid carcinoma on fine-needle aspiration cytology: A case report of a diagnostic pitfall.

    Science.gov (United States)

    Vahidi, Shifteh; Amin, Khalid; Stewart, Jimmie

    2017-11-01

    Chondrosarcoma (CS) of larynx is a rare laryngeal tumor accounting about 1% of laryngeal malignancies. When CS arises from thyroid cartilage, it may clinically present as a thyroid nodule. Here we report a rare case of CS of thyroid cartilage misinterpreted as medullary thyroid carcinoma. The main aim of this case report is to emphasize the important role of accurate clinical history, appropriate physical examination, and proper localization of the tumor and clear definitive imaging in conjunction with interpretation of cytologic smears. When any of these roles are unclear, it may result in misinterpretation of the cytologic smears. In these unusual circumstances, when cytomorphologic features does not completely fit an entity, communication with the physician and the consideration of a broad differential diagnoses in the head and neck pathology may lead to correct diagnosis and avoid diagnostic pitfalls. Also in certain conditions, ancillary studies including laboratory tests are necessary for definitive classification. © 2017 Wiley Periodicals, Inc.

  12. Ultrasound Evaluation of Thyroid Gland Pathologies After Radiation Therapy and Chemotherapy to Treat Malignancy During Childhood

    Energy Technology Data Exchange (ETDEWEB)

    Lollert, André, E-mail: andre.lollert@unimedizin-mainz.de [Department of Diagnostic and Interventional Radiology, Section of Pediatric Radiology, Medical Center of the Johannes Gutenberg University, Mainz (Germany); Gies, Christina; Laudemann, Katharina [Department of Diagnostic and Interventional Radiology, Section of Pediatric Radiology, Medical Center of the Johannes Gutenberg University, Mainz (Germany); Faber, Jörg [Department of Pediatrics and Adolescent Medicine, Medical Center of the Johannes Gutenberg University, Mainz (Germany); Jacob-Heutmann, Dorothee [Department of Radio-oncology and Radiotherapy, Medical Center of the Johannes Gutenberg University, Mainz (Germany); König, Jochem [Institute for Medical Biostatistics, Epidemiology and Informatics, Medical Center of the Johannes Gutenberg University, Mainz (Germany); Düber, Christoph; Staatz, Gundula [Department of Diagnostic and Interventional Radiology, Section of Pediatric Radiology, Medical Center of the Johannes Gutenberg University, Mainz (Germany)

    2016-01-01

    Purpose: The purpose of this study was to evaluate correlations between treatment of malignancy by radiation therapy during childhood and the occurrence of thyroid gland pathologies detected by ultrasonography in follow-up examinations. Methods and Materials: Reductions of thyroid gland volume below 2 standard deviations of the weight-specific mean value, occurrence of ultrasonographically detectable thyroid gland pathologies, and hypothyroidism were retrospectively assessed in 103 children and adolescents 7 months to 20 years of age (median: 7 years of age) at baseline (1997-2013) treated with chemoradiation therapy (with the thyroid gland dose assessable) or with chemotherapy alone and followed by ultrasonography and laboratory examinations through 2014 (median follow-up time: 48 months). Results: A relevant reduction of thyroid gland volume was significantly correlated with thyroid gland dose in univariate (P<.001) and multivariate analyses for doses above 2 Gy. Odds ratios were 3.1 (95% confidence interval: 1.02-9.2; P=.046) for medium doses (2-25 Gy) and 14.8 (95% confidence interval: 1.4-160; P=.027) for high doses (>25 Gy). Thyroid gland dose was significantly higher in patients with thyroid gland pathologies during follow-up (P=.03). Univariate analysis revealed significant correlations between hypothyroidism and thyroid gland dose (P<.001). Conclusions: Ultrasonographically detectable changes, that is, volume reductions, pathologies, and hypothyroidism, after malignancy treatment during childhood are associated with thyroid gland dose. Both ultrasonography and laboratory follow-up examinations should be performed regularly after tumor therapy during childhood, especially if the treatment included radiation therapy.

  13. Clinical And Pathological Implications Of Concurrent Autoimmune Thyroid Disorders And Papillary Thyroid Cancer.

    OpenAIRE

    Cunha, L L; Ferreira, R C; Marcello, M A; Vassallo, J; Ward, L S

    2011-01-01

    Cooccurrences of chronic lymphocytic thyroiditis (CLT) and thyroid cancer (DTC) have been repeatedly reported. Both CLT and DTC, mainly papillary thyroid carcinoma (PTC), share some epidemiological and molecular features. In fact, thyroid lymphocytic inflammatory reaction has been observed in association with PTC at variable frequency, although the precise relationship between the two diseases is still debated. It also remains a matter of debate whether the association with a CLT or even an a...

  14. Diffuse lipomatosis of the thyroid gland: A pathologic curiosity

    Directory of Open Access Journals (Sweden)

    Gupta Ruchika

    2009-04-01

    Full Text Available We report the case of a 45-year-old man who presented with a 4-year history of midline neck swelling associated with recent onset respiratory distress. Local examination showed a lobulated diffuse thyroid enlargement. A subtotal thyroidectomy was performed. The right lobe weighed 225 g and the left lobe weighed 130 g. Multiple sections from both the lobes revealed diffuse infiltration of the stroma by mature adipose tissue. There was no evidence of amyloid deposits or papillary carcinoma. A final diagnosis of diffuse lipomatosis of the thyroid gland was rendered. Lipomatosis or adenolipomatosis of the thyroid gland is an extremely rare entity. The various differential diagnoses of fat in the thyroid include benign entities like amyloid goiter, adenolipoma, lymphocytic thyroiditis, intrathyroid thymic or parathyroid lipoma and malignant tumors like liposarcoma and encapsulated papillary carcinoma. Adequate clinical details and a thorough histopathological examination are mandatory for diagnosis.

  15. Diagnostic significance of the serum thyroid hormone indicies in various thyroid diseases

    International Nuclear Information System (INIS)

    Han, B.H.; Ko, S.M.; Yoon, S.R.; Ro, H.K.

    1980-01-01

    In an attempt to evaluate the diagnostic significance of the serum thyroid hormones in various thyroid function states, the author measured serum T 3 uptake, serum T 3 , serum T 4 , serum free T 4 and free T 4 index in 27 cases of normal subjects, 11 cases of hypothyroidism, 152 cases of euthyroidism and 81 cases of hyperthyroidism by the radioimmunoassay method. The results were as follows: 1) The ranges of serum thyroid hormones in normal subjects were, serum T 3 uptake; 27.4-42.1%, serum T 3 ; 93-245 ng/dl, serum T 4 ; 4.08-12.9 ng/dl and serum free T 4 ; 0.57-1.53 ng/dl (M+-2 S.D.). 2) Free T 4 index and serum T 4 show relatively high diagnostic value in euthyroidism group, and serum T 3 and T 4 in hypothyroidism group, while serum T 3 , free T 4 and T 4 show relatively high diagnostic value in hyperthyroidism group. 3) There were significant correlation between free T 4 index and serum T 4 (r=0.68) and between free T 4 index and serum free T 4 (r=0.67) in hyperthyroidism group. (author)

  16. A multispectral imaging approach for diagnostics of skin pathologies

    Science.gov (United States)

    Lihacova, Ilze; Derjabo, Aleksandrs; Spigulis, Janis

    2013-06-01

    Noninvasive multispectral imaging method was applied for different skin pathology such as nevus, basal cell carcinoma, and melanoma diagnostics. Developed melanoma diagnostic parameter, using three spectral bands (540 nm, 650 nm and 950 nm), was calculated for nevus, melanoma and basal cell carcinoma. Simple multispectral diagnostic device was established and applied for skin assessment. Development and application of multispectral diagnostics method described further in this article.

  17. Size discrepancy between sonographic and pathological evaluation of solitary papillary thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Bachar, Gideon, E-mail: gidybahar@gmail.com [Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Buda, Inon, E-mail: inonbuda@gmail.com [Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Cohen, Maya, E-mail: mayac@clalit.org.il [Department of Imaging, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Hadar, Tuvia, E-mail: hadartuv@gmail.com [Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Hilly, Ohad, E-mail: ohadhilly@gmail.com [Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Schwartz, Nofrat, E-mail: nofrat@gmail.com [Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Department of Otolaryngology, Meir Hospital, Kefar Sabah, Tel Aviv University, Tel Aviv (Israel); Shpitzer, Thomas, E-mail: thomas-s@013net.net [Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Segal, Karl, E-mail: segalk@clalit.org.il [Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100 (Israel); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel)

    2013-11-01

    Background: Sonographic size of suspicious thyroid lesions is an essential parameter in the evaluation of thyroid nodules, determining the need for needle biopsy and has impact on the extent of surgery. Limited data is available on the correlation between the size of the thyroid nodule on sonography and the actual size measured during histological examination. The aim of the present study was to compare these two modalities and to discuss the potential clinical implications of the findings in the study population. Methods: The database of Rabin Medical Center was reviewed for all patients with histologically proven papillary carcinoma of the thyroid treated by thyroid surgery between 2005 and 2010. Results: 292 patients with papillary thyroid carcinoma were included. The mean sonographic size of the nodule was 2.19 ± 1.15 cm. The mean pathological diameter was 1.69 ± 1.09 cm. Discrepancies between tumor histological diameter and the sonographically measurement were more prominent in tumors larger than 1.5 cm. Nonetheless, 18.8% of thyroid nodules that were measured by US as larger than 1 cm, were found to be smaller than 1 cm on final pathology. Similarly, 7.2% of nodules evaluated by sonography were determined as being larger than 4 cm, while their definitive size was smaller than 4 cm. Conclusions: We noted a significant discrepancy between the preoperative sonographic and the pathologic size measurements for papillary thyroid carcinoma. The sonographic evaluation misclassifies both patients with small and large thyroid tumors, and consequently exposes them to unnecessary workup and more extensive operation. This discrepancy between the ultrasound findings and actual tumor size should be taken into account in clinical practice and help guide the evaluation and treatment of patients with thyroid nodules.

  18. Carcinoma of the Thyroid. Preoperative diagnostic and prognostic factors

    International Nuclear Information System (INIS)

    Tennvall, J.

    1984-01-01

    By improving preoperative diagnosis and identification of important prognostic factors of thyroid carcinoma (TC) it might be possible to decrease the number of diagnostic surgical intervantions and to give patients with a confirmed TC a more adequate treatment. Preoperative diagnosis: consecutive series of 83 patients with scintigrams and of 203 patients with fine-needle aspiration (AC) with subsequently histologically confirmed TC were evaluated as well as 217 patients with confirmed benign thyroid disorders. The most common scintigraphic appearance was a solitary reduced uptake (70%). The sensitivity of AC for medullary and undifferentiated TC was 0.82-0.84, but it was for papillary (occult TC excluded) 0.58 and for follicular TC 0.42. A 'cold' nodule with also a decreased thallium-uptake is mostly a benign disorder, but with an increased uptake it might be a well-differentiated TC or a follicular adenoma. These could, however, be significantly separated by the thallium-elimination rate (p=0.0001). Prognostic factors: During 1955-1972, 262 patients with histologically verified TC were referred to the Department and 226 of these (86%) with a median follow-up of 11 years form the basis for prognostic multivariate analyses. According to these analyses, and when deaths in intercurrent disease were estimated, neither age at diagnosis nor sex were found to be important predictors of survival of TC. The following predictors were identified: for papillary TC: tumour extension beyond the thyroid capsule and marked cellular atypia; for follicular TC: tumour extension beyond the thyroid capsule, marked cellular atypia and distant metastases; for medullary TC: tumour extension beyond the thyroid capsule. (Author)

  19. Thyroiditis

    Science.gov (United States)

    ... Anaplastic Thyroid Cancer Complementary and Alternative Medicine in Thyroid Disease FNA Biopsy of Thyroid Nodules Goiter Graves’ Disease ... Cancer Nuclear Radiation & the Thyroid Older Patients and Thyroid Disease Papillary & Follicular Thyroid Cancer Postpartum Thyroiditis Pregnancy and ...

  20. DRAFT: Russian Association of Endocrinologists Clinic Guidelines for Thyroid Nodules Diagnostic and Treatment

    Directory of Open Access Journals (Sweden)

    Vladimir Eduardovich Vanushko

    2015-05-01

    Full Text Available Russian guidelines for diagnostic of thyroid nodules gained some actual questions: necessity of ultrasound (US-screening of the thyroid cancer, indications for fine needle aspiration and exam of calcitonin, necessity of unification of US and cytopathology classification for signs of thyroid nodules. 

  1. Thyroid cancers and benign thyroid pathologies among Chernobyl clean-up workers from Latvia

    International Nuclear Information System (INIS)

    Kurjane, N.; Orlikov, G.; Ritenberga, R.; Lemanis, N.; Lemane, R.

    1998-01-01

    The aim of the work is to detect the frequency and the character of thyroid diseases manly with thyroid cancer diagnosed among Chernobyl clean-up workers from Latvia. Conclusions: Usually, in Latvia every year there are 2-3 thyroid cancer cases per 100 thousand inhabitants, but there are 3 cases per 5 thousands Chernobyl clean-up workers - that mean 20 times more than in general population. The first case of thyroid follicular and papillary carcinoma in the Chernobyl clean-up workers from Latvia was diagnosed after a latent period of 10 years. Among benign thyroid lesions, cystic colloid goiter and nodular colloid goiter seem to be commonly associated with radiation exposure to the thyroid gland

  2. Diagnostic and Prognostic Value of TSH Levels in Differentiated Thyroid Cancers

    Directory of Open Access Journals (Sweden)

    Mazhar Müslüm Tuna

    2014-03-01

    Full Text Available Purpose: The frequency of thyroid surgery for suspected malignancy but with a benign result in pathological examination is increasing in recent years. For this reason, additional preoperative markers are needed for increasing the sensitivity for evaluating the preoperative malignancy risk of thyroid nodules. In this study, we aimed to evaluate the diagnostic value of serum TSH levels for determining the differentiated thyroid cancers (DTC and to identify a proper cut-off value if relevant association is present. Material and Method: Our study included 380 patients who underwent thyroidectomy due to nodular goiter in our hospital between 01.01.2012 and 01.06.2013 retrospectively. 201 patients who were diagnosed with DTC constituted the study group, and 179 consecutive patients with a benign pathology result were included as controls. Patients who had overt hyperthyroidism or hypothyroidism and was taken medicines that affect TSH level were excluded. Results: There were no significant differences between the two groups in terms of age, sex, and family history of thyroid disease. Preoperative TSH levels were 1.66 mIU/lt and 1.59 mIU/lt in patients with DTC and controls, respectively (p=0.641. There was no correlation between TSH and tumor size, and no relationship between TSH and capsular invasion, vascular invasion, extrathyroidal invasion and lymph node metastasis. Discussion: In our study, no relationship was found between preoperative TSH level and DTC. In addition, there was no relationship between TSH and bad prognostic parameters. Turk Jem 2014; 1: 1-4

  3. Multiscale imaging of human thyroid pathologies using integrated optical coherence tomography (OCT) and optical coherence microscopy (OCM)

    Science.gov (United States)

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

    2010-02-01

    We evaluate the feasibility of optical coherence tomography (OCT) and optical coherence microscopy (OCM) for imaging of benign and malignant thyroid lesions ex vivo using intrinsic optical contrast. Thirty four thyroid gland specimens were imaged from 17 patients, covering a spectrum of pathology, ranging from normal thyroid to neoplasia and benign disease. The integrated OCT and OCM imaging system allows seamlessly switching between low and high magnifications, in a way similar to traditional microscopy. Good correspondence was observed between optical images and histological sections. The results provide a basis for interpretation of future OCT and OCM images of the thyroid tissues and suggest the possibility of future in vivo evaluation of thyroid pathology.

  4. Diffuse Optical Characterization of the Healthy Human Thyroid Tissue and Two Pathological Case Studies.

    Directory of Open Access Journals (Sweden)

    Claus Lindner

    Full Text Available The in vivo optical and hemodynamic properties of the healthy (n = 22 and pathological (n = 2 human thyroid tissue were measured non-invasively using a custom time-resolved spectroscopy (TRS and diffuse correlation spectroscopy (DCS system. Medical ultrasound was used to guide the placement of the hand-held hybrid optical probe. TRS measured the absorption and reduced scattering coefficients (μa, μs' at three wavelengths (690, 785 and 830 nm to derive total hemoglobin concentration (THC and oxygen saturation (StO2. DCS measured the microvascular blood flow index (BFI. Their dependencies on physiological and clinical parameters and positions along the thyroid were investigated and compared to the surrounding sternocleidomastoid muscle. The THC in the thyroid ranged from 131.9 μM to 144.8 μM, showing a 25-44% increase compared to the surrounding sternocleidomastoid muscle tissue. The blood flow was significantly higher in the thyroid (BFIthyroid = 16.0 × 10-9 cm2/s compared to the muscle (BFImuscle = 7.8 × 10-9 cm2/s, while StO2 showed a small (StO2, muscle = 63.8% to StO2, thyroid = 68.4%, yet significant difference. Two case studies with thyroid nodules underwent the same measurement protocol prior to thyroidectomy. Their THC and BFI reached values around 226.5 μM and 62.8 × 10-9 cm2/s respectively showing a clear contrast to the nodule-free thyroid tissue as well as the general population. The initial characterization of the healthy and pathologic human thyroid tissue lays the ground work for the future investigation on the use of diffuse optics in thyroid cancer screening.

  5. Inter-Observer Variation in the Pathologic Identification of Minimal Extrathyroidal Extension in Papillary Thyroid Carcinoma

    Science.gov (United States)

    Su, Henry K.; Wenig, Bruce M.; Rowe, Meghan E.; Asa, Sylvia L.; Baloch, Zubair; Du, Eugenie; Faquin, William C.; Fellegara, Giovanni; Giordano, Thomas; Ghossein, Ronald; LiVolsi, Virginia A.; Lloyd, Ricardo; Mete, Ozgur; Ozbek, Umut; Rosai, Juan; Suster, Saul; Thompson, Lester D.; Turk, Andrew T.; Urken, Mark L.

    2016-01-01

    Background: Extrathyroidal extension (ETE) is a significant prognostic factor in papillary thyroid carcinoma (PTC). Minimal extrathyroidal extension (mETE) is characterized by involvement of the sternothyroid muscle or perithyroid soft tissue, and is generally identified by light microscope examination. Patients with mETE, identified pathologically, are automatically upstaged to pT3. However, the prognostic implications of mETE have been a source of controversy in the literature. Moreover, there is also controversy surrounding the identification of mETE on pathological specimens. The objective of this study was to determine the level of agreement among expert pathologists in the identification of mETE in PTC cases. Methods: Eleven expert pathologists from the United States, Italy, and Canada were asked to perform a review of 69 scanned slides of representative permanent sections of PTC specimens. Each slide was evaluated for the presence of mETE. The pathologists were also asked to list the criteria they use to identify mETE. Results: The overall strength of agreement for identifying mETE was slight (κ = 0.14). Inter-pathologist agreement was best for perithyroidal skeletal muscle involvement (κ = 0.46, moderate agreement) and worst for invasion around thick-walled vascular structures (κ = 0.02, slight agreement). In addition, there was disagreement over the constellation of histologic features that are diagnostic for mETE, which affected overall agreement for diagnosing mETE. Conclusions: Overall agreement for the identification of mETE is poor. Disagreement is a result of both variation in individual pathologists' interpretations of specimens and disagreement on the histologic criteria for mETE. Thus, the utility of mETE in staging and treatment of PTC is brought into question. The lack of concordance may explain the apparent lack of agreement regarding the prognostic significance of this pathologic feature. PMID:26953223

  6. Hypermetabolic Thyroid Incidentaloma on Positron Emission Tomography: Review of Laboratory, Radiologic, and Pathologic Characteristics

    Directory of Open Access Journals (Sweden)

    Mehrdad Bakhshayesh Karam

    2017-01-01

    Full Text Available Introduction. Incidental hypermetabolic thyroid lesions on Positron Emission Tomography have significant clinical value and may harbor malignancy. In this study we evaluated laboratory, radiologic, and pathologic characteristics of incidental hypermetabolic thyroid lesions. Materials and Methods. We evaluated 18 patients prospectively with various malignancies and hypermetabolic thyroid incidentaloma. The thyroid function tests, ultrasound assessment, and guided FNA biopsy were performed on all cases. Results. We included 9 male and 9 female patients with mean age of 51 years. Most common malignancy was colon cancer. Metabolic activity quantification using maximum standard uptake value demonstrated range between 1.4 and 65.4 with mean value of 9.4. We found highest metabolic activity in patients with lung adenocarcinoma, B-cell lymphoma, and colon adenocarcinoma. On ultrasound exam most thyroid lesions were of solid, hypoechoic, noncalcified nature with either normal or peripheral increased vascularity. FNA biopsy report was benign in 15 cases and malignant or highly suggestive for malignancy in 3 other cases. Two of the three malignant cases demonstrated metabolic activity higher than average SUV max. Conclusion. Most thyroid hypermetabolic incidentalomas are benign lesions, while higher values of SUV max are in favor of malignancy. This mandates further evaluation of incidentally found thyroid hypermetabolic lesions on routine PET/CT scans.

  7. Diagnostic Accuracy of Detecting Hashimoto's Thyroiditis in Thyroid Cancer Patients Who Underwent Thyroid Surgery: Comparison of Ultrasonography, Positron Emission Tomography/CT, Contrast Enhanced CT, and Anti-Thyroid Antibody

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Gyun; Lee, Tae Hyun; Park, Dong Hee; Nam, Sang Been [Dept. of Radiology, Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    2012-11-15

    To compare the diagnostic accuracy of ultrasonography (US), F18-fluorodeoxyglucose positron emission tomography/CT (PET/CT), contrast enhanced CT (CECT), serum anti-thyroid antibody for detecting Hashimoto's thyroiditis in thyroid cancer patients who underwent neck surgery. A total of 150 patients with suspicious for thyroid cancer, who had previously undergone US guided needle aspiration of thyroid, were evaluated with the use of US, PET/CT, CECT and serum anti-thyroid antibody. The four studies were performed within two months before neck surgery. Hashimoto's thyroiditis was confirmed by histopathological results. The diagnostic accuracy of US, PET/CT, CECT and serum anti-thyroid antibody were calculated statistically. Hashimoto's thyroiditis was diagnosed in 51 out of the 150 patients, following neck surgery. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of US were 76.5%, 92.9%, 84.8%, 88.5%, and 87.3%, respectively. The corresponding values of PET/CT were 37.3%, 96.0%, 82.6%, 74.8%, and 76.0%, and CECT were 62.7%, 89.9%, 76.2%, 82.4%, and 80.7%, and serum anti-thyroid antibody level were 90.2%, 93.9%, 88.5%, 94.9%, and 92.7%, respectively. McNemar test revealed significant difference among PET/CT and others, but no significant differences among US, CECT and serum anti-thyroid antibody. Overall, serum anti-thyroid antibody showed most accurate diagnostic performance. In detecting Hashimoto's thyroiditis, serum anti-thyroid antibody showed higher diagnostic accuracy than others. US also showed relatively high diagnostic accuracy.

  8. Radioguided surgery of primary hyperparathyroidism in a population with a high prevalence of thyroid pathology

    Energy Technology Data Exchange (ETDEWEB)

    Garcia-Talavera, Paloma [University Hospital of Valladolid, Department of Nuclear Medicine, Valladolid (Spain); Gonzalez, Carmen; Gomez, Alberto [University Hospital of Salamanca, Department of Surgery, Salamanca (Spain); Garcia-Talavera, Jose Ramon; Martin, Esther; Martin, Mariano [University Hospital of Salamanca, Department of Nuclear Medicine, Salamanca (Spain)

    2010-11-15

    Patients with concomitant thyroid pathology are usually excluded from minimally invasive radioguided parathyroidectomy (MIRP). We assessed the value in these patients of the gamma probe, alone or in combination with other techniques, in MIRP and unilateral or bilateral approaches. We evaluated its performance in association with intraoperative determination of intact parathyroid hormone (ioPTHi) and preoperative {sup 99m}Tc-MIBI dual phase scintigraphy. Included in the study were 87 patients with a diagnosis of primary hyperparathyroidism who underwent radioguided surgery. They were divided into two groups depending on the presence of concomitant thyroid pathology (TP group, 33 patients) or absence of concomitant thyroid pathology (NTP group, 54 patients). In the TP group, ioPTHi achieved the highest accuracy (90.9%), followed by the gamma probe (81.8%) and scintigraphy (69.7%). In the NTP group, the probe (94.4%) performed better than ioPTH and scintigraphy (both 85.2%). In the TP group, scintigraphy in combination with the gamma probe had a success rate of 90.9%, and 94% in combination with ioPTHi. The three techniques are applied together had a success rate of 97%. For all patients undergoing MIRP, the probe alone worked well, irrespective of the presence or absence of concomitant thyroid pathology. Patients with concomitant thyroid pathology should not be a priori excluded from a MIRP, as long as other adjuvant techniques (scintigraphy or ioPTHi) are used in conjunction with the gamma probe. In these patients, the probe can also be helpful in unilateral or bilateral surgery. (orig.)

  9. Postpartum Thyroiditis

    Science.gov (United States)

    ... disorders cannot be distinguished from one another on pathology specimens. As in Hashimoto’s thyroiditis, postpartum thyroiditis is associated with the development of anti-thyroid (anti-thyroid peroxidase, anti- thyroglobulin) antibodies. Women with ...

  10. Relationship of Shape of Macrocalcification and Thyroid Cancer: Correlation with US and Pathologic Findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sun Young; Lee, Han Bee; Cho, Woo Ho; Kim, Jae Hyung; Jeong, Myeong Ja; Kim, Soung Hee; Kim, Ji Young; Kim, Soo Hyun; Kang, Mi Jin; Lee, Ji Hae [Dept. of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2012-08-15

    The purpose of this study was to categorize macrocalcifications into several subtypes by the US findings and to determine which type of macrocalcification in a thyroid nodule is associated with thyroid malignancy. We retrospectively analyzed the macrocalcification patterns of thyroid nodules in 396 patients that underwent ultrasonography (US)-guided thyroid FNA or surgery in our institution between August 2009 and August 2011. Two radiologists evaluated US findings and categorized macrocalcifications into 5 subtyes : (A) solitary macrocalcification no association with thyroid nodule; (B) nodular macrocalcification( s) within indeterminate thyroid nodule; (C) dense macrocalcification without ability to interpret internal content by its posterior acoustic shadowing; (D) irregular- shaped macrocalcification(s); (E) macrocalcification with other suspicious malignant US finding(s). A chi-squared test and a Fisher exact test were used for comparison of categoric variables. The diagnostic sensitivity, specificity, positive and negative predictive values (PPV and NPV) were obtained. Among total of 417 nodules, 114 (27.3%) were suspicious malignancy or malignancy on histopathological result. Macrocalcification with other malignant US feature had the highest incidence of malignancy (77.5%), followed by irregular-shaped macrocalcification(s) (43.9%), and dense macrocalcification without ability to interpret internal content by its posterior acoustic shadowing (38.5%), solitary macrocalcification no association with thyroid nodule (8.3%) respectively, and nodular macrocalcification( s) with indeterminate thyroid nodule had the lowest incidence (7.5%). A nodule with macrocalcification with other malignant US finding(s) has the highest odds ratio (42.52), followed by a nodule with irregular-shaped macrocalcification(s) (9.65) and dense macrocalcification (7.72). Leaving macrocalcification with compositive malignant findings aside, irregular-shaped macrocalcification is more

  11. Diagnostic utility of DREAM gene mRNA levels in thyroid tumours

    OpenAIRE

    Batista, Fernando A.; Marcello, Marjory A.; Martins, Mariana B.; Peres, Karina C.; Cardoso, Ulieme O.; Silva, Aline C. D. N.; Bufalo, Natassia E.; Soares, Fernando A.; Silva, Márcio J. da; Assumpção, Lígia V.; Ward, Laura S.

    2018-01-01

    ABSTRACT Objective The transcriptional repressor DREAM is involved in thyroid-specific gene expression, thyroid enlargement and nodular development, but its clinical utility is still uncertain. In this study we aimed to investigate whether DREAM mRNA levels differ in different thyroid tumors and how this possible difference would allow the use of DREAM gene expression as molecular marker for diagnostic and/or prognosis purpose. Materials and methods We quantified DREAM gene mRNA levels and ...

  12. Amiodarone-Induced Thyrotoxic Thyroiditis: A Diagnostic and Therapeutic Challenge

    OpenAIRE

    Umang Barvalia; Barkha Amlani; Ram Pathak

    2014-01-01

    Amiodarone is an iodine-based, potent antiarrhythmic drug bearing a structural resemblance to thyroxine (T4). It is known to produce thyroid abnormalities ranging from abnormal thyroid function testing to overt hypothyroidism or hyperthyroidism. These adverse effects may occur in patients with or without preexisting thyroid disease. Amiodarone-induced thyrotoxicosis (AIT) is a clinically recognized condition commonly due to iodine-induced excessive synthesis of thyroid, also known as type 1 A...

  13. A forecast of the thyroid pathology at the children irradiated prenatally

    International Nuclear Information System (INIS)

    Akulich, N.S.

    1995-01-01

    It is investigated a state of the hypophysis thyroid system at 44 pregnant women in age 19-36 years, which were irradiated by low dozes during the Chernobyl NPP accident and evacuated from the contaminated zone in first 10 days. The average doze of internal irradiation of the thyroid for pregnant women is equal 4,374 +- 1,364 mGy and for irradiated prenatally children -5,283 +- 1,454 mGy. The researches of free thyroxine, triiodothyronine and thyroxine binding globulin were done by the radiation immunological method in a venous blood serum, and a thyrotropic hormone - by a set of the 'CIS Bio International' firm. The diagnosis of the thyroid pathology was confirmed by a ultrasonic research and determination of contents of thyroid hormones. The account of the internal irradiation dozes for a thyroid was conducted by means of a use of a single exponential model of a removing of iodine 131. The fetus' thyroid irradiation doze owing to a entering of radioisotopes to the mother's body was estimated by means of the dose rate on the basis of the Johnson three component model. Direct correlation between the thyroid function at pregnant women, which were irradiation by low doses, and frequency of occurrence of an endemic goiter at the children irradiated prenatally is established. At the contents of the free thyroxine 128,9 +- 4,8 nmol/l or more, triiodothyronine 1,9 +- 0,2 nmol/l or less and increase of an activity of thyrotropic hormone from 1,3 +- 0,1 μU/ml in 12 - 27 weeks of pregnancy up to 1,9 +- 0,2 μU/ml in 38-40 weeks it is possible to predict an occurrence of the thyroid pathology at the future child. Is offered to use from the 12-weak term of pregnancy a radiation immunological method of research of thyrotropic and thyroid hormones of pregnant women, subjected to radiation effect, for preventive maintenance and revealing of early disorders of a thyroid at the children irradiated prenatally. 10 refs., 1 tab

  14. Thyroid Nodule Size at Ultrasound as a Predictor of Malignancy and Final Pathologic Size.

    Science.gov (United States)

    Cavallo, Allison; Johnson, Daniel N; White, Michael G; Siddiqui, Saaduddin; Antic, Tatjana; Mathew, Melvy; Grogan, Raymon H; Angelos, Peter; Kaplan, Edwin L; Cipriani, Nicole A

    2017-05-01

    Thyroid-related mortality has remained constant despite the increasing incidence of thyroid carcinoma. Most thyroid nodules are benign; therefore, ultrasound and fine needle aspiration (FNA) are integral in cancer screening. We hypothesize that increased nodule size at ultrasound does not predict malignancy and correlation between nodule size at ultrasound and pathologic exam is good. Resected thyroids with preoperative ultrasounds were identified. Nodule size at ultrasound, FNA diagnosis by Bethesda category, size at pathologic examination, and final histologic diagnosis were recorded. Nodule characteristics at ultrasound and FNA diagnoses were correlated with gross characteristics and histologic diagnoses. Nodules for which correlation could not be established were excluded. Of 1003 nodules from 659 patients, 26% were malignant. Nodules 6 cm). At ultrasound size cutoffs of 2, 3, 4, and 5 cm, smaller nodules had higher malignancy rates than larger nodules. Of the 455 not subject to FNA, 11% were malignant. Ultrasound size alone is a poor predictor of malignancy, but a relatively good predictor of final pathologic size (R 2  = 0.748), with less correlation at larger sizes. In nodules subject to FNA, false negative diagnoses were highest (6-8%) in nodules 3-6 cm, mostly due to encapsulated follicular variant of papillary carcinoma. Thyroid nodule size is inversely related to malignancy risk, as larger nodules have lower malignancy rates. However, the relationship of size to malignancy varies by FNA status. All nodules (regardless of FNA status) demonstrate a risk trough at ≥2 cm. Nodules subject to FNA show step-wise decline in malignancy rates by size, demonstrating that size alone should not be considered as an independent risk factor. Size at ultrasound shows relatively good correlation with final pathologic size. False negative rates are low in this series. Lesions with the appropriate constellation of clinical and radiographic findings should

  15. Discrepancies between the ultrasonographic and gross pathological size of papillary thyroid carcinomas

    Energy Technology Data Exchange (ETDEWEB)

    Hahm, Soo Yeon; Shin, Jung Hee; Oh, Young Lyun; Son, Young Ik [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2016-07-15

    The goal of this study was to investigate the level of agreement between tumor sizes measured on ultrasonography (US) and in pathological specimens of papillary thyroid carcinomas (PTCs) and to identify the US characteristics contributing to discrepancies in these measurements. We retrospectively reviewed the US findings and pathological reports of 490 tumors in 431 patients who underwent surgery for PTC. Agreement was defined as a difference of <20% between the US and pathological tumor size measurements. Tumors were divided by size into groups of 0.5-1 cm, 1-2 cm, 2-3 cm, and ≥3 cm. We compared tumors in which the US and pathological tumor size measurements agreed and those in which they disagreed with regard to the following parameters: taller-than-wide shape, infiltrative margin, echogenicity, microcalcifications, cystic changes in tumors, and the US diagnosis. The rate of agreement between US and the pathological tumor size measurements was 64.1% (314/490). Statistical analysis indicated that the US and pathological measurements significantly differed in tumors <1.0 cm in size (P=0.033), with US significantly overestimating the tumor size by 0.2 cm in such tumors (P<0.001). Cystic changes were significantly more frequent in the tumors where US and pathological tumor size measurements disagreed (P<0.001). Thyroid US may overestimate the size of PTCs, particularly for tumors <1.0 cm in size. This information may be helpful in guiding decision making regarding surgical extent.

  16. Impact of Ecologically Unfriendly Environment on the Formation of Thyroid Pathology in Children Against Iodine Deficiency

    Directory of Open Access Journals (Sweden)

    N.S. Kosmynina

    2014-02-01

    Full Text Available By prevalence among thyroid pathological conditions in Ukraine, the diffuse nontoxic goiter is dominated, the frequency of which, in addition to iodine deficiency, is influenced by anthropogenic pollution of environment. The article evaluated the role of the negative impact of polluted environment on the formation of thyroid disease in children from ecologically unfriendly region on the background of endemic iodine deficiency compared with children from ecologically friendly area of iodine deficiency. It has been determined the frequency of diffuse endemic goiter in children from studied groups according to palpation and ultrasonography. The functional state of the pituitary-thyroid system in children living in iodine deficiency environmentally unfriendly and ecologically friendly areas has been researched.

  17. Thyroid Radiation Dose to Patients from Diagnostic Radiology Procedures over Eight Decades: 1930-2010.

    Science.gov (United States)

    Chang, Lienard A; Miller, Donald L; Lee, Choonsik; Melo, Dunstana R; Villoing, Daphnée; Drozdovitch, Vladimir; Thierry-Chef, Isabelle; Winters, Sarah J; Labrake, Michael; Myers, Charles F; Lim, Hyeyeun; Kitahara, Cari M; Linet, Martha S; Simon, Steven L

    2017-12-01

    This study summarizes and compares estimates of radiation absorbed dose to the thyroid gland for typical patients who underwent diagnostic radiology examinations in the years from 1930 to 2010. The authors estimated the thyroid dose for common examinations, including radiography, mammography, dental radiography, fluoroscopy, nuclear medicine, and computed tomography (CT). For the most part, a clear downward trend in thyroid dose over time for each procedure was observed. Historically, the highest thyroid doses came from the nuclear medicine thyroid scans in the 1960s (630 mGy), full-mouth series dental radiography (390 mGy) in the early years of the use of x rays in dentistry (1930s), and the barium swallow (esophagram) fluoroscopic exam also in the 1930s (140 mGy). Thyroid uptake nuclear medicine examinations and pancreatic scans also gave relatively high doses to the thyroid (64 mGy and 21 mGy, respectively, in the 1960s). In the 21st century, the highest thyroid doses still result from nuclear medicine thyroid scans (130 mGy), but high thyroid doses are also associated with chest/abdomen/pelvis CT scans (18 and 19 mGy for males and females, respectively). Thyroid doses from CT scans did not exhibit the same downward trend as observed for other examinations. The largest thyroid doses from conventional radiography came from cervical spine and skull examinations. Thyroid doses from mammography (which began in the 1960s) were generally a fraction of 1 mGy. The highest average doses to the thyroid from mammography were about 0.42 mGy, with modestly larger doses associated with imaging of breasts with large compressed thicknesses. Thyroid doses from dental radiographic procedures have decreased markedly throughout the decades, from an average of 390 mGy for a full-mouth series in the 1930s to an average of 0.31 mGy today. Upper GI series fluoroscopy examinations resulted in up to two orders of magnitude lower thyroid doses than the barium swallow. There are

  18. Carcinoma of the thyroid

    International Nuclear Information System (INIS)

    Botta Zunino, L.

    1992-01-01

    Reference is made to the diagnostic evaluation of thyroid nodule, reaffirming the concepts of algorithm study, sensitivity and specificity of diagnostic procedures and cost-effectiveness. Stressing once again the place of cytology and the concept of selecting patients for surgery, surgical tactics in front of the thyroid nodule and the need for probate multidisciplinary study and treatment of this pathology. Briefly discusses the most controversial treatment of differentiated thyroid carcinomas, the sine qua non of the pathologist in the operating room in thyroid surgery and the value of the quantification of nuclear DNA in the diagnosis and prognosis of these tumors (Author) [es

  19. Clinico-pathological and prognostic findings on 27 cases of medullary thyroid carcinoma.

    Science.gov (United States)

    Gabsi, Azza; El Amine El Hadj, Olfa; Goucha, Aida; Said, Gritli; Laabidi, Besma; Gamoudi, Amor

    2017-02-01

    Medullary thyroid carcinoma is a rare tumor accounting for less than 10% of thyroid neoplasm. This tumor is characterized by important histological polymorphism which makes morphological diagnosis difficult and immunohistochemical study often necessary. We aim to perform a retrospective review of clinical and pathological characteristics of medullary carcinoma. We will discuss the place of immunohistochemistry in the positive diagnosis and as a prognostic factor. patients with thyroid medullary carcinoma diagnosed in department of pathology at carcinologic institute between 1998 and 2013 were retrospectively included. Clinic, radiologic and prognostic variables were assessed. Slides were reviewed for all the patients with confirmed tumors. Twenty-seven patients with CMT were identified. The average age was 55 years with predominance of males. The average consultation time was 16 months. The most common presentation symptom was a cervical lymph node. Total thyroidectomy was performed in 23 patients. Tumor was nodular and unique in 22 cases. The average size was 2.1 cm. CMT was of mixed type containing both medullary and papillary compound in four cases. Amyloid substance was present and abundant in 21cases. Positive staining for calcitonin was observed in 16 cases. Distant metastasis or metastatic lymph nodes was observed in eight cases with an average period of 42 months. Radiotherapy was performed in fifteen cases and two patients received chemotherapy. In the absence of amyloid deposits, immunohistochemical staining with calcitonin is useful to confirm the diagnosis. The prognosis of this entity is more pejorative than papillary thyroid carcinoma.

  20. Performances of scintigraphy in the primitive hyperparathyroidism and the associated thyroid pathologies

    International Nuclear Information System (INIS)

    Monteil, J.; Mathonnet, M.; Chianea, T.; Cubertafond, P.; Piquet, L.; Rince, C.; Bournaud, E.; Verbeke, S.; Perdrisot, R.; Vandroux, J.C.

    1997-01-01

    The data from scintigraphic and echographic exploration were compared to the surgery results in 32 patients (29 F and 3 M) presenting a primitive hyperparathyroidism, biologically proved, associated to a thyroid pathology. The scintigraphies were achieved with a collimator placed anteriorly and oblique-anteriorly, 4 h after injection by iodine 123 (7 MBq) and 30 min and 2 h after injection of 99m Tc-MIBI (555 MBq). The cervical echography and scintigraphy are independently interpreted. The results are given in a table containing the sensitivity, specificity, V.P.P. and V.P.N. for scintigraphy and echography, respectively. The association of a primary hyperparathyroidism and of a thyroid pathology (with a prevalence of 70% in our region) appears to affect less the performances of scintigraphy imaging than those of morphologic imaging

  1. Use of colloidal gold in diagnostic surgical pathology.

    Science.gov (United States)

    Warhol, M J

    1989-01-01

    Colloidal gold immuno-electron microscopy is a powerful tool for defining antigenicity at the subcellular level. Such studies permit correlation with cell fractionation studies. They also allow one to assess the specificity of a particular antibody. The most useful reagent for immuno-electron microscopy is colloidal gold stabilized by a binding protein, either staphylococcal protein A or immunoglobulin. This method permits highly discrete labeling, and the system is useful for most antibodies used in diagnostic pathology.

  2. INSULIN LIKE GROWTH FACTOR 1 POSSIBLE DEPENDENCE IN PATIENTS WITH METABOLIC SYNDROME OF NODULAR PATHOLOGY OF THE THYROID GLAND.

    Science.gov (United States)

    Rekvava, M; Dundua, T; Kobulia, M; Javashvili, L; Giorgadze, E

    2017-09-01

    Metabolic syndrome and nodular pathology of the thyroid gland is a widespread problem nowadays. Recently there has been a notable coincidence between metabolic syndrome and nodular pathology of thyroid gland. Hence, it is interesting to reveal the connection between these two diseases. It is possible that insulin-like growth factor system (IGF), namely IGF 1 is connecting link between metabolic syndrome and nodular pathology of thyroid gland, because IGF1 stimulates growth and proliferation of cells in the body. We have investigated18-82 years of age 71 patients. group 1 n27- subjects with thyroid nodular disease, and metabolic syndrome, group 2 n31- subjects with thyroid nodular disease and without metabolic syndrome. group 3 n13 - subjects with metabolic syndrome and no thyroid pathology. In all groups were assessed thyroid structural data, defined parameters of carbohydrate metabolism, thyroid function and blood concentration of IGF1. In patients with hyperinsulinemia IGF 1 was noted in normal or reduced concentration. In I group IGF1 was normal in 70,4% (n=19), decreased in 29,6% (n=8), In II group was normal in 77,4 % (n=24), decreased in 22,6% (n=7) and in III group was normal in 76,9% (n=10), decreased in 23,1% (n=3). Increase of IGF 1 in patients with thyroid nodular disease patients was not noted. Statistically significant connection between IGF1 and thyroid nodules was not revealed. For the further investigation of this connection we plan to measure IGF1 in the thyroid histological samples in the future studies.

  3. Serum Immunoproteomics Combined With Pathological Reassessment of Surgical Specimens Identifies TCP-1ζ Autoantibody as a Potential Biomarker in Thyroid Neoplasia.

    Science.gov (United States)

    Belousov, Pavel V; Bogolyubova, Apollinariya V; Kim, Yan S; Abrosimov, Alexander Y; Kopylov, Arthur T; Tvardovskiy, Andrey A; Lanshchakov, Kirill V; Sazykin, Alexei Y; Dvinskikh, Nina Y; Bobrovskaya, Yana I; Selivanova, Lilia S; Shilov, Evgeniy S; Schwartz, Anton M; Shebzukhov, Yuriy V; Severskaia, Natalya V; Vanushko, Vladimir E; Moshkovskii, Sergei A; Nedospasov, Sergei A; Kuprash, Dmitry V

    2015-09-01

    Current methods of preoperative diagnostics frequently fail to discriminate between benign and malignant thyroid neoplasms. In encapsulated follicular-patterned tumors (EnFPT), this discrimination is challenging even using histopathological analysis. Autoantibody response against tumor-associated antigens is a well-documented phenomenon with prominent diagnostic potential; however, autoantigenicity of thyroid tumors remains poorly explored. Objectives were exploration of tumor-associated antigen repertoire of thyroid tumors and identification of candidate autoantibody biomarkers capable of discrimination between benign and malignant thyroid neoplasms. Proteins isolated from FTC-133 cells were subjected to two-dimensional Western blotting using pooled serum samples of patients originally diagnosed with either papillary thyroid carcinoma (PTC) or EnFPT represented by apparently benign follicular thyroid adenomas, as well as healthy individuals. Immunoreactive proteins were identified using liquid chromatography-tandem mass-spectrometry. Pathological reassessment of EnFPT was performed applying nonconservative criteria for capsular invasion and significance of focal PTC nuclear changes (PTC-NCs). Recombinant T-complex protein 1 subunitζ (TCP-1ζ) was used to examine an expanded serum sample set of patients with various thyroid neoplasms (n = 89) for TCP-1ζ autoantibodies. All patients were included in tertiary referral centers. A protein demonstrating a distinct pattern of EnFPT-specific seroreactivity was identified as TCP-1ζ protein. A subsequent search for clinicopathological correlates of TCP-1ζ seroreactivity revealed nonclassical capsular invasion or focal PTC-NC in all TCP-1ζ antibody-positive cases. Further studies in an expanded sample set confirmed the specificity of TCP-1ζ autoantibodies to malignant EnFPT. We identified TCP-1ζ autoantibodies as a potential biomarker for presurgical discrimination between benign and malignant encapsulated follicular

  4. Primary Lymphoma of the Thyroid: Diagnostic and Therapeutic Considerations

    Directory of Open Access Journals (Sweden)

    Basro Sarinah

    2010-01-01

    Conclusion: The diagnosis of primary thyroid lymphoma should be considered when dealing with rapidly growing goitres. The role of FNAC in diagnosing thyroid lymphoma is limited but it is still useful in the initial work-up. Nevertheless, surgical intervention is often required to establish the diagnosis and relieve critical airway compression. A combination of chemotherapy and irradiation is the mainstay of management.

  5. A Prospective Study of Medical Diagnostic Radiography and Risk of Thyroid Cancer

    Science.gov (United States)

    Neta, Gila; Rajaraman, Preetha; Berrington de Gonzalez, Amy; Doody, Michele M.; Alexander, Bruce H.; Preston, Dale; Simon, Steven L.; Melo, Dunstana; Miller, Jeremy; Freedman, D. Michal; Linet, Martha S.; Sigurdson, Alice J.

    2013-01-01

    Although diagnostic x-ray procedures provide important medical benefits, cancer risks associated with their exposure are also possible, but not well characterized. The US Radiologic Technologists Study (1983–2006) is a nationwide, prospective cohort study with extensive questionnaire data on history of personal diagnostic imaging procedures collected prior to cancer diagnosis. We used Cox proportional hazard regressions to estimate thyroid cancer risks related to the number and type of selected procedures. We assessed potential modifying effects of age and calendar year of the first x-ray procedure in each category of procedures. Incident thyroid cancers (n = 251) were diagnosed among 75,494 technologists (1.3 million person-years; mean follow-up = 17 years). Overall, there was no clear evidence of thyroid cancer risk associated with diagnostic x-rays except for dental x-rays. We observed a 13% increase in thyroid cancer risk for every 10 reported dental radiographs (hazard ratio = 1.13, 95% confidence interval: 1.01, 1.26), which was driven by dental x-rays first received before 1970, but we found no evidence that the relationship between dental x-rays and thyroid cancer was associated with childhood or adolescent exposures as would have been anticipated. The lack of association of thyroid cancer with x-ray procedures that expose the thyroid to higher radiation doses than do dental x-rays underscores the need to conduct a detailed radiation exposure assessment to enable quantitative evaluation of risk. PMID:23529772

  6. [Treatment of patient having thyroid nodules: dimension of disease, diagnostic choices and guide-lines].

    Science.gov (United States)

    Pedrazzini, L

    2005-06-01

    The demand of nodule thyroid diagnosis has increased very much in the last years, because of large diffusion of medical information among the population, the increased use and improvement of medical technology that evidences more and more morphology alterations of the gland. The prevalence of palpable thyroid nodule is 2.1-4.2%, but when the ultrasonography is used the prevalence can reach in average 67%. The thyroid cancer however is a rare event: 1% of all malign tumours. The medium incidence is 2.1 for 100,000 men per year, and 5.19 for 100,000 women per year. pretest illness low probability presents a necessity of a very accurate diagnostic test. The introduction of FNA in the 70 has changed the diagnosis, and allowed to spare time and money. The patient with thyroid nodules should be evaluated by experienced physicians in the thyreopathy field, using efficient remote and family anamnesis, by an accurate palpation of the thyroid and the neck, cl ing necessary diagnostic controls. The physician should perform the FNA with a cytopathologist and should convey to him all the clinical and biotumoral information. He should be able to interpret correctly the results of the FNA and to suggest the diagnostic and therapeutical follow-up. This review reveals the best compromise between cost-effectiveness, based on the evidence results taken from international literature, taking into consideration various diagnostic opportunities at our disposal. Guide-lines for the treatment of patients with thyroid nodule are proposed.

  7. Technetium-99m thyroid scan; does it have a diagnostic aid in sub-clinical auto-immune thyroid disease in systemic lupus erythematosus patients?

    Science.gov (United States)

    Amin, A; Alkemary, A; Abdo, M; Salama, M

    2016-02-01

    Technetium-99m (Tc-99m) thyroid scintigraphy is a well known diagnostic tool that shows the entire gland in a single image. We aimed to evaluate its additive diagnostic value in subclinical autoimmune thyroid disease (S-AITD) in systemic lupus erythematosus (SLE) patients. We investigated 100 systemic lupus erythematosus (SLE) patients without overt thyroid involvement (eight men and 92 women; mean age 40±6.5 years) and 50 age and sex matched controls. All were subjected to thyroid evaluation using anti-thyroglobulin (anti-TG) and anti-thyroid peroxidase (anti-TPO) antibodies; hormones (FT3; FT4 and TSH) and Tc-99m thyroid scintigraphy. 14/100 (14%) and none (0%) were positive for S-AITD in SLE and control groups, respectively (P = 0.0001). They were classified by thyroid scintigraphy and hormonal profile into 2/14 Hashimoto; 10/14 atrophic thyroiditis and 2/14 Graves' disease. Anti-TPO was elevated in 12 SLE cases, while anti-TG was elevated in only 2/14 (P = 0.0001). Thyroid scintigraphy showed statistically significant associations with FT4, TSH and anti-TPO. Tc-99m thyroid scintigraphy may have an additional diagnostic role in S-AITD among SLE patients, with an impact on patient management. This potential needs to be further evaluated in a larger series on a multicenter basis. © The Author(s) 2015.

  8. Feline focus: Diagnostic testing for feline thyroid disease: hypothyroidism.

    Science.gov (United States)

    Peterson, Mark E

    2013-08-01

    Although naturally occurring hypothyroidism is very rare in cats, iatrogenic hypothyroidism is a recognized complication of treatment for hyperthyroidism. However, confirming the diagnosis of hypothyroidism in cats is not generally straightforward. The potential for false-negative and false-positive results exists with all thyroid function tests, especially in older cats that may have concurrent nonthyroidal illness. Therefore, all thyroid function test results must be interpreted in light of the cat's history, clinical signs, and other laboratory findings. If a low to low-normal serum thyroxine (T4) value is found in a cat that has been treated for hyperthyroidism, repeating the total T4 analysis, determining free T4 and thyroid stimulating hormone (TSH) concentrations, or performing a TSH stimulation test or thyroid scintigraphy may be needed to confirm the diagnosis.

  9. Radiation protection to the eye and thyroid during diagnostic cerebral angiography : a phantom study

    International Nuclear Information System (INIS)

    Shortt, C. P.; Malone, L.; Thornton, J.; Brennan, P.; Lee, M. J.

    2008-01-01

    Full text: We measured radiation doses to the eye and thyroid during diagnostic cerebral angiography to assess the effectiveness of bismuth and lead shields at dose reduction. Phantom head angiographic studies were performed with bismuth (study 1) and lead shields (study 2). In study 1 (12 phantoms), thermoluminescent dosimeters (TLD) were placed over the eyes and thyroid in three groups: (i) no shields (four phantoms); (ii) anterior bismuth shields (four phantoms) and (iii) anterior and posterior bismuth shields (four phantoms). In a second study (eight phantoms), lead shields were placed over the thyroid only and TLD dose measurements obtained in two groups: (i) no shielding (four phantoms) and (ii) thyroid lead shielding (four phantoms). A standard 4-vessel cerebral angiogram was performed on each phantom. Study 1 (bismuth shields) showed higher doses to the eyes compared with thyroid (mean 13.03 vs 5.98 mSv, P < 0.001) and a higher eye dose on the X-ray tube side. Overall, the use of bismuth shielding did not significantly reduce dose to either eyes or thyroid in the measured TLD positions. In study 2, a significant thyroid dose reduction was found with the use of lead shields (47%, mean 2.46 vs 4.62 mSv, P < 0.001). Considerable doses to the eyes and thyroid highlight the need for increased awareness of patient protection. Eye shielding is impractical and interferes with diagnostic capability. Thyroid lead shielding yields significant protection to the thyroid, is not in the field of view and should be used routinely.

  10. Radiation protection to the eye and thyroid during diagnostic cerebral angiography: a phantom study.

    LENUS (Irish Health Repository)

    Shortt, C P

    2008-08-01

    We measured radiation doses to the eye and thyroid during diagnostic cerebral angiography to assess the effectiveness of bismuth and lead shields at dose reduction. Phantom head angiographic studies were performed with bismuth (study 1) and lead shields (study 2). In study 1 (12 phantoms), thermoluminescent dosimeters (TLD) were placed over the eyes and thyroid in three groups: (i) no shields (four phantoms); (ii) anterior bismuth shields (four phantoms) and (iii) anterior and posterior bismuth shields (four phantoms). In a second study (eight phantoms), lead shields were placed over the thyroid only and TLD dose measurements obtained in two groups: (i) no shielding (four phantoms) and (ii) thyroid lead shielding (four phantoms). A standard 4-vessel cerebral angiogram was performed on each phantom. Study 1 (bismuth shields) showed higher doses to the eyes compared with thyroid (mean 13.03 vs 5.98 mSv, P < 0.001) and a higher eye dose on the X-ray tube side. Overall, the use of bismuth shielding did not significantly reduce dose to either eyes or thyroid in the measured TLD positions. In study 2, a significant thyroid dose reduction was found with the use of lead shields (47%, mean 2.46 vs 4.62 mSv, P < 0.001). Considerable doses to the eyes and thyroid highlight the need for increased awareness of patient protection. Eye shielding is impractical and interferes with diagnostic capability. Thyroid lead shielding yields significant protection to the thyroid, is not in the field of view and should be used routinely.

  11. The microcomputer and image analysis in diagnostic pathology.

    Science.gov (United States)

    Jarvis, L R

    1992-06-01

    This paper presents a snapshot view of the influence and direction of microcomputer technology for image analysis techniques in diagnostic pathology. Microcomputers have had considerable impact in bringing image analysis to wider application. Semi-automated tracing techniques are a simple means of providing objective data and assist in a wide range of diagnostic problems. From the common theme of reducing subjectivity in diagnostic assessment, an extensive body of research has accrued. Some studies have addressed the need for quality control for reliable, routine application. Video digitizer cards bring digital image analysis within the reach of laboratory budgets, providing powerful tools for investigation of a wide range of cellular and tissue features. The use of staining procedures compatible with quantitative evaluation has become equally important. As well as assisting scene segmentation, cytochemical and immunochemical staining techniques relate the data to biological processes. With the present state of the art, practical use of microcomputer based image analysis is impaired by limitations of information extraction and specimen throughput. Recent advances in colour video imaging provide an extra dimension in the analysis of multi-spectral stains. Improvements will also be felt with predictable increase in speed of microprocessors, and with single chip devices which deliver video rate processing. If the full potential of this hardware is realized, high-speed, routine analysis becomes feasible. In addition, a microcomputer imaging system can play host to companion functions, such as image archiving and transmission. With this outlook, the use of microcomputers for image analysis in diagnostic pathology is certain to increase.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Incidence of thyroid carcinoma in patients who had diagnostic iodine-131 tests during childhood and adolescence

    International Nuclear Information System (INIS)

    Hahn, K.; Schnell-Inderst, P.; Haenseler, G.J.; Kandziora, C.; Meyer, G.

    1999-01-01

    To determine the carcinogenic effects of diagnostic amounts of radioactive iodine-131 on the infantile thyroid gland a multi-center retrospective cohort study was conducted which included data of 4973 subjects who had either been referred to diagnostic iodine-131 uptake tests (2262 subjects) or had had a diagnostic procedure of the thyroid without 131-iodine (2711 subjects) until the age of 18 years. Follow-up examinations of 35 percent of the subjects in the iodine-131 group and 41 percent of the subjects in the control group took place after a mean time period of 20 years after the first examination. Dosimetry of the thyroid burden of iodine-131 was carried out according to ICRP 53. The median of the thyroid organ dose was 1012 mGy. The report compares prevalences or incidences of thyroid disorders resp. occurring in both groups and gives a stratified analysis of primary diagnosis, age at exposure, and organ dose. A total number of five carcinomas of the thyroid was found. In the radioiodine group two carcinomas were assessed in a period of 16500 person-years. The control group yielded three carcinomas over 21000 person-years (Relative rate: 0,89, 95% confidence interval: 0,14-5,13). (orig.) [de

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

    Directory of Open Access Journals (Sweden)

    "Shirzad M

    2001-11-01

    Full Text Available Frozen section is a useful method in the diagnosis of different malignancies including those of thyroid origin. However, there are still controversies about its application, sensitivity and specificity for thyroid neoplasm. In this study, diagnostic value of frozen section (FS was compared with permanent histopathologic and Fine Needle Aspiration (FNA. In this study, which was conducted in process research method, permanent sample, FNA, and frozen section results in 214 patients was compared. All of these 214 patients had been seeking medical evaluation for thyroid nodules between years 1997 and 1999 in Shariati hospital. All pathologic evaluations were performed by pathology staff of this hospital. Permanent pathology was considered as the gold standard; so the specificity, sensitivity and diagnostic precision of FNA and FS were evaluated on the basis of its results. We use Macnemar test for this purpose. The number of patients during this period were 214 (160 women and 54 men. Mean age of our patients was 42.3±5.4 and their age ranged between 12 to 84 years. Pathologic results revealed that 163 of the patients (76 percent had benign lesions, and 51 of them (24 percent had malignant lesions. Thyroid malignancies comparised papillary carcinoma (70 percent, follicular carcinoma (13.5 percent, papilofollicular carcinoma (6 percent, medulary carcinoma (6 percent, Hurtle cell carcinoma (4 percent and anaplastic carcinoma (5 percent. FNA was done in all of the patients before surgery and was able to determine the status of nodules in 150 patients. Sensitivity, specificity and precision of FNA in these 150 patients were 72, 96 and 90 percents respectively. When FNA was unable to determine the status of a nodule (64 remaining patients, FS was applied to do the job. A sensitivity of 36 percent, specificity of 85 percent and precision of 73 percent was found in this group of patients. Macnemar test showed that there is no significant difference between

  14. Surgical requirements for radiological diagnostics of liver pathologies

    International Nuclear Information System (INIS)

    Gruenberger, T.

    2004-01-01

    Radiology is an essential preoperative tool for a liver surgeon to plan extent of resection and potential difficulties during liver surgery. Primary goal in defining liver pathologies is a careful patients' history, a clinical evaluation and reviewing at least one radiological film one could acquire. Don't rely on written reports that may direct you in a useless track. This overview tries to address the essential radiological requests of a surgeon in defining liver tumors ethiology and best optional treatment. Major advances in radiologic diagnostics led to an improvement in the adequate staging of a given liver pathology. Therefore we are nowadays able to inform our patients about possible treatment options without leaving a big gap to possible intra-operative findings which may alter the therapy. Surgical exploration to define therapeutic strategies becomes fundamental only in a minority of patients with unclear preoperative imaging studies. Interdisciplinary groups should define future strategies in a patient with a given liver pathology. Specialisation has defined the hepatobiliary surgeon which should be consulted in case of a liver or biliary tumor to guide possible therapeutic treatment options. (orig.) [de

  15. Diagnosis and prognosis of tissue pathologies by Raman microspectroscopy: an application to human thyroid tumors

    Science.gov (United States)

    Manfait, Michel; Lamaze, Philippe; Lamfarraj, Hasnae; Pluot, Michel; Sockalingum, Ganesh D.

    2000-05-01

    This study shows a first application of Raman microspectroscopy to the study of thyroid tissue samples classified as carcinomas, adenomas and nodules. Treatment of the Raman data using statistical methods show that it is possible to classify most of the samples in accord with the pathological examinations. Furthermore, Raman spectral image based on specific bands or frequencies defined as 'functional descriptors' allow to construct maps of micro- zones of such tissues. Such maps can be useful as complementary tools for tissue diagnosis and prognosis, since they carry molecular information important to such ends.

  16. [Diagnostic value of selective anorexia in pathological weight loss].

    Science.gov (United States)

    Braquet, P; Mercier, G; Reynes, J; Jeandel, C; Pinzani, V; Guilpain, P; Rivière, S; Le Quellec, A

    2016-02-01

    The diagnostic value of selective anorexia is debated. Some authors have suggested an association between meat aversion and cancer, but most do not use it as a diagnostic tool. We aimed to characterize anorexia of different diseases to search for an association between selective aversions and diagnostic groups. All the patients admitted to three departments of a teaching hospital were included consecutively for 22months if they had more than 10 % weight loss in less than one year. Patients were excluded if history taking was not reliable, or if they suffered from anorexia nervosa. We compiled diagnoses at discharge and validated them six months later. We used logistic regression to identify independent factors associated with selective anorexia. Inclusion criteria were met in 106patients (female 44 %, median age 65years). Most frequent diagnoses were: cancer (36 %), infection (35 %), digestive diseases (19 %), non organic diseases (21 %). Recent selective anorexia was found in 46 % of the cases. It was significantly associated with female gender (P=0.002), marginally with young age (P=0.069) and long duration of weight loss (P=0.079). Opioid use at admission was negatively associated with selective anorexia (P=0.001). No specific diagnostic category was found to be associated. Selective anorexia does not appear to be a useful symptom to investigate pathological weight loss. It behaves more like a non-specific reactivation by current disease of earlier latent personal food aversions. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  17. Comparison of FDG Uptake with Pathological Parameters in the Well-differentiated Thyroid Cancer

    International Nuclear Information System (INIS)

    Choi, Woo Hee; Chung, Yong An; Kim, Ki Jun; Park, Chang Suk; Jung, Hyun Suk; Sohn, Hyung Sun; Chung, Soo Kyo; Yoo, Chang Young

    2009-01-01

    Differentiated thyroid cancer (DTC) has variable degree of F-18 FDG avidity. The purpose of this study was to evaluate the relationship between F-18 FDG uptake and pathological or immunohistochemical features of DTC. DTC patients who underwent both pre-operative F-18 FDG PET/CT scan and surgery were included in the study. Maximum standardized uptake values (SUVmax) of primary tumor were calculated. If the primary tumor showed no perceptibly increased F-18 FDG uptake, region of interest was drawn based on finding of CT portion of the PET/CT images. Pathological and immunohistochemical markers such as presence of lymph node (LN) metastasis and underlying thyroiditis, tumor size, Ki-67 labeling index, expressions of EGFR, COX-2, and Galectin-3 were evaluated. Total of 106 patients was included (102 papillary carcinomas, 4 follicular carcinomas). The mean SUVmax of the large tumors (above 1 cm) was significantly higher than the mean SUVmax of small (equal to or less than 1 cm) ones (7.8±8.5 vs. 3.6±3.1, p=0.004). No significant difference in F-18 FDG uptake was found according to the presence or absence of LN metastasis and underlying thyroiditis, or the degree of Ki-67 labeling index, expression of EGFR, COX-2 and Galectin-3. In conclusion, the degree of F-18 FDG uptake in DTC was associated with the size of primary tumor. But there seem to be no relationship between F-18 FDG uptake of DTC and expression of Ki-67, EGFR, COX-2 and Galectin-3

  18. [DIAGNOSTIC AND TREATMENT STRATEGY IN FOLLICULAR TUMOR OF THYROID GLAND].

    Science.gov (United States)

    Mikhaĭlova, M V; Zubarovskiĭ, I N; Osipenko, S K

    2015-01-01

    The article is based on the treatment results of 44 patients with follicular tunor of thyroid gland. A staged morphological assessment of thyroid nodes was performed for all patients: in case of preoperative fine-needle biopsy, urgent intraoperative study and according to results of final histological research. The urgent histological study of surgical material was conducted for 44 patients with diagnosis "follicular tumor" according to fine-needle biopsy. The data of final histological study were matched with findings of intraoperative research. A micro-follicular adenoma was detected in 22 patients (50%) and 6 (13,6%) patients had this diagnosis combined with autoimmune thyroiditis. The general part of patients didn't changed in final study, but the rate of diagnosis "micro-follicular adenoma against the background of autoimmune thyroiditis" increased. Papillary carcinoma was revealed in 5 (11,4%) patients and follicular cancer had 4 (9,1%) patients detected in intraoperative study and 3 (6,8%) more patients according to data of final research. The histopathologic feature of colloid goiter was observed in 7 (15,9%) cases and a part of such patients reduced to 6,8% during final study. One of the patients (2,3%) had final diagnosis "oncocytoma". In case of thyroid nodules detection the needle biopsy should be carried out regardless to the size of nodule. The authors recommended performing the surgery with the urgent histological study in case of undetermined histological report. The following surgical strategy was specified by the results of the urgent histological report.

  19. Thyroid ultrasound

    Science.gov (United States)

    ... Thyroid physiology and diagnostic evaluation of patients with thyroid disorders. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology . 13th ed. Philadelphia, PA: Elsevier; 2016:chap 11. ... Thyroid Tests Read more Ultrasound ...

  20. Image standards in Tissue-Based Diagnosis (Diagnostic Surgical Pathology

    Directory of Open Access Journals (Sweden)

    Vollmer Ekkehard

    2008-04-01

    Full Text Available Abstract Background Progress in automated image analysis, virtual microscopy, hospital information systems, and interdisciplinary data exchange require image standards to be applied in tissue-based diagnosis. Aims To describe the theoretical background, practical experiences and comparable solutions in other medical fields to promote image standards applicable for diagnostic pathology. Theory and experiences Images used in tissue-based diagnosis present with pathology – specific characteristics. It seems appropriate to discuss their characteristics and potential standardization in relation to the levels of hierarchy in which they appear. All levels can be divided into legal, medical, and technological properties. Standards applied to the first level include regulations or aims to be fulfilled. In legal properties, they have to regulate features of privacy, image documentation, transmission, and presentation; in medical properties, features of disease – image combination, human – diagnostics, automated information extraction, archive retrieval and access; and in technological properties features of image acquisition, display, formats, transfer speed, safety, and system dynamics. The next lower second level has to implement the prescriptions of the upper one, i.e. describe how they are implemented. Legal aspects should demand secure encryption for privacy of all patient related data, image archives that include all images used for diagnostics for a period of 10 years at minimum, accurate annotations of dates and viewing, and precise hardware and software information. Medical aspects should demand standardized patients' files such as DICOM 3 or HL 7 including history and previous examinations, information of image display hardware and software, of image resolution and fields of view, of relation between sizes of biological objects and image sizes, and of access to archives and retrieval. Technological aspects should deal with image

  1. A young woman with a supraclavicular swelling; some diagnostic aspects of thyroid carcinoma

    International Nuclear Information System (INIS)

    Logmans, S.C.; Jobsis, A.C.; Schoot, J.V. van der; Schipper, M.E.I.; Kromhout, J.G.

    1983-01-01

    The case is reported of a woman aged 24 years who presented a supraclavicular swelling caused by a lymph-node metastasis of an adenopapillary carcinoma. The primary tumour was found in the thyroid in which palpation and scintigraphy failed to reveal any abnormalities. The diagnosis and the diagnostic value of scintigraphic and immunohistological examination are considered. (Auth.)

  2. Does Tumor Size Influence the Diagnostic Accuracy of Ultrasound-Guided Fine-Needle Aspiration Cytology for Thyroid Nodules?

    Directory of Open Access Journals (Sweden)

    Do Hoon Koo

    2016-01-01

    Full Text Available Background. Fine-needle aspiration cytology (FNAC is diagnostic standard for thyroid nodules. However, the influence of size on FNAC accuracy remains unclear especially in too small or too large thyroid nodules. The objective of this retrospective cohort study was to investigate the effect of nodule size on FNAC accuracy. Methods. All consecutive patients who underwent thyroidectomy for nodules in 2010 were enrolled. FNAC results (according to the Bethesda system were compared to pathological diagnosis. The nodules were categorized into groups A–E on the basis of maximal diameter on ultrasound (≤0.5, >0.5–1, >1-2, >2–4, and >4 cm, resp.. Results. There were 502 cases with 690 nodules. Overall FNAC sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 95.4%, 98.2%, 99.4%, 86.4%, and 96.0%, respectively. False-negative rates (FNRs of groups A–E were 3.2%, 5.1%, 1.3%, 13.3%, and 50%, respectively. Accuracy rates of groups A–E were 96.8%, 94.8%, 99%, 94.7%, and 87.5%, respectively. Conclusion. Although accuracy rates of FNAC in thyroid nodules smaller than 0.5 cm are comparable to the other group, thyroid nodules larger than 4 cm with benign cytology carry a higher risk of malignancy, which suggest that those should be considered for intensive follow-up or repeated biopsy.

  3. Accuracy of Triple Diagnostic Test in Patients with Thyroid Nodule at Dr. Cipto Mangunkusumo General Hospital

    Directory of Open Access Journals (Sweden)

    Diani Kartini

    2017-04-01

    Full Text Available The aim of the study is to evaluate the accuracy of triple diagnostic test on thyroid nodules. The data from patients’ medical records who came to Cipto Mangunkusumo General Hospital for the first time or for evaluation of thyroid nodule and patients who underwent thyroidectomy during 2010 to 2011. Clinical examination was scored by McGill Thyroid Nodule Score. ROC procedure was performed to obtain clinical cut-off scores of diagnosis of malignant. Ultrasonography (USG result was considered malignant for TIRADS 4, 5, and 6. If clinical, USG and histopathology examinations of triple diagnostic give positive results, it will be classified as concordant malignant whereas if all those three show benign results, the classification is benign. Thyroid carcinoma was found in 134 out of 161 patients with thyroid nodule. There were 84 patients with concordant results for all three elements of the triple test. Out of 84 patients with concordant triple diagnostic results, there were 53 malignant cases (32.9% and 31 benign cases (19.3%. Main histopathological findings among patients with thyroid carcinoma was papillary (90.3%, follicular (3%, medullary (0.7%, and anaplastic (6%. The sensitivity and specificity of triple diagnostic was 77% and 94%, with positive predictive value of 98%, negative predictive value of 51,6% and accuracy of 80.9%. Combination of clinical findings, USG, and FNAB gave malignant probability of 92%, better than combination of clinical findings and USG (81.6% or clinical findings and FNAB (87%. Triple diagnostic cannot be used as an ideal test to replace frozen section examination in managing thyroid nodule. However, in cases with concordant results of each triple diagnostic’s element, the positive predictive value (98% and malignant probability (92% is high. Keywords: thyroid nodule, triple diagnostic, accuracy.   Akurasi Metode Triple Diagnostic pada Pasien Nodul Tiroid  di RSUPN Dr. Cipto Mangunkusumo   Abstrak Tujuan

  4. The diagnostic value of dynamic contrast-enhanced MRI for thyroid tumors

    International Nuclear Information System (INIS)

    Yuan, Ying; Yue, Xiu-Hui; Tao, Xiao-Feng

    2012-01-01

    Background and purpose: The exact place for dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in the diagnosis and management of thyroid tumors is still under debate. We performed the study to analyze and compare the parameters generated from DCE-MRI for thyroid lesions. Materials and methods: For each thyroid lesion, time intensity curves (TIC), time of peak enhancement (T peak ), maximum enhancement ratio (ER max ) and maximum rise slope (Slope max ) were plotted and calculated. Receiver operator characteristics (ROC) analysis was conducted to assess the diagnostic ability and appropriate cut-off value. The area under the ROC curve (AUC) and the confidence intervals (CIs) were also assessed. Results: Forty-two patients were consecutively included. All 21 lesions demonstrated the rapid inflow and washout pattern (type-I) were benign. The 12 cases with delayed inflow pattern (type-III) were all malignant. When compared with the benign lesions, the thyroid carcinoma showed significantly lower Slope max and higher T peak (P max was found between malignant and benign ones (P = 0.15). The AUC of ER max , Slope max and T peak in differentiating benign thyroid lesions from malignant ones were 0.63, 0.93and 1, respectively. The ER max cut-off value of 73.86 (sensitivity, 71.4%; specificity, 64.3%), Slope max cut-off value of 2.4126 (sensitivity, 92.9%; specificity, 82.1%) and T peak value of 28 (sensitivity, 100%; specificity, 100%) offered the best diagnostic performances. Conclusions: DCE-MRI, especially the pattern of TIC and the value of Slope max and T peak , could be helpful in differentiating thyroid carcinoma from benign thyroid lesions.

  5. DRY TAP: A DIAGNOSTIC ALERT FOR UNDERLYING BONE MARROW PATHOLOGY.

    Science.gov (United States)

    Ahmad, Saqib Qayyum; Yusuf, Rizwan; Zafar, Nadeem; Ali, Nadir

    2015-01-01

    Dry tap is an annoying experience in bone marrow (BM) findings, especially in cases where the diagnosis may hinge on BM findings. This study was conducted to determine, on, the basis of bone marrow (BM) trephine biopsy, the frequency of various underlying conditions causing a dry tap, among different age groups. It was a descriptive study carried out at PAF hospital Mianwali, Pakistan from 1" Jan 2009 to 31 Dec 2012. Record of all BM aspirations and trephine biopsies performed during 4 years was retrieved from hospital's laboratory. Total number of BM aspirations and trephines were counted and the subject's ages and genders recorded. Frequencies and percentages of patients with dry tap, in paediatric group ( or = 60 years) were calculated. Diagnoses of patients with dry tap made on BM biopsy were noted for each group and their frequencies calculated. Of 548 BM aspirations, dry tap was encountered in 52 (9.5%) cases. Acute lymphoblastic leukaemia (ALL) was the commonest cause of dry tap in paediatric age, seen in 6 (60%) of 10 children. In young to middle-aged group, non Hodgkin lymphoma (NHL) was the commonest cause, found in 6 (30%) of 20 cases. NHL and metastatic tumours, seen in 8 (36.4%) and 6 (27.3%) of 22 patients respectively, were the most frequent causes of dry tap in the elderly. Dry tap, in most of the cases, is like a diagnostic alert for the presence of an underlying BM pathology, nature of which depends upon age group.

  6. Ret/PTC activation does not influence clinical and pathological features of adult papillary thyroid carcinomas.

    Science.gov (United States)

    Puxeddu, Efisio; Moretti, Sonia; Giannico, Angela; Martinelli, Marco; Marino, Cecilia; Avenia, Nicola; Cristofani, Roberto; Farabi, Raffaele; Reboldi, Gianpaolo; Ribacchi, Rodolfo; Pontecorvi, Alfredo; Santeusanio, Fausto

    2003-05-01

    RET proto-oncogene rearrangements (ret/PTCs) represent the most common genetic alterations found in papillary thyroid carcinomas (PTCs). Correlation of ret/PTC expression with clinical outcome is controversial. The aim of the present study was to analyze the frequency of RET rearrangements in adult PTCs, and to investigate if ret/PTCs influence biological behavior and clinical features of the cancers. Ret/PTC rearrangements were looked for in tIssue samples of 48 PTCs collected at our institution. Data about clinical and pathological features of the tumors were also reviewed. Three separate association analyses were carried out on the cohort evaluating the effects of, respectively, ret/PTC positivity, preferential RET tyrosine kinase domain (RET-TK) expression, and ret/PTC plus RET-TK positivity, on age, sex, tumor size, staging, number of neoplastic foci, and histological subtype. The genetic study was conducted with the RT-PCR-Southern blot technique. Standard Student's t-test and Fisher exact test were applied for the association analyses. The molecular genetic study demonstrated the positivity of ret/PTC1 and ret/PTC3 in 13 of 48 tumors (27.1%), and an exclusive or preferential RET-TK expression in 17 cases (35.4%). None of the three genetico-clinical analyses showed any significant association between ret/PTC expression and the clinical and pathological features of the cancers. These data indicate that RET rearrangements may not play any distinctive role in driving histotype development and cancer progression in these neoplasms. Moreover, they weaken the possibility of using ret/PTC as a prognostic marker for papillary thyroid carcinomas.

  7. Autoimmune thyroiditis goitrogenic. Aspects of clinical and laboratorial diagnostic

    International Nuclear Information System (INIS)

    Costa, H.F.Z. da.

    1986-01-01

    To asses the accuracy achieved by the A.C.A.T. and other clinical and laboratorial criterion in the diagnoses of T.A.I.B. we investigated twenty patients with goiter and antimicrossomal antibodies titres of 1/1.600 or more. Analysing the parameters useful in the diagnosis, we found a significant correlation between the antimicrossomal antibodies titres and the basal TSH concentration, an elevated basal TSH and an exaggerated response to TRH independent of the patient clinical status reflecting in the majority of the cases a state of subclinical hypotyroidism; an irregular appearance of the radioisotope thyroid scan and a positive response to a perchlorate discharge test. We conclude that from the parameters useful in the T.A.I.B. diagnosis, the A.C.A.T. detection mainly the antimicrossomal antibodies, is an excellent tool to detect patients with a clinical suspect of thyroid auto-immune disease and when we found high tires in a patient with goiter and an elevated basal TSH concentration we can suggest T.A.I.B. diagnosis. (author)

  8. [CONTROVERSIES REGARDING THE ACCURACY AND LIMITATIONS OF FROZEN SECTION IN THYROID PATHOLOGY: AN EVIDENCE-BASED ASSESSMENT].

    Science.gov (United States)

    Stanciu-Pop, C; Pop, F C; Thiry, A; Scagnol, I; Maweja, S; Hamoir, E; Beckers, A; Meurisse, M; Grosu, F; Delvenne, Ph

    2015-12-01

    Palpable thyroid nodules are present clinically in 4-7% of the population and their prevalence increases to 50%-67% when using high-resolution neck ultrasonography. By contrast, thyroid carcinoma (TC) represents only 5-20% of these nodules, which underlines the need for an appropriate approach to avoid unnecessary surgery. Frozen section (PS) has been used for more than 40 years in thyroid surgery to establish the diagnosis of malignancy. However, a controversy persists regarding the accuracy of FS and its place in thyroid pathology has changed with the emergence of fine-needle aspiration (FNA). A PubMed Medline and SpringerLink search was made covering the period from January 2000 to June 2012 to assess the accuracy of ES, its limitations and indications for the diagnosis of thyroid nodules. Twenty publications encompassing 8.567 subjects were included in our study. The average value of TC among thyroid nodules in analyzed studies was 15.5 %. ES ability to detect cancer expressed by its sensitivity (Ss) was 67.5 %. More than two thirds of the authors considered PS useful exclusively in the presence of doubtful ENA and for guiding the surgical extension in cases confirmed as malignant by FNA; however, only 33% accepted FS as a routine examination for the management of thyroid nodules. The influence of FS on surgical reintervention rate in nodular thyroid pathology was considered to be negligible by most studies, whereas 31 % of the authors thought that FS has a favorable benefit by decreasing the number of surgical re-interventions. In conclusion, the role of FS in thyroid pathology evolved from a mandatory component for thyroid surgery to an optional examination after a pre-operative FNA cytology. The accuracy of FS seems to provide no sufficient additional benefit and most experts support its use only in the presence of equivocal or suspicious cytological features, for guiding the surgical extension in cases confirmed as malignant by FNA and for the

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

    International Nuclear Information System (INIS)

    Rink, T.; Schroth, H.J.; Dembowski, W.; Klinger, K.

    2000-01-01

    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 ( [de

  10. Performances of scintigraphy in the primitive hyperparathyroidism and the associated thyroid pathologies; Performances de la scintigraphie dans les hyperparathyroidies primitives et les pathologies thyroidiennes associees

    Energy Technology Data Exchange (ETDEWEB)

    Monteil, J. [Service de Medecine Nucleaire, CHRU de Limoges (France); Mathonnet, M. [Service de Chirurgie Endocrinienne, CHRU de Limoges (France); Chianea, T. [Service de Medecine Nucleaire, CHRU de Limoges (France); Cubertafond, P. [Service de Chirurgie Endocrinienne, CHRU de Limoges (France); Piquet, L.; Rince, C.; Bournaud, E.; Verbeke, S.; Perdrisot, R.; Vandroux, J.C. [Service de Medecine Nucleaire, CHRU de Limoges (France)

    1997-12-31

    The data from scintigraphic and echographic exploration were compared to the surgery results in 32 patients (29 F and 3 M) presenting a primitive hyperparathyroidism, biologically proved, associated to a thyroid pathology. The scintigraphies were achieved with a collimator placed anteriorly and oblique-anteriorly, 4 h after injection by iodine 123 (7 MBq) and 30 min and 2 h after injection of {sup 99m}Tc-MIBI (555 MBq). The cervical echography and scintigraphy are independently interpreted. The results are given in a table containing the sensitivity, specificity, V.P.P. and V.P.N. for scintigraphy and echography, respectively. The association of a primary hyperparathyroidism and of a thyroid pathology (with a prevalence of 70% in our region) appears to affect less the performances of scintigraphy imaging than those of morphologic imaging

  11. Technology of creation of an expert system for diagnosing thyroid pathology based on a set of qualitative signs of cell atypia.

    Science.gov (United States)

    Kirillov, Vladimir; Gladyshev, Alexander; Demidchik, Evgeny

    2010-12-01

    An expert system for differential diagnosis of thyroid pathology has been developed, in which the function of transforming qualitative signs of cell atypia into the quantitative form is realized. It based on the set of qualitative signs of cell atypia and works in the mode by the question-answer principle. An expert system (software) contained the X-matrix and six standard S-matrices. The X-matrix was designed for filling with the alternative answers yes/no regarding the presence of cells with characteristic signs of atypia in the visual fields of a preparation. S-matrices characterized the main forms of thyroid diseases, such as papillary and follicular cancer, follicular adenoma, autoimmune thyroiditis, nodular colloid and diffuse toxic goiter, by their set of yes/no answers. The answers entered to the X-matrix were compared with answers of the S-matrix. Each element of each S-matrix, besides the answers yes/no, contained its weighting coefficient corresponding to a qualitative feature of a certain nosologic form. Weighting coefficient of each feature for every nosologic form was calculated by their frequency of occurrence in 30 visual fields. Comparison of X-matrices with S-matrices and verification of diagnosis according to the value of a diagnostic index with a percentage probability was performed in the automatic mode. Diagnostic index was determined by the sum of weighting coefficients of features with the coincident yes/no answers, while comparing X-matrix elements with the corresponding S-matrix elements. The software displayed on the monitor is the list of nosologic forms in the order of decreasing the diagnostic index values. Copyright © 2010 Wiley-Liss, Inc.

  12. Integrated Case-Based Applied Pathology (ICAP): a diagnostic-approach model for the learning and teaching of veterinary pathology.

    Science.gov (United States)

    Krockenberger, Mark B; Bosward, Katrina L; Canfield, Paul J

    2007-01-01

    Integrative Case-Based Applied Pathology (ICAP) cases form one component of learning and understanding the role of pathology in the veterinary diagnostic process at the Faculty of Veterinary Science, University of Sydney. It is a strategy that focuses on student-centered learning in a problem-solving context in the year 3 curriculum. Learning exercises use real case material and are primarily delivered online, providing flexibility for students with differing learning needs, who are supported by online, peer, and tutor support. The strategy relies heavily on the integration of pre-clinical and para-clinical information with the introduction of clinical material for the purposes of a logical three-level, problem-oriented approach to the diagnosis of disease. The focus is on logical diagnostic problem solving, primarily using gross pathology and histopathological material, with the inclusion of microbiological, parasitological, and clinical pathological data. The ICAP approach is linked to and congruent with the problem-oriented approach adopted in veterinary medicine and the case-based format used by one of the authors (PJC) for the teaching and learning of veterinary clinical pathology in year 4. Additionally, final-year students have the opportunity, during a diagnostic pathology rotation, to assist in the development and refinement of further ICAPs, which reinforces the importance of pathology in the veterinary diagnostic process. Evidence of the impact of the ICAP approach, based primarily on student surveys and staff peer feedback collected over five years, shows that discipline-specific learning, vertical and horizontal integration, alignment of learning outcomes and assessment, and both veterinary and generic graduate attributes were enhanced. Areas for improvement were identified in the approach, most specifically related to assistance in the development of generic teamwork skills.

  13. Thyroid Ultrasound: Change of Inter-observer Variability and Diagnostic Performance after Training

    International Nuclear Information System (INIS)

    Moon, Hee Jung; Kim, Eun Kyung; Kwak, Jin Young; Park, Jeong Seon

    2011-01-01

    To investigate and compare inter-observer variability and diagnostic performance of thyroid ultrasound (US) between a faculty member and observing residents. From October 2007 to June 2009, 18 residents underwent training in thyroid US section. Group 1 included 8 residents that were trained for the first time and group 2 included 10 residents that were trained for the second time. US features of nodules were recorded according to the composition, echogenicity, margin, calcifications, shape, and final assessment by a faculty member and residents, respectively. Following a discussion, a faculty member performed fine needle aspiration. Then, the inter-observer variability and diagnostic performance between a faculty member and residents were investigated and compared for US. In group 1, agreement for composition in resident 1, calcification for residents 5 and 6, and shape for resident 4 were slight, moderate, moderate, and moderate, respectively. In group 2, agreement for composition in residents 1 and 10 were moderate. Substantial or greater agreement was observed more frequently in group 2 than 1. The diagnostic performances for both the faculty and residents were high and not statistically different. Agreement for US features between a faculty and residents as well as diagnostic performance were high. Moreover, diagnostic performance of residents that underwent training a second time of training was higher than residents that underwent training only once

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

    DEFF Research Database (Denmark)

    Eszlinger, Markus; Hegedüs, László; Paschke, Ralf

    2014-01-01

    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 rear...

  15. Calsequestrin distribution, structure and function, its role in normal and pathological situations and the effect of thyroid hormones

    Czech Academy of Sciences Publication Activity Database

    Novák, Petr; Soukup, Tomáš

    2011-01-01

    Roč. 60, č. 3 (2011), s. 439-452 ISSN 0862-8408 R&D Projects: GA ČR(CZ) GA304/08/0256 Grant - others:EC(XE) Myores 511978 Institutional research plan: CEZ:AV0Z50110509 Keywords : skeletal and heart muscle * calcium binding proteins * calsequestrin * muscle pathology * thyroid hormones Subject RIV: EA - Cell Biology Impact factor: 1.555, year: 2011

  16. Novelties in treatment approach of poly-neoplasias developed during thyroid pathologies.

    Science.gov (United States)

    Makaridze, T; Mardaleishvili, K

    2010-11-01

    In publication were discussed pathogenic mechanisms which are developed during concordance of malignant tumors of thyroid gland and reproductive systems and dishormonal hyperplasias, also functional disturbances which accompany thyroid gland diseases and principles of treatment during synchronic and metachronic manifestations. The treatment of polyneoplasias by "neurotransmitive control" is proposed. Importance of thyroid suppressive therapy was assessed. The efficacy of thyrotrophic hormone suppression by neurotransmitters in prevention of malignant tumors of reproductive system was reported.

  17. Double thyroid ectopia (with incidental papillary thyroid microcarcinoma) (2010: 8b)

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Alexandra [Instituto Portugues de Oncologia de Francisco Gentil-Centro de Lisboa, Department of Radiology, Lisbon (Portugal); Martins, Mariluz [Instituto Portugues de Oncologia de Francisco Gentil-Centro de Lisboa, Department of Head and Neck Surgery, Lisbon (Portugal); Andre, Saudade [Instituto Portugues de Oncologia de Francisco Gentil-Centro de Lisboa, Department of Pathology, Lisbon (Portugal)

    2010-11-15

    We present the case of a 45-year-old man with a long-standing history of a slow-growing left submandibular mass. Imaging was diagnostic as it disclosed an absent orthotopic thyroid gland and heterogeneous masses, with both solid and cystic components, as well as calcifications in the left sublingual/submandibular space and in the left paramedian aspect of the tongue base, consistent with double thyroid ectopia, originating from central and lateral thyroid anlages, respectively. Pathology confirmed an ectopic thyroid goiter in the left submandibular space with an incidental papillary microcarcinoma. Scintigraphy also demonstrated ectopic thyroid tissue in the left tongue base. (orig.)

  18. Isolated sphenoid sinus pathology: spectrum of diagnostic and treatment modalities.

    Science.gov (United States)

    Nour, Yasser Ahmed; Al-Madani, Ayman; El-Daly, Ahmed; Gaafar, Alaa

    2008-12-01

    Isolated sphenoid sinus pathology is a relatively uncommon entity. The present study is a retrospective review of 40 patients with isolated sphenoid sinus pathology who were treated at the Department of Otorhinolaryngology, Alexandria University between July 2002 and December 2005. Special emphasis will be given to the role of various endoscopic approaches in the surgical management of isolated sphenoid sinus pathology. Factors that govern the selection of each approach will be discussed. Extracted data included patient demographics, clinical presentation, imaging studies, treatment modalities and complications. Sphenoid sinus was approached through one of the following three approaches: (1) endoscopic transnasal approach, (2) endoscopic transseptal approach and (3) endoscopic transpterygoid approach. Outcome measures were based on assessment of patients' symptoms and confirmation of a patent sphenoid sinus by office endoscopy. The pathology spectrum was rather wide and included 26 (65%) inflammatory conditions (acute/chronic sphenoiditis, mucoceles, and fungal sinusitis), 7 (17.5%) neoplasms and 7 (17.5%) miscellaneous conditions (cerebrospinal fluid (CSF) rhinorrhea, sphenochoanal polyp, and fibrous dysplasia). The most common initial symptom was headache (50%) followed by ophthalmological symptoms (22.5%). Other presenting symptoms included CSF leak in five patients, epistaxis in four patients and nasal obstruction and/or rhinorrhea in two patients. Radiological workup included computed tomography (CT) scan of the paranasal sinuses in all patients. Magnetic resonance imaging (MRI) was performed in 21 patients (52.5%). The most common indication was a sphenoid mass based on endoscopic and CT findings. Four patients with acute/chronic sphenoiditis were successfully treated with medical therapy. One patient with fibrous dysplasia did not require any definitive treatment. Thirty-five patients underwent endoscopic surgery under general anaesthesia. An adjuvant

  19. System of polarization phasometry of polycrystalline blood plasma networks in mammary gland pathology diagnostics

    Science.gov (United States)

    Zabolotna, Natalia I.; Oliinychenko, Bogdan P.; Radchenko, Kostiantyn O.; Krasnoshchoka, Anastasiia K.; Shcherba, Olga K.

    2015-09-01

    The polarizing phase meter system of polycrystalline networks of human blood plasma which is used for the mammary gland pathology diagnostics was proposed in this paper. Increasing the accuracy of the phase value determination was achieved using a combination of low coherent source of radiation and circularly polarized probing of biological object. Thus, high informativity of polarizing phase meter system for the diagnosis of breast pathology using the phase mapping of the human blood plasma films were determined, thereafter statistical, correlational, fractal structure analysis of the obtained phase maps was carried out and the quantitative criterias of the phase diagnostics and differentiation of the breast pathological conditions were determined too.

  20. Thyroid pathology in deer mice (Peromyscus maniculata) from a reclaimed mine site on the athabasca oil sands.

    Science.gov (United States)

    Movasseghi, Ahmad R; Rodríguez-Estival, Jaime; Smits, Judit E G

    2017-03-01

    Information on naturally occurring thyroid disease in wild animals in general and in small mammals specifically is extremely limited. In the present field-based work, we investigated the structure and function of thyroid glands of deer mice (Peromyscus maniculata) studied as sentinels of ecosystem sustainability on reclaimed areas post-mining on the oil sands of northeastern Alberta, because of their greater sensitivity to contaminants relative to meadow voles (Microtus pennsylvanicus) on the same sites. Extraction of bitumen in the oil sands of northeastern Alberta, results in the release of contaminants including polycyclic aromatic compounds (PACs), metals, and metalloids to the environment that have a measurable biological cost to wildlife living in the affected areas. In previous investigations, deer mice exposed to pollution at reclaimed areas showed compromised ability to regenerate glutathione indicating oxidative stress, together with decreased testicular mass and body condition during the breeding season. In the present study, thyroid glands from those deer mice from the reclaimed site had markedly increased follicular cell proliferation and decreased colloid compared to animals from the reference site. This pathology was positively associated with the greater oxidative stress in the deer mice. Thyroid hormones, both thyroxine and triiodothyronine, were also higher in animals with greater oxidative stress indicating increased metabolic demands from contaminant related subclinical toxicity. This work emphasizes the value of using a combination of endocrinological, histological and oxidative stress biomarkers to provide sensitive measures of contaminant exposure in small mammals on the oil sands. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Diagnostic radiography exposure increases the risk for thyroid microcarcinoma: a population-based case-control study.

    Science.gov (United States)

    Zhang, Yawei; Chen, Yingtai; Huang, Huang; Sandler, Jason; Dai, Min; Ma, Shuangge; Udelsman, Robert

    2015-09-01

    Thyroid cancer incidence and diagnostic radiography exposures, particularly computed tomography (CT) scanning and nuclear medicine examinations, have increased substantially in the USA. However, very few epidemiologic studies have directly investigated their associations. A population-based case-control study was conducted in Connecticut in 2010-2011, including 462 histologically confirmed incident thyroid cancer cases and 498 population-based controls. Multivariate unconditional logistic regression models were used to estimate the associations between diagnostic radiography and the risk of thyroid cancer, controlling for potential confounding factors. Exposure to any form of diagnostic radiography was associated with an increased risk of well-differentiated thyroid microcarcinoma [tumor size≤10 mm, odds ratio (OR)=2.76, 95% confidence interval (CI): 1.31-5.81]. The highest risk increase occurred with nuclear medicine examinations (excluding cardiology tests and thyroid uptake studies; OR=5.47, 95% CI: 2.10-14.23), followed by chest CT scanning (OR=4.30, 95% CI: 1.66-11.14), head and neck CT scanning (OR=3.88, 95% CI: 1.75-8.63), upper gastrointestinal series (OR=3.56, 95% CI: 1.54-8.21), lower gastrointestinal series (OR=3.29, 95% CI: 1.41-7.66), kidney radiography involving dye injection into a vein or artery (OR=3.21, 95% CI: 1.20-8.54), mammography (OR=2.95, 95% CI: 1.14-7.61), chest radiography (OR=2.93, 95% CI: 1.37-6.29), and abdomen CT scanning (OR=2.54, 95% CI: 1.02-6.30). No significant associations were found between these imaging modalities and thyroid tumors larger than 10 mm. This study provides the first direct evidence that CT scanning and nuclear medicine examinations are associated with an increased risk of thyroid cancer. The novel finding that an array of diagnostic radiography procedures are associated with thyroid microcarcinomas warrants further investigation.

  2. Influence of the thyroid remnant in the elevation of the serum thyroglobulin after thyroidectomy in differentiated thyroid carcinoma. Importance of the diagnostic iodine total-body scanning

    International Nuclear Information System (INIS)

    Caballero-Calabuig, Elisa; Cano-Terol, Carmen; Sopena-Monforte, Ramon; Reyes-Ojeda, Dolores; Abreu-Sanchez, Pedro; Ferrer-Rebolleda, Jose; Sopena-Novales, Pablo; Plancha-Mansanet, Carmen; Felix-Fontestad, Jesus

    2008-01-01

    Stimulated thyroglobulin (Tg) and 131 I total-body scan (TBS) have been the mainstays of differentiated thyroid carcinoma (DTC), but now diagnostic TBS has been eliminated from some follow-up protocols. Nevertheless, Tg can be negative in the presence of thyroid tissue, and moderately elevated Tg poses management problems. The purpose of this study was to check how many patients have Tg negative but visible thyroid tissue and if diagnostic TBS could be clinically useful. Retrospective review of 317 exams (stimulated Tg and TBS) of 128 patients with DTC. Patients with high-grade criteria and/or positive autoantibodies are excluded. Tg is considered positive if higher than the sensitivity level of the technique. TBS is positive if thyroid remnant, lymphatic node or metastases are detected. Results are classified in Tg and TBS concordant or discordant. Discordant 131 I TBS and Tg were found in 74/317 studies (23.3%), 48 (65%) being TBS positive and Tg negative. None of 128 patients had a first post-surgery negative scan, but 13 (10%) were Tg negative, even two patients with lymph node uptake. One year after radioiodine treatment, 26 out of 115 patients (initially Tg and TBS concordant positive) showed Tg negative and TBS still positive due to cervical remnants (20 patients), lymph node uptake (one) and metastasis (five); 20 patients remained Tg and TBS positive, but 14 of them only showed thyroid remnants. We propose to perform periodic diagnostic TBS to improve Tg specificity, at least while neck thyroid activity is detected, even if Tg is negative. (orig.)

  3. Evaluating the diagnostic device DETEC-PC for the thyroid uptakes

    International Nuclear Information System (INIS)

    Alonso Abad, Dolores; Arista Romeu, Eduardo; Alonso Abad, Ariel

    2008-01-01

    A study is presented for evaluating the diagnostic capacity of the DETEC-PC, detection measurement system for the Thyroid Uptakes. A clinical trial was designed for that effect and all the patients included were evaluated using the DETEC-PC and the well-known radioimmunoassay (RIA) standard diagnostic procedure known by acronym RIA. For the Thyroid Uptakes using the DETEC-PC patients received an oral administration of a solution of radioactive iodine. The radioactive substance is attracted chemically to the gland and ionising radiation detector captures their emissions. The iodine concentration in the Thyroid, as well as the variation of this concentration over time reflects the function of the gland. The RIA is based on the analysis of the values associated with the t3, t4 and tsh hormones, and when these three parameters are in a certain range the patients can be classified. The sample size was calculated in order to estimate the gross coincidence percent between both methods with a precision of 1 % at a confidence level of 95%. In total 110 patients were included in the trial. Mainly two types of statistical analysis were carried out, in the first analysis all the patients included in the study were considered whereas in the second analysis the patients with doubtful RIA results were not included. Ideally the performance of a diagnostic tool is evaluated through the estimation of its sensitivity and specificity. Nevertheless, in the present study the reference procedure (RIA) can not be considered a gold standard diagnostic device. In such a setting the international regulations advise to use measurements of agreement to evaluate the diagnostic capacity of the new method. In the present study we evaluated the level of diagnostic agreement between the DETEC-PC and the RIA using the Kappa statistics. Additionally, the confidence interval for the Kappa statistics and the corresponding significant test for the present of agreement were also computes. The obtained

  4. Molecular pathology in adult gliomas: diagnostic, prognostic, and predictive markers.

    LENUS (Irish Health Repository)

    Jansen, Michael

    2010-07-01

    Over the past 10 years, there has been an increasing use of molecular markers in the assessment and management of adult malignant gliomas. Some molecular signatures are used diagnostically to help pathologists classify tumours, whereas others are used to estimate prognosis for patients. Most crucial, however, are those markers that are used to predict response to certain therapies, thereby directing clinicians to a particular treatment while avoiding other potentially deleterious therapies. Recently, large-scale genome-wide surveys have been used to identify new biomarkers that have been rapidly developed as diagnostic and prognostic tools. Given these developments, the pace of discovery of new molecular assays will quicken to facilitate personalised medicine in the setting of malignant glioma.

  5. Inclusion-body myositis: clinical, diagnostic, and pathologic aspects.

    Science.gov (United States)

    Engel, W King; Askanas, Valerie

    2006-01-24

    The diagnostic aspects of sporadic inclusion-body myositis (s-IBM), and a few comments on our own approach to its treatment, are presented to foster the goals of this symposium, which was organized to provoke new ideas concerning the cause and treatment of this currently unsolvable disease. s-IBM is the most common, progressive, debilitating muscle disease beginning in persons over age 50 years, and it is more common in men. Diagnostic parameters reviewed are clinical, muscle-biopsy histochemistry, electrophysiologic and CSF evaluations. Overall, the degenerative phenomena in s-IBM muscle fibers seem to be the major cause of the progressive, unstoppable weakness, rather than the lymphocytic inflammation. Available treatments are of only slight, temporary benefit for only some s-IBM patients, indicating a desperate need for definitive therapies.

  6. Diagnostic sampling and gross pathology of New World camelids.

    Science.gov (United States)

    Bildfell, Robert J; Löhr, Christiane V; Tornquist, Susan J

    2012-11-01

    This article provides an overview of tests and appropriate samples to send to a Veterinary Diagnostic Laboratory for the diagnosis of common diseases of New World Camelids (NWC) such as abortions, congenital anomalies, anemia, enteritis, endoparasitism, gastric ulcer, hepatic lipidosis, encephalitis, pneumonia, dermatosis, neoplasia and cryptococcosis. Unique anatomic features of NWC and common findings encountered during gross necropsy examination are briefly reviewed. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Computer-aided diagnostic system for detection of Hashimoto thyroiditis on ultrasound images from a Polish population.

    Science.gov (United States)

    Acharya, U Rajendra; Sree, S Vinitha; Krishnan, M Muthu Rama; Molinari, Filippo; Zieleźnik, Witold; Bardales, Ricardo H; Witkowska, Agnieszka; Suri, Jasjit S

    2014-02-01

    Computer-aided diagnostic (CAD) techniques aid physicians in better diagnosis of diseases by extracting objective and accurate diagnostic information from medical data. Hashimoto thyroiditis is the most common type of inflammation of the thyroid gland. The inflammation changes the structure of the thyroid tissue, and these changes are reflected as echogenic changes on ultrasound images. In this work, we propose a novel CAD system (a class of systems called ThyroScan) that extracts textural features from a thyroid sonogram and uses them to aid in the detection of Hashimoto thyroiditis. In this paradigm, we extracted grayscale features based on stationary wavelet transform from 232 normal and 294 Hashimoto thyroiditis-affected thyroid ultrasound images obtained from a Polish population. Significant features were selected using a Student t test. The resulting feature vectors were used to build and evaluate the following 4 classifiers using a 10-fold stratified cross-validation technique: support vector machine, decision tree, fuzzy classifier, and K-nearest neighbor. Using 7 significant features that characterized the textural changes in the images, the fuzzy classifier had the highest classification accuracy of 84.6%, sensitivity of 82.8%, specificity of 87.0%, and a positive predictive value of 88.9%. The proposed ThyroScan CAD system uses novel features to noninvasively detect the presence of Hashimoto thyroiditis on ultrasound images. Compared to manual interpretations of ultrasound images, the CAD system offers a more objective interpretation of the nature of the thyroid. The preliminary results presented in this work indicate the possibility of using such a CAD system in a clinical setting after evaluating it with larger databases in multicenter clinical trials.

  8. Immunoassay of thyroid peroxidase autoantibodies: diagnostic performance in automated third generation methods. A multicentre evaluation.

    Science.gov (United States)

    D'Aurizio, Federica; Tozzoli, Renato; Villalta, Danilo; Pesce, Giampaola; Bagnasco, Marcello

    2015-02-01

    The use of automated immunometric methods for the detection of anti-thyroid peroxidase antibodies (TPOAb), the main serological marker of autoimmune thyroid diseases (AITD), has expanded in recent years. However, it is not known whether these new automated platforms have improved the diagnostic performance of TPOAb assays. The aim of this study was to evaluate the potential improvement of the inter-method agreement of current automated third generation systems, 12 years after a previous study, which had assessed the analytical variability between semi-automated second generation methods of TPOAb detection. Eight pools of sera from patients with chronic lymphocytic thyroiditis, exhibiting different TPOAb concentrations, were collected from routine laboratory diagnostics and distributed to seven companies throughout Italy. All automated third generation methods were calibrated against the Medical Research Council (MRC) reference preparation 66/387. The overall mean variability (CV) was 93.6% when results were expressed in part as arbitrary Units (U/mL) and in part as International Units (IU/mL). The conversion of all values in IU/mL resulted in a significant decrease of CV (49.8%). The CV expressed as COM (cut-off concentration multiples) was 64.0%. Agreement of qualitative results was 95.3% with a pronounced difference in the threshold values proposed by manufacturers (range 3.2-35.0 IU/mL). These findings confirm the improvement of harmonisation between different methods of automated third generation TPOAb assays. Nevertheless, further efforts should be made in the definition of the positive cut-off concentration to avoid misclassification of AITD patients as well as in a new international reference preparation and in the autoantigen purification modality.

  9. Highlighting nuclear membrane staining in thyroid neoplasms with emerin: review and diagnostic utility.

    Science.gov (United States)

    Kinsella, Mary D; Hinrichs, Benjamin; Cohen, Cynthia; Siddiqui, Momin T

    2013-06-01

    Immunohistochemical staining (IHC) with emerin, an integral inner nuclear membrane protein, highlights nuclear membrane details in papillary thyroid carcinoma (PTC). We evaluated emerin for highlighting nuclear shape, grooves, inclusions, circumferential nuclear membrane irregularities ("garlands"), deep "stellate" membrane invaginations, and crescents in 34 fine-needle aspiration (FNA) cell blocks, PTC (n = 24) and follicular neoplasms (FN) (n = 10). Tissue microarrays were also examined for 182 cases, PTC (n = 95) and non-PTC (n = 87). Emerin IHC of PTC revealed a predominantly oval nuclear shape in the majority of cases, with FN demonstrating round nuclei and FV of PTC showing a roughly equal distribution of round and oval shapes. In addition to oval nuclear shape, the presence of emerin-positive nuclear grooves, circumferential emerin nuclear "garlands," nuclear crescent shapes, and chromatin clearing on cell block H&E staining were significant predictors of PTC by regression analysis. Emerin IHC of thyroid FNA and surgical specimens serves as a useful adjunct to conventional H&E staining in the diagnosis of PTC and its distinction from FN by delineating diagnostic nuclear membrane irregularities ("garlands" and crescents), nuclear grooves, and a characteristic oval nuclear shape. In diagnostically challenging cases with limited cellularity, emerin staining can help to provide a more definitive diagnosis of PTC. Copyright © 2012 Wiley Periodicals, Inc.

  10. Pathology

    Directory of Open Access Journals (Sweden)

    Huihong Xu MD

    2016-08-01

    Full Text Available Medical students are often unsure about the viability of a career as a physician in pathology. In particular, they are concerned that pathologists may not have a gratifying lifestyle or be well compensated. These worries may cause angst among medical students considering pathology and among junior pathology residents wondering if they made the correct career choice. A 2016 survey of nearly 20 000 physicians including nearly 400 pathologists provides reassuring data about compensation and career choice. This survey showed that 52% of pathologists are satisfied with their career choice and 63% are satisfied with their compensation. Among the 26 specialties that were surveyed, pathologists ranked 2 in believing that they were fairly compensated. Moreover, 66% of pathologists find that making diagnostic decisions, a core aspect of our discipline, is the most rewarding aspect of their career. Pathologists also ranked among the highest groups of physicians in reporting happiness at work and among the lowest groups reporting burnout. Overall, these 2016 surveys show that the majority of pathologists find deep satisfaction in their careers as pathologists.

  11. Central nervous system tumors: Radiologic pathologic correlation and diagnostic approach

    Directory of Open Access Journals (Sweden)

    Ishita Pant

    2015-01-01

    Full Text Available Objective: This study was conducted to formulate location-wise radiologic diagnostic algorithms and assess their concordance with the final histopathological diagnosis so as to evaluate their utility in a rural setting where only basic facilities are available. Materials and Methods: A retrospective analysis to assess the concordance of radiology (primarily MRI with final histopathology report was done. Based on the most common incidence of tumor location and basic radiology findings, diagnostic algorithms were prepared. Results: For supratentorial intraaxial parenchymal location concordance was seen in all high-grade astrocytomas, low- and high-grade oligodendrogliomas, metastatic tumors, primitive neuroectodermal tumors, high-grade ependymomas, neuronal and mixed neuro-glial tumors and tumors of hematopoietic system. Lowest concordance was seen in low-grade astrocytomas. In the supratentorial intraaxial ventricular location, agreement was observed in choroid plexus tumors, ependymomas, low-grade astrocytomas and meningiomas; in the supratentorial extraaxial location, except for the lack of concordance in the only case of metastatic tumor, concordance was observed in meningeal tumors, tumors of the sellar region, tumors of cranial and paraspinal nerves; the infratentorial intraaxial parenchymal location showed agreement in low- as well as high-grade astrocytomas, metastatic tumors, high-grade ependymoma, embryonal tumors and hematopoietic tumors; in the infratentorial intraaxial ventricular location, except for the lack of concordance in one case of low-grade astrocytoma and two cases of medulloblastomas, agreement was observed in low- and high-grade ependymoma; infratentorial extraaxial tumors showed complete agreement in all tumors of cranial and paraspinal nerves, meningiomas, and hematopoietic tumors. Conclusion: A location-based approach to central nervous system (CNS tumors is helpful in establishing an appropriate differential diagnosis.

  12. Comparison of diagnostic value of conventional ultrasonography and shear wave elastography in the prediction of thyroid lesions malignancy.

    Science.gov (United States)

    Szczepanek-Parulska, Ewelina; Woliński, Kosma; Stangierski, Adam; Gurgul, Edyta; Biczysko, Maciej; Majewski, Przemysław; Rewaj-Łosyk, Magdalena; Ruchała, Marek

    2013-01-01

    Thyroid nodular disease (TND) is a very common disorder. However, since the rate of malignancy is reported to be 3-10%, only a minority of patients require aggressive surgical treatment. As a result, there is a need for diagnostic tools which would allow for a reliable differentiation between benign and malignant nodules. Although a number of conventional ultrasonographic (US) features are proved to be markers of malignancy, Shear Wave Elastography (SWE) is considered to be an improvement of conventional US. The aim of this study was to compare conventional US markers and SWE diagnostic values in the differentiation of benign and malignant thyroid nodules. All patients referred for thyroidectomy, irrespective of the indications, underwent a US thyroid examination prospectively. Patients with TND were included into the study. Results of the US and SWE examinations were compared with post-surgical histopathology. One hundred and twenty two patients with 393 thyroid nodules were included into the study. Twenty two patients were diagnosed with cancer. SWE turned out to be a predictor of malignancy superior to any other conventional US markers (OR=54.5 using qualitative scales and 40.8 using quantitative data on maximal stiffness with a threshold of 50 kPa). Although most conventional US markers of malignancy prove to be significant, none of them are characterized by both high sensitivity and specificity. SWE seems to be an important step forward, allowing for a more reliable distinction of benign and malignant thyroid nodules. Our study, assessing SWE properties on the highest number of thyroid lesions at the time of publication, confirms the high diagnostic value of this technique. It also indicates that a quantitative evaluation of thyroid lesions is not superior to simpler qualitative methods.

  13. Comparison of diagnostic value of conventional ultrasonography and shear wave elastography in the prediction of thyroid lesions malignancy.

    Directory of Open Access Journals (Sweden)

    Ewelina Szczepanek-Parulska

    Full Text Available INTRODUCTION: Thyroid nodular disease (TND is a very common disorder. However, since the rate of malignancy is reported to be 3-10%, only a minority of patients require aggressive surgical treatment. As a result, there is a need for diagnostic tools which would allow for a reliable differentiation between benign and malignant nodules. Although a number of conventional ultrasonographic (US features are proved to be markers of malignancy, Shear Wave Elastography (SWE is considered to be an improvement of conventional US. The aim of this study was to compare conventional US markers and SWE diagnostic values in the differentiation of benign and malignant thyroid nodules. MATERIALS AND METHODS: All patients referred for thyroidectomy, irrespective of the indications, underwent a US thyroid examination prospectively. Patients with TND were included into the study. Results of the US and SWE examinations were compared with post-surgical histopathology. RESULTS: One hundred and twenty two patients with 393 thyroid nodules were included into the study. Twenty two patients were diagnosed with cancer. SWE turned out to be a predictor of malignancy superior to any other conventional US markers (OR=54.5 using qualitative scales and 40.8 using quantitative data on maximal stiffness with a threshold of 50 kPa. CONCLUSIONS: Although most conventional US markers of malignancy prove to be significant, none of them are characterized by both high sensitivity and specificity. SWE seems to be an important step forward, allowing for a more reliable distinction of benign and malignant thyroid nodules. Our study, assessing SWE properties on the highest number of thyroid lesions at the time of publication, confirms the high diagnostic value of this technique. It also indicates that a quantitative evaluation of thyroid lesions is not superior to simpler qualitative methods.

  14. Diagnostic assessment of intraoperative cytology for papillary thyroid carcinoma: using a decision tree analysis.

    Science.gov (United States)

    Pyo, J-S; Sohn, J H; Kang, G

    2017-03-01

    The aim of this study was to elucidate the cytological characteristics and the diagnostic usefulness of intraoperative cytology (IOC) for papillary thyroid carcinoma (PTC). In addition, using decision tree analysis, effective features for accurate cytological diagnosis were sought. We investigated cellularity, cytological features and diagnosis based on the Bethesda System for Reporting Thyroid Cytopathology in IOC of 240 conventional PTCs. The cytological features were evaluated in terms of nuclear score with nuclear features, and additional figures such as presence of swirling sheets, psammoma bodies, and multinucleated giant cells. The nuclear score (range 0-7) was made via seven nuclear features, including (1) enlarged, (2) oval or irregularly shaped nuclei, (3) longitudinal nuclear grooves, (4) intranuclear cytoplasmic pseudoinclusion, (5) pale nuclei with powdery chromatin, (6) nuclear membrane thickening, and (7) marginally placed micronucleoli. Nuclear scores in PTC, suspicious for malignancy, and atypia of undetermined significance cases were 6.18 ± 0.80, 4.48 ± 0.82, and 3.15 ± 0.67, respectively. Additional figures more frequent in PTC than in other diagnostic categories were identified. Cellularity of IOC significantly correlated with tumor size, nuclear score, and presence of additional figures. Also, IOCs with higher nuclear scores (4-7) significantly correlated with larger tumor size and presence of additional figures. In decision tree analysis, IOCs with nuclear score >5 and swirling sheets could be considered diagnostic for PTCs. Our study suggests that IOCs using nuclear features and additional figures could be useful with decreasing the likelihood of inconclusive results.

  15. 3D-Pathology: a real-time system for quantitative diagnostic pathology and visualisation in 3D

    Science.gov (United States)

    Gottrup, Christian; Beckett, Mark G.; Hager, Henrik; Locht, Peter

    2005-02-01

    This paper presents the results of the 3D-Pathology project conducted under the European EC Framework 5. The aim of the project was, through the application of 3D image reconstruction and visualization techniques, to improve the diagnostic and prognostic capabilities of medical personnel when analyzing pathological specimens using transmitted light microscopy. A fully automated, computer-controlled microscope system has been developed to capture 3D images of specimen content. 3D image reconstruction algorithms have been implemented and applied to the acquired volume data in order to facilitate the subsequent 3D visualization of the specimen. Three potential application fields, immunohistology, cromogenic in situ hybridization (CISH) and cytology, have been tested using the prototype system. For both immunohistology and CISH, use of the system furnished significant additional information to the pathologist.

  16. The diagnostic utility of ultrasonography, CT and PET/CT for the preoperative evaluation of cervical lymph node metastasis inpapillary thyroid cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim Young Sang; Lee, Tae Hyun; Park, Dong Hee [Dept. of Radiology, Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    2016-08-15

    To compare the diagnostic utility of ultrasonography (US), CT and positron emission tomography/CT (PET/CT) in the preoperative evaluation of cervical lymph node metastasis in patients with papillary thyroid carcinoma. The study population consisted of 300 patients with pathologically diagnosed papillary thyroid carcinoma after thyroidectomy and neck dissection. Preoperative US, CT, and PET/CT findings were compared with pathologic outcomes after thyroidectomy and neck dissection. Sensitivity in detecting central lymph node metastasis (US 29.9%, CT 27.9%, PET/CT 18.8%) was lower than that for lateral lymph node metastasis (US 56.3%, CT 66.2%, PET/CT 43.7%). Specificity in detecting central lymph node metastasis (US 80.6%, CT 77.7%, PET/CT 83.0%) was lower than that for lateral lymph node metastasis (US 96.8%, CT 80.6%, PET/CT 95.2%). The combination of US and CT had higher specificity (77.3%) and higher sensitivity (33.1%) than US alone. PET/CT has no significant additional benefit over the combination of US and CT. In preoperative evaluations of neck lymph node metastasis, US and CT and PET/CT are more useful in lateral lymph node areas than in central lymph node areas. The combination of US and CT has higher sensitivity than US alone.

  17. A potential diagnostic application of magnetization transfer contrast: an in vitro NMR study of excised human thyroid tissues

    Science.gov (United States)

    Callicott, C.; Goode, A. W.

    1998-03-01

    A series of freshly excised thyroid tissues was analysed using a nuclear magnetic resonance spectrometer and then subjected to routine histo-pathology examination. Whilst simple values for normal tissue and goitre are not significantly different, the degree of intra-subject and variability is shown to be an indicator of benign thyroid disease. Using data collected from an inversion-recovery sequence performed with and without magnetization transfer, a magnetization transfer rate constant was calculated for each tissue sample. These data suggest that this parameter may provide in vivo discrimination between follicular cancer and follicular adenoma.

  18. How to Introduce Virtual Microscopy (VM in Routine Diagnostic Pathology: Constraints, Ideas, and Solutions

    Directory of Open Access Journals (Sweden)

    Klaus Kayser

    2012-01-01

    Full Text Available Context: Virtual microscopy which is the diagnostic work with digitized microscopic images in tissue – based diagnosis is in its childhood in being implemented in routine diagnosis. Until today, only a few pathology institutions take use of this new technology, although it is available since several years. Why?

  19. Pathology of common diseases of the thyroid gland in Port Harcourt ...

    African Journals Online (AJOL)

    Background: Thyroid diseases are rare in this environment but are more frequent in Western and Northern parts of Nigeria. These diseases present with neck swellings, pains and resulting in high morbidity and mortality rate as well as posing cosmetic problems. Aim: To study the frequency, age distribution and histological ...

  20. Nonthyroid Metastasis to the Thyroid Gland: Case Series and Review with Observations by Primary Pathology.

    Science.gov (United States)

    Russell, Jonathon O; Yan, Kenneth; Burkey, Brian; Scharpf, Joseph

    2016-12-01

    Nonthyroid metastases to the thyroid gland can cause morbidity, including dysphagia, dysphonia, and airway compromise. Because metastatic malignancies portend a poor prognosis, obtaining equipoise between treatment morbidity and local disease progression is paramount. We reviewed cases of nonthyroid metastases to determine treatment and prognostic recommendations. Case series with chart review. Tertiary care hospital. We searched PubMed for reported cases between 1994 and September 2013 using search terms as follows: any combination of primary tumor locations and thyroid, as well as the terms thyroid and metastasis. Only unique cases of nonthyroid metastases were included. Combined with 17 additional tumors at our own institution, we found 818 unique nonthyroid metastases, of which 384 had management and survival data available. Renal cell carcinoma was most common, presenting in 293 (35.8%) patients, followed by lung and gastrointestinal malignancies. Patients were treated with total thyroidectomy (34.0%), subtotal thyroidectomy including lobectomy (32.6%), and no surgery (33.5%). Surgical management was associated with improved survival duration (P thyroid gland are unusual tumors. Surgical intervention is associated with improved survival, but expected morbidity of untreated tumors is difficult to assess. Site of origin, time to diagnosis, and surgical approach are related to survival and recurrence rates. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  1. Diagnostic time in digital pathology: A comparative study on 400 cases

    Directory of Open Access Journals (Sweden)

    Aleksandar Vodovnik

    2016-01-01

    Full Text Available Background: Numerous validation studies in digital pathology confirmed its value as a diagnostic tool. However, a longer time to diagnosis than traditional microscopy has been seen as a significant barrier to the routine use of digital pathology. As a part of our validation study, we compared a digital and microscopic diagnostic time in the routine diagnostic setting. Materials and Methods: One senior staff pathologist reported 400 consecutive cases in histology, nongynecological, and fine needle aspiration cytology (20 sessions, 20 cases/session, over 4 weeks. Complex, difficult, and rare cases were excluded from the study to reduce the bias. A primary diagnosis was digital, followed by traditional microscopy, 6 months later, with only request forms available for both. Microscopic slides were scanned at ×20, digital images accessed through the fully integrated laboratory information management system (LIMS and viewed in the image viewer on double 23” displays. A median broadband speed was 299 Mbps. A diagnostic time was measured from the point slides were made available to the point diagnosis was made or additional investigations were deemed necessary, recorded independently in minutes/session and compared. Results: A digital diagnostic time was 1841 and microscopic 1956 min; digital being shorter than microscopic in 13 sessions. Four sessions with shorter microscopic diagnostic time included more cases requiring extensive use of magnifications over ×20. Diagnostic time was similar in three sessions. Conclusions: A diagnostic time in digital pathology can be shorter than traditional microscopy in the routine diagnostic setting, with adequate and stable network speeds, fully integrated LIMS and double displays as default parameters. This also related to better ergonomics, larger viewing field, and absence of physical slide handling, with effects on both diagnostic and nondiagnostic time. Differences with previous studies included a design

  2. Cushing Syndrome: Diagnostic Workup and Imaging Features, With Clinical and Pathologic Correlation.

    Science.gov (United States)

    Wagner-Bartak, Nicolaus A; Baiomy, Ali; Habra, Mouhammed Amir; Mukhi, Shalini V; Morani, Ajaykumar C; Korivi, Brinda R; Waguespack, Steven G; Elsayes, Khaled M

    2017-07-01

    Cushing syndrome (CS) is a constellation of clinical signs and symptoms resulting from chronic exposure to excess cortisol, either exogenous or endogenous. Exogenous CS is most commonly caused by administration of glucocorticoids. Endogenous CS is subdivided into two types: adrenocorticotropic hormone (ACTH) dependent and ACTH independent. Cushing disease, which is caused by a pituitary adenoma, is the most common cause of ACTH-dependent CS for which pituitary MRI can be diagnostic, with bilateral inferior petrosal sinus sampling useful in equivocal cases. In ectopic ACTH production, which is usually caused by a tumor in the thorax (e.g., small cell lung carcinoma, bronchial and thymic carcinoids, or medullary thyroid carcinoma) or abdomen (e.g., gastroenteropancreatic neuroendocrine tumors or pheochromocytoma), CT, MRI, and nuclear medicine tests are used for localizing the source of ACTH. In ACTH-independent CS, which is caused by various adrenal abnormalities, adrenal protocol CT or MRI is usually diagnostic.

  3. Diagnostic x-ray exposure increases the risk of thyroid microcarcinoma: a population-based case-control study

    Science.gov (United States)

    Zhang, Yawei; Chen, Yingtai; Huang, Huang; Sandler, Jason; Dai, Min; Ma, Shuangge; Udelsman, Robert

    2015-01-01

    Objective Thyroid cancer incidence and diagnostic x-ray exposures, particularly CT scans and nuclear medicine examinations have increased substantially in the United States. However, very few epidemiologic studies have directly investigated their associations. Methods A population-based case-control study was conducted in Connecticut in 2010–2011 including 462 histologically confirmed incident thyroid cancer cases and 498 population-based controls. Multivariate unconditional logistic regression models were used to estimate the associations between diagnostic x-rays and risk of thyroid cancer controlling for potential confounding factors. Results Exposure to any diagnostic x-rays was associated with an increased risk of well-differentiated thyroid microcarcinoma (tumor size ≤10 mm, OR=2.76, 95%CI: 1.31–5.81). The highest risk increase occurred with nuclear medicine examinations (excluding cardiology tests and thyroid uptake studies; OR=5.47, 95%CI: 2.10–14.23), followed by chest CT scans (OR=4.30, 95%CI: 1.66–11.14), head and neck CT scans (OR=3.88, 95%CI: 1.75–8.63), upper gastrointestinal series (OR=3.56, 95%CI: 1.54–8.21), lower gastrointestinal series (OR=3.29, 95%CI: 1.41–7.66), kidney x-rays involving dye injection into a vein or artery (OR=3.21, 95%CI: 1.20–8.54), mammograms (OR=2.95, 95%CI: 1.14–7.61), chest x-rays (OR=2.93, 95%CI: 1.37–6.29), and abdomen CT scans (OR=2.54, 95%CI: 1.02–6.30). No significant associations were found between these imaging modalities and thyroid tumors larger than 10 mm. Conclusions This study provides the first direct evidence that CT scans and nuclear medicine examinations are associated with an increased risk of thyroid cancer. The novel finding that an array of diagnostic x-ray procedures are associated thyroid microcarcinomas warrants further investigation. PMID:25932870

  4. Structure of a Thyroid Gland Pathologies in a Population of Children and the Teenagers Living in Conditions Endemic Goiter of Northern Territories by Results of Ultrasonic Researches

    Directory of Open Access Journals (Sweden)

    Y Girsh

    2009-12-01

    Full Text Available For studying structure pathologies of a thyroid gland at children and the teenagers living in northern territories Khanty-Mansiysk of autonomous region, for the period 2000–2008 the retrospective analysis of results of 3002 ultrasonic researches of a thyroid gland is lead To 32.7% of cases at children and teenagers attributes endemic goiter a craw are revealed. Chronic lymphocytic thyroiditis, changes thyroid gland, are revealed in 4.2% of cases. The one-central and multinodal craw was made with 2.1 and 0.7%, accordingly. In 60.3% according to ultrasonic of inspection of pathology a thyroid gland it is not revealed. The basic ultrasonic models colloidal a craw, central cellular a craw and an adenoma of a thyroid gland are developed. The estimation of criteria the importance of the given models is lead, the estimation of results has allowed to consider, that the received ultrasonic models were adequate for ultrasound research.

  5. 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

    Directory of Open Access Journals (Sweden)

    María Teresa Marrero Rodríguez

    2007-12-01

    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

  6. The pathology of childhood thyroid tumors in the Russian Federation after Chernobyl

    International Nuclear Information System (INIS)

    Abrosimov, A.Yu.; Lushnikov, E.F.; Tsyb, A.F.; Harach, H.R.; Thomas, G.A.; Williams, E.D.

    1996-01-01

    The histological verification of thyroid carcinoma that have occurred in children in the contaminated areas of the Russian Federation after Chernobyl has been performed by pathologists from Obninsk and Cambridge. Formalin fixed material and paraffin blocks of 10 cases of childhood thyroid cancer were received from different hospitals in Russia during 1993-1995. 4 of the cases were female, and 6 male. In one of these cases the material available in Cambridge unfortunately showed no tumor. Of the other 9 cases, all were papillary carcinomas. 5 showed the solid follicular pattern, predominant in younger children in the UK and forming the great majority of the recent childhood cases in both Belarus and the Ukraine. 2 were predominantly oxyphil carcinomas which were classified with papillary carcinomas on both architectural and cytological grounds, and 2 showed the features of the classic type of papillary carcinoma, predominant among the older children in the UK. All children came from areas contaminated by fallout from the Chernobyl accident, with 6 from Bryansk 1 from Kaluga and 3 from Tula. All cases were confirmed by immunohistochemistry and in situ hybridization for thyroid differentiation markers. The oncogenes ret, met and p53 were also studied by immunohistochemistry

  7. Multi-immunoreaction-based dual-color capillary electrophoresis for enhanced diagnostic reliability of thyroid gland disease.

    Science.gov (United States)

    Woo, Nain; Kim, Su-Kang; Kang, Seong Ho

    2017-08-04

    Thyroid-stimulating hormone (TSH) secretion plays a critical role in regulating thyroid gland function and circulating thyroid hormones (i.e., thyroxine (T4) and triiodothyronine (T3)). A novel multi-immunoreaction-based dual-color capillary electrophoresis (CE) technique was investigated in this study to assess its reliability in diagnosing thyroid gland disease via simultaneous detection of TSH, T3, and T4 in a single run of CE. Compared to the conventional immunoreaction technique, multi-immunoreaction of biotinylated streptavidin antibodies increased the selectivity and sensitivity for individual hormones in human blood samples. Dual-color laser-induced fluorescence (LIF) detection-based CE performed in a running buffer of 25mM Na 2 B 4 O 7 -NaOH (pH 9.3) allowed for fast, simultaneous quantitative analysis of three target thyroid hormones using different excited wavelengths within 3.2min. This process had excellent sensitivity and detection limits of 0.05-5.32 fM. The results showed 1000-100,000 times higher detection sensitivity than previous methods. Method validation with enzyme linked immunosorbent assay for application with human blood samples showed that the CE method was not significantly different at the 98% confidence level. Therefore, the developed CE-LIF method has the advantages of high detection sensitivity, faster analysis time, and smaller sample amount compared to the conventional methods The combined multi-immunoreaction and dual-color CE-LIF method should have increased diagnostic reliability for thyroid gland disease compared to conventional methods based on its highly sensitive detection of thyroid hormones using a single injection and high-throughput screening. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Sella turcica morphology and the pituitary gland--a new contribution to craniofacial diagnostics based on histology and neuroradiology

    DEFF Research Database (Denmark)

    Kjær, Inger

    2012-01-01

    , thyroid, and heart (velocardiofacial syndrome). Pathological sella turcica morphology can also be associated with malformations in the cerebellum and larynx (Cri-du-Chat syndrome). This review demonstrates the value of combining profile radiographic diagnostics with neuroradiological diagnostics in cases...

  9. Metastatic renal cell carcinoma in the thyroid gland: ultrasonographic features and the diagnostic role of core needle biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ok Kyu; Koo, Ja Seung; Kwak, Jin Young; Moon, Hee Jung; Yoon, Jung Hyun; Kim, Eun Kyung [Severance Hospital, Yonsei University College of Medicine, Seoul(Korea, Republic of)

    2017-07-15

    The aims of this study were to present the ultrasonographic (US) features of metastatic renal cell carcinoma (RCC) in the thyroid gland and to evaluate the diagnostic utility of fine needle aspiration (FNA) and core needle biopsy (CNB). Eight patients with nine metastatic RCC nodules in the thyroid glands who were treated from January 2002 to March 2015 in a single tertiary hospital were consecutively selected and retrospectively reviewed. US features and clinical history were obtained from the institution’s medical database. FNA was performed nine times on eight nodules and CNB was performed six times on six nodules. The diagnostic utility of FNA and CNB was evaluated. All nine nodules showed mass formation without diffuse thyroid involvement. On ultrasonography, metastatic RCC nodules were solid (100%), hypoechoic (100%), and ovalshaped nodules with a well-defined smooth margin (88.9%) and increased vascularity (100%, with 55% showing extensive vascularity). No calcifications were noted in any nodules. Lymph node metastasis and direct extension to nearby structures beyond the thyroid gland were not found. One FNA (11%) was able to confirm metastatic RCC, whereas all six CNBs confirmed metastatic RCC. Metastatic RCC appears as oval-shaped hypoechoic solid nodules with well-defined smooth margins, no calcifications, and increased vascularity on ultrasonography. Characteristic US features along with a previous history of RCC should raise clinical suspicion, and CNB should be performed to make an accurate diagnosis.

  10. Thyroid lymphography-computed tomography (TLG-CT)

    International Nuclear Information System (INIS)

    Matsuyama, Koukichi

    1992-01-01

    There are several useful diagnostic examinations for thyroid disease. The diagnostic value of CT in thyroid disease is still controvertial, although CT has become a routine clinical examination, since the plain CT does not always identify tumors accurately. In this paper, we introduce for the first time thyroid lymphography-computed tomography (TLG-CT) which may improve the diagnostic value of CT. The technique combines CT with thyroid lymphography. We performed TLG-CT in 92 patients with various thyroid diseases and 20 normal controls and classified the radiological features into the following 6 types: entire (normal thyroid); moth-eaten (Hashimoto's thyroiditis); defect (follicular adenoma and adenomatous goiter); lobate (papillary carcinoma); localized (various thyroid diseases); and extrathyroid defect (parathyroid tumor). In addition, we examined the relationship between TLG-CT type and the macroscopic appearance of the cut surface of the thyroid and lymph node metastasis in 20 patients with papillary carcinoma. The results suggest that papillary TLG-CT type carcinomas have a high incidence of lymph node metastasis. Our preliminary results suggest that TLG-CT is a potentially valuable diagnostic tool in the detection of thyroid disease and the assessment of the pathologic diagnosis as well as lymph node metastasis. (author)

  11. Investigation of protein and lipid metabolism in thyroid pathology using whole-body radiometry

    International Nuclear Information System (INIS)

    Gorobets, V.F.; Matveenko, E.G.

    1987-01-01

    Radiometry of the whole body and its organs was employed to study certain aspects of protein-aminoacid and lipid metabolism in patients with thyroid diseases. Metabolism of human serum 131 I-albumin was studied in 12 patients with neurocirculatory dystonia, in 13 patients with diffuse toxic goiter (in 10 before and after drug therapy) and in 9 controls. 75 Se-methionine aminoacid metabolism was investigated in 9 patients with toxic thyroid adenoma and in 13 controls. The body cell mass was determined in 82 patients with thyrotoxicosis by a measurable amount of 40 K. These data were compared with those of 249 healthy persons. An increase in catabolism of labeled albumin, intensification of labeled methionine metabolism at the tissue level, signs of a decrease in the total amount of metabolic albumin in the body were revealed. Intensification of protein metabolism resulted in a decrease in the body cell mass of these patients. After adequate therapy the above indices of protein metabolism in patients with thyrotoxicosis returned to normal. The assimilation of fatty acids and neutral fat was disturbed both in thyrotoxicosis and hypothyroidism

  12. Thyroid perfusion imaging as a diagnostic tool in Graves' disease. Arterial spin labeling magnetic resonance imaging vs. colour-coded Doppler ultrasound

    International Nuclear Information System (INIS)

    Muessig, K.; Leibniz Center for Diabetes Research, Duesseldorf; University Hospital of Tuebingen; Schraml, C.; Schwenzer, N.F.; University Hospital of Tuebingen; Rietig, R.; Balletshofer, B.; Martirosian, P.; Haering, H.U.; Schick, F.; Claussen, C.D.

    2012-01-01

    Purpose: Though increased thyroid perfusion assessed by colour-coded Doppler ultrasound (CDUS) is characteristic of Graves' disease (GD), sometimes perfusion assessment by CDUS is not possible. In these cases, arterial spin labelling (ASL), a novel magnetic resonance imaging (MRI) technique allowing non-invasive thyroid perfusion quantification, may have additional diagnostic value. We aimed to evaluate the potential of ASL-MRI for assessment of increased blood perfusion in patients with GD compared to CDUS. Materials and Methods: Thyroid perfusion was measured by CDUS (volume flow rate calculated from pulsed wave Doppler signals and vessel diameter) and ASL-MRI at 1.5 T in 7 patients with GD and 10 healthy controls. Results: In patients with GD, average perfusion in both thyroid lobes was markedly increased compared to controls. Both techniques applied for volume related perfusion as well as absolute volume flow in thyroid feeding vessels provided similar results (all p = 0.0008). Using a cut-off value of 22 ml/min for the volume flow rate assessed by CDUS in the four feeding vessels allowed discrimination between patients with GD and controls in all cases. After adjusting thyroid perfusion for the differences in organ volume, both CDUS and ASL revealed also complete discrimination between health and disease. Conclusion: Thyroid perfusion measurement by ASL-MRI reliably discriminate GD from normal thyroid glands. In patients in whom thyroid arteries cannot be depicted by CDUS for technical or anatomical reasons, ASL-MRI may have additional diagnostic value. (orig.)

  13. Thyroid perfusion imaging as a diagnostic tool in Graves' disease. Arterial spin labeling magnetic resonance imaging vs. colour-coded Doppler ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Muessig, K. [University Hospital of Duesseldorf (Germany). Dept. of Metabolic Diseases; Leibniz Center for Diabetes Research, Duesseldorf (Germany). Inst. for Clinical Diabetology; University Hospital of Tuebingen (Germany). Div. of Endocrinology, Diabetes, Nephrology, Angiology, and Clinical Chemistry; Schraml, C.; Schwenzer, N.F. [University Hospital of Tuebingen (Germany). Dept. of Radiology, Section on Experimental Radiology; University Hospital of Tuebingen (Germany). Dept. of Radiology, Diagnostic and Interventional Radiology; Rietig, R.; Balletshofer, B. [University Hospital of Tuebingen (Germany). Div. of Endocrinology, Diabetes, Nephrology, Angiology, and Clinical Chemistry; Martirosian, P.; Haering, H.U.; Schick, F. [University Hospital of Tuebingen (Germany). Dept. of Radiology, Section on Experimental Radiology; Claussen, C.D. [University Hospital of Tuebingen (Germany). Dept. of Radiology, Diagnostic and Interventional Radiology

    2012-12-15

    Purpose: Though increased thyroid perfusion assessed by colour-coded Doppler ultrasound (CDUS) is characteristic of Graves' disease (GD), sometimes perfusion assessment by CDUS is not possible. In these cases, arterial spin labelling (ASL), a novel magnetic resonance imaging (MRI) technique allowing non-invasive thyroid perfusion quantification, may have additional diagnostic value. We aimed to evaluate the potential of ASL-MRI for assessment of increased blood perfusion in patients with GD compared to CDUS. Materials and Methods: Thyroid perfusion was measured by CDUS (volume flow rate calculated from pulsed wave Doppler signals and vessel diameter) and ASL-MRI at 1.5 T in 7 patients with GD and 10 healthy controls. Results: In patients with GD, average perfusion in both thyroid lobes was markedly increased compared to controls. Both techniques applied for volume related perfusion as well as absolute volume flow in thyroid feeding vessels provided similar results (all p = 0.0008). Using a cut-off value of 22 ml/min for the volume flow rate assessed by CDUS in the four feeding vessels allowed discrimination between patients with GD and controls in all cases. After adjusting thyroid perfusion for the differences in organ volume, both CDUS and ASL revealed also complete discrimination between health and disease. Conclusion: Thyroid perfusion measurement by ASL-MRI reliably discriminate GD from normal thyroid glands. In patients in whom thyroid arteries cannot be depicted by CDUS for technical or anatomical reasons, ASL-MRI may have additional diagnostic value. (orig.)

  14. Role of single photon emission computed tomography/computed tomography in diagnostic iodine-131 scintigraphy before initial radioiodine ablation in differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Agrawal, Kanhaiyalal; Bhattacharya, Anish; Mittal, Bhagwant Rai

    2005-01-01

    The study was performed to evaluate the incremental value of single photon emission computed tomography/computed tomography (SPECT/CT) over planar radioiodine imaging before radioiodine ablation in the staging, management and stratification of risk of recurrence (ROR) in differentiated thyroid cancer (DTC) patients. Totally, 83 patients (21 male, 62 female) aged 17–75 (mean 39.9) years with DTC were included consecutively in this prospective study. They underwent postthyroidectomy planar and SPECT/CT scans after oral administration of 37–114 MBq iodine-131 (I-131). The scans were interpreted as positive, negative or suspicious for tracer uptake in the thyroid bed, cervical lymph nodes and sites outside the neck. In each case, the findings on planar images were recorded first, without knowledge of SPECT/CT findings. Operative and pathological findings were used for postsurgical tumor–node–metastasis staging. The tumor staging was reassessed after each of these two scans. Single photon emission computed tomography/computed tomography localized radioiodine uptake in the thyroid bed in 9/83 (10.8%) patients, neck nodes in 24/83 (28.9%) patients and distant metastases in 8/83 (9.6%) patients in addition to the planar study. Staging was changed in 8/83 (9.6%), ROR in 11/83 (13.2%) and management in 26/83 (31.3%) patients by the pretherapy SPECT/CT in comparison to planar imaging. SPECT/CT had incremental value in 32/83 patients (38.5%) over the planar scan. Single photon emission computed tomography/computed tomography is feasible during a diagnostic I-131 scan with a low amount of radiotracer. It improved the interpretation of pretherapy I-131 scintigraphy and changed the staging and subsequent patient management

  15. Predictive Diagnostic Pathology in the Target Therapy Era in Breast Cancer.

    Science.gov (United States)

    Marchio, Caterina; Balmativola, Davide; Castiglione, Roberta; Annaratone, Laura; Sapino, Anna

    2017-01-01

    Treatment strategies in oncology are nowadays largely based on the "target therapy model", which allows to personalize the cure of each patient depending on distinctive host and disease features. As a general concept "targeted drugs" are effective only when the tumor exhibits the "target", which in breast cancer pathology may correspond to the expression of estrogen receptors and/or of HER2. These biomarkers are evaluated on breast cancer tissues by companion diagnostic tests, however, evidence suggests that the first step in breast cancer predictive pathology is still represented by morphology. For instance, histological types, such as tubular and cribriform carcinomas, define patients who may not need any treatments other than surgical excision. Neoadjuvant studies have shown that patients affected by lobular carcinomas are not likely to have any beneficial effects from chemotherapy. The second step in prediction is represented by immunophenotyping. If the immunohistochemical evaluation of four markers (estrogen and progesterone receptors, HER2 and Ki67) remains the best practice for breast cancer predictive pathology, molecular pathology has certainly reshaped the way we approach breast cancer diagnosis. The aim of this review is to discuss current knowledge in predictive pathology for the management of breast cancer patients, focusing on the benefits and drawbacks of traditional tools and of novel improvements of molecular biology.

  16. Detection of neck recurrence in patients with differentiated thyroid cancer: comparison of ultrasound, contrast-enhanced CT and {sup 18}F-FDG PET/CT using surgical pathology as a reference standard: (ultrasound vs. CT vs. {sup 18}F-FDG PET/CT in recurrent thyroid cancer)

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Young Lan; Yoon, Dae Young; Ku, You Jin [Hallym University College of Medicine, Department of Radiology, Kangdong Seong-Sim Hospital, Seoul (Korea, Republic of); Baek, Sora [Hallym University College of Medicine, Department of Nuclear Medicine, Kangdong Seong-Sim Hospital, Seoul (Korea, Republic of); Rho, Young-Soo; Chung, Eun-Jae [Hallym University College of Medicine, Department of Otorhinolaryngology, Ilsong Memorial Institute of Head and Neck Cancer, Kangdong Seong-Sim Hospital, Seoul (Korea, Republic of); Koh, Sung Hye [Hallym University Sacred Heart Hospital, Department of Radiology, Hallym University College of Medicine, Anyang, Gyonggi-do (Korea, Republic of)

    2012-10-15

    To compare the diagnostic performance of ultrasound, contrast-enhanced computed tomography (CT) and {sup 18}F-FDG positron emission tomography (PET)/CT for detecting recurrent differentiated thyroid cancer in the neck. Twenty patients who had undergone previous surgery for differentiated thyroid cancer (19 papillary carcinomas; 1 medullary carcinoma) and presented with pathologically proven recurrence in the neck were included. All patients had undergone ultrasound, CT and PET/CT in the 2 months before further surgery. In each patient, ultrasound, CT and PET/CT images were retrospectively reviewed to determine the presence of loco-regional recurrence by level-by-level analysis. Imaging results were correlated with the histological evaluation of the neck dissection as a standard of reference. Recurrences were found at 52 out of 110 cervical nodal levels surgically explored. The sensitivity, specificity and accuracy were 69.2 %, 89.7 % and 80.0 % for ultrasound; 63.5 %, 94.8 % and 80.0 % for CT; and 53.8 %, 79.3 % and 67.3 % for PET/CT, respectively. ROC analysis revealed higher diagnostic performance with ultrasound than with PET/CT for detecting recurrent tumour. Although no significant difference was found among the three techniques, the sensitivity and specificity of ultrasound and CT were higher than those of PET/CT for the evaluation of cervical recurrence in patients with differentiated thyroid cancer. circle Ultrasound, CT and {sup 18} F-FDG PET/CT can all detect recurrent thyroid cancer. circle Ultrasound and CT have higher sensitivity and specificity. (orig.)

  17. Systemic Sarcoidosis with Thyroid Involvement.

    Science.gov (United States)

    Okuma, Hideyuki; Hashimoto, Koshi; Wang, Xin; Ohkiba, Noriaki; Murooka, Nozomi; Akizuki, Norikazu; Inazawa, Takeshi; Ogawa, Yoshihiro

    2017-08-15

    A 66-year-old woman, who was diagnosed with iritis, visited our hospital due to general malaise. A blood analysis revealed hypercalcemia. Computed tomography revealed mediastinal and hilar lymph node hyperplasia. Moreover, 67 Gallium scintigraphy demonstrated strong accumulation in the lesions, suggesting sarcoidosis. A core needle biopsy (CNB) of the hypoechoic areas of the thyroid was performed because the patient refused to undergo a bronchoscopic examination. The scattering of slightly acidophilic epithelioid cell granulomas was observed in the pathological examination of the biopsy specimen. Based on this finding, the patient was diagnosed with sarcoidosis. Although sarcoidosis rarely involves the thyroid gland, in the present case, thyroid CNB was an alternative diagnostic method that allowed a pathological diagnosis to be obtained.

  18. PathEdEx – Uncovering high-explanatory visual diagnostics heuristics using digital pathology and multiscale gaze data

    Directory of Open Access Journals (Sweden)

    Dmitriy Shin

    2017-01-01

    Full Text Available Background: Visual heuristics of pathology diagnosis is a largely unexplored area where reported studies only provided a qualitative insight into the subject. Uncovering and quantifying pathology visual and nonvisual diagnostic patterns have great potential to improve clinical outcomes and avoid diagnostic pitfalls. Methods: Here, we present PathEdEx, an informatics computational framework that incorporates whole-slide digital pathology imaging with multiscale gaze-tracking technology to create web-based interactive pathology educational atlases and to datamine visual and nonvisual diagnostic heuristics. Results: We demonstrate the capabilities of PathEdEx for mining visual and nonvisual diagnostic heuristics using the first PathEdEx volume of a hematopathology atlas. We conducted a quantitative study on the time dynamics of zooming and panning operations utilized by experts and novices to come to the correct diagnosis. We then performed association rule mining to determine sets of diagnostic factors that consistently result in a correct diagnosis, and studied differences in diagnostic strategies across different levels of pathology expertise using Markov chain (MC modeling and MC Monte Carlo simulations. To perform these studies, we translated raw gaze points to high-explanatory semantic labels that represent pathology diagnostic clues. Therefore, the outcome of these studies is readily transformed into narrative descriptors for direct use in pathology education and practice. Conclusion: PathEdEx framework can be used to capture best practices of pathology visual and nonvisual diagnostic heuristics that can be passed over to the next generation of pathologists and have potential to streamline implementation of precision diagnostics in precision medicine settings.

  19. [Clinical importance of thyroid gland cytology].

    Science.gov (United States)

    Ting, S; Synoracki, S; Bockisch, A; Führer, D; Schmid, K W

    2015-11-01

    The cytological evaluation of fine needle biopsies (FNB) of the thyroid gland crucially depends on a close cooperation between clinicians and cytopathologists. Scintigraphy, sonography as well as clinical data and patient history are necessary for a correct interpretation of the indications for FNB; moreover, these data are of outstanding importance for cytopathologists for the correct interpretation of the cytomorphological findings. This overview describes the present standards in the acquisition, technical workup and cytopathological interpretation of thyroid gland tissue obtained by FNB, particularly focusing on the rapidly growing relevance of additional molecular pathological investigations to increase the diagnostic accuracy of thyroid FNB.

  20. Advanced diagnostic methods in oral and maxillofacial pathology. Part II: immunohistochemical and immunofluorescent methods.

    Science.gov (United States)

    Jordan, Richard C K; Daniels, Troy E; Greenspan, John S; Regezi, Joseph A

    2002-01-01

    The practice of pathology is currently undergoing significant change, in large part due to advances in the analysis of DNA, RNA, and proteins in tissues. These advances have permitted improved biologic insights into many developmental, inflammatory, metabolic, infectious, and neoplastic diseases. Moreover, molecular analysis has also led to improvements in the accuracy of disease diagnosis and classification. It is likely that, in the future, these methods will increasingly enter into the day-to-day diagnosis and management of patients. The pathologist will continue to play a fundamental role in diagnosis and will likely be in a pivotal position to guide the implementation and interpretation of these tests as they move from the research laboratory into diagnostic pathology. The purpose of this 2-part series is to provide an overview of the principles and applications of current molecular biologic and immunologic tests. In Part I, the biologic fundamentals of DNA, RNA, and proteins and methods that are currently available or likely to become available to the pathologist in the next several years for their isolation and analysis in tissue biopsies were discussed. In Part II, advances in immunohistochemistry and immunofluorescence methods and their application to modern diagnostic pathology are reviewed.

  1. Odontogenic tumors: A retrospective study of four Brazilian diagnostic pathology centers

    Science.gov (United States)

    da-Costa, Daniela O P.; Maurício, Almir S.; de-Faria, Paulo A S.; da-Silva, Licínio E.; Mosqueda-Taylor, Adalberto

    2012-01-01

    Objective: This article presents the results of a retrospective study of the frequency and classification of odontogenic tumors recorded at four centers of diagnostic pathology in Rio de Janeiro, Brazil. Study Design: All medical records and microscopic slides of odontogenic tumor specimens for the years 1997 to 2007 were retrieved from the files of four services of diagnostic pathology in Rio de Janeiro City. Diagnoses were re-evaluated and the tumors classified according to the latest (2005) World Health Organization Classification of Tumors. Results: A total of 201 odontogenic tumors were found among 15,758 oral biopsies (1.3%). The frequencies of these tumors at the four centers ranged from 0.5% at the National Cancer Institute to 3.3% in a private laboratory. Chi-square analysis revealed statistically significant differences (p<0.05) between the proportions of odontogenic tumors in the studied centers. Of these, 94.5% were benign and 5.5% were malignant. Keratocystic odontogenic tumor (32.3%) was the most frequent lesion, followed by ameloblastoma (29.8%) and odontoma (18.4%). Conclusions: Odontogenic tumors are uncommon in Brazil. Different pathology laboratories reported divergent frequencies of odontogenic tumors, which may reflect institutional specializations and the patient populations served. Key words:Odontogenic tumors, jaw neoplasms, epidemiology, WHO classification. PMID:22143740

  2. Design of an enhanced fuzzy k-nearest neighbor classifier based computer aided diagnostic system for thyroid disease.

    Science.gov (United States)

    Liu, Da-You; Chen, Hui-Ling; Yang, Bo; Lv, Xin-En; Li, Li-Na; Liu, Jie

    2012-10-01

    In this paper, we present an enhanced fuzzy k-nearest neighbor (FKNN) classifier based computer aided diagnostic (CAD) system for thyroid disease. The neighborhood size k and the fuzzy strength parameter m in FKNN classifier are adaptively specified by the particle swarm optimization (PSO) approach. The adaptive control parameters including time-varying acceleration coefficients (TVAC) and time-varying inertia weight (TVIW) are employed to efficiently control the local and global search ability of PSO algorithm. In addition, we have validated the effectiveness of the principle component analysis (PCA) in constructing a more discriminative subspace for classification. The effectiveness of the resultant CAD system, termed as PCA-PSO-FKNN, has been rigorously evaluated against the thyroid disease dataset, which is commonly used among researchers who use machine learning methods for thyroid disease diagnosis. Compared to the existing methods in previous studies, the proposed system has achieved the highest classification accuracy reported so far via 10-fold cross-validation (CV) analysis, with the mean accuracy of 98.82% and with the maximum accuracy of 99.09%. Promisingly, the proposed CAD system might serve as a new candidate of powerful tools for diagnosing thyroid disease with excellent performance.

  3. Practical applications of energy dispersive X-ray microanalysis in diagnostic oral pathology.

    Science.gov (United States)

    Daley, T D; Gibson, D

    1990-03-01

    Energy dispersive X-ray microanalysis is a powerful tool that can reveal the presence and relative quantities of elements in minute particles in biologic materials. Although this technique has been used in some aspects of dental research, it has rarely been applied to diagnostic oral pathology. The purpose of this paper is to inform practicing dentists and oral specialists about the diagnostic potential of this procedure by presenting three case reports. The first case involved the identification of flakes of a metallic material claimed by a 14-year-old girl to appear periodically between her mandibular molars. In the second case, a periodontist was spared a lawsuit when a freely mobile mass in the antrum of his patient was found to be a calcium-phosphorus compound not related to the periodontal packing that had been used. The third case involved the differential diagnosis of amalgam tattoo and graphite tattoo in a pigmented lesion of the hard palate mucosa. The results of the analyses were significant and indicate a role for this technique in the assessment of selected cases. Potential for wider use of energy dispersive X-ray microanalysis in diagnostic oral pathology exists as research progresses.

  4. Practical applications of energy dispersive X-ray microanalysis in diagnostic oral pathology

    Energy Technology Data Exchange (ETDEWEB)

    Daley, T.D.; Gibson, D. (Univ. of Western Ontario, London (Canada))

    1990-03-01

    Energy dispersive X-ray microanalysis is a powerful tool that can reveal the presence and relative quantities of elements in minute particles in biologic materials. Although this technique has been used in some aspects of dental research, it has rarely been applied to diagnostic oral pathology. The purpose of this paper is to inform practicing dentists and oral specialists about the diagnostic potential of this procedure by presenting three case reports. The first case involved the identification of flakes of a metallic material claimed by a 14-year-old girl to appear periodically between her mandibular molars. In the second case, a periodontist was spared a lawsuit when a freely mobile mass in the antrum of his patient was found to be a calcium-phosphorus compound not related to the periodontal packing that had been used. The third case involved the differential diagnosis of amalgam tattoo and graphite tattoo in a pigmented lesion of the hard palate mucosa. The results of the analyses were significant and indicate a role for this technique in the assessment of selected cases. Potential for wider use of energy dispersive X-ray microanalysis in diagnostic oral pathology exists as research progresses.

  5. Practical applications of energy dispersive X-ray microanalysis in diagnostic oral pathology

    International Nuclear Information System (INIS)

    Daley, T.D.; Gibson, D.

    1990-01-01

    Energy dispersive X-ray microanalysis is a powerful tool that can reveal the presence and relative quantities of elements in minute particles in biologic materials. Although this technique has been used in some aspects of dental research, it has rarely been applied to diagnostic oral pathology. The purpose of this paper is to inform practicing dentists and oral specialists about the diagnostic potential of this procedure by presenting three case reports. The first case involved the identification of flakes of a metallic material claimed by a 14-year-old girl to appear periodically between her mandibular molars. In the second case, a periodontist was spared a lawsuit when a freely mobile mass in the antrum of his patient was found to be a calcium-phosphorus compound not related to the periodontal packing that had been used. The third case involved the differential diagnosis of amalgam tattoo and graphite tattoo in a pigmented lesion of the hard palate mucosa. The results of the analyses were significant and indicate a role for this technique in the assessment of selected cases. Potential for wider use of energy dispersive X-ray microanalysis in diagnostic oral pathology exists as research progresses

  6. Mechanism-based diagnostic reasoning: thoughts on teaching introductory clinical pathology.

    Science.gov (United States)

    Bender, Holly S.; Lockee, Barbara B.; Danielson, Jared A.; Mills, Eric M.; Boon, G. Daniel; Burton, John K.; Vermeer, Pamela J.; Zimmerman, Kurt L.; Hilmer, Kelly M.

    2000-01-01

    Teaching introductory clinical pathology to veterinary students is a challenging endeavor that requires a shift in learning strategies from rote memorization to diagnostic reasoning. Educational research has identified discrete cognitive stages required to achieve the automated, unconscious thinking process used by experts. Building on this knowledge, we developed a case-based approach to clinical pathology instruction that actively engages students in the learning process and links performance with positive reward. Simulated cases provide context and create a structure, or "schema", which enhances the learning process by enabling students to synthesize facts and link them with their causal mechanism to reach a defensible diagnostic conclusion. Web-based tools, including the "Problem List Generator" and tutorials, have been developed to facilitate this process. Through the collaborative Biomedical Informatics Research Group, we are working to further develop and evaluate Web-based instructional tools and new educational methods, to clarify the diagnostic reasoning processes used by experienced clinical pathologists, and, ultimately, to better educate our future students to be effective diagnosticians.

  7. Cancers related to viral agents that have a direct role in carcinogenesis: pathological and diagnostic techniques.

    Science.gov (United States)

    Carbone, Antonino; De Paoli, Paolo

    2012-08-01

    The International Agency for Research on Cancer has recently reassessed the carcinogenicity of the biological agents classified as 'carcinogenic to humans'. Among the biological agents having a direct role in carcinogenesis, Epstein-Barr virus, Kaposi's sarcoma-associated herpes virus and human papillomavirus contribute to a variety of malignancies worldwide in humans including nasopharyngeal carcinoma, several types of lymphomas, genital tract carcinomas and Kaposi's sarcoma. The authors review the current knowledge on cancers that have been attributed to Epstein-Barr virus, Kaposi's sarcoma-associated herpes virus and human papillomavirus looking at the pathological classification of these cancers and description of the implicated viruses, highlighting a wide range of pathological and virological diagnostic techniques. This review also focuses on the new oncological scenario ahead, once strategies against carcinogenic infectious agents are found to be effective.

  8. Optical diagnostics of tumour cells at different stages of pathology development

    Science.gov (United States)

    Shcheglova, L. S.; Abramova, L. L.; Maryakhina, V. S.

    2013-11-01

    The differences in optical and biophysical properties between the cells of mammary gland tumour extracted from tumours of different diameter are described. It is shown that the spectral and spectrokinetic properties of fluorescent probes in the cells extracted from the tumours 1 - 3 cm in diameter are essentially different. Thus, the extinction coefficient of rhodamine 6G gradually increases with the pathology development. At the same time the rate of interaction of the triplet states of molecular probes with the oxygen, diluted in the tumour cells cytoplasm, decreases with the growth of the tumour capsule diameter. The observed regularities can be due to the changes in the cell structure, biochemical and biophysical properties. The reported data may be useful for developing optical methods of diagnostics of biotissue pathological conditions.

  9. Diagnostic Frequency Ratios Are Insufficient to Measure Laboratory Precision with The Bethesda System for Reporting Thyroid Cytopathology.

    Science.gov (United States)

    Fazeli, Roghayeh; Schneider, Eric B; Ali, Syed Z; Zeiger, Martha A; Olson, Matthew T

    2015-01-01

    Diagnostic frequency ratios such as the atypia of undetermined significance (AUS):malignant ratio are touted to be useful for laboratory precision benchmarking. We therefore sought to examine their reproducibility and usefulness at a tertiary hospital. We reviewed thyroid fine-needle aspirates (FNA) submitted to our institution from outside laboratories and evaluated the ability of diagnostic frequency ratios to capture the complexity of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). Specifically, we evaluated the ability of the AUS:malignant ratio to describe the frequencies of the other TBSRTC diagnoses. A total of 2,784 cases from 19 laboratories were included. The use of the AUS category varied the most. There was insufficient reflection of the non-AUS nonmalignant TBSRTC diagnostic frequencies in our analysis, and these results do not appear to arise from observer variability in the outside laboratories. Diagnostic frequency ratios are not reproducible in our experience and fail to describe the other TBSRTC categories. As such, they are unlikely to prove sufficient for benchmarking laboratory precision with TBSRTC. © 2015 S. Karger AG, Basel.

  10. Statistics of the thyroid pathology operated in the ORL-CCC service of the Hospital Rafael Angel Calderon Guardia, between 2008-2012

    International Nuclear Information System (INIS)

    Ramos Castro, Paula

    2013-01-01

    The statistics of the Servicio de Otorrinolaringologia y Cirugia de Cabeza y Cuello de Hospital Rafael Angel Calderon Guardia were described, in terms of thyroid surgery; in the period from January 1, 2008 to December 31, 2012, compiling 200 cases of operated patients. Due to the increase in the diagnosis of these diseases in the Costa Rican hospital environment and the lack of an instrument to evaluate the therapeutic action, the need to perform an evaluation of the surgical management given to thyroid pathology is born. Through a table of data complications and the systematic review of the records of the population, the presentation of the results obtained was made using the inclusion criteria such as: patients older than 12 years, diagnosis of benign or malignant thyroid pathology with need of surgical resolution, presence of BAAF reported in medical record, case report of patient in interdisciplinary thyroid session, with surgery or surgeries performed in the period between January 2008 and December 2012, with a written report of surgery and biopsy defined with medical record. The exclusion criteria were: patients without reports of FNAB, operative sheet and/or defined biopsy with medical record, patients whose medical record will not be located in the hospital center to collect the information. (author) [es

  11. Implementation of TMA and digitalization in routine diagnostics of breast pathology

    DEFF Research Database (Denmark)

    Rossing, Henrik Holm; Talman, Maj-Lis; Laenkholm, Anne-Vibeke

    2012-01-01

    To ensure optimal treatment of breast cancer patients, breast tumours are classified based on clinico-pathological features. As part of this process, routine diagnostics of breast tumours includes histological typing and grading, as well as profiling by use of an immunohistochemistry panel...... of antibodies, probes and in situ hybridization. This will, as a minimum, include assessment of oestrogen receptor (OR) and HER2. The individual preparation and staining of many breast tumours in a large laboratory with this standard panel is thus time consuming and costly. Herein, we show that in breast cancer...... routine diagnostics the use of the tissue microarray technique in combination with digitalization of the stained multi-slides is not only economical, with a considerable cost reduction, but it also enhances standardization of tumour profiling. We demonstrate that 2 mm breast tumour cores correlate...

  12. IMPLANT-ASSOCIATED PATHOLOGY: AN ALGORITHM FOR IDENTIFYING PARTICLES IN HISTOPATHOLOGIC SYNOVIALIS/SLIM DIAGNOSTICS

    Directory of Open Access Journals (Sweden)

    V. Krenn

    2014-01-01

    Full Text Available In histopathologic SLIM diagnostic (synovial-like interface membrane, SLIM apart from diagnosing periprosthetic infection particle identification has an important role to play. The differences in particle pathogenesis and variability of materials in endoprosthetics explain the particle heterogeneity that hampers the diagnostic identification of particles. For this reason, a histopathological particle algorithm has been developed. With minimal methodical complexity this histopathological particle algorithm offers a guide to prosthesis material-particle identification. Light microscopic-morphological as well as enzyme-histochemical characteristics and polarization-optical proporties have set and particles are defined by size (microparticles, macroparticles and supra- macroparticles and definitely characterized in accordance with a dichotomous principle. Based on these criteria, identification and validation of the particles was carried out in 120 joint endoprosthesis pathological cases. A histopathological particle score (HPS is proposed that summarizes the most important information for the orthopedist, material scientist and histopathologist concerning particle identification in the SLIM.

  13. [Anatomo-functional aspects and diagnostic algorithm (of the upper limb pathologies secondary to repeated trauma)].

    Science.gov (United States)

    Bazzini, G

    2001-01-01

    The epidemiology of work-related musculo-skeletal pathologies of the upper limbs has become significantly relevant in the last years, and a sharp increasing trend can be observed. This paper mainly focuses on the chronic inflammatory and degenerative conditions, which are more complex and difficult to accurately diagnose and treat. A synthesis of the diagnostic picture of the different types, involving the joints, muscles and tendons, and peripheral nerves is provided, with mention of the sensitivity and specificity of the main diagnostic tests. The possible entrapments of the radial, median and ulnar nerves are described in detail. Finally, a brief critical review on the principal movements of the upper limbs which are responsible of the onset of such conditions is presented.

  14. The superiority and benefits of whole body imaging after radioiodine -131 therapy over radioiodine 131 diagnostic imaging in management of thyroid carcinomas

    International Nuclear Information System (INIS)

    Aleid, M.A.

    1995-01-01

    A comparison between diagnostic and post therapeutic radioiodine imaging methods utilized in detection of thyroid metastases in 34 patients with well differentiated thyroid cancer was performed. The study revealed that the differences in detection on neck activity only between the two methods for papillary and follicular thyroid cancer were 35% and 27% respectively. While the overall detection percentages in both papillary and follicular thyroid cancers cases were 23% in diagnostic and 76% in post therapy scintigrams and the detection difference between the methods was 53% when all lesions throughout the body were seen on scintigram for only follicular thyroid cancer cases were counted, the detection percentage was increased up to 109%. It is clear that post therapeutic scans visualize an additional site activity not shown in diagnostic scans. There fore, post therapeutic imaging method is far superior to diagnostic imaging method and highly sensitive in visualization of thyroid metastases. On the other hand, this research also achieves many scientific and financial benefits. Therefore. This method should be adopted in management and follow up of well differentiated malignancies. 2 figs., 2 tabs

  15. Differential expression of aquaporins and its diagnostic utility in thyroid cancer.

    Directory of Open Access Journals (Sweden)

    Dongfeng Niu

    Full Text Available BACKGROUND: Aquaporin3 (AQP3 and Aquaporin4 (AQP4 play a major role in transcellular and transepithelial water movement as water channel membrane proteins. Little is known of their expression and significance in human thyroid tissues. Thus, we examined the expression of AQP3 and AQP4 in normal, hyperplastic and neoplastic thyroid tissues in conjunction with human thyroid cancer cell lines. METHODS AND RESULTS: Immunohistochemical analyses demonstrated AQP3 in the cytoplasmic membrane of normal C cells, but not in follicular cells. In contrast, AQP4 was not found in C cells but was identified in normal follicular cells. AQP4 was positive in 92% of Graves' disease thyroids and 97% of multinodular goiters, and we failed to demonstrate AQP3 in these hyperplastic tissues. In neoplastic thyroid lesions, we observed AQP3 in 91% of medullary thyroid carcinomas but in no other follicular cell tumors. AQP4 was demonstrated in 100% of follicular adenomas, 90% of follicular carcinomas, and 85% of papillary carcinomas, while it was negative in all medullary carcinomas and undifferentiated carcinomas. Reverse transcriptase polymerase chain reaction (RT-PCR analyses revealed AQP3 mRNA expression only in medullary carcinomas and AQP4 mRNA expression in follicular cell-derived tumors except for undifferentiated carcinomas. In thyroid cancer cell lines, using RT-PCR and western blotting, AQP3 mRNA and protein were only identified in the TT cell line (human medullary carcinoma cell line and AQP4 in the other cell lines. In addition, AQP3 mRNA expression was up-regulated by FBS and calcium administration in both a dose and time dependent manner in TT cells. CONCLUSION: The differential expressions of AQP3 and AQP4 may reflect the biological nature and/or function of normal, hyperplastic, and neoplastic thyroid cells and additionally may have value in determining differential diagnoses of thyroid tumors.

  16. Diagnostic whole body scan (pre-therapy scan) in differentiated thyroid cancer: A single center community hospital experience.

    Science.gov (United States)

    Santhanam, P; Driscoll, H K; Venkatraman, P

    2016-01-01

    Diagnostic whole body scan (pre-therapy scan) with either I-123 or I-131 (radioactive isotopes of iodine) is performed to assess the extent of thyroid cancer especially distant metastasis prior to administering the therapeutic dose of I-131. Our aim of the following study was to determine the utility of the diagnostic pre-therapy scan in the management of differentiated thyroid cancer. It was a case-control study carried out by retrospective chart review, of a randomly selected 100 patients with differentiated thyroid cancer who had followed in our community hospital over the course of 1 year. We collected data on multiple variables in the subjects - including age, gender, pre-operative size of the nodules, diagnosis, stage of the malignancy, size of the tumor, multifocality, lymphovascular invasion, dose of radioiodine used for remnant ablation, recurrence rates and persistence rates. Continuous variables were compared using the independent sample Mann-Whitney U-test whereas the Chi-square test was used for nominal variables. The mean dose of radioactive iodine administered was 97.56 (±27.98) in the pre-therapy scan group and it was 97.23 (±32.40) in the control group. There was no difference between the two groups (P - 0.45). There was also no difference in the recurrence rates between the groups (P = 1.0). There was a trend toward a higher degree of persistent cancer in the group that had the pre-therapy scans (P - 0.086). Pre-therapy scan may not affect the dose of radio-iodine I-131 used for remnant ablation of differentiated thyroid cancer and does not influence the recurrence rates. This was especially true with respect to I-131 remnant ablation for low risk tumors.

  17. Thyroid Diseases

    Science.gov (United States)

    ... your thyroid gland does not make enough thyroid hormones Thyroid cancer Thyroid nodules - lumps in the thyroid gland Thyroiditis - swelling of the thyroid To diagnose thyroid diseases, doctors use a medical history, physical exam, and thyroid tests. They sometimes also ...

  18. Comparison of the diagnostic utility of digital pathology systems for telemicrobiology

    Directory of Open Access Journals (Sweden)

    Daniel D Rhoads

    2016-01-01

    Full Text Available Introduction: Telemicrobiology is a growing component of clinical microbiology informatics. However, few studies have been performed to assess the diagnostic utility of telemicroscopy systems in evaluating infectious agents. Objective: Evaluate multiple contemporary digital pathology platforms for use in diagnostic telemicrobiology. Materials and Methods: A mix of thirty cases that included viral, bacterial, fungal, and parasitological findings were evaluated by four experts using ×40 whole slide imaging (WSI scans, ×83 oil-immersion WSI scans, ×100 oil-immersion WSI scans, digital photomicrographs, and glass slides. Results: The ×83 WSI, ×100 WSI, and photomicrograph interpretations were not significantly different in quality and accuracy when compared to glass slide interpretations. The ×40 WSI interpretations were of lower quality and were more likely to be incorrect when compared to glass slide interpretations. Conclusions: In this study, high magnification, oil-immersion digital pathology platforms are better suited to support telemicrobiology applications and yield interpretations on par with glass slide evaluations.

  19. A diagnostic dilemma in breast pathology – benign fibroadenoma with multinucleated stromal giant cells

    Directory of Open Access Journals (Sweden)

    Tobbia Igdam

    2008-08-01

    Full Text Available Abstract Fibroadenomas are common benign breast tumours that display a characteristic pathological morphology, although several epithelial and stromal variations exist. A very rare histological finding is the presence of multinucleated giant cells throughout the stroma of a benign fibroadenoma. Cells of this type, which are more commonly found incidentally within the interlobular stroma of breast tissue, are benign and should not be mistaken for malignant cells on microscopic examination. Unfortunately a lack of awareness of this pathological entity can lead to diagnostic confusion amongst pathologists resulting in the multinucleate giant cells being mistaken for highly mitotic cells and consequently the fibroadenoma being mistaken for a malignant lesion. This may have serious implications for the subsequent management of the patient. The presence of this unusual cell type in the stroma does not alter the prognosis of otherwise benign lesion. We encountered two such cases at our institution in a six month period recently. We present their histories along with relevant radiological, microscopic and immunohistochemical features, followed by a discussion of this unusual pathological entity.

  20. Comparative analysis of diagnostic performance, feasibility and cost of different test-methods for thyroid nodules with indeterminate cytology.

    Science.gov (United States)

    Sciacchitano, Salvatore; Lavra, Luca; Ulivieri, Alessandra; Magi, Fiorenza; De Francesco, Gian Paolo; Bellotti, Carlo; Salehi, Leila B; Trovato, Maria; Drago, Carlo; Bartolazzi, Armando

    2017-07-25

    Since it is impossible to recognize malignancy at fine needle aspiration (FNA) cytology in indeterminate thyroid nodules, surgery is recommended for all of them. However, cancer rate at final histology is blood assay.We performed systematic reviews and meta-analyses to compare their features, feasibility, diagnostic performance and cost. GEC, GEC+BRAF, M/F panel+miRNA GEC and M/F panel by NGS were the best in ruling-out malignancy (sensitivity = 90%, 89%, 89% and 90% respectively). BRAF and M/F panel alone and by NGS were the best in ruling-in malignancy (specificity = 100%, 93% and 93%). The M/F by NGS showed the highest accuracy (92%) and BRAF the highest diagnostic odds ratio (DOR) (247). GAL-3-ICC performed well as rule-out (sensitivity = 83%) and rule-in test (specificity = 85%), with good accuracy (84%) and high DOR (27) and is one of the cheapest (113 USD) and easiest one to be performed in different clinical settings.In conclusion, the more accurate molecular-based test-methods are still expensive and restricted to few, highly specialized and centralized laboratories. GAL-3-ICC, although limited by some false negatives, represents the most suitable screening test-method to be applied on a large-scale basis in the diagnostic algorithm of indeterminate thyroid lesions.

  1. Digital pathology in the diagnostic setting: beyond technology into best practice and service management.

    Science.gov (United States)

    Cheng, Chee Leong; Tan, Puay Hoon

    2017-05-01

    Digital pathology (DP) and whole-slide imaging (WSI) technology have matured substantially over the last few years and there is growing evidence from validation studies that WSI is comparable to glass slides for histopathology diagnosis, although with some limitations, which can be appropriately minimised. Whether the controlled environment of validation studies translates to the same level of robustness when WSI is used in the actual diagnostic setting depends on the technical quality of WSI acquisition and on factors that influence the pre-image acquisition variables including the quality of glass slide inputs, and postimage acquisition variables such as access and use of WSI. The concept of 'DP service management' is introduced to fulfil the holistic needs of a laboratory intending to use the DP solution incorporating WSI for diagnostic purposes. The DP service management team should be an integral part of the diagnostic laboratory as it plays a central role undertaking responsibility to address an extensive range of issues from technical and training to governance and accreditation, hence ensuring a viable and sustainable diagnostic DP integration and usage. The pathologist as a specialist in the field and key decision maker of histopathology diagnoses has the duty and responsibility to acquaint and familiarise with DP and WSI when using the technology, especially on their indications and limitations, so as to take full advantage of these tools to enhance diagnostic quality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  2. Radiologic and pathologic findings of a follicular variant of papillary thyroid cancer with extensive stromal fat: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jn Woo; Kim, Tae Hyung; Roh, Hong Gee; Moon, Won Jin; Lee, Sang Hwa; Hwang, Tae Sook; Park, Kyoung Sik [Konkuk University Medical Center, Konkuk University School of Medicine, Seoul (Korea, Republic of)

    2015-12-15

    Thyroid cancer may have small adipose structures detected by microscopy. However, there are no reports of thyroid cancer with gross fat evaluated by radiological methods. We reported a case of a 58-year-old woman with a fat containing thyroid mass. The mass was hyperechoic and ovoid in shape with a smooth margin on ultrasonography. On computed tomography, the mass had markedly low attenuation suggestive of fat, and fine reticular and thick septa-like structures. The patient underwent a right lobectomy. The mass was finally diagnosed as a follicular variant of papillary thyroid cancer with massive stromal fat.

  3. Pocket pathologist: A mobile application for rapid diagnostic surgical pathology consultation

    Directory of Open Access Journals (Sweden)

    Douglas J Hartman

    2014-01-01

    Full Text Available Introduction: Telepathology allows the digital transmission of images for rapid access to pathology experts. Recent technologic advances in smartphones have allowed them to be used to acquire and transmit digital images of the glass slide, representing cost savings and efficiency gains over traditional forms of telepathology. We report our experience with developing an iPhone application (App - Pocket Pathologist to facilitate rapid diagnostic pathology teleconsultation utilizing a smartphone. Materials and Methods: A secure, web-based portal (http://pathconsult.upmc.com/ was created to facilitate remote transmission of digital images for teleconsultation. The App augments functionality of the web-based portal and allows the user to quickly and easily upload digital images for teleconsultation. Image quality of smartphone cameras was evaluated by capturing images using different adapters that directly attach phones to a microscope ocular lens. Results: The App was launched in August 2013. The App facilitated easy submission of cases for teleconsultation by limiting the number of data entry fields for users and enabling uploading of images from their smartphone′s gallery wirelessly. Smartphone cameras properly attached to a microscope create static digital images of similar quality to a commercial digital microscope camera. Conclusion: Smartphones have great potential to support telepathology because they are portable, provide ubiquitous internet connectivity, contain excellent digital cameras, and can be easily attached to a microscope. The Pocket Pathologist App represents a significant reduction in the cost of creating digital images and submitting them for teleconsultation. The iPhone App provides an easy solution for global users to submit digital pathology images to pathology experts for consultation.

  4. The place occupied by early measurement (20th minute) of the thyroid uptake of sup(99m)Tc pertechnetate in thyroid pathology

    International Nuclear Information System (INIS)

    Guilloteaux, Gerard.

    1977-01-01

    The place occupied by early measurement (20th minute) of the thyroid uptake of sup(99m)Tc pertechnetate is situated for different types of thyroid condition (hypo-, normo- and hyperthyroidism). The use of technetium is simple in practice because only the cervical and crural radioactivity measurements are required. Like all simplified methods it involves risks of errors but lends itself to systematic routine use. The practical advantages of this isotope, which in view of its short half-life appears with iodine 123 as the nearly ideal tracer for thyroid exploration at present are outlined. The thyroid gland can be studied both functionally and scintigraphically at the cost of minimum irradiation, which is a great advantage. The fact that a number of data may be obtained in less than an hour (including scintigraphy) is a particularly valuable asset. However the method has its limits. For example a diagnosis of hyper or hypothyroidism based on the technetium uptake at the 20th minute alone is out of the question. A zero uptake may be observed in the presence of Basedow's disease or conversely a high uptake in hypo- or euthyroid cases. Discrimination is satisfactory between hyper and euthyroid but not between eu- and hypothyroid subjects. Technological progress however promises a routine use of 123 I and 99mTc together, the two isotopes serving to explore two different phases of the thyroid metabolism [fr

  5. Shear-Wave Elastography for the Preoperative Risk Stratification of Follicular-patterned Lesions of the Thyroid: Diagnostic Accuracy and Optimal Measurement Plane.

    Science.gov (United States)

    Samir, Anthony E; Dhyani, Manish; Anvari, Arash; Prescott, Jason; Halpern, Elkan F; Faquin, William C; Stephen, Antonia

    2015-11-01

    To evaluate the diagnostic accuracy of shear-wave elastography (SWE) for the diagnosis of malignancy in follicular lesions and to identify the optimal SWE measurement plane. The institutional review board approved this HIPAA-compliant, single-institution, prospective pilot study. Subjects scheduled for surgery after a previous fine-needle aspiration report of "atypia of undetermined significance" or "follicular lesion of undetermined significance," "suspicion for follicular neoplasm," or "suspicion for Hurthle cell neoplasm," were enrolled after obtaining informed consent. Subjects underwent conventional ultrasonography (US), Doppler evaluation, and SWE preoperatively, and their predictive value for thyroid malignancy was evaluated relative to the reference standard of surgical pathologic findings. Thirty-five patients (12 men, 23 women) with a mean age of 55 years (range, 23-85 years) and a fine-needle aspiration diagnosis of atypia of undetermined significance or follicular lesion of undetermined significance (n = 16), suspicion for follicular neoplasm (n = 14), and suspicion for Hurthle cell neoplasm (n = 5) were enrolled in the study. Male sex was a statistically significant (P = .02) predictor of malignancy, but age was not. No sonographic morphologic parameter, including nodule size, microcalcification, macrocalcification, halo sign, taller than wide dimension, or hypoechogenicity, was associated with malignancy. Similarly, no Doppler feature, including intranodular vascularity, pulsatility index, resistive index, or peak-systolic velocity, was associated with malignancy. Higher median SWE tissue Young modulus estimates from the transverse insonation plane were associated with malignancy, yielding an area under the receiver operating characteristic curve of 0.81 (95% confidence interval: 0.62, 1.00) for differentiation of malignant from benign nodules. At a cutoff value of 22.3 kPa, sensitivity, specificity, positive predictive value, and negative predictive

  6. Treatment and survival of patients with thyroid lymphoma : A population-based study with clinical and pathologic reviews

    NARCIS (Netherlands)

    Kuper-Hommel, M.J.; Snijder, S.; Jansen-Heijnen, M.L.; Vreugdenhil, A.; Noordijk, E.M.; Kluin-Nelemans, Hanneke; Coebergh, J.W.; van Krieken, J.H.

    2005-01-01

    Purpose: The purpose of this study was to determine the incidence, clinical and histologic features, and patterns of outcome of thyroid lymphomas. Patients and Methods: A retrospective population-based survey of 38 patients with thyroid lymphoma was taken. Median age was 69 years (range, 33-87

  7. Evaluation of the diagnostic capacity of the DETEC-PC for the attract of iodine in thyroid

    International Nuclear Information System (INIS)

    Alonso A, D.; Arista R, E.; Alonso A, A.

    2006-01-01

    A comparative study whose main objective is the evaluation of the diagnoses capacity of the DETEC - PC, a detection-measurement system for the reception of iodine in thyroid, with it presumptive diagnostic is presented. To such effect a clinical essay was designed in which all the patients included in the study were evaluated using the new equipment (DETEC - PC) and the standard diagnoses procedure well-known for the initials RIA. The sample size was calculated in a such way that the percent of gross coincidence among both methods could be estimate with a precision of 1% at a trust level of 95%. In total 110 patients were included in the essay. For the analysis of the agreement in the diagnostic it was used the Kappa statistician. The obtained results showed a high grade of gross agreement and an agreement level among moderate and substantial when it was corrected by possible random agreement among both procedures. (Author)

  8. Modern approaches to diagnostics of combined degenerative hip and spine pathology

    Directory of Open Access Journals (Sweden)

    V. V. Khominets

    2014-01-01

    Full Text Available The results of standard radiographs of 90 patients with hip-spine syndrome associated with one unilateral or bilateral III stage hip osteoarthhrosis were analyzed with the aim to improve the diagnostics of pathological changes in the "hip joint-pelvis- spine" complex. 12 parameters of sagittal spinal-pelvic balance and 3 parameters of frontal one were studied and the degenerative changes in spinal motional segments were evaluated. The statistical processing of obtained data was made. It was stated that the most frequent variant of sagittal spinal-pelvic profile is hyperlordosic one, followed by formation of degenerative changes especially in dorsal regions of spine (р=0,076.The strategy of patient examination with hip-spine syndrome was established from clinical and radiographic positions.

  9. An evaluation of generalized periodontitis treatment, based on diagnostics of pathological teeth mobility, using periotestometry. Clinical review

    Directory of Open Access Journals (Sweden)

    Т. І. Matviykiv

    2017-10-01

    Full Text Available The aim – to evaluate the effectiveness of the periodontal treatment using the method of periotestometry at the stage of early periodontal pathology diagnostics and record physiological mobility shift into pathological mobility. Materials and methods. Observed and treated 117 patients, diagnosed with chronic generalized periodontitis (GP of I–II degree (chronic course. Сlinical status of the oral cavity was evaluated based on: Yasynovsky Probe (immigration of leukocytes into the oral cavity, PMA Index, Greene–Vermillion hygienical index, Kulazhenko Probe. At the stages of complex periodontal treatment the measurements of the teeth mobility (in the area of the teeth involved in the pathological process, prosthetic appliances were carried out using automative pulse method periotestometry by application of the "Periotest-M" device (V. I. Herelyuk, T. I. Matviykiv, 2014. Results. At the stage of early diagnostics of periodontal pathology based on the results of mobility measurements, the change of physiological mobility into a pathological was assessed. Upon receipt of sustainability of pathological mobility indicators, as well as clinical indeces the remission of dystrophic-inflammatory processes in the periodontium were evaluated. Conclusion. Evaluating the effectiveness of GP treatment based on the study of pathological teeth mobility using periotestometry allows to optimize and correct complex periodontal treatment on its stages. An addidion of the periotestometry method on the stages of generalized periodontitis treatment will prolongate remission of this pathology in the future. chronic periodontitis; tooth mobility; periotestometry; combined modality therapy

  10. Advanced diagnostic methods in oral and maxillofacial pathology. Part I: molecular methods.

    Science.gov (United States)

    Jordan, R C; Daniels, T E; Greenspan, J S; Regezi, J A

    2001-12-01

    The practice of pathology is currently undergoing significant change, in large part due to advances in the analysis of DNA, RNA, and proteins in tissues. These advances have permitted improved biologic insights into many developmental, inflammatory, metabolic, infectious, and neoplastic diseases. Moreover, molecular analysis has also led to improvements in accuracy of disease diagnosis and classification. It is likely that, in the future, these methods will increasingly enter into the day-to-day diagnosis and management of patients. The pathologist will continue to play a fundamental role in diagnosis and will likely be in a pivotal position to guide the implementation and interpretation of these tests as they move from the research laboratory into diagnostic pathology. The purpose of this 2-part series is to provide an overview of the principles and applications of current molecular biologic and immunologic tests. Part I will discuss the biologic fundamentals of DNA, RNA, and proteins and the methods that are currently available or likely to become available to the pathologist in the next several years for their isolation and analysis in tissue biopsies.

  11. HRCT appearances of pulmonary interstitial diseases. The pathologic basis and clinical diagnostic significance

    International Nuclear Information System (INIS)

    Ma Daqing; Li Tieyi; Guan Yansheng; He Wen; Nie Yongkang

    1999-01-01

    Objective: To evaluate the CT appearances, the pathologic basis and diagnostic significance of pulmonary interstitial diseases. methods: 14 isolated lungs with interstitial diseases were obtained at autopsy and surgery. The lungs were inflated and fixed. HRCT and 1 cm thin slice soft X-ray radiograph were performed and then histologic examination was done. HRCT images of 72 cases with interstitial diseases were analysed. The HRCT appearances of 10 cases were followed up for 1.5-7.0 years. Results: According to HRCT-pathologic correlation, pulmonary interstitial diseases had the following HRCT findings: (1) Intralobular interstitial thickening (33 cases, 46%), including fine linear, reticular and radiating appearances and the interface sign. (2) Interlobular septal thickening (24 cases, 33%). (3) Thickening of bronchovesicular bundles (35 cases, 49%), with coarse, blurred or smooth bundle, and nodular shape. (4) Subpleural lines (31 cases, 43%). (5) Ground-glass opacity (22 cases, 31%) with peripheral, diffuse or locular distribution. (6) Honeycombing (27 cases, 38%), having sizes: 5 mm. Of the 10 cases with follow-up, 2 cases became normal on CT and 8 cases progressing to honeycombed lung. Conclusions: The HRCT findings of pulmonary interstitial diseases represent abnormalities of axial, peripheral and septal interstitium. Interstitial fibrosis of the lung can be differentiated from that without fibrosis by HRCT. Ground-glass opacity, intralobular interstitial thickening and subpleural lines are preliminary findings of pulmonary interstitial fibrosis

  12. Opportunities and challenges associated with clinical diagnostic genome sequencing: a report of the Association for Molecular Pathology.

    Science.gov (United States)

    Schrijver, Iris; Aziz, Nazneen; Farkas, Daniel H; Furtado, Manohar; Gonzalez, Andrea Ferreira; Greiner, Timothy C; Grody, Wayne W; Hambuch, Tina; Kalman, Lisa; Kant, Jeffrey A; Klein, Roger D; Leonard, Debra G B; Lubin, Ira M; Mao, Rong; Nagan, Narasimhan; Pratt, Victoria M; Sobel, Mark E; Voelkerding, Karl V; Gibson, Jane S

    2012-11-01

    This report of the Whole Genome Analysis group of the Association for Molecular Pathology illuminates the opportunities and challenges associated with clinical diagnostic genome sequencing. With the reality of clinical application of next-generation sequencing, technical aspects of molecular testing can be accomplished at greater speed and with higher volume, while much information is obtained. Although this testing is a next logical step for molecular pathology laboratories, the potential impact on the diagnostic process and clinical correlations is extraordinary and clinical interpretation will be challenging. We review the rapidly evolving technologies; provide application examples; discuss aspects of clinical utility, ethics, and consent; and address the analytic, postanalytic, and professional implications. Copyright © 2012 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.

  13. A prospective study of shoulder pain in primary care: Prevalence of imaged pathology and response to guided diagnostic blocks

    Directory of Open Access Journals (Sweden)

    McNair Peter J

    2011-05-01

    Full Text Available Abstract Background The prevalence of imaged pathology in primary care has received little attention and the relevance of identified pathology to symptoms remains unclear. This paper reports the prevalence of imaged pathology and the association between pathology and response to diagnostic blocks into the subacromial bursa (SAB, acromioclavicular joint (ACJ and glenohumeral joint (GHJ. Methods Consecutive patients with shoulder pain recruited from primary care underwent standardised x-ray, diagnostic ultrasound scan and diagnostic injections of local anaesthetic into the SAB and ACJ. Subjects who reported less than 80% reduction in pain following either of these injections were referred for a magnetic resonance arthrogram (MRA and GHJ diagnostic block. Differences in proportions of positive and negative imaging findings in the anaesthetic response groups were assessed using Fishers test and odds ratios were calculated a for positive anaesthetic response (PAR to diagnostic blocks. Results In the 208 subjects recruited, the rotator cuff and SAB displayed the highest prevalence of pathology on both ultrasound (50% and 31% respectively and MRA (65% and 76% respectively. The prevalence of PAR following SAB injection was 34% and ACJ injection 14%. Of the 59% reporting a negative anaesthetic response (NAR for both of these injections, 16% demonstrated a PAR to GHJ injection. A full thickness tear of supraspinatus on ultrasound was associated with PAR to SAB injection (OR 5.02; p p p p ≤ 0.05. Conclusions Rotator cuff and SAB pathology were the most common findings on ultrasound and MRA. Evidence of a full thickness supraspinatus tear was associated with symptoms arising from the subacromial region, and a biceps tendon sheath effusion and an intact rotator cuff were associated with an intra-articular GHJ pain source. When combined with clinical information, these results may help guide diagnostic decision making in primary care.

  14. Cytological Diagnostic Approach in 3 Cases of Langerhans Cell Histiocytosis Presenting Primarily as a Thyroid Mass.

    Science.gov (United States)

    Oza, Nikita; Sanghvi, Kintan; Menon, Santosh; Pant, Vinita; Patil, Meenal; Kane, Shubhada

    2015-01-01

    Langerhans cell histiocytosis (LCH) is a monoclonal disease of specialised histiocytes characterised by the proliferation of neoplastic Langerhans cells (LCs) with a varying admixture of mature lymphocytes, eosinophils and plasma cells. LCH commonly occurs in the paediatric population and young adults with the involvement of bone, skin and lymph nodes. LCH has a protracted clinical course with an overall mortality rate of 3%. Primary involvement of the thyroid gland in LCH at presentation is a rare phenomenon that can result in misdiagnosis with consequent mismanagement. Ultrasound-guided fine-needle aspiration cytology (FNAC) of the thyroid was performed in 3 cases at a tertiary cancer centre, including 2 referral cases where the patient presented with the only symptom of progressive thyroid enlargement. These cases were reported initially or on review and the results were correlated with histology/ancillary techniques. A cytological diagnosis of suspicion for LCH was offered in 2 cases at our centre and 1 case was referred to our centre with a diagnosis of suspected papillary thyroid carcinoma. On review of outside smears at our centre, the diagnosis was changed to suspected LCH. The diagnosis was confirmed by immunopositivity for CD68, CD1a and S100 in 1 case and Tru-cut biopsy followed by immunohistochemistry for CD1a, S100, TTF-1 and LCA in the other 2 cases. FNAC was helpful in accurately diagnosing LCH even though the presentation was unusual. Thus, unnecessary surgery was obviated. © 2015 S. Karger AG, Basel.

  15. Impact of recombinant TSH on quality of life in thyroid carcinoma patients undergoing remnant ablation or diagnostic whole body scanning

    International Nuclear Information System (INIS)

    Schroeder, Pamela R.; Ladenson, Paul W.; for the Members of the Thyrogen Trials

    2005-01-01

    Full text: Thyroid remnant ablation with 131 I is often necessary in the initial treatment of thyroid carcinoma. A recent study demonstrated that use of recombinant TSH (rh TSH) was equivalently effective to withdrawal from levothyroxine (L-T 4 ) for postoperative remnant ablation. Quality of life was also shown to be negatively impacted in patients withdrawn from L-T 4 , but not those maintained euthyroid and treated after rh TSH. In this study, we compare the impact of rh TSH on quality of life in patients undergoing remnant ablation versus those undergoing diagnostic whole body scanning (WBS) in a previous trial. Health-related quality of life was measured using the SF-36 survey, which consists of 8 domains describing the physical and mental functioning of patients and 2 physical and mental summary domains, in both trials at baseline on L-T 4 , after rh TSH while on L-T 4 and after L-T 4 withdrawal. Mean SF-36 scores declined from the rh TSH treatment versus L-T 4 withdrawal in both trials to a similar extent in all 8 domains and the 2 summary domains, as evidenced by overlapping 95% confidence intervals. Further SF-6D scores, which summarize all 8 domains in a single zero-to-one metric, were used to characterize the overall quality of life among patients in the two trials. The SF-6D scores for patients after rh TSH administration in the diagnostic and ablation trials were 0.803 and 0.714, respectively. In contrast, SF-6D scores for patients undergoing L-T 4 withdrawal in the diagnostic and ablation trials were 0.637 and 0.548, respectively (p 4 withdrawal both experience a comparable decrease in quality of life, which can be prevented by use of rh TSH in the euthyroid state. (author)

  16. Commentary on pathologic diagnosis of asbestosis and critique of the 2010 Asbestosis Committee of the College of American Pathologists (CAP) and Pulmonary Pathology Society's (PPS) update on the diagnostic criteria for pathologic asbestosis.

    Science.gov (United States)

    Hammar, Samuel P; Abraham, Jerrold L

    2015-10-01

    We reviewed the 2010 Asbestosis Committee's update on the diagnostic criteria for pathologic asbestosis. We must respectfully disagree with many of the criteria set forth therein, especially for recognizing asbestosis at its earliest stages; with statements focusing on the number of asbestos bodies needed in order to make a pathologic diagnosis of asbestosis; and regarding the benefits and pitfalls of relying on fiber analysis for diagnostic purposes, especially where chrysotile asbestos is concerned, including the methodology used for fiber determination. This critique has become even more relevant with the 2014 Helsinki criteria publication, which adopted the 2010 CAP/PPS criteria. Based on our review of these newer criteria and our experience in this field, we find that the CAP-NIOSH 1982 criteria is still the most acceptable method for the pathologic diagnosis and grading of asbestosis, which can be described as pulmonary fibrosis caused by inhalation of asbestos fibers. © 2015 Wiley Periodicals, Inc.

  17. Circulating levels of PTEN and KLLN in papillary thyroid carcinoma: can they be considered as novel diagnostic biomarkers?

    Science.gov (United States)

    Razavi, S Adeleh; Modarressi, Mohammad Hossein; Yaghmaei, Parichehr; Tavangar, S Mohammad; Hedayati, Mehdi

    2017-09-01

    PTEN and KLLN are two tumor suppressor genes located in 10q23, share a bidirectional promoter and have roles in carcinogenesis. Formerly, the role of PTEN mutations and KLLN epimutations were identified in incidence of thyroid lesions in individuals with Cowden syndrome, a rare autosomal dominant inherited disorder. This study is the first of its type to assess PTEN and KLLN circulating levels in patients with sporadic papillary thyroid carcinoma (PTC) and compare to patients with multinodular goiter (MNG) and healthy individuals. Plasma levels of PTEN and KLLN were determined by enzyme-linked immunosorbent assay in three groups consisted of PTC (n = 33), MNG (n = 26) and healthy persons (n = 30). The association of demographic/pathological characteristics with the levels of PTEN and KLLN were evaluated. A significant lower plasma levels of PTEN and KLLN were observed in PTC patients compared with those of healthy persons (PTEN, 9.43 ± 3.20 vs. 16.96 ± 1.28 ng/ml, P = 0.000; KLLN, 1.81 ± 0.83 vs. 2.57 ± 1.09 ng/ml, P = 0.005), while no statistical difference was found between PTC and MNG groups. Patients with MNG lesion had significantly lower levels of PTEN/KLLN (PTEN, 9.62 ± 2.97 vs. 16.96 ± 1.28 ng/ml, P = 0.000; KLLN, 1.34 ± 0.86 vs. 2.57 ± 1.09 ng/ml, P = 0.000) compared to the healthy controls. The demographic/pathological characteristics did not demonstrate an association with the levels of PTEN and KLLN. The study suggests that the lowered levels of PTEN and KLLN are associated with both sporadic PTC and MNG tumorigenesis, but they cannot be considered as circulating biomarkers for differential diagnosis between malignancy and benignity in indeterminate thyroid nodules.

  18. 'Focal thyroid inferno' on color Doppler ultrasonography: A specific feature of focal Hashimoto's thyroiditis

    Energy Technology Data Exchange (ETDEWEB)

    Fu, Xianshui, E-mail: fuxs1968@163.com [Department of Ultrasound, Peking University Third Hospital, 49 Huayuanbeilu Road, Beijing 100191 (China); Guo, Limei, E-mail: guolimei@bjmu.edu.cn [Department of Pathology, Peking University Third Hospital, 49 Huayuanbeilu Road, Beijing 100191 (China); Zhang, Huabin, E-mail: huabinzhang@bjmu.edu.cn [Department of Ultrasound, Peking University Third Hospital, 49 Huayuanbeilu Road, Beijing 100191 (China); Ran, Weiqiang, E-mail: ranwq-sina@vip.sina.com [Department of Ultrasound, Peking University Third Hospital, 49 Huayuanbeilu Road, Beijing 100191 (China); Fu, Peng, E-mail: fupeng01@gmail.com [Department of Ultrasound, Peking University Third Hospital, 49 Huayuanbeilu Road, Beijing 100191 (China); Li, Zhiqiang, E-mail: lizhq126@126.com [Department of Ultrasound, Peking University Third Hospital, 49 Huayuanbeilu Road, Beijing 100191 (China); Chen, Wen, E-mail: wendy7989@sina.com [Department of Ultrasound, Peking University Third Hospital, 49 Huayuanbeilu Road, Beijing 100191 (China); Jiang, Ling, E-mail: papayaling@yahoo.com.cn [Department of Ultrasound, Peking University Third Hospital, 49 Huayuanbeilu Road, Beijing 100191 (China); Wang, Jinrui, E-mail: jinrui_wang@sina.com [Department of Ultrasound, Peking University Third Hospital, 49 Huayuanbeilu Road, Beijing 100191 (China); Jia, Jianwen, E-mail: drjia88@sohu.com [Department of Ultrasound, Peking University Third Hospital, 49 Huayuanbeilu Road, Beijing 100191 (China)

    2012-11-15

    Purpose: To evaluate color-Doppler features predictive of focal Hashimoto's thyroiditis. Materials and methods: A total of 521 patients with 561 thyroid nodules that underwent surgeries or gun biopsies were included in this study. These nodules were divided into three groups: focal Hashimoto's thyroiditis (104 nodules in 101 patients), benignity other than focal Hashimoto's thyroiditis (73 nodules in 70 patients), and malignancy (358 nodules in 350 patients). On color Doppler sonography, four vascularity types were determined as: hypovascularity, marked internal flow, marked peripheral flow and focal thyroid inferno. The {chi}{sup 2} test was performed to seek the potential vascularity type with the predictive ability of certain thyroid pathology. Furthermore, the gray-scale features of each nodule were also studied. Results: The vascularity type I (hypovascularity) was more often seen in focal Hashimoto's thyroiditis than other benignity and malignancy (46% vs. 20.5% and 19%). While the type II (marked internal flow) showed the opposite tendency (26.9% [focal Hashimoto's thyroiditis] vs. 45.2% [other benignity] and 52.8% [malignancy]). However, type III (marked peripheral flow) was unable to predict any thyroid pathology. Importantly, type IV (focal thyroid inferno) was exclusive to focal Hashimoto's thyroiditis. All 8 type IV nodules appeared to be solid, hypoechoic, and well-defined. Using 'focal thyroid inferno' as an indicator of FHT, the diagnostic sensitivity and specificity were 7.7% and 100% respectively. Conclusions: The vascularity type of 'focal thyroid inferno' is specific for focal Hashimoto thyroiditis. Recognition of this particular feature may avoid unnecessary interventional procedures for some solid hypoechoic thyroid nodules suspicious of malignancy.

  19. Structure of the thyroid pathology in the radiation exposed areas of Leningrad region: late consequences of Chernobyl accident after 20 years

    Energy Technology Data Exchange (ETDEWEB)

    Semenov, A.; Uspenskaya, A.; Bychenkova, E.; Chinchuk, I.; Novokshonov, K.; Chernikov, R.; Sleptsov, I.; Bubnov, A.; Fedotov, Y.; Makarin, V.; Karelina, Y. [Endocrinology, NWRMC FHSDA, ST-Petersburg (Russian Federation)

    2012-07-01

    After the Chernobyl accident large areas of the USSR were contaminated with fallout, it has been proved that I{sup 131} caused higher incidence of papillary thyroid cancer in children and adolescents. Further observation for over 20 years showed retention of high annual prevalence of this pathology among the population. The aim of this study is to evaluate the ultimate result of the influence of I{sup 131} on the thyroid gland. The study included 454 women living in localities affected by the Chernobyl accident in April-May 1986 (case) and 909 women living in fallout-free localities (ICCIDD method). The incidence of malignant thyroid tumors among the inhabitants of the contaminated territories is higher than in the control area. This phenomenon can not be unambiguously attributed to radiation induced cancers, but requires further investigation, perhaps by the method of carrying out continuous and all-round prophylactic medical examination. High incidence of autoimmune changes can be considered to have been caused by the action of I{sup 131} and prophylactic supplement with stable iodine

  20. Is Diagnostic Performance of Quantitative 2D-Shear Wave Elastography Optimal for Clinical Classification of Benign and Malignant Thyroid Nodules?: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Nattabi, Haliimah A; Sharif, Norhafidzah M; Yahya, Noorazrul; Ahmad, Rozilawati; Mohamad, Mazlyfarina; Zaki, Faizah M; Yusoff, Ahmad N

    2017-10-17

    This study is a dedicated 2D-shear wave elastography (2D-SWE) review aimed at systematically eliciting up-to-date evidence of its clinical value in differential diagnosis of benign and malignant thyroid nodules. PubMed, Web of Science, and Scopus databases were searched for studies assessing the diagnostic value of 2D-SWE for thyroid malignancy risk stratification published until December 2016. The retrieved titles and abstracts were screened and evaluated according to the predefined inclusion and exclusion criteria. Methodological quality of the studies was assessed using the Quality Assessment of Studies of Diagnostic Accuracy included in Systematic Review 2 (QUADAS-2) tool. Extracted 2D-SWE diagnostic performance data were meta-analyzed to assess the summary sensitivity, specificity, and area under the receiver operating characteristic curve. After stepwise review, 14 studies in which 2D-SWE was used to evaluate 2851 thyroid nodules (1092 malignant, 1759 benign) from 2139 patients were selected for the current study. Study quality on QUADAS-2 assessment was moderate to high. The summary sensitivity, specificity and area under the receiver operating characteristic curve of 2D-SWE for differential diagnosis of benign and malignant thyroid nodules were 0.66 (95% confidence interval [CI]: 0.64-0.69), 0.78 (CI: 0.76-0.80), and 0.851 (Q* = 0.85), respectively. The pooled diagnostic odds ratio, negative likelihood ratio, and positive likelihood ratio were 12.73 (CI: 8.80-18.43), 0.31 (CI: 0.22-0.44), and 3.87 (CI: 2.83-5.29), respectively. Diagnostic performance of quantitative 2D-SWE for malignancy risk stratification of thyroid nodules is suboptimal with mediocre sensitivity and specificity, contrary to earlier reports of excellence. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  1. Development of Pathological Diagnostics of Human Kidney Cancer by Multiple Staining Using New Fluorescent Fluolid Dyes

    Directory of Open Access Journals (Sweden)

    Dilibaier Wuxiuer

    2014-01-01

    Full Text Available New fluorescent Fluolid dyes have advantages over others such as stability against heat, dryness, and excess light. Here, we performed simultaneous immunostaining of renal tumors, clear cell renal cell carcinoma (RCC, papillary RCC, chromophobe RCC, acquired cystic disease-associated RCC (ACD-RCC, and renal angiomyolipoma (AML, with primary antibodies against Kank1, cytokeratin 7 (CK7, and CD10, which were detected with secondary antibodies labeled with Fluolid-Orange, Fluolid-Green, and Alexa Fluor 647, respectively. Kank1 was stained in normal renal tubules, papillary RCC, and ACD-RCC, and weakly or negatively in all other tumors. CK7 was positive in normal renal tubules, papillary RCC, and ACD-RCC. In contrast, CD10 was expressed in renal tubules and clear cell RCC, papillary RCC, AML, and AC-RCC, and weakly in chromophobe RCC. These results may contribute to differentiating renal tumors and subtypes of RCCs. We also examined the stability of fluorescence and found that fluorescent images of Fluolid dyes were identical between a tissue section and the same section after it was stored for almost three years at room temperature. This indicates that tissue sections can be stored at room temperature for a relatively long time after they are stained with multiple fluorescent markers, which could open a door for pathological diagnostics.

  2. Concurrent Intrathyroidal Thyroid Cancer and Thyroid Cancer in Struma Ovarii: A Case Report and Literature Review.

    Science.gov (United States)

    Middelbeek, Roeland J W; O'Neill, Brian T; Nishino, Michiya; Pallotta, Johanna A

    2017-05-01

    The presence of differentiated thyroid cancer in mature cystic teratomas in the ovaries is rare, and usually incidentally found on surgical pathology specimens. We present a case of simultaneous intrathyroidal thyroid cancer and thyroid cancer within a struma ovarii, presenting specific diagnostic challenges. A 55-year-old woman had an intrathyroidal, encapsulated 1.2-cm papillary thyroid carcinoma, follicular variant, which was resected. Laboratory studies showed an elevated thyroglobulin level of 35 ng/mL while on suppressive levothyroxine therapy. During preparation for radioactive iodine ablation, thyroglobulin increased dramatically to 3490 ng/mL. A pretreatment whole-body scan showed residual tracer uptake in the thyroid bed and increased radiotracer uptake in the pelvis that raised concern for a pelvic metastasis, given the marked thyroglobulin elevation. After ablation, the posttreatment scan showed intense focal uptake in the pelvis. Single-photon emission computed tomography-computed tomography confirmed that the tracer uptake corresponded to a right adnexal mass. The patient underwent a laparoscopic bilateral salpingo-oophorecotomy with pelvic washings. The final pathology of the right ovary showed papillary thyroid carcinoma arising in a mature cystic teratoma. In addition, there was abundant normal thyroid tissue with colloid surrounding the carcinoma, indicating a source for the dramatic rise in thyroglobulin levels and suggesting that the ovarian papillary thyroid cancer arose within the teratoma and was not metastatic disease. Thyroglobulin measurements have been undetectable for 5 years since surgery and radioiodine treatment. Concurrent intrathyroidal thyroid cancer and differentiated thyroid cancer in struma ovarii are very rare, but can often be distinguished on clinical grounds.

  3. Prevalence of the B Type Raf Kinase V600E Mutation in Cytologically Indeterminate Thyroid Nodules: Correlation with Ultrasonographic and Pathologic Features

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chae Hyun; Choi, Yoon Jung; Choi, Seon Hyeong; Rho, Myong Ho Kook Shin Ho; Chung, Eun Chul [Dept. of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine, Seoul (Korea, Republic of); Chae, Seoung Wan; Kim, Dong Hoon; Sohn, Jin Hee [Dept. of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine, Seoul (Korea, Republic of); Yun, Ji Sup [Dept. of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine, Seoul (Korea, Republic of)

    2012-01-15

    To study the prevalence of B type Raf kinase (BRAF) mutations, and to evaluate the ultrasonographic and clinicopathological features associated with thyroid cytology of indeterminate nodules. We assessed the presence or absence of BRAF mutation in 44 specimens from patients with cytologically indeterminate thyroid nodules according to two consecutive preoperative fine needle aspiration cytology procedures. In 9 specimens, the test for BRAF mutation was not possible due to scant cellularity. DNA was extracted from the atypical cells and then analyzed for the BRAF V600E mutation by pyrosequencing. The ultrasonographic and clinicopathological features of the patients were characterized according to their mutation status. The BRAF V600E mutation was present in 17 (48.6%) of 35 patients with indeterminate cytology results and in 17 (54.8%) of the 31 patients with papillary thyroid cancer (PTC). Twenty two of 35 cytologically indeterminate nodules had calcifications, and among them 14 cases were proven to be positive for BRAF V600E mutations. Extrathyroid extension was significantly more frequent in the presence of the BRAF V600E mutation (p = 0.027), while tumor size, lympho-vascular invasion, or lymph node metastasis were not associated with the mutation. Screening for BRAF V600E mutations in conjunction with cytology may increase the diagnostic accuracy for PTC with indeterminate cytology results.

  4. Analysis of thyroid malignant pathologic findings identified during 3 rounds of screening (1997-2008) of a cohort of children and adolescents from belarus exposed to radioiodines after the Chernobyl accident.

    Science.gov (United States)

    Zablotska, Lydia B; Nadyrov, Eldar A; Rozhko, Alexander V; Gong, Zhihong; Polyanskaya, Olga N; McConnell, Robert J; O'Kane, Patrick; Brenner, Alina V; Little, Mark P; Ostroumova, Evgenia; Bouville, Andre; Drozdovitch, Vladimir; Minenko, Viktor; Demidchik, Yuri; Nerovnya, Alexander; Yauseyenka, Vassilina; Savasteeva, Irina; Nikonovich, Sergey; Mabuchi, Kiyohiko; Hatch, Maureen

    2015-02-01

    Recent studies of children and adolescents who were exposed to radioactive iodine-131 (I-131) after the 1986 Chernobyl nuclear accident in Ukraine exhibited a significant dose-related increase in the risk of thyroid cancer, but the association of radiation doses with tumor histologic and morphologic features is not clear. A cohort of 11,664 individuals in Belarus who were aged ≤18 years at the time of the accident underwent 3 cycles of thyroid screening during 1997 to 2008. I-131 thyroid doses were estimated from individual thyroid activity measurements taken within 2 months after the accident and from dosimetric questionnaire data. Demographic, clinical, and tumor pathologic characteristics of the patients with thyroid cancer were analyzed using 1-way analysis of variance, chi-square tests or Fisher exact tests, and logistic regression. In total, 158 thyroid cancers were identified as a result of screening. The majority of patients had T1a and T1b tumors (93.7%), with many positive regional lymph nodes (N1; 60.6%) but few distant metastases (M1; <1%). Higher I-131 doses were associated with higher frequency of solid and diffuse sclerosing variants of thyroid cancer (P < .01) and histologic features of cancer aggressiveness, such as lymphatic vessel invasion, intrathyroidal infiltration, and multifocality (all P < .03). Latency was not correlated with radiation dose. Fifty-two patients with self-reported thyroid cancers which were diagnosed before 1997 were younger at the time of the accident and had a higher percentage of solid variant cancers compared with patients who had screening-detected thyroid cancers (all P < .0001). I-131 thyroid radiation doses were associated with a significantly greater frequency of solid and diffuse sclerosing variants of thyroid cancer and various features of tumor aggressiveness. © 2014 American Cancer Society.

  5. Functional scintigraphy of the thyroid

    International Nuclear Information System (INIS)

    Baehre, M.; Emrich, D.

    1983-01-01

    In order to obtain more diagnostic information by thyroid scintigraphy we used a gamma camera with a high resolution collimator and a computer. This led to an improvement of thyroid scintigrams and their documentation. Additionally it allowed to obtain values for global and regional uptake of pertechnetate before and under suppression. The usefulness of this method was proven by investigation of 50 individuals with normal thyroid function and 32 euthyroid patients with pathological suppressibility in an area of iodine deficiency. In normals global thyroid uptake and its suppression correlated with the FT 4 I and Δ TSH after TRH in dependence of their iodine excretion. Three types of pathological reaction under suppression could be delineated: 1. pure focal autonomy, 2. generalized (disseminated) autonomy, 3. combined focal and disseminated autonomy. The means of Δ TSH decreased stepwise from group 1 to 3 indicating increasing autonomy. The method is predominantly helpful to detect autonomy in euthyroid goitre. It is superior to qualitative evaluation of scintigrams. Additionally it is useful for decisions in therapy, especially for functionally orientated operation. (orig.) [de

  6. Expression of ck-19, galectin-3 and hbme-1 in the differentiation of thyroid lesions: systematic review and diagnostic meta-analysis

    Directory of Open Access Journals (Sweden)

    de Matos Leandro

    2012-08-01

    Full Text Available Abstract Background To distinguish between malignant and benign lesions of the thyroid gland histological demonstration is often required since the fine-needle aspiration biopsy method applied pre-operatively has some limitations. In an attempt to improve diagnostic accuracy, markers using immunocytochemistry and immunohistochemistry techniques have been studied, mainly cytokeratin-19 (CK-19, galectin-3 (Gal-3 and Hector Battifora mesothelial-1 (HBME-1. However, current results remain controversial. The aim of the present article was to establish the diagnostic accuracy of CK-19, Gal-3 and HBME-1 markers, as well as their associations, in the differentiation of malignant and benign thyroid lesions. Methods A systematic review of published articles on MEDLINE and The Cochrane Library was performed. After establishing inclusion and exclusion criteria, 66 articles were selected. The technique of meta-analysis of diagnostic accuracy was employed and global values of sensitivity, specificity, area under the summary ROC curve, and diagnostic odds ratio (dOR were calculated. Results For the immunohistochemistry technique, the positivity of CK-19 for the diagnosis of malignant thyroid lesions demonstrated global sensitivity of 81% and specificity of 73%; for Gal-3, sensitivity of 82% and specificity of 81%; and for HBME-1, sensitivity of 77% and specificity of 83%. The association of the three markers determined sensitivity of 85%, specificity of 97%, and diagnostic odds ratio of 95.1. Similar results were also found for the immunocytochemistry assay. Conclusion This meta-analysis demonstrated that the three immunomarkers studied are accurate in pre- and postoperative diagnosis of benign and malignant thyroid lesions. Nevertheless, the search for other molecular markers must continue in order to enhance this diagnostic accuracy since the results found still show a persistency of false-negative and false-positive tests. Virtual slides Http

  7. Change of dynamics of development of a thyroid gland at children of school age of the both Gomel' and Mogilev area

    International Nuclear Information System (INIS)

    Sidorovich, M.V.; Loban, S.M.

    2009-01-01

    The given work estimates dynamics of development of a thyroid gland depending on age and anthopometrical parameters at children of school age. Results of work can be used in the further researches on the given subjects, for diagnostics of pathologies of a thyroid gland and their prevention, forecasting of groups of risk of diseases by a thyroid gland of children of school age and teenagers depending on development of anatomic, anthopometrical and age data. (authors)

  8. Molecular Pathology and Personalized Medicine: The Dawn of a New Era in Companion Diagnostics-Practical Considerations about Companion Diagnostics for Non-Small-Cell-Lung-Cancer.

    Science.gov (United States)

    Plönes, Till; Engel-Riedel, Walburga; Stoelben, Erich; Limmroth, Christina; Schildgen, Oliver; Schildgen, Verena

    2016-01-15

    Companion diagnostics (CDx) have become a major tool in molecular pathology and assist in therapy decisions in an increasing number of various cancers. Particularly, the developments in lung cancer have been most impressing in the last decade and consequently lung cancer mutation testing and molecular profiling has become a major business of diagnostic laboratories. However, it has become difficult to decide which biomarkers are currently relevant for therapy decisions, as many of the new biomarkers are not yet approved as therapy targets, remain in the status of clinical studies, or still have not left the experimental phase. The current review is focussed on those markers that do have current therapy implications, practical implications arising from the respective companion diagnostics, and thus is focused on daily practice.

  9. The Incidental Thyroid Lesion in Parathyroid Disease Management

    Directory of Open Access Journals (Sweden)

    Uthman Alamoudi MD

    2017-03-01

    Full Text Available Objective The incidental thyroid lesion is a common finding during general imaging studies. Their management has been the subject of numerous studies and recommendations. Parathyroid disease workup necessitates imaging investigation of the adjacent thyroid gland and therefore provides a unique window to the perioperative management of thyroid incidentaloma. The specific prevalence of incidental thyroid lesions in the context of parathyroid disease is unknown. We seek to investigate its prevalence during parathyroid workup and surgery and to ascertain if there was a change in management of these patients. Study Design Five-year retrospective database review. Setting Tertiary care medical center. Subjects and Methods The source and indication for referral, preoperative investigation findings, and management of the incidental thyroid lesions were examined. The actual procedure performed and final pathology results were assessed. Results A total of 98 patients and 106 operations, including revision surgeries, were identified. There were 21 incidental thyroid lesions (21.4% detected, whereby 15 patients underwent fine-needle aspirations and 12 subsequently had diagnostic hemithyroidectomies. This decision was made preoperatively in 5 patients and intraoperatively in 7 patients at the time of parathyroid surgery. Along with other pathologies, there were 7 patients with micropapillary thyroid carcinoma identified. Conclusions In our series, the prevalence of incidental thyroid lesion and thyroid malignancy is comparable to the general population. The management of the initial parathyroid disease in our patients was altered by the imaging and cytological findings of these thyroid lesions. This has implications on perioperative counseling of the thyroid and parathyroid disease.

  10. [Thyroid gland pathology in children population exposed to the combination of iodine deficiency and fluoride pollution of environment].

    Science.gov (United States)

    Savchenkov, M F; Efimova, N V; Manueva, R S; Nikolaeva, L A; Shin, N S

    The article presents results of study of the impact of iodine deficiency and technogenic fluoride on the state of the thyroid gland in children. On the example of two districts of the city of Bratsk there were executed dynamic investigations (2002 and 2012), including the estimation of the pollution of ambient air and soil by fluorine compounds, levels of iodine intake by the body, the clinical examination of children aged from 5 to 7 years d and interviewing of their parents. In the course of the medical examination there were executed: physical examination by the pediatrician, endocrinologist, ultrasound examination of the thyroid gland, the determination both of serum hormone content by radioimmunoassay and urinary excretion offluorine and iodine. Concentrations of hydrogen fluoride and a solidfluorides in ambient air led to the accumulation offluoride ion in the soil. The iodine entering with drinking water and food, was established to provide only 37.5-50% of the daily requirement of iodine. Increased fluoride ion content in urine and milk teeth in children is associated with the concentrations of the fluorine-containing pollutants in the ambient air and soil. The fluoride pollution against the background of the natural iodine deficiency was established to increase the frequency of functional and morphological disorders of the thyroid gland in children.

  11. The application of special technologies in diagnostic anatomic pathology: is it consistent with the principles of evidence-based medicine?

    Science.gov (United States)

    Marchevsky, Alberto M

    2005-05-01

    Proponents of evidence-based medicine (EBM) have emphasized the need to consider the quality of different sources of medical information and have proposed various methods to integrate available "best evidence" into rules, guidelines and other diagnostic, therapeutic and prognostic models. The various factors that can affect the internal validity of studies in anatomic pathology, such as interobserver variability, use of retrospective rather than prospective data and others, are reviewed. The need for testing for the external validity of the results of anatomic pathology studies is introduced, using "test sets" of cases that have not been used to generate the classification or prognostic models. This methodology has been seldom used in anatomic pathology to validate the generalizability of various "entities," usefulness of diagnostic tests under different conditions and other information. Basic concepts of meta-analysis for research synthesis are introduced; these methods have been seldom used in anatomic pathology to integrate information from different studies using quantitative techniques rather than summary tables that merely list the results of various publications. The potential use of decision analysis and value of information analysis for the adoption of new tests is briefly discussed.

  12. Misdiagnosis of thyroid nodules by ultrasonography: report of a large series

    International Nuclear Information System (INIS)

    Ruan Jianqiu; Xu Huixiong; Xie Xiaoyan; Lv Mingde

    2010-01-01

    Objective: To analyze the common factors of ultrasonographic misdiagnosis of thyroid nodules. Methods: From 2006 to 2009, the pre-operative ultrasonographic diagnosis on 1933 patients with pathologically confirmed thyroid nodules were reviewed. Results: Of 2011 sonograms, ultrasonic diagnosis was corxect in 1575. The 436 diagnostic errors included false negative malignancy (133), false positive malignancy (37), and misdiagnosis between benign lesions (266). Conclusion: There were three main reasons of misdiagnosis including insufficient understanding of the high morbidity of nodular goiter and the relatively low incidence of thyroid adenoma; low awareness of the ultrasonographic diversity of nodular goiter and the sonographic characteristics of the thyroid adenoma and thyroid carcinoma; coexistence of underlying thyroid disease and multifocal nodules. (authors)

  13. The impacts of thyroid function on the diagnostic accuracy of cystatin C to detect acute kidney injury in ICU patients: a prospective, observational study.

    Science.gov (United States)

    Wang, Feilong; Pan, Wenzhi; Wang, Hairong; Zhou, Yu; Wang, Shuyun; Pan, Shuming

    2014-01-09

    Cystatin C (Cysc) could be affected by thyroid function both in vivo and in vitro and thereby may have limited ability to reflect renal function. We aimed to assess the association between Cysc and thyroid hormones as well as the effect of thyroid function on the diagnostic accuracy of Cysc to detect acute kidney injury (AKI). A total of 446 consecutive intensive care unit (ICU) patients were screened for eligibility in this prospective AKI observational study. Serum Cysc, thyroid hormones and serum creatinine (Scr) were measured upon entry to the ICU. We also collected each patient's baseline characteristics including the Acute Physiology and Chronic Health Evaluation II (APACHE-II) score. The diagnostic performance of Cysc was assessed from the area under the receiver operator characteristic curve (AUC) in each quartile of thyroid hormone(s). A total of 114 (25.6%) patients had a clinical diagnosis of AKI upon entry to the ICU. The range of free thyroxine (FT4) value was 4.77 to 39.57 pmol/L. Multivariate linear regression showed that age (standardized beta = 0.128, P Patients were divided into four quartiles based on FT4 levels. The AUC for Cysc in detecting AKI in each quartile were as follows: 0.712 in quartile I, 0.754 in quartile II, 0.829 in quartile III and 0.797 in quartile IV. There was no significant difference in the AUC between any two groups (all P > 0.05). The optimal cut-off value of Cysc for diagnosing AKI increased across FT4 quartiles (1.15 mg/L in quartile I, 1.15 mg/L in quartile II, 1.35 mg/L in quartile III and 1.45 mg/L in quartile IV). There was no significant impact of thyroid function on the diagnostic accuracy of Cysc to detect AKI in ICU patients. However, the optimal cut-off value of Cysc to detect AKI could be affected by thyroid function.

  14. Diagnostic concordance of breast pathologists: lessons from the National Health Service Breast Screening Programme Pathology External Quality Assurance Scheme.

    Science.gov (United States)

    Rakha, Emad A; Ahmed, Mohamed A; Aleskandarany, Mohammed A; Hodi, Zsolt; Lee, Andrew H S; Pinder, Sarah E; Ellis, Ian O

    2017-03-01

    Previous concordance studies examining accuracy of breast diagnosis by pathologists, typically targeting difficult, histologically challenging breast lesions using artificial and restrictive environments, have reported aberrantly high levels of diagnostic discordance. The results of these studies may be misinterpreted by non-pathologists and raise concerns relating to routine practice. This study aims to assess the diagnostic agreement among UK breast pathologists. Two hundred and forty consecutive breast lesions, submitted by participants from their routine practice, included in the UK National Health Service Breast Screening Programme (NHSBSP) breast pathology EQA scheme during the last 10 years were reviewed. An average of approximately 600 participants viewed each case. Data on diagnostic categories (benign, atypical, in-situ malignant and invasive malignant) were collected. In this study, benign and atypical diagnoses were grouped together. The overall diagnostic agreement level was in the almost perfect range. Thirty-five cases (14.6%) showed diagnostic concordance of ≤95%. Reasons for discordance included one or more of: (1) scheme methodology limitations such as: (i) miscoding of certain lesions (e.g. phyllodes tumours and lobular neoplasia) (n = 7) and (ii) variable representation of the index lesion on glass slides (n = 18); and (2) diagnostically challenging cases that may be interpreted more easily using immunohistochemistry (n = 28). These latter included benign and malignant papillary lesions (n = 12), complex sclerosing lesions (n = 7), intraductal epithelial proliferative lesions (n = 6) and an unusual special tumour type (n = 1). Further review identified pathologists' misinterpretation in 13 cases (5.4%), with an average discordance rate of only 4.2%. The performance of breast pathologists is high. Exclusion of the effect of the scheme methodology limitations highlights further the high performance rate and identifies true diagnostically

  15. Quantitative optical diagnostics in pathology recognition and monitoring of tissue reaction to PDT

    Science.gov (United States)

    Kirillin, Mikhail; Shakhova, Maria; Meller, Alina; Sapunov, Dmitry; Agrba, Pavel; Khilov, Alexander; Pasukhin, Mikhail; Kondratieva, Olga; Chikalova, Ksenia; Motovilova, Tatiana; Sergeeva, Ekaterina; Turchin, Ilya; Shakhova, Natalia

    2017-07-01

    Optical coherence tomography (OCT) is currently actively introduced into clinical practice. Besides diagnostics, it can be efficiently employed for treatment monitoring allowing for timely correction of the treatment procedure. In monitoring of photodynamic therapy (PDT) traditionally employed fluorescence imaging (FI) can benefit from complementary use of OCT. Additional diagnostic efficiency can be derived from numerical processing of optical diagnostics data providing more information compared to visual evaluation. In this paper we report on application of OCT together with numerical processing for clinical diagnostic in gynecology and otolaryngology, for monitoring of PDT in otolaryngology and on OCT and FI applications in clinical and aesthetic dermatology. Image numerical processing and quantification provides increase in diagnostic accuracy. Keywords: optical coherence tomography, fluorescence imaging, photod

  16. iPathology cockpit diagnostic station: validation according to College of American Pathologists Pathology and Laboratory Quality Center recommendation at the Hospital Trust and University of Verona.

    Science.gov (United States)

    Brunelli, Matteo; Beccari, Serena; Colombari, Romano; Gobbo, Stefano; Giobelli, Luca; Pellegrini, Andrea; Chilosi, Marco; Lunardi, Maria; Martignoni, Guido; Scarpa, Aldo; Eccher, Albino

    2014-01-01

    Validation of digital whole slide images is crucial to ensure that diagnostic performance is at least equivalent to that of glass slides and light microscopy. The College of American Pathologists Pathology and Laboratory Quality Center recently developed recommendations for internal digital pathology system validation. Following these guidelines we sought to validate the performance of a digital approach for routine diagnosis by using an iPad and digital control widescreen-assisted workstation through a pilot study. From January 2014, 61 histopathological slides were scanned by ScanScope Digital Slides Scanner (Aperio, Vista, CA). Two independent pathologists performed diagnosis on virtual slides in front of a widescreen by using two computer devices (ImageScope viewing software) located to different Health Institutions (AOUI Verona) connected by local network and a remote image server using an iPad tablet (Aperio, Vista, CA), after uploading the Citrix receiver for iPad. Quality indicators related to image characters and work-flow of the e-health cockpit enterprise system were scored based on subjective (high vs poor) perception. The images were re-evaluated two weeks apart. The whole glass slides encountered 10 liver: hepatocarcinoma, 10 renal carcinoma, 10 gastric carcinoma and 10 prostate biopsies: adenocarcinoma, 5 excisional skin biopsies: melanoma, 5 lymph-nodes: lymphoma. 6 immuno- and 5 special stains were available for intra- and internet remote viewing. Scan times averaged two minutes and 54 seconds per slide (standard deviation 2 minutes 34 seconds). Megabytes ranged from 256 to 680 (mean 390) per slide storage. Reliance on glass slide, image quality (resolution and color fidelity), slide navigation time, simultaneous viewers in geographically remote locations were considered of high performance score. Side by side comparisons between diagnosis performed on tissue glass slides versus widescreen were excellent showing an almost perfect concordance (0

  17. Development of a clinical decision model for thyroid nodules

    Directory of Open Access Journals (Sweden)

    Eberhardt John

    2009-08-01

    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

  18. Clinico-pathological study to evaluate oral lichen planus for the establishment of clinical and histopathological diagnostic criteria.

    Science.gov (United States)

    Hiremath, Santhosh; Kale, Alka D; Hallikerimath, Seema

    2015-01-01

    Lichen planus and lichenoid lesions affecting the oral cavity show similar clinico-pathological features creating a diagnostic dilemma. Hence, the aim of the present study was to establish a clinical and histopathological correlation in the diagnosis of oral lichen planus, based on the modified WHO diagnostic criteria of oral lichen planus and oral lichenoid lesions proposed by Van der Meij and Van der Waal in 2003. In the present study, 100 cases of oral lichen planus were clinically and histopathologically analyzed. Out of the 100 cases, 50 were prospective and 50 were retrospective cases. Prospective cases were collected based on the clinical diagnosis of oral lichen planus and oral lichenoid lesion. Retrospective cases were collected based on the histopathological diagnosis of oral lichen planus. Both the clinical and histopathological analyses were performed based on a proposal for a set of modified diagnostic criteria of oral lichen planus and oral lichenoid lesion. A final diagnosis of oral lichen planus was made only after the correlation of the clinical diagnosis with the histopathological diagnosis. The interobserver agreement among three observers for both prospective and retrospective cases in the final diagnosis of oral lichen planus was found to be "good" to "very good" indicating high reproducibility. However, the final diagnoses of true oral lichen planus after clinico-pathological correlation in prospective and retrospective study groups appeared to be 38.0% and 54.0% respectively. The results of the present study revealed mild to moderate clinico-pathological correlation in the final diagnosis of oral lichen planus for the prospective and retrospective study groups respectively.

  19. Endorsing good quality assurance practices in molecular pathology: risks and recommendations for diagnostic laboratories and external quality assessment providers.

    Science.gov (United States)

    Tembuyser, Lien; Dequeker, Elisabeth M C

    2016-01-01

    Quality assurance is an indispensable element in a molecular diagnostic laboratory. The ultimate goal is to warrant patient safety. Several risks that can compromise high quality procedures are at stake, from sample collection to the test performed by the laboratory, the reporting of test results to clinicians, and the organization of effective external quality assessment schemes. Quality assurance should therefore be safeguarded at each level and should imply a holistic multidisciplinary approach. This review aims to provide an overview of good quality assurance practices and discusses certain risks and recommendations to promote and improve quality assurance for both diagnostic laboratories and for external quality assessment providers. The number of molecular targets is continuously rising, and new technologies are evolving. As this poses challenges for clinical implementation and increases the demand for external quality assessment, the formation of an international association for improving quality assurance in molecular pathology is called for.

  20. Diagnostics of femoroacetabular impingement and labral pathology of the hip: a systematic review of the accuracy and validity of physical tests

    NARCIS (Netherlands)

    Tijssen, M.P.W.; Cingel, R.E. van; Willemsen, L.; de Visser, E.

    2012-01-01

    PURPOSE: Femoroacetabular impingement (FAI) and labral pathology have been recognized as causative factors for hip pain. The clinical diagnosis is now based on MRI-A (magnetic resonance imaging-arthrogram) because the physical diagnostic tests available are diverse and information on diagnostic

  1. Comparison of the Diagnostic Efficacy of Ultrasound-Guided Core Needle Biopsy With 18- Versus 20-Gauge Needles for Thyroid Nodules.

    Science.gov (United States)

    Ahn, Hye Shin; Seo, Mirinae; Ha, Su Min; Kim, Hee Sung

    2018-03-25

    To compare the diagnostic efficacy, complication rate, and core needle biopsy (CNB) specimen yield in 18- versus 20-gauge ultrasound (US)-guided CNB for diagnosis of thyroid nodules. We included 81 consecutive thyroid nodules with US-guided biopsy by a 20-gauge core needle and 86 consecutive thyroid nodules with US-guided biopsy by an 18-gauge core needle during 2 years. The rate of inconclusive results, including nondiagnostic or atypia/follicular lesion of undetermined significance, was compared. The diagnostic performance for malignancy was assessed in nodules with a final diagnosis. The complication rate and CNB specimen yield were also compared. Eighteen-gauge CNB showed a lower rate of nondiagnostic results (1.2% versus 8.6%; P = .024) than 20-gauge CNB; however, the rates of atypia/follicular lesion of undetermined significance and inconclusive results were not significantly different between the groups (P > .05). In addition, 18-gauge CNB showed higher sensitivity (75.0% versus 66.7%), a higher negative predictive value (83.9% versus 75.9%), and higher accuracy (78.3% versus 74.4%) for detecting malignancy than 20-gauge CNB, although the results did not achieve statistical significance. No major complications occurred in either of the CNB groups. The 18-gauge needle group had significantly fewer CNBs and larger specimen diameters (P gauge needle could be more effective for the diagnosis of thyroid nodules than CNB with a 20-gauge needle. © 2018 by the American Institute of Ultrasound in Medicine.

  2. A novel diagnostic tool reveals mitochondrial pathology in human diseases and aging

    DEFF Research Database (Denmark)

    Scheibye-Knudsen, Morten; Scheibye-Alsing, Karsten; Canugovi, Chandrika

    2013-01-01

    The inherent complex and pleiotropic phenotype of mitochondrial diseases poses a significant diagnostic challenge for clinicians as well as an analytical barrier for scientists. To overcome these obstacles we compiled a novel database, www.mitodb.com, containing the clinical features of primary...

  3. Phenotype analysis of early risk factors from electronic medical records improves image-derived diagnostic classifiers for optic nerve pathology

    Science.gov (United States)

    Chaganti, Shikha; Nabar, Kunal P.; Nelson, Katrina M.; Mawn, Louise A.; Landman, Bennett A.

    2017-03-01

    We examine imaging and electronic medical records (EMR) of 588 subjects over five major disease groups that affect optic nerve function. An objective evaluation of the role of imaging and EMR data in diagnosis of these conditions would improve understanding of these diseases and help in early intervention. We developed an automated image processing pipeline that identifies the orbital structures within the human eyes from computed tomography (CT) scans, calculates structural size, and performs volume measurements. We customized the EMR-based phenome-wide association study (PheWAS) to derive diagnostic EMR phenotypes that occur at least two years prior to the onset of the conditions of interest from a separate cohort of 28,411 ophthalmology patients. We used random forest classifiers to evaluate the predictive power of image-derived markers, EMR phenotypes, and clinical visual assessments in identifying disease cohorts from a control group of 763 patients without optic nerve disease. Image-derived markers showed more predictive power than clinical visual assessments or EMR phenotypes. However, the addition of EMR phenotypes to the imaging markers improves the classification accuracy against controls: the AUC improved from 0.67 to 0.88 for glaucoma, 0.73 to 0.78 for intrinsic optic nerve disease, 0.72 to 0.76 for optic nerve edema, 0.72 to 0.77 for orbital inflammation, and 0.81 to 0.85 for thyroid eye disease. This study illustrates the importance of diagnostic context for interpretation of image-derived markers and the proposed PheWAS technique provides a flexible approach for learning salient features of patient history and incorporating these data into traditional machine learning analyses.

  4. Non-allergic rhinitis in children: Epidemiological aspects, pathological features, diagnostic methodology and clinical management

    Science.gov (United States)

    Poddighe, Dimitri; Gelardi, Matteo; Licari, Amelia; del Giudice, Michele Miraglia; Marseglia, Gian Luigi

    2016-01-01

    Chronic rhinitis is a very common disease, as the prevalence in the general population resulted to be 40%. Allergic rhinitis has been considered to be the most frequent form of chronic rhinitis, as non-allergic rhinitis has been estimated to account for 25%. However, several evidences suggested that non-allergic rhinitis have been underrated, especially in children. In pediatrics, the diagnostic definition of non-allergic rhinitis has been often limited to the exclusion of an allergic sensitization. Actually, local allergic rhinitis has been often misdiagnosed as well as mixed rhinitis has not been recognized in most cases. Nasal cytology is a diagnostic procedure being suitable for routine clinical practice with children and could be a very useful tool to characterize and diagnose non-allergic rhinitis, providing important clues for epidemiological analysis and clinical management. PMID:28074172

  5. Non-allergic rhinitis in children: Epidemiological aspects, pathological features, diagnostic methodology and clinical management.

    Science.gov (United States)

    Poddighe, Dimitri; Gelardi, Matteo; Licari, Amelia; Del Giudice, Michele Miraglia; Marseglia, Gian Luigi

    2016-12-26

    Chronic rhinitis is a very common disease, as the prevalence in the general population resulted to be 40%. Allergic rhinitis has been considered to be the most frequent form of chronic rhinitis, as non-allergic rhinitis has been estimated to account for 25%. However, several evidences suggested that non-allergic rhinitis have been underrated, especially in children. In pediatrics, the diagnostic definition of non-allergic rhinitis has been often limited to the exclusion of an allergic sensitization. Actually, local allergic rhinitis has been often misdiagnosed as well as mixed rhinitis has not been recognized in most cases. Nasal cytology is a diagnostic procedure being suitable for routine clinical practice with children and could be a very useful tool to characterize and diagnose non-allergic rhinitis, providing important clues for epidemiological analysis and clinical management.

  6. The "demise" of diagnostic and research ocular pathology: temporary or forever?

    Science.gov (United States)

    Apple, David J; Werner, Liliana; Mamalis, Nick; Olson, Randall J

    2003-01-01

    Several authorities have documented a significant decrease in support for modern eye pathology/pathology research laboratories. Indeed, many laboratories have closed or suffered marked cutbacks. The purpose of this report is to ask why this is so and to seek a possible means for reversing this trend. Observations from the senior author's experience and a case from author's facility are analyzed. There are several reasons for ocular pathologists' difficulties, such as financial problems, lack of vision, personality conflicts, and problems with the departmental administration. Until recently, most research and development in several subspecialty fields of ophthalmology, including biodevices research, has been done primarily by engineers and in-house workers in industry. This precludes proper independent, nonbiased control and guidance from academia. Most ocular pathologists have not participated in this relatively new and wide-open field. We suggest a new realm of activity for today's newly trained ocular pathologists. Based on personal experience of two decades of fruitful collaboration with industry, we believe that ocular pathologists are uniquely trained to apply their expertise to various new fields of research that most pathologists today have not utilized. An important example is research on clinicopathological aspects of implantable biodevices. In addition, support and oversight should be provided by the major ophthalmic societies, such as the American Academy of Ophthalmology, in order to retain (even regain) control over this field. This is mandatory in order to control the safety and efficacy of new drugs and devices being introduced almost daily. Only then can clear differentiation between profit and patient welfare be achieved as potentially dangerous devices and techniques are let loose on the market. The field of "routine, descriptive" eye pathology is severely wounded and will return only in an attenuated fashion. In general, full-time support for

  7. Diagnostic value of BI-RADS categories in the management of patients with benign breast pathology

    Directory of Open Access Journals (Sweden)

    G. P. Korzhenkova

    2016-01-01

    Full Text Available Reasonable tactics of management of the patients with breast disease depends of the quality of diagnostics methods. Modern requirements to the methods of diagnosis – a precision, high information value, accessibility. In the article BI-RADS (Breast Imaging Reporting and Data System is being discussed. This system is a good tool to determine the proper algorithm of breast disease patients’ management.

  8. The pathology of HPV-related head and neck cancer: implications for the diagnostic pathologist.

    Science.gov (United States)

    Westra, William H

    2015-01-01

    A subset of head and neck squamous cell carcinomas are caused by the human papillomavirus (HPV). This HPV-related form of head and neck squamous cell carcinoma (HPV-HNSCC) has captured the attention of the oncology community for its rising incidence, its link to non-traditional risk factors, and its divergent clinical behavior. To diagnose this special form of head and neck squamous cell carcinoma is to provide important prognostic information and, in some instances, redirect clinical therapy. The diagnosis of HPV-HNSCC is aided by a strong appreciation for its characteristic microscopic findings and by an awareness of aberrant features that set apart a growing list of HPV-HNSCC morphologic variants. This review will delineate the microscopic appearance of HPV-HNSCC, spotlight ways in which the misinterpretation of these microscopic features can lead to diagnostic confusion, offer recommendations for appropriate terminology when diagnosing HPV-HNSCC, and provide examples of specific diagnostic scenarios where HPV testing can inform the diagnostic process. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Pseudo-angiomatous liver metastasis of thyroid medullary carcinoma: multimodality diagnostic approach; Metastase hepatique pseudoangiomateuse d'un carcinome medullaire de la thyroide: approche diagnostique multimodalite

    Energy Technology Data Exchange (ETDEWEB)

    Imperiale, A.; Keomany, J.; Rust, E.; Constantinesco, A. [CHU de Strasbourg, Service de biophysique et medecine nucleaire, 67 (France); Greget, M. [CHU de Strasbourg, Service de radiologie 1, 67 (France); Chabrier, G.; Goichot, B. [CHU de Strasbourg, Service de medecine interne, endocrinologie et nutrition, 67 (France); Detour, J. [CHU de Strasbourg, Service de radiopharmacie, 67 (France); Pessaux, P. [CHU de Strasbourg, Service de chirurgie generale, hepatique et endocrinienne, 67 (France)

    2010-07-01

    Purpose: Illustrate the result of the diagnosis by multimodality imaging (MRI, scintigraphy {sup 123}I-Mibg, PET/CT{sup 18}F-F.D.G. and {sup 18}F-F DOPA) with liver metastasis looking like a single angioma in a patient with atypical medullary thyroid carcinoma. Conclusions: Angiomas must be taken into account in the differential diagnosis of liver metastasis of endocrine tumors, particularly in the case of small injuries where it may be difficult to differentiate a peripheral nodular contrast enhancement of a globular enhancement characteristics of angiomas. (N.C.)

  10. Thyroid storm

    Science.gov (United States)

    Thyrotoxic storm; Hyperthyroid storm; Accelerated hyperthyroidism; Thyroid crisis; Thyrotoxicosis - thyroid storm ... Thyroid storm occurs due to a major stress such as trauma, heart attack , or infection. In rare ...

  11. Hyper-Echoic Rim in Thyroid Nodules: A New Ultrasonographic Feature for Malignancy Prediction.

    Science.gov (United States)

    Dong, YiJie; Zhan, WeiWei; Zhou, JianQiao; Song, LinLin; Ni, XiaoFeng; Zhang, BenYan

    2016-09-01

    The goal of this study was to verify the ultrasound features of hyper-echoic rims in thyroid nodules and to evaluate their diagnostic value in predicting thyroid malignancies. We retrospectively analyzed 228 pathologically proven thyroid nodules (137 malignant and 91 benign nodules). Forty-eight thyroid nodules had a hyper echogenic rim. All malignant nodules (137) were papillary carcinomas, which were studied to identify the correlation between the hyper-echoic rim (detected by ultrasound) and other histologic features. Presence of a hyper-echoic rim had high specificity (94.51%), but low sensitivity (31.39%) in predicting malignancy (p hyper-echogenic rim could be one additional ultrasound parameter in the diagnosis of thyroid lesions. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  12. The relation between the change of pathology and the metergasis of immunity after thyroid arterial embolization in treating hyperthyroidism caused by Graves' disease

    International Nuclear Information System (INIS)

    Tian Min; Zhao Wei; Shen Jin; Yu Yongzhong; Yi Genfa; Xiang Shutian; Li Liyuan; Yang Huiying; Li Hong; Lu Guijun

    2007-01-01

    Objective: To study the relation between change of thyroid tissues and thyroid auto- antibody after thyroid arterial embolization in the treatment of hyperthyroidism caused by Graves' disease with observation on changes of histopathology and thyroid auto-antibody in 3 years after thyroid arterial embolization, and to understand the foundation of the therapeutic action after arterial embolization. Methods: 1. Thirty-eight patients with Graves' disease treated by transcathter arterial embolization had been tested serum TT3, TT4, FT3, FT4, rT3, TSH, TGAb, TPOAb, TRAb and followed up with color Doppler ultrasound respectively at different periods (before arterial embolization and 7 day, 6 month, 3 year after arterial embolization). 2. 23 patients underwent needle aspiration biopsy of the thyroid gland. Results: Volume of thyroid gland instantly dwindled in size after thyroid arterial embolization or within a few days. The changes of histopathology mainly showed acute ischemic necrosis 7 days after thyroid arterial embolization and followed by fibrous hyperplasia mesenchymal proliferation and follicular atrophy occurring 6 months and 3 years afterward. TGAb, TPOAb at the 3rd year after thyroid arterial embolization were higher than those before the thyriod arterial embolization. FT3, FT4, TRAb at 6 month after thyroid arterial embolization were lower than those of the 3 years. Conclusion: Maladjustment of immunity in GD patients would be improved through the treatment of thyroid arterial embolization, synchronously with the promotion in histopathology. The outcomings of the shrinkage of thyroid tissue, decrease of thyroxin secretion and improvement of immunity provide a combination therapy for GD. (authors)

  13. Stitch Abscess Masquerading as Recurrent Thyroid Cancer ...

    African Journals Online (AJOL)

    Recurrent thyroid cancer after remnant ablation is a known entity in follow up of differentiated thyroid cancer. It is however unusual for a stitch abscess to present as a recurrent thyroid cancer. We highlight the diagnostic dilemma of a stitch abscess masquerading as a recurrent thyroid cancer in a young female adult in the ...

  14. Diagnostic accuracy of shear wave elastography for prediction of breast malignancy in patients with pathological nipple discharge.

    Science.gov (United States)

    Guo, Xiaobo; Liu, Ying; Li, Wanhu

    2016-01-22

    Pathological nipple discharge (PND) may indicate malignant breast lesions. As the role of shear wave elastography (SWE) in predicting these malignant lesions has not yet been evaluated, we aim to evaluate the diagnostic value of SWE for this condition. Prospective diagnostic accuracy study comparing a combination of qualitative and quantitative measurements of SWE (index test) to a ductoscopy and microdochectomy for histological diagnosis (reference test). Fuzhou General Hospital of Nanjing military command. A total of 379 patients with PND were finally included from January, 2011 to March 2014, after we screened 1084 possible candidates. All participants were evaluated through SWE, with qualitative parameters generated by Virtual Touch tissue imaging (VTI) and quantitative parameters generated by Virtual Touch tissue quantification (VTQ). All the patients were consented to receive a ductoscopy and microdochectomy for histological diagnosis, and the results were set as a reference test. Sensitivity and specificity of the combined VTI and VTQ of the SWE for detection of malignancy in patients with PND. The 379 participants presented with 404 lesions. The results of pathological examination showed that 326 (80.7%) of the 404 lesions were benign and the other 78 (19.3%) were malignant. An area under the curve of elasticity score, VTQm and VTQc, were 0.872, 0.825 and 0.857, respectively, with the corresponding cut-off point as 2.50, 2.860 m/s and 3.015 m/s, respectively. After a combination of these measurements, the sensitivity, specificity, and positive and negative predictive value (PPV and NPV), were 89.7%, 72.1%, 43.5% and 96.7%, respectively. The sensitivity analysis showed 82% of the sensitivity and 96.8% of the specificity, in which patients with no pathological findings in ductoscopy were excluded. Ultrasonographic elastography is sensitive for patients with PND and could be used as a triage test before ductoscopy examination. Studies for further improvement

  15. FAIR true-FISP perfusion imaging of the thyroid gland.

    Science.gov (United States)

    Schraml, Christina; Boss, Andreas; Martirosian, Petros; Schwenzer, Nina F; Claussen, Claus D; Schick, Fritz

    2007-07-01

    To evaluate the feasibility of quantitative perfusion MRI of the thyroid gland using an arterial spin labeling (ASL) method. An ASL technique with flow-sensitive alternating inversion-recovery (FAIR) spin preparation and a true fast imaging in the steady state (TrueFISP) signal readout strategy was implemented on a 1.5T whole-body unit. Anatomical and perfusion imaging of the thyroid gland was performed in eight healthy volunteers and one patient with functioning adenoma. Quantitative perfusion maps were calculated using the extended Bloch equations. In all subjects the perfusion images showed diagnostic image quality. The mean examination time was 24 minutes for multiplanar perfusion imaging of the entire thyroid gland. Individual perfusion values ranged between 341 +/- 91 and 640 +/- 90 mL/100 g/minute, with a mean perfusion of 461 +/- 90 mL/100 g/minute. The functioning adenoma showed markedly reduced perfusion compared to normal thyroidal parenchyma. No perfusion was noticeable inside four detected thyroid cysts. Quantitative ASL perfusion imaging of the thyroid gland using a FAIR-TrueFISP sequence leads to perfusion maps that may provide important information for assessing thyroid gland pathologies and monitoring therapeutic treatment. Copyright 2007 Wiley-Liss, Inc.

  16. MEDULLARY THYROID CARCINOMA

    Directory of Open Access Journals (Sweden)

    V. S. Medvedev

    2013-01-01

    Full Text Available Medullary thyroid carcinoma belongs to orphan diseases affecting a small part of the population. Multicenter trials are required to elaborate a diagnostic algorithm, to define treatment policy, and to predict an outcome.

  17. Diagnostic Accuracy of Virtual Pathology vs Traditional Microscopy in a Large Dermatopathology Study.

    Science.gov (United States)

    Kent, Michael N; Olsen, Thomas G; Feeser, Theresa A; Tesno, Katherine C; Moad, John C; Conroy, Michael P; Kendrick, Mary Jo; Stephenson, Sean R; Murchland, Michael R; Khan, Ayesha U; Peacock, Elizabeth A; Brumfiel, Alexa; Bottomley, Michael A

    2017-12-01

    Digital pathology represents a transformative technology that impacts dermatologists and dermatopathologists from residency to academic and private practice. Two concerns are accuracy of interpretation from whole-slide images (WSI) and effect on workflow. Studies of considerably large series involving single-organ systems are lacking. To evaluate whether diagnosis from WSI on a digital microscope is inferior to diagnosis of glass slides from traditional microscopy (TM) in a large cohort of dermatopathology cases with attention on image resolution, specifically eosinophils in inflammatory cases and mitotic figures in melanomas, and to measure the workflow efficiency of WSI compared with TM. Three dermatopathologists established interobserver ground truth consensus (GTC) diagnosis for 499 previously diagnosed cases proportionally representing the spectrum of diagnoses seen in the laboratory. Cases were distributed to 3 different dermatopathologists who diagnosed by WSI and TM with a minimum 30-day washout between methodologies. Intraobserver WSI/TM diagnoses were compared, followed by interobserver comparison with GTC. Concordance, major discrepancies, and minor discrepancies were calculated and analyzed by paired noninferiority testing. We also measured pathologists' read rates to evaluate workflow efficiency between WSI and TM. This retrospective study was caried out in an independent, national, university-affiliated dermatopathology laboratory. Intraobserver concordance of diagnoses between WSI and TM methods and interobserver variance from GTC, following College of American Pathology guidelines. Mean intraobserver concordance between WSI and TM was 94%. Mean interobserver concordance was 94% for WSI and GTC and 94% for TM and GTC. Mean interobserver concordance between WSI, TM, and GTC was 91%. Diagnoses from WSI were noninferior to those from TM. Whole-slide image read rates were commensurate with WSI experience, achieving parity with TM by the most experienced

  18. Diagnostic significance of serum concentrations of soluble Fas ligand (sFasL) in children with autoimmune thyroid disease.

    Science.gov (United States)

    Mikos, Hanna; Mikos, Marcin; Niedziela, Marek

    2017-05-01

    The aim of the study was to assess serum levels of sFasL as a marker of thyroid dysfunction in children with autoimmune thyroid disease (AITD). The group comprised 45 newly diagnosed children with Hashimoto's thyroiditis and Graves' disease versus euthyroid control group: 11 with hypothyroidism (10 girls and 1 boy, aged 12.2 ± 1.9 years), 19 children with hyperthyroidism (15 girls and 4 boys, aged 12.4 ± 4.9 years) and 15 healthy subjects (7 girls and 8 boys, aged 10.5 ± 4.8 years). Thyroid function (TSH, fT4, fT3), autoimmune (ATG, ATPO, TRAb) and anthropometric (weight, height, BMI, BMI-SDS, Cole index) parameters were evaluated. sFasL concentration was measured by ELISA. Nonparametric statistical test and ROC analysis were performed to assess the data. We found no significant differences in serum concentrations of sFasL between boys and girls in the studied groups. Significantly higher sFasL levels (median 0.26 ng/ml) were identified in children with hypothyroidism compared with the control group (median 0.06 ng/ml, p autoimmune thyroid disease.

  19. Thyroid Problems

    Science.gov (United States)

    ... What is the thyroid gland and what are thyroid disorders? Your thyroid gland is a small structure in ... get older, you’re more likely to develop thyroid disorders. In addition to being more common with age, ...

  20. Ultrasound findings of diffuse metastasis of gastric signet-ring-cell carcinoma to the thyroid gland.

    Science.gov (United States)

    Morita, Koji; Sakamoto, Takahiko; Ota, Shuji; Masugi, Hideo; Chikuta, Ikumi; Mashimo, Yamato; Edo, Naoki; Tokairin, Takuo; Seki, Nobuhiko; Ishikawa, Toshio

    2017-01-01

    It has been shown that metastases to the thyroid from extrathyroidal malignancies occur as solitary or multiple nodules, or may involve the whole thyroid gland diffusely. However, diffuse metastasis of gastric cancer to the thyroid is extremely rare. Here, we report a case of a 74-year-old woman with diffuse infiltration of gastric adenocarcinoma (signet-ring-cell carcinoma/poorly differentiated adenocarcinoma) cells in the thyroid. The pathological diagnosis was made based on upper gastrointestinal endoscopy with biopsy and fine-needle aspiration cytology of the thyroid. An 18F-FDG PET/CT revealed multiple lesions with increased uptake, including the bilateral thyroid gland. On thyroid ultrasound examination, diffuse enlargement with internal heterogeneity and hypoechoic reticular lines was observed. On color Doppler imaging, a blood-flow signal was not detected in these hypoechoic lines. These findings were similar to those of diffuse metastases caused by other primary cancers, such as lung cancer, as reported earlier. Therefore, the presence of hypoechoic reticular lines without blood-flow signals is probably common to diffuse thyroid metastasis from any origin and an important diagnostic finding. This is the first report to show detailed ultrasound findings of diffuse gastric cancer metastasis to the thyroid gland using color Doppler.

  1. Actualización de la conducta diagnóstica en el nódulo de tiroides Updating on diagnostic behavior in thyroid nodule

    Directory of Open Access Journals (Sweden)

    Silvia Elena Turcios Tristá

    2010-12-01

    Full Text Available En los últimos años la frecuencia diagnóstica del nódulo de tiroides se ha incrementado, y constituye una de las entidades de mayor asistencia en las consultas de endocrinología en nuestro país. A pesar de no existir cambios en el diagnóstico diferencial de acuerdo con el estado funcional del nódulo, sí se han incorporado algunos elementos diagnósticos útiles para identificar mejor el riesgo de malignidad de la lesión. El ultrasonido aporta nuevos datos y aparecen estudios novedosos como la elastografía. El objetivo de esta actualización es rememorar algunos criterios sobre el diagnóstico del nódulo tiroideo, así como plantear los aspectos que tienen un nivel de evidencia científica reconocida en la actualidad. Puede servir como guía de trabajo para contribuir a una racional y óptima toma de decisiones en el paciente con un nódulo de tiroides.In past years the diagnostic frequency of thyroid nodule increased and it is one of entities of more attendance to Endocrinology consultations in our country. Despite there are not changes in differential diagnosis according to the nodule functional status, certainly some useful diagnostic elements have been incorporated to identify better the malignancy risk of lesion. The ultrasound (US provides new data and to appear novel studies e.g. the elastography. The objective of present updating is to remember some criteria on the diagnosis of thyroid nodule, as well as to propose the features with a recognized scientific evidence at present time. May to be a working guide to contribute to a rational and optimal decision-making in the patient presenting with a thyroid nodule.

  2. Evaluation of molecular diagnostic approaches for the detection of BRAF p.V600E mutations in papillary thyroid cancer: Clinical implications.

    Directory of Open Access Journals (Sweden)

    Artur Kowalik

    Full Text Available Differentiated papillary thyroid cancer (PTC is the most common cancer of the endocrine system. PTC has a very good prognosis and a high 5 year survival rate; however, some patients are unresponsive to treatment, and their diagnosis eventually results in death. Recent efforts have focused on searching for prognostic and predictive factors that may enable treatment personalization and monitoring across the course of the disease. The presence of the BRAF mutation is considered to contribute to the risk of poor clinical course, according to American Thyroid Association (ATA recommendations. The method used for genotyping can impact the predicted mutation frequency; however, ATA recommendations do not address this issue. We evaluated the molecular diagnostic (BRAF p.V600E mutation results of 410 patients treated for PTC. We thoroughly analyzed the impact of three different BRAF mutation detection methods, Sanger Sequencing (Seq, allele-specific amplification PCR (ASA-PCR, and quantitative PCR (qPCR, on the frequency of mutation detection in 399 patients. Using Seq, we detected the BRAF mutation in 37% of patients; however, we were able to detect BRAF mutations in 57% and 60% of patients using the more sensitive ASA-PCR and qPCR technologies, respectively. Differences between methods were particularly marked in the thyroid papillary microcarcinoma group; BRAF p.V600E mutations were found in 37% of patients using Seq and 63% and 66% of patients using ASA-PCR and qPCR, respectively. We also evaluated how these different diagnostic methods were impacted by DNA quality. Applying methods with different sensitivities to the detection of BRAF p.V600E mutations may result in different results for the same patient; such data can influence stratification of patients into different risk groups, leading to alteration of treatment and follow-up schemes.

  3. Coexistence of papillary thyroid cancer and Hashimoto thyroiditis in children: report of 3 cases.

    Science.gov (United States)

    Koibuchi, Harumi; Omoto, Kiyoka; Fukushima, Noriyoshi; Toyotsuji, Tomonori; Taniguchi, Nobuyuki; Kawano, Mikihiko

    2014-07-01

    This report documents 3 pediatric papillary thyroid carcinoma cases with associated Hashimoto thyroiditis. In all 3 cases, hypoechoic nodules accompanied by multiple echogenic spots were noted on sonography of the thyroid. Hashimoto thyroiditis was suspected on the basis of positive thyroid autoantibody test results and pathologic examinations of thyroidectomy specimens, which revealed chronic thyroiditis with lymphocytic infiltration as the background of papillary thyroid carcinoma development. The potential for papillary carcinoma development warrants close follow-up, and meticulous sonographic examinations must be performed in children with Hashimoto thyroiditis. © 2014 by the American Institute of Ultrasound in Medicine.

  4. The special features of cardiovascular pathology diagnostics in patients with epilepsy

    Directory of Open Access Journals (Sweden)

    Татьяна Анатольевна Литовченко

    2015-11-01

    Full Text Available Aim. The researchers noticed the changes of parameters of cardiovascular system functioning in patients with epilepsy during epileptic attacks and in interictal period. The aim of research was the study of informativity of the different methods of study of cardiovascular system functioning for detection and evaluation of risk of cardiac pathology development in patients with epilepsy.Materials and methods. We examined 50 patients with epilepsy and CVP and 50 patients with epilepsy without CVP. All patients underwent clinical and neurological examination, electrocardiography, echocardioscopy, examination of heart rhythm variability, dopplerography of carotid arteries, analysis of lipid blood spectrum, brain evaluation on indications on SCORE, МРТ.Results. There was revealed that the use of valproates and carbamazepine is associated with dyslipidemia development; valproates – with increase of intima-media complex thickness, cambamazepine – with increased risk of development of heart rhythm and conduction disorder; lamotrigine and levetiracetam – with increase of heart rate. The combined use of levetiracetam and carbamazepine is associated with extension of QT interval. The most significant increase of risk of CVP development during the next 10 years on SCORE was noticed in patients who take carbamazepine.Conclusions. The definition of intima-media complex thickness at dopplerography of carotid arteries, patients evaluation on SCORE, lipidograms, heart rhythm variability, definition of myocardial work index at echocardioscopy along with the standard ECG are effective for determination of risk factors and early detection of CVP in patients with epilepsy

  5. Immunoperoxidase staining for involucrin: a potential diagnostic aid in cervicovaginal pathology.

    Science.gov (United States)

    Warhol, M J; Antonioli, D A; Pinkus, G S; Burke, L; Rice, R H

    1982-12-01

    Involucrin, a protein subunit of keratinocyte cross-linked envelopes, is a distinctive marker for suprabasal differentiation in stratified squamous epithelium. Immunoperoxidase staining for involucrin was used to evaluate paraffin sections of tissue obtained by colposcopically directed biopsies of infectious, metaplastic, and dysplastic lesions of the cervix and vagina. Areas of normal squamous epithelium, papillary and flat condyloma acuminatum, and mature and immature squamous metaplasia showed positive staining in 99 per cent of samples lacking significant inflammation and in 60 per cent of those with moderate or severe inflammation. In contrast, only 19 per cent of the squamous cell dysplasias, even those without much inflammation, showed positive staining, and no area with moderate or severe inflammation showed positive staining. These findings indicate that expression of involucrin is modulated by cellular pathologic features and microenvironment. We suggest that immunoperoxidase staining for involucrin may be useful in distinguishing mild dysplasia from immature metaplasia and flat condyloma in some biopsy specimens in which routine histologic examination yields an indeterminate diagnosis.

  6. New diagnostic signs in hydatid diseases; Radiography, ultrasound, CT and MRI correlated to pathology

    Energy Technology Data Exchange (ETDEWEB)

    Sinner, W.N. von (King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia). Department of Radiology)

    17 of 70 patients with hydatid disease had verified Echinococcus granulosis infection of the chest. In 14 patients (20 percent) the primary location was the lung parenchyma. 2 patients had primary and 1 secondary mediastinal hydatid cysts, and 1 patient a primary hydatid cyst of the chest wall. In 3 above-mentioned patients, secondary pleural involvement occurred, of which 2 were due to ruptured pulmonary cysts and 1 due to an hydatid cyst arising in the liver and having prolapsed into the chest. In all cases, clinical findings, radiography, ultrasound, computed tomography (CT) and/or magnetic resonance imaging (MRI) were correlated to macroscopic and microscopic pathology. Characteristic signs made recognition of hydatid disease possible, sometimes even when serologic tests had been non-conclusive. Assessment of other cysts throughout the body with or without involvement of neighbouring organs or tissues allowed appropriate therapeutic management. CT and MRI also played a key role in recognizing complications (e.g., rupture, infection of cysts). (author). 43 refs.; 8 figs.; 1 tab.

  7. US of the Nongravid Cervix with Multimodality Imaging Correlation: Normal Appearance, Pathologic Conditions, and Diagnostic Pitfalls.

    Science.gov (United States)

    Wildenberg, Joseph C; Yam, Benjamin L; Langer, Jill E; Jones, Lisa P

    2016-01-01

    The adult uterine cervix may exhibit a wide variety of pathologic conditions that include benign entities (eg, cervicitis, hyperplasia, nabothian cysts, cervical polyps, leiomyomas, endometriosis, and congenital abnormalities) as well as malignant lesions, particularly cervical carcinoma. In addition, lesions that arise in the uterine body may secondarily involve the cervix, such as endometrial carcinoma and prolapsed intracavitary masses. Many of these conditions can be identified and characterized at ultrasonography (US), which is considered the first-line imaging examination for the female pelvis. However, examination of the cervix is often cursory during pelvic US, such that cervical disease may be overlooked or misdiagnosed. Transabdominal US of the cervix may not afford sufficient spatial resolution to depict cervical disease in many patients; therefore, endovaginal US is considered the optimal technique. Use of supplemental imaging techniques, particularly the application of transducer pressure on the cervix, may be helpful. This review describes the normal appearance of the cervix at US, the appearance of cervical lesions and conditions that mimic abnormalities at US, and optimal US techniques for evaluation of the cervix. This information will help radiologists detect and diagnose cervical abnormalities more confidently at pelvic US. Online supplemental material is available for this article. (©)RSNA, 2016.

  8. Diagnostic value of voice acoustic analysis in assessment of occupational voice pathologies in teachers.

    Science.gov (United States)

    Niebudek-Bogusz, Ewa; Fiszer, Marta; Kotylo, Piotr; Sliwinska-Kowalska, Mariola

    2006-01-01

    It has been shown that teachers are at risk of developing occupational dysphonia, which accounts for over 25% of all occupational diseases diagnosed in Poland. The most frequently used method of diagnosing voice diseases is videostroboscopy. However, to facilitate objective evaluation of voice efficiency as well as medical certification of occupational voice disorders, it is crucial to implement quantitative methods of voice assessment, particularly voice acoustic analysis. The aim of the study was to assess the results of acoustic analysis in 66 female teachers (aged 40-64 years), including 35 subjects with occupational voice pathologies (e.g., vocal nodules) and 31 subjects with functional dysphonia. The acoustic analysis was performed using the IRIS software, before and after a 30-minute vocal loading test. All participants were subjected also to laryngological and videostroboscopic examinations. After the vocal effort, the acoustic parameters displayed statistically significant abnormalities, mostly lowered fundamental frequency (Fo) and incorrect values of shimmer and noise to harmonic ratio. To conclude, quantitative voice acoustic analysis using the IRIS software seems to be an effective complement to voice examinations, which is particularly helpful in diagnosing occupational dysphonia.

  9. Diagnostic medicine: A comprehensive ABCDE algorithm for accurate interpretation of radiology and pathology images and data.

    Science.gov (United States)

    Zioga, Christina A; Destouni, Chariklia T

    2015-01-01

    A pathway to the procedure of interpreting radiology images or pathology slides is presented. This simplified mnemonic can be used as a memory aid determining the order in which diagnosis should be approached. First, before we place the radiology image in front of the lightbox or the slide under the microscope we have to be sure that it is adequately labelled and prepared (Correct). It is also necessary to have or gather all available information concerning the patient and if possible his full medical history (A, Available Information). Once we come across the image, two fundamental questions should be answered: which part of the body does the image concern and-where applicable-if the image is adequate (B, Body). Next, we proceed to answer if we have a neoplastic tissue or not (C, Cancer). We then either form a differential diagnosis list or we reach to a final diagnosis (D, Diagnosis), which is followed by the writing of the report (E, Exhibit). These series of steps followed as an ad hoc procedure by most specialists, are important in order to achieve a complete and clear diagnosis and report, which is intended to support optimal clinical practice. This ABCDE concept is a generic standard approach which is not limited to specific specimens and can lead to faster diagnosis with less mistakes.

  10. US Diagnosis for Thyroid Nodules with an Indeterminate Cytology

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Jong Geun; Kim, Dong Wook [Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of); Kang, Tae Woo [Saegyaero Hospital, Busan (Korea, Republic of)

    2011-09-15

    We wanted to assess the diagnostic efficacy of thyroid ultrasound (US) for evaluating thyroid nodules with indeterminate cytology. Among 1865 nodules in 1278 patients who received a prospective US diagnosis of their thyroid nodule(s) and who subsequently underwent US-guided fine-needle aspiration, 130 nodules with indeterminate cytology were enrolled in the study. Each thyroid nodule was prospectively classified by a single radiologist into 1 of 5 diagnostic categories: 'benign', 'probably benign', 'indeterminate', 'suspicious for malignancy' and 'malignant.' The solid nodules were classified using all 5 categories and the partially cystic nodules classified using 4 categories ('indeterminate' was omitted). We calculated the diagnostic efficacy of thyroid US by comparing the US diagnoses with the pathology results. Of 130 nodules with indeterminate cytology (130/1865, 7.0%), 62 nodules were surgically removed. Nineteen nodules were assigned to the indeterminate category on US. The malignantly rate of the US-indeterminate category was 56.5% (35/62). The sensitivity, specificity and positive and negative predictive values were 81.0%, 81.8%, 81.0%, 81.8% and 81.4%, respectively, when US-indeterminate nodules were excluded. There was no significant difference of diagnostic efficacy when these nodules were reclassified as malignant, but there was a significant difference of diagnostic efficacy when these nodules were reclassified as benign. Our US classification may be a feasible method for managing thyroid nodules with indeterminate cytology

  11. A novel diagnostic tool reveals mitochondrial pathology in human diseases and aging.

    Science.gov (United States)

    Scheibye-Knudsen, Morten; Scheibye-Alsing, Karsten; Canugovi, Chandrika; Croteau, Deborah L; Bohr, Vilhelm A

    2013-03-01

    The inherent complex and pleiotropic phenotype of mitochondrial diseases poses a significant diagnostic challenge for clinicians as well as an analytical barrier for scientists. To overcome these obstacles we compiled a novel database, www.mitodb.com, containing the clinical features of primary mitochondrial diseases. Based on this we developed a number of qualitative and quantitative measures, enabling us to determine whether a disorder can be characterized as mitochondrial. These included a clustering algorithm, a disease network, a mitochondrial barcode and two scoring algorithms. Using these tools we detected mitochondrial involvement in a number of diseases not previously recorded as mitochondrial. As a proof of principle Cockayne syndrome, ataxia with oculomotor apraxia 1 (AOA1), spinocerebellar ataxia with axonal neuropathy 1 (SCAN1) and ataxia-telangiectasia have recently been shown to have mitochondrial dysfunction and those diseases showed strong association with mitochondrial disorders. We next evaluated mitochondrial involvement in aging and detected two distinct categories of accelerated aging disorders, one of them being associated with mitochondrial dysfunction. Normal aging seemed to associate stronger with the mitochondrial diseases than the non-mitochondrial partially supporting a mitochondrial theory of aging.

  12. Association between autoimmune thyroiditis and depressive disorder in psychiatric outpatients.

    Science.gov (United States)

    Degner, Detlef; Haust, Merle; Meller, Johannes; Rüther, Eckart; Reulbach, Udo

    2015-02-01

    Thyroid diseases are often associated with psychiatric disorders. The prevalence of autoimmune thyroiditis in the general population is estimated to be at about 5-14 %. A clinical study was conducted to evaluate the association between autoimmune thyroiditis and depression in psychiatric outpatients. Fifty-two patients with depression and nineteen patients with schizophrenia (serving as control group), attending a psychiatric outpatient unit, were included. In addition to the measurement of thyroid-stimulating hormone (TSH), free triiodothyronine, free thyroxine, antithyroid peroxidase (anti-TPO) antibodies, and anti-thyroglobulin antibodies, ultrasound examination of the thyroid gland was performed. The proportion of pathologically increased anti-TPO levels in patients with depression was high. Furthermore, the distribution of pathologically increased anti-TPO levels was significantly (χ (2) = 5.5; p = 0.019) different between patients with depression (32.7 %) and patients with schizophrenia (5.3 %). In a gender- and age-adjusted logistic regression, the odds ratio of uni- or bipolar patients with depression for an autoimmune thyroiditis was ten times higher (95 % CI = 1.2-85.3) when compared with schizophrenia patients. TSH basal level did not differ between patients with depression and patients with schizophrenia. Our study demonstrates a strong association between anti-TPO levels, which are considered to be of diagnostic value for autoimmune thyroiditis (in combination with a hypoechoic thyroid in ultrasonography) with uni- or bipolar depression. It should be noted that the routinely measured TSH level is not sufficient in itself to diagnose this relevant autoimmune comorbidity.

  13. 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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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

  14. Clinical and dosimetric analysis of peculiarities of intellectual development, mental and behavioural disorders in children with oncological pathology of the thyroid gland

    International Nuclear Information System (INIS)

    Igumnov, S.A.; Drozdovich, V.V.

    1998-01-01

    A study of 116 children with thyroid cancer was conducted in 1995-1997. On the basis of the data obtained the three-level system of prophylaxis and correction of mental and behavioural disorders in the children suffering from thyroid cancer has been developed

  15. “Pseudo-thyroid lobe”: A diagnostic conundrum caused by ossified anterior longitudinal ligament on bone scan

    International Nuclear Information System (INIS)

    Zaman, Maseeh Uz; Fatima, Nosheen; Sajjad, Zafar; Zaman, Unaiza; Zaman, Areeba; Tahseen, Rabia

    2015-01-01

    Radionuclide bone imaging is one of the most commonly performed nuclear medicine procedure around the world and characterized by its high sensitivity and relatively low specificity. False positive findings on a bone scan are very common; however, dense uptake over unilateral ossified anterior longitudinal ligament appearing as single thyroid lobe on a bone scan has not been described in the literature

  16. Posterior meniscus root tears: associated pathologies to assist as diagnostic tools.

    Science.gov (United States)

    Matheny, Lauren M; Ockuly, Andrew C; Steadman, J Richard; LaPrade, Robert F

    2015-10-01

    The purpose of this study was to investigate associated pathologies identified at arthroscopy in patients with meniscus root tears. This study was Institutional Review Board approved. All patients who underwent arthroscopic knee surgery where a complete meniscus root tear was identified were included in this study. Concurrent ligament tears and articular cartilage changes ≥Outerbridge grade 2 were recorded and stored in a data registry. Fifty patients (28 males, 22 females) [mean age = 36.5 years (range 17.1-68.1 years)] who were diagnosed with a medial or lateral meniscus root tear at arthroscopy were included in this study out of 673 arthroscopic surgeries (prevalence 7.4 %). Twenty-three (46 %) patients had a medial meniscus root tear, 26 (52 %) patients had a lateral meniscus root tear and one (2 %) patient had both. Thirty-four per cent of patients (n = 17) underwent partial meniscectomy, while 60 % (n = 31) underwent suture repair. During arthroscopy, 60 % (n = 30) of patients were diagnosed with an anterior cruciate ligament (ACL) tear. Patients with lateral meniscus root tears were 10.3 times (95 % CI 2.6-42.5) more likely to have ACL tears than patients with medial meniscus root tears (p = 0.012). Patients who had medial meniscus root tears were 5.8 times (95 % CI 1.6-20.5) more likely to have chondral defects than patients who had lateral meniscus root tears (p = 0.044). In this study, patients' preoperative functional scores and activity levels were low. Patients with lateral meniscal root tears were more likely to have an ACL tear. Patients with medial meniscal root tears were more likely to have an knee articular cartilage defect with an Outerbridge grade 2 or higher chondral defect. This study confirms the importance of comprehensive assessment of concurrent injuries to properly diagnose meniscus root tears. IV.

  17. Thyroid cancer around Chernobyl

    International Nuclear Information System (INIS)

    Beral, V.

    1997-01-01

    The author's presentation on thyroid cancer around Chernobyl will focus on four different things. First will be the time trends, or the pattern of thyroid cancer occurrence before and after the accident. It is now very well known that the increase in thyroid cancer in children in several areas has been unprecedented. Second, the author discusses thyroid cancer in general and patterns of thyroid cancer around the world before the Chernobyl accident, including differences by age and pathology. Third, the author presents relatively crude analyses of risk according to dose to the thyroid gland. And last, the author attempts to contrast the findings for thyroid cancer in relation to the internal radioiodine dose in Chernobyl studies with analyses of the effects of external dose on thyroid cancer incidence. The bottom line to be developed is similar to that presented by Elaine Ron with regard to effects of external dose on thyroid cancer. The similarities between the childhood finding from Chernobyl studies and external radiation studies appear more remarkable than the differences

  18. Non-Hodgkin's lymphoma - Part I: Etiology, pathology, diagnostic evaluation and principles of management

    International Nuclear Information System (INIS)

    Gospodarowicz, Mary K.; Sutcliffe, Simon B.

    1997-01-01

    Objective: To review the approach to the diagnosis, classification, assessment, treatment and continuing management of patients with non-Hodgkin's lymphoma with an emphasis on the role of radiation therapy and the management of localized disease. Non-Hodgkin's lymphomas are a diverse group of diseases with an age standardized incidence of approximately 17 per 100,000 population. They become more common with increasing age and frequently involve extranodal sites. A number of potential etiological causes have been defined e.g. congenital and acquired immunodeficiency states, viruses, ionizing radiation, chronic inflammatory diseases and environmental toxins. Management is most influenced by the histological type of lymphoma. Numerous classifications have derived from architectural and cytological observations (Rappaport), concepts involving morphologic and phenotypic characterization of lineage and differentiation (Lukes-Collins, Kiel), and grade in the context of cytological differentiation and prognosis (Working Formulation). The introduction of the REAL classification has characterized clinico-pathological entities within a B-cell, T-cell and Hodgkin's disease framework, and recognized histopathologic grade as a variable within each category. The utility of this approach is likely to increase as disease entities become further defined through karyotypic and genotypic characterization. Stage is the other principal determinant of management. Whilst the Ann Arbor staging classification is employed routinely, its limitations in the context of extranodal disease, characterization of local disease extent and bulk have resulted in the incorporation of additional prognostic factors into management policies. Important prognostic factors include patient-related variables (age, performance status), disease-related attributes (bulk, number of involved nodes, B-symptoms) and biological attributes (LDH, ESR, β-2 macroglobulin, soluble CD-30, proliferation indices). The

  19. Non-Hodgkin's lymphoma - Part I: Etiology, pathology, diagnostic evaluation and principles of management

    International Nuclear Information System (INIS)

    Gospodarowicz, Mary K.; Sutcliffe, Simon B.

    1996-01-01

    Objective: To review the approach to the diagnosis, classification, assessment, treatment and continuing management of patients with non-Hodgkin's lymphoma with an emphasis on the role of radiation therapy and the management of localized disease. Non-Hodgkin's lymphomas are a diverse group of diseases with an age standardized incidence of approximately 17 per 100,000 population. They become more common with increasing age and frequently involve extranodal sites. A number of potential etiological causes have been defined e.g. congenital and acquired immunodeficiency states, viruses, ionizing radiation, chronic inflammatory diseases and environmental toxins. Management is most influenced by the histological type of lymphoma. Numerous classifications have derived from architectural and cytological observations (Rappaport), concepts involving morphologic and phenotypic characterization of lineage and differentiation (Lukes-Collins, Kiel), and grade in the context of cytological differentiation and prognosis (Working Formulation). The introduction of the REAL classification has characterized clinico-pathological entities within a B-cell, T-cell and Hodgkin's disease framework, and recognized histopathologic grade as a variable within each category. The utility of this approach is likely to increase as disease entities become further defined through karyotypic and genotypic characterization. Stage is the other principal determinant of management. Whilst the Ann Arbor staging classification is employed routinely, its limitations in the context of extranodal disease, characterization of local disease extent and bulk have resulted in the incorporation of additional prognostic factors into management policies. Important prognostic factors include patient-related variables (age, performance status), disease-related attributes (bulk, number of involved nodes, B-symptoms) and biological attributes (LDH, ESR, β-2 macroglobulin, soluble CD-30, proliferation indices). The

  20. Static and dynamic thyroid scintigraphy

    International Nuclear Information System (INIS)

    Mahlstedt, J.

    1986-01-01

    Static images as isolated investigation in thyroid diagnosis mainly provides morphologic information, and therefore sonography is largely applied for this purpose. 99m Tc-pertechnetate scans or 123 I-scans are indicated in cases of malpositions and serve to clarify lesions of unknown dignity. Additionally 201 Tl-chloride is suited for examinations with regard to metabolically active thyroid tissue, whereby differential diagnostic laboratory tests must be carried out to exclude parathyroid adenoma. Dynamic thyroid scans before and after regulation tests (suppression, stimulation) reflect the physiological correlation between the iodine avidity of the thyroid, the peripheral thyroid hormone concentrations and the hypophyseal regulation in the TRH-test. The main application of this procedure is the clarification of thyroid autonomy, i.e. indication, detection, quantification or exclusion of thyroid autonomy. For the treatment of immunogenic thyrotoxicosis, dynamic thyroid scintigraphy provides important information about the onset of remission, thus permitting to end thyreostatic therapy. (orig.) [de

  1. Indirect magnetic resonance arthrography of the shoulder; a reliable diagnostic tool for investigation of suspected labral pathology

    Energy Technology Data Exchange (ETDEWEB)

    Fallahi, Farshid [North Cumbria University Hospitals NHS Trust, Carlisle (United Kingdom); North Cumbria University Hospitals, Department of Radiology, Carlisle (United Kingdom); Green, Nick; Gadde, Sarat; Jeavons, Lisa; Armstrong, Patrick; Jonker, Leon [North Cumbria University Hospitals NHS Trust, Carlisle (United Kingdom)

    2013-09-15

    Indirect magnetic resonance arthrography (I-MRA) confers significant logistical advantages over direct MRA and does not require articular injection. In this study, we determined the diagnostic performance of I-MRA in relation to conventional MRI and arthroscopy or surgery in detecting tears of the glenoid labrum, including Bankart lesions and superior labral antero-posterior (SLAP) tears in a standard clinical setting. Ninety-one symptomatic patients underwent conventional MRI and I-MRA of the affected shoulder, followed by either arthroscopy or open surgery. The scans were interpreted independently by two experienced radiology consultants with a special interest in musculoskeletal radiology. Using the surgical findings as the standard of reference, sensitivity, specificity, and diagnostic accuracy of conventional non-contrast MRI and I-MRA in the detection of labral tears were calculated. The sensitivity of I-MRA was 95 and 97 %, respectively, for two radiologists as opposed to 79 and 83 % for conventional MRI. For both radiologists, the specificity of I-MRA, as well as MRI, was 91 % for detection of labral tears of all types. Accuracy of diagnosis was 93 and 95 %, respectively, for two radiologists with indirect MRA, compared to 84 and 86 % with non-contrast MRI. This retrospective study shows that I-MRA is a highly accurate and sensitive method for the detection of labral tears. The data obtained supports the use of I-MRA as standard practice in patients with shoulder instability due to suspected labral pathology where further investigative imaging is indicated. (orig.)

  2. [Diagnostics of magnesium deficiency and measurements of magnesium concentrations in biosubstrates in norm and in various pathologies].

    Science.gov (United States)

    Gromova, O A; Kalacheva, A G; Torshin, I Iu; Grishina, T R; Semenov, V A

    2014-01-01

    In accordance with the evidence from large-scale studies magnesium deficiency has a significant negative impact on the cardiovascular system, carbohydrate and fat metabolism. Diagnosis of magnesium deficiency should be based on clinical symptoms of magnesium deficit and confirmed by additional diagnostic methods--ECG myography, bone densitometry, and quantitative determination of magnesium in various biosubstrates (whole blood, red blood cells, plasma, serum, saliva, urine, nails, hair). It is also desirable to estimate dietary intake of magnesium according to food frequency questionnaires verified by measurements of magnesium in blood. Analysis of magnesium content in blood and other biosubstrates allows to establish those perturbations of compartmentalization of magnesium in tissues that are typical for a particular pathology. It is important to emphasize that one should not confuse values of magnesium levels measured in serum and in plasma as it leads to serious errors in the diagnosis of magnesium deficiency and results in underdiagnosis of magnesium deficiency (code E61.2 of ICD-10).

  3. A Calcitonin Non-producing Neuroendocrine Tumor of the Thyroid Gland.

    Science.gov (United States)

    Kasajima, Atsuko; Cameselle-Teijeiro, José; Loidi, Lourdes; Takahashi, Yoshio; Nakashima, Noriaki; Sato, Satoko; Fujishima, Fumiyoshi; Watanabe, Mika; Nakazawa, Tadao; Naganuma, Hiroshi; Kondo, Tetsuo; Kato, Ryohei; Sasano, Hironobu

    2016-12-01

    Neuroendocrine tumors of the thyroid gland are generally considered to derive from parafollicular endocrine cells (C cells) and are generally referred to as medullary thyroid carcinomas (MTC). Calcitonin secretion is almost always detected in MTC and a prerequisite for both clinical and pathological diagnosis. Thyroid neuroendocrine tumors without any apparent calcitonin secretion reflect a diagnostic dilemma because non-calcitonin-producing MTCs have virtually not been characterized. Here, we report a case of primary thyroid neuroendocrine tumors lacking calcitonin secretion or expression. The tumor cells expressed cytokeratins, chromogranin A, and synaptophysin, all of which were consistent with epithelial and neuroendocrine differentiation. Thyroid transcription factor-1 paired box gene 8, and carcinoembryonic antigen were also immunohistochemically detected, consistent with its thyroid origin. However, the tumor was negative for calcitonin both by immunohistochemistry and in situ hybridization, hence, not meeting the definition of MTC. Despite the loss of calcitonin expression, immunoreactivity for the calcitonin-gene-related peptide was detected in the tumor. Somatic gene mutations of RET, H-RAS, K-RAS, or BRAF were not detected in this case. A limited number of calcitonin non-producing thyroid neuroendocrine tumors are available in the scientific literature available in English, and its etiology and clinical manifestations remain largely unknown. Our case, along with the rare, previously reported cases, suggests that calcitonin non-producing neuroendocrine tumors of the thyroid gland are most likely derived from C cells, but should be differentiated from ordinary MTCs.

  4. Maintaining euthyroidism: fundamentals of thyroid hormone ...

    African Journals Online (AJOL)

    Thyroid-related pathologies, especially subclinical and clinical hypothyroidism, are commonly described in clinical practice. While illnesses related to aberrant thyroid hormone homeostasis are the most prevalent endocrinological conditions diagnosed, important aspects related to thyroid hormone physiology are often ...

  5. Thyroid hemiagenesis with immunthyropathy

    International Nuclear Information System (INIS)

    Mikosch, P.; Gallowitsch, H.J.; Kresnik, E.; Lind, P.

    1999-01-01

    A case of Graves' disease occurring in a patient with hemiagenesis is presented. The detection of the rare occurrence of a congential hemiagenesis is often made by either clinical symptoms of thyroid dysfunction or anatomical abnormalities such as nodular goiter. The symptoms of hyperthyroidism in the current case led to the diagnostic confirmation by scintiscanning and ultrasonography of an absent lobe. Anti-thyroid antibody studies documented the presence of Graves' disease within the remaining lobe. (orig.) [de

  6. Vascularity in thyroid neoplasms

    DEFF Research Database (Denmark)

    Larsen, Karen Kjaer; Andersen, Niels Frost; Melsen, Flemming

    2006-01-01

    The aim of the present study was to evaluate the reliability of four different methods (vascular grading, Chalkley count, microvessel density (MVD) and stereological estimation) for quantifying intratumoral microvascularity in thyroid neoplasms, by comparing the variability within and between...... count should be the preferred method for assessing microvascularity in thyroid neoplasms. The diagnostic evaluation revealed a tendency towards higher degree of vascularity in FA compared to both FC and PC for all methods. No statistically significant association was seen between vascular density...

  7. Comparison analysis between conventional ultrasonography and ultrasound elastography of thyroid nodules

    Energy Technology Data Exchange (ETDEWEB)

    Shuzhen, Cong, E-mail: cinufzu@163.com [People' s Hospital of Guangdong Province, Department of Ultrasound, Guangdong (China)

    2012-08-15

    Objective: To compare the effectiveness of conventional ultrasonography and ultrasound elastography in differential diagnosis of thyroid nodular diseases. Methods: 244 patients with 291 thyroid nodules were examined by ultrasonography and ultrasound elastography respectively; the examination results were compared against pathological findings to determine the effectiveness of these two examination methods. Results: The sensitivity and positive predictive value of conventional ultrasonography is higher than those of ultrasound elastography, but its specificity, accuracy, and negative predictive value is lower than those of the later. Conclusions: Ultrasound elastography is superior to conventional ultrasonography in differential diagnosis of thyroid nodules. However, ultrasonography is the basis of examination; only on this basis, an additional ultrasound elastography examination could greatly improve the diagnostic rate of thyroid nodular diseases.

  8. Thyroid Metastasis from Breast Carcinoma Accompanied by Papillary Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Song-I Yang

    2014-07-01

    Full Text Available Metastasis to the thyroid gland is very rare. Recently, we experienced a case of thyroid metastasis from breast cancer accompanying a papillary thyroid. A 51-year-old female patient presented with a palpated lymph node on her left lateral neck. The patient had undergone a left modified radical mastectomy followed by chemotherapy and hormonal therapy 12 years prior. Ultrasonography of the neck revealed a malignant looking nodule at the left thyroid lobe, measuring 0.9 × 0.9 cm, and several cystic nodules at the right thyroid lobe. Ultrasonography of the neck additionally revealed a malignant looking lymph node at the right level VI. Fine-needle aspiration of the left thyroid lobe resulted in a diagnosis of papillary thyroid carcinoma and that of the right level VI in Hurthle cell lesion. The patient had a total thyroidectomy with selective dissection of the left neck node. Pathologic assessment of the specimen revealed metastatic carcinoma from the breast carcinoma and papillary thyroid carcinoma. Although the thyroid gland is highly vascularized, metastasis of malignant tumors to the thyroid is relatively rare and detection of metastasis shows a low frequency. So a careful evaluation of thyroid tumor should be considered in a patient with a history of other malignancy.

  9. Evaluation of diffuse thyroid diseases and thyroid nodules by CT

    International Nuclear Information System (INIS)

    Okamoto, Kyoko; Imanishi, Yoshimasa; Nakaji, Shunsuke; Shinagawa, Toshihito

    2007-01-01

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

  10. Treatment of thyroid follicular carcinoma.

    Science.gov (United States)

    Ríos, Antonio; Rodríguez, José M; Parrilla, Pascual

    2015-12-01

    Differentiated thyroid carcinoma includes 2 different tumor types, papillary (PC) and follicular carcinoma (FC), and although similar, their prognosis is different. FC is uncommon, and this has led to it often being analyzed together with PC, and therefore the true reality of this tumor is difficult to know. As a result, the diagnostic and therapeutic management and the prognostic factors in differentiated carcinoma are more predictive of PC than FC. In this review we analyze the current state of many of the therapeutic aspects of this pathology. The best surgical technique and the usefulness of associated lymphadenectomy is also analyzed. Regarding post-surgical ablation with 131I, the indications, doses and usefulness are discussed. For the remaining therapies we analyze the few indications for radiotherapy and chemotherapy, and of new drugs such as tyrosine kinase inhibitors. Copyright © 2015 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Infrapopliteal calcification patterns in critical limb ischemia: diagnostic, pathologic and therapeutic implications in the search for the endovascular holy grail.

    Science.gov (United States)

    Mustapha, Jihad A; Diaz-Sandoval, Larry J; Saab, Fadi

    2017-06-01

    Critical limb ischemia (CLI) represents the terminal stage of peripheral arterial disease (PAD) and is characterized by multilevel and multivessel disease. Amongst patients with infrainguinal disease, approximately one third have predominantly isolated infrapopliteal disease and the remaining two thirds, a combination of femoropopliteal and infrapopliteal disease. Isolated infrapopliteal disease is mainly seen in the elderly, diabetic, or dialysis-dependent patients. These patients have higher risk of amputation and shorter amputation-free survival. Infrapopliteal disease presents with either complex high-grade calcified tandem lesions in multiple vessels or with long chronic total occlusion (CTO) segments with plaques characterized by higher calcium and lower fibro-fatty content than the inflow vessels, as arterial calcium deposition increases as we progress distally in the arterial tree. Vascular calcification occurs in both intima and media. Intimal calcification leads to development of calcified atheroma and occlusive lesions. Medial calcification leads to stiffening and decrease in arterial wall elasticity and compliance leading to atherosclerosis, reduced perfusion, and PAD, increasing cardiovascular mortality among patients with end-stage renal disease. This article attempts to review the implications of the diverse pathologic patterns of calcium distribution in infrapopliteal vessels of CLI patients, on the diagnostic modalities, technological developments, and the evolution of therapeutic approaches to improve outcomes among these patients. A critical analysis of the currently available data is provided, pointing to the surprising omission on the role of calcium on outcomes, and future directions are discussed. Is infrapopliteal calcium a roadblock or the avenue towards new paths? Necessity remains the mother of invention.

  12. Endocrine pathology: past, present and future.

    Science.gov (United States)

    Asa, Sylvia L; Mete, Ozgur

    2018-01-01

    Endocrine pathology is the subspecialty of diagnostic pathology which deals with the diagnosis and characterisation of neoplastic and non-neoplastic diseases of the endocrine system. This relatively young subspecialty was initially focused mainly on thyroid and parathyroid pathology, with some participants also involved in studies of the pituitary, the endocrine pancreas, and the adrenal glands. However, the endocrine system involves much more than these traditional endocrine organs and the discipline has grown to encompass lesions of the dispersed neuroendocrine cells, including neuroendocrine tumours (NETs) of the lungs, gastrointestinal tract, thymus, breast and prostate, as well as paraganglia throughout the body, not just in the adrenals. Indeed, the production of hormones is the hallmark of the endocrine system, and some aspects of gynecological/testicular, bone and liver pathology also fall into the realm of this specialty. Many of the lesions that are the focus of this discipline are increasing in incidence and their pathology is becoming more complex with increased understanding of molecular pathology and a high incidence of familial disease. The future of endocrine pathology will demand a depth of understanding of structure, function, prognosis and prediction as pathologists play a key role in the multidisciplinary care team of patients with endocrine diseases. It is anticipated that new technologies will allow increased subspecialisation in pathology and growth of this important area of expertise. Copyright © 2017 Royal College of Pathologists of Australasia. Published by Elsevier B.V. All rights reserved.

  13. Esterase activity in the guinea pig thyroid under normal and pathological conditions (vitamin A deficiency) with special regard to cyst-like structures

    DEFF Research Database (Denmark)

    Kirkeby, S

    1977-01-01

    By use of different activators and inhibitors, TOCP(tri-o-cresyl phosphate), PCMB (parachloromercury benzoate), NiCl2, Pb(NO3)2, HgCl2, Hg(NO3)2, eserine and sodium taurocholate, it is shown that the esterase in the cyst cells and in group I cells of the guinea pig thyroid probably are A-esterase...... isoenzymes. The activity in the majority of cyst cells is considerably stronger than in the other thyroid epithelial cells, and it is resistant to Hg inactivation. Neither esterase type nor intensity of the reaction product is altered in group I-II or cyst cells during vitamin A-deficiency. When a normal...... diet is given, the esterase in all thyroid epithelial cells is very sensitive to sodium taurocholate, while in cyst cells it is rather resistant to this inhibitor at vitamin-A-deficiency....

  14. Thyroid ultrasound-guided fine-needle aspiration : The positive influence of on-site adequacy assessment and number of needle passes on diagnostic cytology rate

    NARCIS (Netherlands)

    de Koster, Elizabeth J.|info:eu-repo/dai/nl/413775151; Kist, Jakob W.|info:eu-repo/dai/nl/413752224; Vriens, Menno R.|info:eu-repo/dai/nl/236443461; Rinkes, Inne H M Borel|info:eu-repo/dai/nl/10221350X; Valk, Gerlof D.|info:eu-repo/dai/nl/163319391; De Keizer, Bart|info:eu-repo/dai/nl/271625112

    2016-01-01

    Objective: Nondiagnostic cytology is the most important limitation of thyroid ultrasound-guided fine-needle aspiration (US-FNA). This study aimed to identify factors associated with the adequacy rate of thyroid US-FNA. Study Design: Consecutive thyroid US-FNAs (2006-2013) were retrospectively

  15. Thyroid Ultrasound-Guided Fine-Needle Aspiration: The Positive Influence of On-Site Adequacy Assessment and Number of Needle Passes on Diagnostic Cytology Rate

    NARCIS (Netherlands)

    Koster, E.J. de; Kist, J.W.; Vriens, M.R.; Rinkes, I.H.; Valk, G.D.; Keizer, B. de

    2016-01-01

    OBJECTIVE: Nondiagnostic cytology is the most important limitation of thyroid ultrasound-guided fine-needle aspiration (US-FNA). This study aimed to identify factors associated with the adequacy rate of thyroid US-FNA. STUDY DESIGN: Consecutive thyroid US-FNAs (2006-2013) were retrospectively

  16. Painless thyroiditis associated to thyroid carcinoma: role of initial ultrasonography evaluation.

    Science.gov (United States)

    Valentini, Raisa Bressan; Macedo, Bruno Mussoi de; Izquierdo, Rogério Friedrich; Meyer, Erika Laurini Souza

    2016-04-01

    Even though it is a rare event, most associations of thyroid carcinoma with subacute thyroiditis described in the literature are related to its granulomatous form (Quervain's thyroiditis). We present a patient with subacute lymphocytic thyroiditis (painless thyroiditis) and papillary thyroid cancer that was first suspected in an initial ultrasound evaluation. A 30-year old female patient who was referred to the emergency room due to hyperthyroidism symptoms was diagnosed with painless thyroiditis established by physical examination and laboratory findings. With the presence of a palpable painless thyroid nodule an ultrasound was prescribed and the images revealed a suspicious thyroid nodule, microcalcification focus in the heterogeneous thyroid parenquima and cervical lymphadenopathy. Fine needle aspiration biopsy was taken from this nodule; cytology was assessed for compatibility with papillary thyroid carcinoma. Postsurgical pathology evaluation showed a multicentric papillary carcinoma and lymphocytic infiltration. Subacute thyroiditis, regardless of type, may produce transitory ultrasound changes that obscure the coexistence of papillary carcinoma. Due to this, initial thyroid ultrasound evaluation should be delayed until clinical recovery. We recommended a thyroid ultrasound exam for initial evaluation of painless thyroiditis, particularly in patients with palpable thyroid nodule. Further cytological examination is recommended in cases presenting with suspect thyroid nodule and/or non-nodular hypoechoic (> 1 cm) or heterogeneous areas with microcalcification focus.

  17. Accurate Determination of the Pathological Stage with the Gross Dissection Protocol for Radical Cystectomy (GDPRC in Daily Routine Diagnostics

    Directory of Open Access Journals (Sweden)

    Farkas Sükösd

    2015-12-01

    diagnostic accuracy.-----------------------------------------Cite this article as:  Sükösd F, Iványi B, Pajor L. Accurate Determination of the Pathological Stage with the Gross Dissection Protocol for Radical Cystectomy (GDPRC in Daily Routine Diagnostics . Int J Cancer Ther Oncol 2015; 3(4:3407.[This abstract was presented at the BIT’s 8th Annual World Cancer Congress, which was held from May 15-17, 2015 in Beijing, China.

  18. Guidelines for a national epidemiological surveillance system of thyroid cancer in France

    International Nuclear Information System (INIS)

    2002-10-01

    At the request of the French Department of Health, a multidisciplinary Thyroid Cancer Committee, coordinated by the French Public Health Agency analysed the observed increase of thyroid cancer incidence in France and outlined the limits of the present case registration system. This Committee set up guidelines to improve the national surveillance system of thyroid cancer. The Committee analysed 4 models for the incidence survey, 3 of which have been excluded: a poor cost-benefit ratio precludes the constitution of a national registry dedicated to thyroid cancer; however, the Committee has recommended this model that still exists for thyroid cancer of the youth(under 19 years old), a national system base exclusively on pathological data would only be relevant after significant improvement of data collection, obligatory of all cases of thyroid cancer is inappropriate considering the fit prognosis of this cancer. A two level system is proposed with continuous registration of incident caes through the National Hospital Discharge survey, specific focused analysis of clinical and pathological data in case of a cluster alert in any given area. Whatever the system, it seems necessary to in general: propose a unique health registration number per patient, improve access to medical data, organize a national standardised collection of pathological findings, follow up the diagnosis practices related to thyroid cancer that have an impact on incidence rates. In conclusion, a reliable incidence survey and a follow up of diagnostic practices and of risk factors may provide a relevant model of epidemiological survey of thyroid cancers in France but such a system requires a long lasting strategic and financial involvement. (author)

  19. Differential diagnosis of thyroid nodules with virtual touch tissue imaging of ARFI elastography

    Science.gov (United States)

    Li, Tao; Zhou, Pei; Ding, Mingyue; Mi, Yongwei; Li, Yiyong; Zhang, Ji

    2016-04-01

    The aim of this study was to evaluate the diagnostic performance of virtual touch tissue imaging (VTI) based on ARFI elastography technique for differentiating malignant from benign thyroid nodules. One hundred pathologically proven thyroid nodules (80 benign, 20 malignant) in 76 participants were recruited in this study. The likelihood of malignancy in the light of VTI features was scored into 6 levels by one experienced sonogist who was blinded to pathological results. In addition, the mean gray value within the thyroid nodule (mGVTN) derived from VTI image was calculated for quantitative analysis. Receiver-operating characteristic curve (ROC) analyses were performed to assess the diagnostic performance of VTI score and mGVTN. The frequency of malignant nodules (11/20) classified between VTI levels 4 to 6 was more than that of benign nodules (6/80) (p thyroid nodules. The diagnosis performance of mGVTN was almost consistent with that of VTI score, which indicated that the mGVTN as a quantitative parameter might facilitate doctors diagnosing malignant thyroid nodules by VTI.

  20. Cervical lymph node metastases from thyroid cancer: does thyroglobulin and calcitonin measurement in fine needle aspirates improve the diagnostic value of cytology?

    Directory of Open Access Journals (Sweden)

    Baldini Enke

    2013-02-01

    Full Text Available Abstract Background Measurement of thyroglobulin (Tg protein in the washout of the needle used for fine needle aspiration biopsy cytology (FNAB-C has been shown to increase the sensitivity of FNAB-C in identifying cervical lymph node (CLN metastasis from well-differentiated thyroid cancer (TC. In this study, we evaluated whether routine measurement of Tg protein (FNAB-Tgp, Tg mRNA (FNAB-Tgm and calcitonin (CT mRNA (FNAB-CTm in the FNAB washout of CLN increases the accuracy of FNAB-C in the diagnosis of suspicious metastatic CLN. Methods In this prospective study 35 CLN from 28 patients were examined. Histology showed metastatic papillary TC (PTC in 26 CLN, metastatic medullary TC (MTC in 3 CLN, metastatic anaplastic TC (ATC in 3 CLN and 3 metastatic CLN from extra-thyroidal cancers. Results The overall accuracy of FNAB-C was 84.4%, reaching 95.7% when the analysis was restricted to PTC. Both FNAB-Tgp and FNAB-Tgm compared favorably with FNAB-C and shown diagnostic performances not statistically different from that of FNAB-C. However, FNAB-Tgp and FNAB-Tgm/FNAB-CTm were found useful in cases in which cytology results were inadequate or provided diagnosis inconsistent with patient's clinical parameters. Conclusions We demonstrated that FNAB-C, Tg/CT mRNA and Tg protein determination in the fine-needle washout showed similar accuracy in the diagnosis of metastatic CLN from TC. The results of this study suggest that samples for Tg protein and Tg/CT mRNA measurements from CLN suspicious for metastatic TC should be collected, but their measurements should be restricted to cases in which FNAB-C provides uninformative or inconsistent diagnosis with respect to patient's clinical parameters.

  1. Cervical lymph node metastases from thyroid cancer: does thyroglobulin and calcitonin measurement in fine needle aspirates improve the diagnostic value of cytology?

    Science.gov (United States)

    2013-01-01

    Background Measurement of thyroglobulin (Tg) protein in the washout of the needle used for fine needle aspiration biopsy cytology (FNAB-C) has been shown to increase the sensitivity of FNAB-C in identifying cervical lymph node (CLN) metastasis from well-differentiated thyroid cancer (TC). In this study, we evaluated whether routine measurement of Tg protein (FNAB-Tgp), Tg mRNA (FNAB-Tgm) and calcitonin (CT) mRNA (FNAB-CTm) in the FNAB washout of CLN increases the accuracy of FNAB-C in the diagnosis of suspicious metastatic CLN. Methods In this prospective study 35 CLN from 28 patients were examined. Histology showed metastatic papillary TC (PTC) in 26 CLN, metastatic medullary TC (MTC) in 3 CLN, metastatic anaplastic TC (ATC) in 3 CLN and 3 metastatic CLN from extra-thyroidal cancers. Results The overall accuracy of FNAB-C was 84.4%, reaching 95.7% when the analysis was restricted to PTC. Both FNAB-Tgp and FNAB-Tgm compared favorably with FNAB-C and shown diagnostic performances not statistically different from that of FNAB-C. However, FNAB-Tgp and FNAB-Tgm/FNAB-CTm were found useful in cases in which cytology results were inadequate or provided diagnosis inconsistent with patient's clinical parameters. Conclusions We demonstrated that FNAB-C, Tg/CT mRNA and Tg protein determination in the fine-needle washout showed similar accuracy in the diagnosis of metastatic CLN from TC. The results of this study suggest that samples for Tg protein and Tg/CT mRNA measurements from CLN suspicious for metastatic TC should be collected, but their measurements should be restricted to cases in which FNAB-C provides uninformative or inconsistent diagnosis with respect to patient's clinical parameters. PMID:23421519

  2. Thyroid Nodules

    Science.gov (United States)

    Thyroid nodules Overview Thyroid nodules are solid or fluid-filled lumps that form within your thyroid, a small gland located at the base of ... just above your breastbone. The great majority of thyroid nodules aren't serious and don't cause ...

  3. Esterase activity in the guinea pig thyroid under normal and pathological conditions (vitamin A deficiency) with special regard to cyst-like structures

    DEFF Research Database (Denmark)

    Kirkeby, S

    1977-01-01

    By use of different activators and inhibitors, TOCP(tri-o-cresyl phosphate), PCMB (parachloromercury benzoate), NiCl2, Pb(NO3)2, HgCl2, Hg(NO3)2, eserine and sodium taurocholate, it is shown that the esterase in the cyst cells and in group I cells of the guinea pig thyroid probably are A-esterase......By use of different activators and inhibitors, TOCP(tri-o-cresyl phosphate), PCMB (parachloromercury benzoate), NiCl2, Pb(NO3)2, HgCl2, Hg(NO3)2, eserine and sodium taurocholate, it is shown that the esterase in the cyst cells and in group I cells of the guinea pig thyroid probably are A......-esterase isoenzymes. The activity in the majority of cyst cells is considerably stronger than in the other thyroid epithelial cells, and it is resistant to Hg inactivation. Neither esterase type nor intensity of the reaction product is altered in group I-II or cyst cells during vitamin A-deficiency. When a normal...... diet is given, the esterase in all thyroid epithelial cells is very sensitive to sodium taurocholate, while in cyst cells it is rather resistant to this inhibitor at vitamin-A-deficiency....

  4. The thyroid protection in case of nuclear accident by an iodine prophylaxis

    International Nuclear Information System (INIS)

    Carrera, F.

    2004-12-01

    The first part of the thesis describes the thyroid functional activity and the place of iodine in organisms, iodine is linked to the thyroid functioning. The second part of the thesis is interested in the ionizing radiation effect in general then on the thyroid. The external irradiation has been essentially studied from the data of the Hiroshima and Nagasaki explosions. The internal contamination of thyroid is known by the use of 131 iodine for medical or diagnostic uses. A mixed contamination is described with the example of the nuclear test in Marshall Islands. Follows a chapter devoted to the thyroid cancers, the most serious thyroid radioinduced pathology. The third part concerns the place of iodine in the nuclear power plants. The functioning of a nuclear power plant is described as well as its radioactive emission in normal operation and in accidental situation. The sanitary impact of a radioactive iodine emission is detailed from a bibliographic synthesis coming from the studies on the development of thyroid cancers appeared after the Chernobylsk disaster. The ingestion of steady iodine constitutes an preventive measure efficient against the arising of these cancers. Its efficiency and innocuousness are discussed. Then a last part summarizes the administrative measures taken in France so that the population can have at her disposal iodine tablets before and in case of accidents. (N.C.)

  5. Molecular Pathology and Personalized Medicine: The Dawn of a New Era in Companion Diagnostics—Practical Considerations about Companion Diagnostics for Non-Small-Cell-Lung-Cancer

    Directory of Open Access Journals (Sweden)

    Till Plönes

    2016-01-01

    Full Text Available Companion diagnostics (CDx have become a major tool in molecular pathology and assist in therapy decisions in an increasing number of various cancers. Particularly, the developments in lung cancer have been most impressing in the last decade and consequently lung cancer mutation testing and molecular profiling has become a major business of diagnostic laboratories. However, it has become difficult to decide which biomarkers are currently relevant for therapy decisions, as many of the new biomarkers are not yet approved as therapy targets, remain in the status of clinical studies, or still have not left the experimental phase. The current review is focussed on those markers that do have current therapy implications, practical implications arising from the respective companion diagnostics, and thus is focused on daily practice.

  6. Evidence-Based Diagnostic Algorithm for Glioma: Analysis of the Results of Pathology Panel Review and Molecular Parameters of EORTC 26951 and 26882 Trials.

    Science.gov (United States)

    Kros, Johan M; Huizer, Karin; Hernández-Laín, Aurelio; Marucci, Gianluca; Michotte, Alex; Pollo, Bianca; Rushing, Elisabeth J; Ribalta, Teresa; French, Pim; Jaminé, David; Bekka, Nawal; Lacombe, Denis; van den Bent, Martin J; Gorlia, Thierry

    2015-06-10

    With the rapid discovery of prognostic and predictive molecular parameters for glioma, the status of histopathology in the diagnostic process should be scrutinized. Our project aimed to construct a diagnostic algorithm for gliomas based on molecular and histologic parameters with independent prognostic values. The pathology slides of 636 patients with gliomas who had been included in EORTC 26951 and 26882 trials were reviewed using virtual microscopy by a panel of six neuropathologists who independently scored 18 histologic features and provided an overall diagnosis. The molecular data for IDH1, 1p/19q loss, EGFR amplification, loss of chromosome 10 and chromosome arm 10q, gain of chromosome 7, and hypermethylation of the promoter of MGMT were available for some of the cases. The slides were divided in discovery (n = 426) and validation sets (n = 210). The diagnostic algorithm resulting from analysis of the discovery set was validated in the latter. In 66% of cases, consensus of overall diagnosis was present. A diagnostic algorithm consisting of two molecular markers and one consensus histologic feature was created by conditional inference tree analysis. The order of prognostic significance was: 1p/19q loss, EGFR amplification, and astrocytic morphology, which resulted in the identification of four diagnostic nodes. Validation of the nodes in the validation set confirmed the prognostic value (P < .001). We succeeded in the creation of a timely diagnostic algorithm for anaplastic glioma based on multivariable analysis of consensus histopathology and molecular parameters. © 2015 by American Society of Clinical Oncology.

  7. Diagnostic value of recombinant human thyrotropin-stimulated ¹²³I whole-body scintigraphy in the follow-up of patients with differentiated thyroid cancer.

    Science.gov (United States)

    Alzahrani, Ali S; AlShaikh, OmAlkhaire; Tuli, Mahmoud; Al-Sugair, Abdulaziz; Alamawi, Reem; Al-Rasheed, Maha M

    2012-03-01

    Published data on recombinant human thyrotropin- (rhTSH-) stimulated iodine-123 (¹²³I) diagnostic whole-body scintigraphy (DxWBS) in differentiated thyroid cancer (DTC) surveillance after initial treatment are limited. We sought to evaluate this modality's diagnostic value in this setting. We retrospectively compared rhTSH-stimulated ¹²³I DxWBS results with DTC status concurrently determined by stimulated serum thyroglobulin (Tg) measurement, neck ultrasonography, and other imaging studies. Disease was considered present based on stimulated Tg level ≥1 μg/L without interfering Tg autoantibodies with or without positive imaging or biopsy-proven DTC. We also compared scan positivity and disease detection rates of rhTSH-stimulated DxWBS scans obtained with ¹²³I with those acquired with iodine-131 (¹³¹I) during the same period. The sample comprised 105 consecutive totally thyroidectomized patients undergoing rhTSH-aided DxWBS with I-123 (n = 67) or with ¹³¹I (n = 38) for diagnostic follow-up. rhTSH, 0.9 mg/d, was injected intramuscularly on 2 consecutive days. Oral diagnostic activities of 5 to 10 mCi (185-370 MBq) ¹²³I or 3 mCi (111 MBq) ¹³¹I were given on the third day. DxWBS was performed 24 hours (¹²³I) or 48 to 72 hours (¹³¹I) later. rhTSH-aided ¹²³I DxWBS scans showed 35.3% sensitivity, 98.0% specificity, 85.7% positive predictive value, and 81.6% negative predictive value. rhTSH-stimulated ¹²³I and ¹³¹I DxWBS did not differ in scan positivity (10.4% vs. 13.2%, P = 0.75) or disease detection rates (35.3% vs. 27.8%, P = 1.00). In DTC, rhTSH-aided ¹²³I DxWBS achieves comparable results in diagnostic follow-up with those of rhTSH-aided ¹³¹I DxWBS. Future studies should address the preablation setting and scan activity and timing.

  8. Reevaluation of the Thyroid Scan for the Assessment of Pathophysiologic Status of Thyroid Disease

    International Nuclear Information System (INIS)

    Woo, In Sook; Nah, Jung Il; Kim, Deog Yoon

    1991-01-01

    To diagnosis and understand the pathophysiologic status of thyroid disease, not only hormonal measurements but also thyroid scan is believed to have a unique role. Especially in the cases of the change of the thyroid function by thyroiditis, it is emphasized that thyroid scan can be helpful in differential diagnosis, Discordant results of thyroid hormone levels and thyroid scan are found in transient hyperthyroidism, or in transient hypothyroidism. We analysed and reevaluated thyroid scan to look at the importance of thyroid scan. The results are summarised as follows: 1) 80%. of hyperthyroid patients had hyperthyroidism increased RAIU with even density, they are compatible with Graves' disease. 2) 2.1% of hyperthyroid patients had normal or decreased RAIU, which are classified as high iodine turn over genuine hyperthyroidism. 3) 8.5% of hyperthyroid patients had markedly decreased RAIU at both 2 hour and 24 hour, whose pathologic processes are suggested to be heterogenous namely subacute thyroiditis, postpartum thyroiditis, Hashimoto's thyroiditis, and pamless thyroiditis. 4) 45% of hypothyroid patients had increased 24 hr RAIU, 30% of hypothyroid patients were normal, 25%, decreased. In conclusion, thyroid scan should be reevaluated its useful role to asses the pathophysiologic status of thyroid disease. Especially in cases of transient thyrotoxicosis, thyroid scan is essential to diagnose and follow up the disease process.

  9. Diagnostic value of selected biochemical markers in the detection of recurrence of medullary thyroid cancer - comparison of calcitonin, procalcitonin, chromogranin A, and carcinoembryonic antigen.

    Science.gov (United States)

    Woliński, Kosma; Kaznowski, Jarosław; Klimowicz, Aleksandra; Maciejewski, Adam; Łapińska-Cwojdzińska, Dagny; Gurgul, Edyta; Car, Adrian D; Fichna, Marta; Gut, Paweł; Gryczyńska, Maria; Ruchała, Marek

    2017-01-01

    Medullary thyroid cancer (MTC) is a malignancy of the thyroid gland, which derives from parafollicular C cells. Periodic measurement of biochemical markers of MTC remains a crucial part of patient follow-up and disease monitoring. The aim of the study was to compare the diagnostic value of four selected markers - calcitonin (Ct), procalcitonin (PCT), chromogranin A (CgA), and carcinoembryonic antigen (CEA). Patients with histopathologically confirmed MTC hospitalised in a single department between January 2015 and December 2015 were included in the study. Patients were subdivided into two groups: a remission group and an active disease group, based upon serum markers of MTC and imaging. Levels of Ct, PCT, CgA, and CEA were compared between the groups. Forty-four patients were included; 20 patients presented active disease and 24 were in remission. All patients with active disease had Ct exceeding the upper limit of normal range (10 pg/mL) - for that threshold the sensitivity was 100.0% and the specificity was 73.9%; for the best-fit threshold of 121.0 pg/mL the specificity was 95.8% with sensitivity 100.0%. There was significant correlation between Ct and PCT - p < 0.000001, r = 0.93. All patients with active disease exceeded the upper limit of the normal range (0.5 ng/mL) - for that threshold the sensitivity was 100.0% and the specificity was 83.3%; for the best-fit threshold of 0.95 ng/mL the specificity was 95.8% with sensitivity 100.0%. In case of CEA for the best-fit threshold of 12.66 ng/mL the specificity was 100.0% with sensitivity 57.9%; for CgA the best-fit threshold was 75.66 ng/mL with specificity 83.3% and sensitivity 75.0%. Our study confirms that PCT can be considered as an equivalent alternative for measurement of calcitonin. On the other hand, it is also worth noting that MTC can be a rare cause of very high levels of PTC not resulting from infectious diseases. The diagnostic value of CEA and chromogranin A is much lower and can be within the

  10. HIV and thyroid dysfunction.

    Science.gov (United States)

    Parsa, Alan A; Bhangoo, Amrit

    2013-06-01

    Human Immunodeficiency virus (HIV) infection and Acquired Immunodeficiency Syndrome (AIDS) are associated with dysfunction of many endocrine organs and their axis. HIV infectivity leads to altered metabolism, poor oral intake and increased prevalence of weight loss and wasting which may have a role in thyroid dysfunction. Overt thyroid dysfunction occurs at similar rates as the general population while subclinical disease such as nonthyroidal illness (sick euthyroid syndrome), subclinical hypothyroidism and isolated low T4 levels are more frequent. Moreover, HAART therapy can complicate thyroid function further through drug interactions and the immune reconstitution inflammatory syndrome (IRIS). In this review we report the common thyroid dysfunctions associated with HIV before and after HAART therapy. We discuss presentation, diagnostic work up, treatment and follow up in each condition.

  11. Diagnostics

    DEFF Research Database (Denmark)

    Donné, A.J.H.; Costley, A.E.; Barnsley, R.

    2007-01-01

    In order to support the operation of ITER and the planned experimental programme an extensive set of plasma and first wall measurements will be required. The number and type of required measurements will be similar to those made on the present-day large tokamaks while the specification...... of the measurements—time and spatial resolutions, etc—will in some cases be more stringent. Many of the measurements will be used in the real time control of the plasma driving a requirement for very high reliability in the systems (diagnostics) that provide the measurements. The implementation of diagnostic systems......&D is needed to prepare the systems. In some cases the environmental difficulties are so severe that new diagnostic techniques are required. The starting point in the development of diagnostics for ITER is to define the measurement requirements and develop their justification. It is necessary to include all...

  12. MR imaging of diffuse thyroid disorders

    International Nuclear Information System (INIS)

    Inoue, Masaaki; Fujii, Koichi; Ohnishi, Takuya; Higashikawa, Motoki; Araki, Yutaka; Hamada, Tatsumi; Ishida, Osamu

    1996-01-01

    Magnetic resonance imaging was performed in 38 diffuse goiters, including 30 chronic thyroiditis and 8 Basedow disease. MR findings were analyzed as to degree of swelling, margin, internal structures including homogeneity and low intensity bands. With regard to signal intensity, thyroid-muscle-signal intensity ratios on T1 and T2-weighted images were measured in 19 normal thyroid glands, 30 chronic thyroiditis and 8 Basedow disease. Additionally thyroid-muscle-signal intensity ratios were compared between 19 hypothyroid glands and 11 euthyroid glands in chronic thyroiditis. Chronic thyroiditis tended to show lobulated margins, inhomogeneous intensity, and low intensity bands connecting with vessels or not. Basedow disease tended to display smooth margins, inhomogeneous intensity and low intensity bands connecting with vessels. Thyroid-muscle-signal intensity ratios of Basedow disease and chronic thyroiditis were significantly higher than those of normal thyroid gland at all sequences. In chronic thyroiditis thyroid-muscle-signal intensity ratios of euthyroid glands were significantly higher than those of hypothyroid glands. MR imaging could reflect pathologic features of diffuse goiters. Moreover, MR imaging is potentially contributory to speculate about thyroid function and degree of serious condition in diffuse thyroid disorders. (author)

  13. Cytomorphologic features distinguishing Bethesda category IV thyroid lesions from parathyroid

    Directory of Open Access Journals (Sweden)

    Simon Sung

    2017-01-01

    Full Text Available Background: Thyroid follicular cells share similar cytomorphological features with parathyroid. Without a clinical suspicion, the distinction between a thyroid neoplasm and an intrathyroidal parathyroid can be challenging. The aim of this study was to assess the distinguishing cytomorphological features of parathyroid (including intrathyroidal and Bethesda category IV (Beth-IV thyroid follicular lesions, which carry a 15%–30% risk of malignancy and are often followed up with surgical resection. Methods: A search was performed to identify “parathyroid” diagnoses in parathyroid/thyroid-designated fine-needle aspirations (FNAs and Beth-IV thyroid FNAs (follicular and Hurthle cell, all with diagnostic confirmation through surgical pathology, immunocytochemical stains, Afirma® analysis, and/or clinical correlation. Unique cytomorphologic features were scored (0-3 or noted as present versus absent. Statistical analysis was performed using R 3.3.1 software. Results: We identified five FNA cases with clinical suspicion of parathyroid neoplasm, hyperthyroidism, or thyroid lesion that had an eventual final diagnosis of the parathyroid lesion (all female; age 20–69 years and 12 Beth-IV diagnoses (11 female, 1 male; age 13–64 years. The following cytomorphologic features are useful distinguishing features (P value: overall pattern (0.001, single cells (0.001, cell size compared to red blood cell (0.01, nuclear irregularity (0.001, presence of nucleoli (0.001, nuclear-to-cytoplasmic ratio (0.007, and nuclear chromatin quality (0.028. Conclusions: There are cytomorphologic features that distinguish Beth-IV thyroid lesions and (intrathyroidal parathyroid. These features can aid in rendering correct diagnoses and appropriate management.

  14. Thyroid function testing in women who had a stillbirth

    NARCIS (Netherlands)

    Nijkamp, Janna W.; Korteweg, Fleurisca J.; Groen, Henk; Timmer, Albertus; Van den Berg, Gerrit; Bossuyt, Patrick M.; Mol, Ben Willem J.; Erwich, Jan Jaap H. M.

    ContextThyroid dysfunction is thought to be associated with stillbirth. Therefore, thyroid function is often recommended in the diagnostic investigations for stillbirth. ObjectiveWe aimed to evaluate the added value of thyroid function testing in the diagnostic investigations for stillbirth. Design

  15. Efficiency of the Bethesda System for Thyroid Cytopathology.

    Science.gov (United States)

    Mora-Guzmán, Ismael; Muñoz de Nova, José Luis; Marín-Campos, Cristina; Jiménez-Heffernan, José Antonio; Cuesta Pérez, Juan Julián; Lahera Vargas, Marcos; Torres Mínguez, Emma; Martín-Pérez, Elena

    2018-03-28

    Fine-needle aspiration biopsies are a key tool for preoperative assessment of thyroid nodules, and the Bethesda system is the preferred method to report cytological analysis. The purpose of this study is to assess the efficiency of the Bethesda system to identify the malignancy risk of thyroid nodules. Patients who underwent thyroid surgery between June 2010 and June 2017 were included. Samples were classified into 6categories according to rates of malignancy associated with each diagnostic category. In order to investigate the correlation between categories, a statistical analysis compared the categories with pathology reports. Diagnostic indicators were calculated as a screening test (categories IV, V, VI as true-positive) and as a method to identify malignancy (V, VI as true-positive). In a series of 522 patients, we found 184 (35.2%) malignant tumours, papillary carcinoma being the most prevalent with 155 cases (84.2%). Malignant rates for diagnostic categories were: I, 0%; II, 1.5%; III, 6.4%; IV, 31%; V, 86.5%; VI, 100%. A robust correlation was identified between categories on statistical analysis. For the «screening test» analysis, sensitivity was 98.9%, specificity 84.4%, positive predictive value 69.6%, negative predictive value 99.5%, and diagnostic accuracy 88.2%. Analysing the accuracy to detect malignancy, values were: sensitivity 98.6%, specificity 97.6%, positive predictive value 93.5%, negative predictive value 99.5%, diagnostic accuracy 97.9%. The Bethesda system is a clear and reliable approach to report thyroid cytology and therefore is an effective tool to identify malignancy risk and guide clinical management. Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Timing of post 131I ablation diagnostic whole body scan in differentiated thyroid cancer patients. Less than four months post ablation may be too early.

    Science.gov (United States)

    Winter, M; Winter, J; Heinzel, A; Behrendt, F F; Krohn, T; Mottaghy, F M; Verburg, F A

    2015-01-01

    to determine whether the first three months after 131I ablation is too early to perform radioiodine diagnostic whole body scintigraphy (dxWBS) in differentiated thyroid carcinoma patients. The files of 462 patients who were treated for DTC in our hospital were reviewed. All patients underwent surgical thyroidectomy. 146 patients had data available on a. a dxWBS which was performed less than four months (max 120 days) after 131I ablation with concurrent stimulated TSH stimulated thyroglobulin (Tg) measurement without further therapeutic measures between ablation and dxWBS and b. a second dxWBS or 131I therapy (rxWBS) within 1.5 years after ablation. A discordance between the initial and follow-up scan was found in 25/129 (19%) patients: of 54 patients with a positive initial dxWBS, scan results of a second dxWBS or rxWBS obtained with a suitable distance to the initial scan contradicted the initial one in 15 patients (27%). New lesions were discovered in 10/74 negative first dxWBS cases (14%). A discordance between the initial and follow-up stimulated Tg was found in 5/129 (4%) patients: 2/90 (2%) of patients with a negative stimulated Tg at initial dxWBS subsequently showed a positive results whereas 3/29 (10%) patients with an initially positive Tg showed a negative Tg level at the second procedure. Less than four months after 131I ablation is too early to perform radioiodine diagnostic whole body scintigraphy with concurrent TSH stimulated Tg measurement. The identification of the right, later, timepoint however requires further research.

  17. Diagnosis and pathology of endocrine diseases

    International Nuclear Information System (INIS)

    Shriver, B.D.

    1988-01-01

    This book contains 22 papers under the headings of Diagnosis and Pathology of endocrine diseases. Topics covered include: Laboratory tests in the diagnosis and management of thyroid disorders, Pathology of thyroid diseases, Diagnosis of adrenourtical disease, Radiologic techniques in evaluating endocrine disorders; and the Pituitary and adrenal glands

  18. Diagnosis and pathology of endocrine diseases

    Energy Technology Data Exchange (ETDEWEB)

    Shriver, B.D.

    1988-01-01

    This book contains 22 papers under the headings of Diagnosis and Pathology of endocrine diseases. Topics covered include: Laboratory tests in the diagnosis and management of thyroid disorders, Pathology of thyroid diseases, Diagnosis of adrenourtical disease, Radiologic techniques in evaluating endocrine disorders; and the Pituitary and adrenal glands.

  19. Thyroid cancer in child (about 9 cases)

    International Nuclear Information System (INIS)

    Ech-Charraq, I.; Ben Rais, N.

    2009-01-01

    Children thyroid cancer is a very uncommon affection. Its incidence has sharply risen among the patients who underwent therapeutic irradiation and after the Chernobylsk accident in the contaminated regions. Our study consists of emphasizing the distinctive features of children thyroid cancer on the epidemiological, clinical and para clinical aspects, in order to discuss diagnostic difficulties, prognostic elements as well as a therapeutic approach. Through a study conducted in the nuclear medical department of Rabat, we brought together 9 cases of thyroid cancer in children aged between 11 and 15 years old. In our series, the average age is 13 years, with a feminine prevalence. A family notion of goitre is reported in one case, without notion of irradiation, the revealing mode is mainly an euthyroid goitre and the cervical adenopathies, with good general health conditions being maintained. The scintigraphy showed a cold nodule, witch anatomo-pathological examination is papillary carcinoma. Extensive surgery, ira therapy and substitute hormonal treatment combined allowed a high recovery rate among our patients, with no side effects. The medium-term evolution was positive even in metastases cases. The prognostic is generally good, especially in the differentiated forms. (authors)

  20. Disorders of the equine thyroid gland.

    Science.gov (United States)

    Breuhaus, Babetta A

    2011-04-01

    Regulatory control of the thyroid gland in horses is similar to other species. Clinical signs of hypothyroidism in adult horses are minimal. Several drugs and physiologic and pathophysiological states can cause circulating thyroid hormone concentrations to be low without actual pathology of the thyroid gland. Thus, nonthyroidal factors must be ruled out before a diagnosis of hypothyroidism can be made. Thyroid hormone supplementation seems to be well tolerated, even in euthyroid horses. Neonatal foals have very high circulating thyroid hormone concentrations, and deficiencies result in significant clinical signs. Unlike in adults, two syndromes of hypothyroidism are well described in foals. Copyright © 2011. Published by Elsevier Inc.

  1. Endosonographic examination of thyroid gland among patients with nonthyroid cancers

    Science.gov (United States)

    Alkhatib, Amer A.; Mahayni, Abdulah A.; Chawki, Ghaleb R.; Yoder, Leon; Elkhatib, Fateh A.; Al-Haddad, Mohammad

    2016-01-01

    Objectives: There is limited endosonographic literature regarding thyroid gland pathology, which is frequently visualized during upper endoscopic ultrasound (EUS). Our objective was to assess the prevalence of benign and malignant thyroid lesions encountered during routine upper EUS within a cancer center setting. Materials and Methods: The data were prospectively collected and retrospectively analyzed. All upper EUS procedures performed between October 2012 and July 2014 were reviewed at a large referral cancer center. Data collected included patient demographics, preexisting thyroid conditions, thyroid gland dimensions, the presence or absence of thyroid lesions, and EUS morphology of lesions if present, and interventions performed to characterize thyroid lesions and pathology results when applicable. Results: Two hundred and forty-five EUS procedures were reviewed. Of these, 100 cases reported a detailed endosonographic examination of the thyroid gland. Most of the thyroid glands were endosonographically visualized when the tip of the scope was at 18 cm from the incisors. Twelve cases showed thyroid lesions, out of which three previously undiagnosed thyroid cancers were visualized during EUS (two primary papillary thyroid cancers and one anaplastic thyroid cancer). Transesophageal EUS-guided fine needle aspiration of thyroid lesions was feasible when the lesion was in the inferior portion of the thyroid gland, and the tip of the scope was at 18 cm or more from the incisors. Conclusions: Routine EUS examination may detect unexpected thyroid lesions including malignant ones. We encourage endosonographers to screen the visualized portions of the thyroid gland during routine withdrawal of the echoendoscope. PMID:27803906

  2. Endosonographic examination of thyroid gland among patients with nonthyroid cancers.

    Science.gov (United States)

    Alkhatib, Amer A; Mahayni, Abdulah A; Chawki, Ghaleb R; Yoder, Leon; Elkhatib, Fateh A; Al-Haddad, Mohammad

    2016-01-01

    There is limited endosonographic literature regarding thyroid gland pathology, which is frequently visualized during upper endoscopic ultrasound (EUS). Our objective was to assess the prevalence of benign and malignant thyroid lesions encountered during routine upper EUS within a cancer center setting. The data were prospectively collected and retrospectively analyzed. All upper EUS procedures performed between October 2012 and July 2014 were reviewed at a large referral cancer center. Data collected included patient demographics, preexisting thyroid conditions, thyroid gland dimensions, the presence or absence of thyroid lesions, and EUS morphology of lesions if present, and interventions performed to characterize thyroid lesions and pathology results when applicable. Two hundred and forty-five EUS procedures were reviewed. Of these, 100 cases reported a detailed endosonographic examination of the thyroid gland. Most of the thyroid glands were endosonographically visualized when the tip of the scope was at 18 cm from the incisors. Twelve cases showed thyroid lesions, out of which three previously undiagnosed thyroid cancers were visualized during EUS (two primary papillary thyroid cancers and one anaplastic thyroid cancer). Transesophageal EUS-guided fine needle aspiration of thyroid lesions was feasible when the lesion was in the inferior portion of the thyroid gland, and the tip of the scope was at 18 cm or more from the incisors. Routine EUS examination may detect unexpected thyroid lesions including malignant ones. We encourage endosonographers to screen the visualized portions of the thyroid gland during routine withdrawal of the echoendoscope.

  3. Thyroid nodule

    Science.gov (United States)

    ... symptoms, including: Fatigue Palpitations Chest pain Memory loss Thyroid nodules are sometimes found in people who have Hashimoto's disease. This may cause symptoms of an underactive thyroid gland, such as: Dry ...

  4. Thyroid Cancer

    Science.gov (United States)

    ... body work normally. There are several types of cancer of the thyroid gland. You are at greater ... imaging tests, and a biopsy to diagnose thyroid cancer. Treatment depends on the type of cancer you ...

  5. Thyroid Disease

    Science.gov (United States)

    ... for several months or longer, a condition called amenorrhea . If your body's immune system causes thyroid disease, ... at all for several months or longer (called amenorrhea). How does thyroid disease affect pregnancy? Pregnancy-related ...

  6. Sonographic scoring of solid thyroid nodules: effects of nodule size and suspicious cervical lymph node

    Directory of Open Access Journals (Sweden)

    Ozlem Unsal

    Full Text Available Abstract Introduction Ultrasound is the most frequently used imaging method to evaluate thyroid nodules. Sonographic characteristics of thyroid nodules which are concerning for malignancy are important to define the need for fine needle aspiration biopsy or open surgery. Objective To evaluate malignancy risk of solid thyroid nodules through sonographic scoring. The effects of nodule size ≥2 cm and associated pathologic cervical lymph node in scoring were examined in addition to generally excepted suspicious features. Methods Medical data of 123 patients underwent thyroid surgery were reviewed, and 89 patients (58 females, 31 males were included in the study. The presence and absence of each suspicious sonographic feature of thyroid nodules were scored as 1 and 0, respectively. Total ultrasound score was obtained by adding the positive ultrasound findings. Differently from the literature, nodule size ≥2 cm and associated pathologic cervical node were added in scoring criteria. The diagnostic performance of nodule characteristics for malignancy and the effect of total US score to discriminate malignant and benign disease were calculated. Results A significant relationship was found between malignancy and hypoechogenity, border irregularity, intranodular vascularity, and microcalcification (p < 0.05. Pathologic cervical node was observed predominantly in association with malignant nodules. Positive predictive value of suspicious cervical node for malignancy was 67%, similar to microcalcification. Nodule size ≥2 cm was not distinctive for diagnosis of malignancy. The number of suspicious sonographic features obtained with receiver operating characteristic analysis to discriminate between malignant and benign disease was three. Conclusion Sonographic scoring of thyroid nodules is an effective method for predicting malignancy. The authors suggest including associated pathologic node in the scoring criteria. Further studies with larger cohorts

  7. Consensus statement on surgical pathology of the aorta from the Society for Cardiovascular Pathology and the Association For European Cardiovascular Pathology: II. Noninflammatory degenerative diseases - nomenclature and diagnostic criteria

    NARCIS (Netherlands)

    Halushka, Marc K.; Angelini, Annalisa; Bartoloni, Giovanni; Basso, Cristina; Batoroeva, Lubov; Bruneval, Patrick; Buja, L. Maximilian; Butany, Jagdish; d'Amati, Giulia; Fallon, John T.; Gallagher, Patrick J.; Gittenberger-de Groot, Adriana C.; Gouveia, Rosa H.; Kholova, Ivana; Kelly, Karen L.; Leone, Ornella; Litovsky, Silvio H.; Maleszewski, Joseph J.; Miller, Dylan V.; Mitchell, Richard N.; Preston, Stephen D.; Pucci, Angela; Radio, Stanley J.; Rodriguez, E. Rene; Sheppard, Mary N.; Stone, James R.; Suvarna, S. Kim; Tan, Carmela D.; Thiene, Gaetano; Veinot, John P.; van der Wal, Allard C.

    2016-01-01

    Surgical aortic specimens are usually examined in Pathology Departments as a result of treatment of aneurysms or dissections. A number of diseases, genetic syndromes (Marfan syndrome, Loeys-Dietz syndrome, etc.), and vasculopathic aging processes involved in vascular injury can cause both distinct

  8. X-ray cinematographic determination of standard values of pharyngeal motility as a basis for diagnostic evaluation of pathologic changes

    International Nuclear Information System (INIS)

    Hannig, C.; Hess, U.

    1998-01-01

    The study was intended to reveal a normal bolus, yield standard values of the pharyngeal motility, define reference data and use them for verification with patient groups with known pathologic changes. Furthermore, the dependence of standard values on the physiological ageing process and various bolus volumina was tested. (orig./CB) [de

  9. Radiologic-Pathologic Analysis of Contrast-enhanced and Diffusion-weighted MR Imaging in Patients with HCC after TACE: Diagnostic Accuracy of 3D Quantitative Image Analysis

    Science.gov (United States)

    Chapiro, Julius; Wood, Laura D.; Lin, MingDe; Duran, Rafael; Cornish, Toby; Lesage, David; Charu, Vivek; Schernthaner, Rüdiger; Wang, Zhijun; Tacher, Vania; Savic, Lynn Jeanette; Kamel, Ihab R.

    2014-01-01

    Purpose To evaluate the diagnostic performance of three-dimensional (3Dthree-dimensional) quantitative enhancement-based and diffusion-weighted volumetric magnetic resonance (MR) imaging assessment of hepatocellular carcinoma (HCChepatocellular carcinoma) lesions in determining the extent of pathologic tumor necrosis after transarterial chemoembolization (TACEtransarterial chemoembolization). Materials and Methods This institutional review board–approved retrospective study included 17 patients with HCChepatocellular carcinoma who underwent TACEtransarterial chemoembolization before surgery. Semiautomatic 3Dthree-dimensional volumetric segmentation of target lesions was performed at the last MR examination before orthotopic liver transplantation or surgical resection. The amount of necrotic tumor tissue on contrast material–enhanced arterial phase MR images and the amount of diffusion-restricted tumor tissue on apparent diffusion coefficient (ADCapparent diffusion coefficient) maps were expressed as a percentage of the total tumor volume. Visual assessment of the extent of tumor necrosis and tumor response according to European Association for the Study of the Liver (EASLEuropean Association for the Study of the Liver) criteria was performed. Pathologic tumor necrosis was quantified by using slide-by-slide segmentation. Correlation analysis was performed to evaluate the predictive values of the radiologic techniques. Results At histopathologic examination, the mean percentage of tumor necrosis was 70% (range, 10%–100%). Both 3Dthree-dimensional quantitative techniques demonstrated a strong correlation with tumor necrosis at pathologic examination (R2 = 0.9657 and R2 = 0.9662 for quantitative EASLEuropean Association for the Study of the Liver and quantitative ADCapparent diffusion coefficient, respectively) and a strong intermethod agreement (R2 = 0.9585). Both methods showed a significantly lower discrepancy with pathologically measured necrosis (residual

  10. Sonographic features and ultrasonography-guided fine-needle aspiration of metastases to the thyroid gland

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Jung Hyun; Kim, Eun Kyung; Kwak, Jin Young; Moon, Hee Jung; Kim, Ga Ram [Dept. of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-03-15

    To evaluate the characteristic ultrasonographic (US) features of metastatic carcinoma to the thyroid, and how accurate US features and ultrasonography-guided fine-needle aspiration (US-FNA) are for the diagnosis of thyroid metastases. Twenty-three thyroid lesions in 23 patients (mean age, 66.7 years; range, 46 to 85 years) that had been diagnosed as thyroid metastases were included. The composition, echogenicity, margin, shape, presence of calcifications, underlying parenchymal echotexture, and vascularity were analyzed in US images of the thyroid metastases. Final US assessments were categorized into probably benign and suspicious malignancy. The presence of suspicious metastatic cervical lymph nodes was noted. The medical records, US-FNA cytology, and pathology reports of these patients were retrospectively reviewed. Of the 23 thyroid lesions, the general US appearance was mass-forming in 21 (91.3%) and non-mass-forming in 2 (8.7%). All 23 lesions showed a solid tumor composition. Common US features among the 21 mass-forming thyroid metastases were hypoechogenicity (81.0%), non-circumscribed margins (90.5%), no calcifications (76.2%), and parallel shape (81.0%). Suspicious cervical lymph nodes were present in 18 patients (78.3%). Of the 23 lesions, 21 (91.3%) were classified as suspicious malignancy, and 2 (8.7%) as probably benign. US-FNA showed diagnostic results specific for metastases in 21 of the 22 patients (95.5%) who had undergone US-FNA. Common US features in thyroid metastasis were hypoechogenicity, non-circumscribed margins, no calcifications, parallel shape, and the presence of suspicious cervical lymph nodes. US-FNA can be effectively used in the diagnosis of thyroid metastasis, preventing unnecessary surgery.

  11. Primary Hyperparathyroidism with Thyroid Hemiagenesis

    Directory of Open Access Journals (Sweden)

    Kenichi Sakurai

    2007-04-01

    Full Text Available Thyroid hemiagenesis is a very rare anomaly. We herein report a case with right thyroid lobe agenesis, which was incidentally found during the assessment of primary hyperparathyroidism. A 42-year-old male presenting with urinary lithiasis was suspected of having primary hyperparathyroidism, and had elevated levels of both serum calcium and intact parathyroid hormone. Both computed tomography and ultrasonography demonstrated the absence of right thyroid lobe and a mass of 1 cm in diameter at the left lower pole of the thyroid. The patient underwent lower left parathyroidectomy, which confirmed the right thyroid hemiagenesis, as well as the absence of both upper and lower right parathyroid glands. The resected left lower parathyroid gland was pathologically diagnosed as adenoma. The postoperative course was favourable and he was discharged on the 2nd day after surgery, without complications.

  12. [Thyroid cancer].

    Science.gov (United States)

    Nagayama, Yuji

    2012-03-01

    The thyroid glands are a vulnerable organ to ionizing radiation. Indeed the epidemiological studies have revealed an increase in the incidences of thyroid cancer among atomic bomb survivors in Hiroshima and Nagasaki and radiation casualties in Chernobyl. The carcinogenic risk for the thyroids is dependent on radiation dose, and higher in younger people. Recent advances in molecular biology contribute to clarify the mechanisms for thyroid carcinogenesis at genetic and molecular levels. Here radiation-induced thyroid carcinogenesis is reviewed from epidemiological data to basic research.

  13. The clinician and the thyroid

    International Nuclear Information System (INIS)

    Biersack, H.J.; Hotze, A.

    1991-01-01

    The goiter prevalence in iodine-deficient regions is up to 25%-54%. The most frequent disease in these endemic areas is non-toxic goiter, which is, however, oftentimes connected with autonomously functioning thyroid tissue leading to borderline or overt hyperthyroidism. Other thyroid diseases like cancer, thyroiditis and hypothyroidism play only a miner role in a thyroid clinic, while cases of Graves' disease may be observed more frequently. The most cost-effective tools to evaluate thyroid patients are the hand, ear and mouth of the thyroid clinician. The differential diagnosis of thyroid disorders may be evaluated by a battery of diagnostic tools like in-vitro tests and high performance imaging modalities. Once the diagnosis is established, the appropriate therapeutic procedures (drugs, radioiodine, surgery) have to be chosen. This review should be considered as a guideline for the diagnosis and treatment of thyroid diseases. In addition, special problems concerning elderly patients and pregnant women are discussed, including the differential diagnosis of thyroid diseases. (orig.)

  14. The thyroid protection in case of nuclear accident by an iodine prophylaxis; La protection de la thyroide en cas d'accident nucleaire par une prophylaxie a l'iode

    Energy Technology Data Exchange (ETDEWEB)

    Carrera, F

    2004-12-15

    The first part of the thesis describes the thyroid functional activity and the place of iodine in organisms, iodine is linked to the thyroid functioning. The second part of the thesis is interested in the ionizing radiation effect in general then on the thyroid. The external irradiation has been essentially studied from the data of the Hiroshima and Nagasaki explosions. The internal contamination of thyroid is known by the use of {sup 131}iodine for medical or diagnostic uses. A mixed contamination is described with the example of the nuclear test in Marshall Islands. Follows a chapter devoted to the thyroid cancers, the most serious thyroid radioinduced pathology. The third part concerns the place of iodine in the nuclear power plants. The functioning of a nuclear power plant is described as well as its radioactive emission in normal operation and in accidental situation. The sanitary impact of a radioactive iodine emission is detailed from a bibliographic synthesis coming from the studies on the development of thyroid cancers appeared after the Chernobylsk disaster. The ingestion of steady iodine constitutes an preventive measure efficient against the arising of these cancers. Its efficiency and innocuousness are discussed. Then a last part summarizes the administrative measures taken in France so that the population can have at her disposal iodine tablets before and in case of accidents. (N.C.)

  15. Understanding the Pathological Basis of Neurological Diseases Through Diagnostic Platforms Based on Innovations in Biomedical Engineering: New Concepts and Theranostics Perspectives

    Directory of Open Access Journals (Sweden)

    Laura Ganau

    2018-02-01

    Full Text Available The pace of advancement of genomics and proteomics together with the recent understanding of the molecular basis behind rare diseases could lead in the near future to significant advances in the diagnosing and treating of many pathological conditions. Innovative diagnostic platforms based on biomedical engineering (microdialysis and proteomics, biochip analysis, non-invasive impedance spectroscopy, etc. are introduced at a rapid speed in clinical practice: this article primarily aims to highlight how such platforms will advance our understanding of the pathological basis of neurological diseases. An overview of the clinical challenges and regulatory hurdles facing the introduction of such platforms in clinical practice, as well as their potential impact on patient management, will complement the discussion on foreseeable theranostic perspectives. Indeed, the techniques outlined in this article are revolutionizing how we (1 identify biomarkers that better define the diagnostic criteria of any given disease, (2 develop research models, and (3 exploit the externalities coming from innovative pharmacological protocols (i.e., those based on monoclonal antibodies, nanodrugs, etc. meant to tackle the molecular cascade so far identified.

  16. Analysis of pattern of occurrence of thyroid carcinoma between 2001 and 2010

    Directory of Open Access Journals (Sweden)

    Fábio Muradás Girardi

    2015-10-01

    Full Text Available ABSTRACT INTRODUCTION: An ongoing discussion is found in medical literature about the reasons for changes in thyroid carcinoma incidence patterns over the last decades. OBJECTIVE: To analyze the clinical and pathological characteristics of thyroid carcinoma cases over a decade. METHODS: Cross-sectional study over an historical cohort. Medical records of 628 thyroid cancer cases in a single center were reviewed. 597 patients were included. Microcarcinoma cases were selected for a qualitative analysis phase, in which medical records were reviewed for better understanding of thyroid nodule and thyroid cancer diagnosis process. RESULTS: An increase in the proportion of cases with thyroid cancer diagnosis was observed throughout the decade; new cases were predominantly tumors of less than 2 cm, with histopathological signs of low aggressiveness. There was an increase in proportion of cases with malignant cytological results among microcarcinomas. CONCLUSION: There is a trend for increase in thyroidectomies due to cancer in this institution, with proportional increment of cases with histopathological characteristics indicative of early disease. Among microcarcinomas, there is an increasing group represented by cancer cases that were not incidentally diagnosed, related to an enhancement in preoperative diagnostic methods.

  17. TC pathological Neck

    International Nuclear Information System (INIS)

    Garcia Fontes, M.

    2012-01-01

    This presentation is about different imaging techniques such as ultrasound, CT, RNM, PET-CT. These techniques permit to detect head and neck tumors, breast and digestive pathologies as well as congenital diseases and glandular tumor in the thyroid, parathyroid, muscles, lymphatic, nerves and vessels

  18. Hyalinizing trabecular adenoma of the thyroid gland.

    Science.gov (United States)

    Bishop, Justin A; Ali, Syed Z

    2011-04-01

    Hyalinizing trabecular adenoma (HTA) is a rare primary thyroid neoplasm. Ever since its initial descriptions, controversy has surrounded the lesion, particularly in regard to its malignant potential and most appropriate terminology. HTA shares many features with medullary thyroid carcinoma and particularly papillary thyroid carcinoma, making it an especially treacherous lesion on fine-needle aspiration (FNA). This manuscript reviews the history and pathologic features of HTA, with particular attention to cytologic findings and differential diagnosis. Copyright © 2010 Wiley-Liss, Inc.

  19. New approaches to image thyroid cancer cells and microenvironment

    International Nuclear Information System (INIS)

    Galli, F.; Iodice, V.; Signore, A.; Lauri, C.

    2015-01-01

    Poorly differentiated thyroid cancer (PDTC) and undifferentiated thyroid cancer (UDTC) are still life-threatening pathologies, because of the lack of well-established diagnostic and therapeutic approaches. In the past, many attempts have been made to develop radiopharmaceutical to diagnose or treat radioactive iodine (RAI)-refractory metastases or recurrences, with limited results. Indeed, it was not possible to find a specific and over expressed marker to be used as target of radiopharmaceuticals or targeted therapies. Nowadays, with novel advances in the field of tumor microenvironment, many new markers are available to be used as suitable targets for targeted therapies interfering with signalling pathways of cells involved in the mechanisms that favour tumor growth and metastatization. This opened new perspective in the use of radiopharmaceuticals targeting components of tumor microenvironment for early diagnosis, pre-operative staging or therapy planning and follow up with targeted drugs. In the present review we present the state of novel approaches to image thyroid cancer and its microenvironment, focusing on RAI-refractory thyroid cancer as a real clinical problem to be solved.

  20. Papillary thyroid carcinoma formation in a thyroglossal cyst: a case ...

    African Journals Online (AJOL)

    Thyroglossal cyst rarely presents with carcinoma formation in the remnants of the thyroid gland. We report a 40 year old male with papillary thyroid carcinoma formation in a thyroglossal cyst. The patient underwent surgical intervention for the cyst. His pathology was positive for thyroid carcinoma and he underwent complete ...

  1. Pregnancy and Thyroid Disease

    Science.gov (United States)

    ... thyroid medicines made with animal thyroid, such as Armour Thyroid, but is not useful for your baby’s ... the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. ...

  2. American Thyroid Association

    Science.gov (United States)

    ... Professionals Thyroid Information Find out more information on Thyroid Disease. learn more Meetings ATA meeting dates, information, and ... News Press Releases & Announcements Thyroid Information (Brochures & FAQ's / Thyroid Diseases & Conditions) Cancer of the Thyroid Public Health Statements ...

  3. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Thyroid Scan and Uptake Thyroid scan and uptake uses ... the Thyroid Scan and Uptake? What is a Thyroid Scan and Uptake? A thyroid scan is a ...

  4. Aspects of peripheral thyroid hormone metabolism

    NARCIS (Netherlands)

    M.H. Otten (Marten Henk)

    1984-01-01

    textabstractThe research into thyroid function has a long history. The recognition of goiter as pathology of the thyroid gland dates back to the ancient world of Rome and Greece and possibly even to the early history of chinese medicine. In an excellent review of the historical aspects of the

  5. Maintaining Euthyroidism: Fundamentals of Thyroid Hormone ...

    African Journals Online (AJOL)

    In fact, while thyroid hormones, i.e. triiodothyronine. (T3) and thyroxine (T4), play a ... hormone regulation, iodine metabolism, and the clinical management of thyroid related pathology, the current paper provides a physiological and clinical overview of ...... Surks MI, Goswami G, Daniels GH. The thyrotropin reference range ...

  6. Agenesis of Isthmus of the Thyroid Gland in a Patient with Graves-Basedow Disease and a Solitary Nodule

    Science.gov (United States)

    Ozkan, Omer Faruk; Asık, Mehmet; Toman, Huseyin; Ozkul, Faruk; Cıkman, Oztekin; Karaayvaz, Muammer

    2013-01-01

    The thyroid is a vascular endocrine gland with two lateral lobes connected by a narrow, median isthmus. Although a wide range of congenital anomalies of the thyroid gland has been reported in the literature, agenesis of the thyroid isthmus is a very rare congenital anomaly. Thyroid isthmus agenesis does not manifest clinical symptoms, and it can be confused with other thyroid pathologies. We describe a patient with no isthmus of the thyroid, associated with Graves-Basedow disease. Thyroid isthmus agenesis should be kept in mind in order for surgical procedures involving thyroid pathologies to be carried out safely. PMID:23346452

  7. American Thyroid Association Guide to investigating thyroid hormone economy and action in rodent and cell models.

    Science.gov (United States)

    Bianco, Antonio C; Anderson, Grant; Forrest, Douglas; Galton, Valerie Anne; Gereben, Balázs; Kim, Brian W; Kopp, Peter A; Liao, Xiao Hui; Obregon, Maria Jesus; Peeters, Robin P; Refetoff, Samuel; Sharlin, David S; Simonides, Warner S; Weiss, Roy E; Williams, Graham R

    2014-01-01

    An in-depth understanding of the fundamental principles that regulate thyroid hormone homeostasis is critical for the development of new diagnostic and treatment approaches for patients with thyroid disease. Important clinical practices in use today for the treatment of patients with hypothyroidism, hyperthyroidism, or thyroid cancer are the result of laboratory discoveries made by scientists investigating the most basic aspects of thyroid structure and molecular biology. In this document, a panel of experts commissioned by the American Thyroid Association makes a series of recommendations related to the study of thyroid hormone economy and action. These recommendations are intended to promote standardization of study design, which should in turn increase the comparability and reproducibility of experimental findings. It is expected that adherence to these recommendations by investigators in the field will facilitate progress towards a better understanding of the thyroid gland and thyroid hormone dependent processes.

  8. American Thyroid Association Guide to Investigating Thyroid Hormone Economy and Action in Rodent and Cell Models

    Science.gov (United States)

    Anderson, Grant; Forrest, Douglas; Galton, Valerie Anne; Gereben, Balázs; Kim, Brian W.; Kopp, Peter A.; Liao, Xiao Hui; Obregon, Maria Jesus; Peeters, Robin P.; Refetoff, Samuel; Sharlin, David S.; Simonides, Warner S.; Weiss, Roy E.; Williams, Graham R.

    2014-01-01

    Background: An in-depth understanding of the fundamental principles that regulate thyroid hormone homeostasis is critical for the development of new diagnostic and treatment approaches for patients with thyroid disease. Summary: Important clinical practices in use today for the treatment of patients with hypothyroidism, hyperthyroidism, or thyroid cancer are the result of laboratory discoveries made by scientists investigating the most basic aspects of thyroid structure and molecular biology. In this document, a panel of experts commissioned by the American Thyroid Association makes a series of recommendations related to the study of thyroid hormone economy and action. These recommendations are intended to promote standardization of study design, which should in turn increase the comparability and reproducibility of experimental findings. Conclusions: It is expected that adherence to these recommendations by investigators in the field will facilitate progress towards a better understanding of the thyroid gland and thyroid hormone dependent processes. PMID:24001133

  9. The thyroid nodule. Thyrotropin and peripheral thyroid hormones; Der Schilddruesenknoten. TSH und periphere Hormone

    Energy Technology Data Exchange (ETDEWEB)

    Zimny, M. [Klinikum Hanau (Germany). Inst. fuer Nuklearmedizin

    2008-09-15

    Thyrotropin, free triodothyronine and thyroxine represent the standard serological parameters for the diagnostic work-up of the thyroid but only a minority of thyroid nodules present with subclinical or overt thyroid disorders. Besides a review of the regulation and principle of function of thyroid hormones as well as the effects of subclinical or overt hyperthyroidism, the significant role of these parameters beyond the assessment of hyperthyroidism in thyroid nodules is discussed. There is evidence that the level of thyrotropin within the normal range is predictive for the relevance of autonomous functioning nodules and the risk of malignancy of non-functioning thyroid nodules. Furthermore, the ratio of triodothyronine and thyroxine indicates the etiology of hyperthyroidism. Thyrotropin represents the main parameter to determine the adequate dose of thyroid hormone therapy of thyroid nodules. (orig.)

  10. Thyrotropinoma and multinodular goiter: A diagnostic challenge for hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Duygu Yazgan Aksoy

    2013-01-01

    Full Text Available Thyroid disorders are frequently encountered. The diagnosis is straightforward unless clinical or laboratory findings are inconclusive and/or perplexing. Hyperthyroidism due to a thyrotropin-secreting pituitary adenoma rarely occurs and symptoms due to thyroid hormone excess are subtle. The presentation of the disease becomes unusual when co-secretion of other hormones with thyrotropin or concomitant thyroid parenchymal pathology exist. We present the case of a 63-year-old female patient with thyrotropinoma co-secreting growth hormone and multinodular goiter. She developed hyperthyroidism first due to thyrotropinoma and later due to a toxic nodule. Herein, we discuss the diagnostic and therapeutic challenges of hyperthyroidism with atypical presentation.

  11. [Study of RET protooncogene in multiple endocrine neoplasm 2A and in familial medullary thyroid carcinoma. Clinical pathological findings in asymptomatic carriers].

    Science.gov (United States)

    Belli, Susana; Storani, María E; Dourisboure, Ricardo J; Podestá, Ernesto J; Solano, Angela R

    2003-01-01

    Twenty five percent of the medullary thyroid carcinoma (MTC) is hereditary and 5% is familiar (FMTC), or considered as multiple endocrine neoplasia (MEN) type 2A (17%) or 2B (3%). These diseases are the result of the autosomic dominant inheritance of a mutation in the RET protooncogene, in one out of 12 different known codons. We analyzed 7 families (2 MEN 2A and 5 FMTC). Six mutations were detected in the most frequent codon, 634 (2 MEN 2A y 4 FMTC) and one family with FMTC presented a novel mutation: a transition T > C at codon 630, resulting a C630A change. Among 57 individuals studied, 25 (43.85%) presented the mutation. Seven (28%) were asymptomatic carriers, including 5 children aged 11 +/- 3.2 years. The children underwent total thyroidectomy. The histopathologic examination showed C cells hyperplasia and microcarcinoma focus in both lobes, even in the presence of normal, basal or pentagastrine stimulated, calcitonine levels. In conclusion, we describe a germine novel mutation in the RET protooncogene: C630A; and the corresponding findings of C-cell disease in gene mutated carriers that emphasize the importance of prophylactic thyroidectomy as soon as the molecular diagnosis is confirmed.

  12. Surgery of thyroid gland in Mongolia

    International Nuclear Information System (INIS)

    Ishdorj, Ts

    2007-01-01

    Full text: The surgery department of Central Hospital no.1 operated on 1690 thyroid disease patients in last 7 years (2000-2007). Patients' ages were 9-80 years. Female : Male ratio 10 : 1. In the last years morbidity is changed, Diffuse toxic Goiter has decreased, Thyroid nodule and cancer has increased. During last 7 years we have operated 164 patients for thyroid mass. 69 cases (51.54%) of them were thyroid carcinoma. In this 69 cases include Anaplastic carcinoma 3, Papillary carcinoma 36, follicular carcinoma 30 cases. 80 percent patients from thyroid cancer cases were diagnosed in pre-operative period, 20 percent were diagnosed in inter and post-operation period. For thyroid cancer cases we made the following operations: - Total thyroidectomy 20 cases, Hemithyroidectomy 30 cases, Hemithyroidectomy 29 cases. After operation 49 patients were sent for radioactive I-131 treatment and 3 cases which recurred, were operated a second time. In the treatment of DTG, there has been a decrease in the number of surgeries, while great increase in the use of I-131. From 1990 to 1999 have been done 1307 operations, because of thyroid disease: - 580 (44.37%) for DTG, 636 (48.66%) for thyroid nodule, 37 ( 2.83%) for thyroid cancer. From 2000 to 2007 we have conducted 1608 operations, because of thyroid disease: 473 (29.41%) for DTG, 919 (57.15%) for thyroid nodule and 134 (8.33%) for thyroid cancer. All operations were done by O.V.Nicolaev's method. (intracapsular resection). Conclusion: 1. the numbers of thyroid cases which have been treated by operation is changing. There are an increasing number of cases of Thyroid nodule and thyroid cancer. 2. There is need to improve preoperative diagnostics. 3. Combination of surgery treatment and radioactive I131 treatment gave good results for thyroid cancer. (author)

  13. [Immunohistochemical profile of angiogenesis in the thyroid gland in various thyroid diseases].

    Science.gov (United States)

    Rurua, N Z; Gogiashvili, L E; Tsagareli, Z G

    2013-12-01

    The purpose of the study - to determine the feature of the vascular endothelial growth factor (VEGF) and thyroid-stimulating hormone (TSH) expression in the thyroid gland (TG) in various thyroid diseases. Material - thyroid tissue (operative material) with histologically confirmed diagnosis: 10 - follicular adenoma, 17 - multinodular goiter, 8 - thyroiditis Hashimoto, 8 - papillary carcinoma, 10 - intact (normal) thyroid samples (forensic autopsy). The immunohistochemical study of the material showed the following results: the increase of the Hürtle cells population 40 % or more indicates a hyperthyroidism tendency despite TSH+ receptor status. Under the thyroid pathology TSH and VEGF expression appears in thyrocytes and also in microvascular endothelial cells. VEGF expression is below the norm in the Hashimoto thyroiditis. VEGF is involved not only in angiogenesis, but in pathophysiological shifts in thyroid tissue. Microvessel density (MVD) and TSH positive receptor status under the thyroid pathology testify the absence of the endothelial cells transformation, however, this index can not serve as a biopothential prognostic marker of thyroid disease.

  14. Lingual thyroid - report of two cases

    International Nuclear Information System (INIS)

    Souza, Ricardo Pires de; Abicalaf, Ricardo Souza; Pimentel, Claudia Andreia Rabay; Santos, Leynalze Ramos; Soares, Aldemir Humberto; Gois Filho, Jose Francisco de; Carvalho, Marcos Brasilino de; Rapoport, Abrao

    1997-01-01

    The authors report two cases of lingual thyroid, an uncommon developmental anomaly of embryogenesis characterized by a failure of the normal migration of thyroid tissue to the neck, with presence of the thyroid gland in the mid-line of the tongue base between circumvallate papillae and the epiglottis. The lesions may appear at nay time from birth to old age and have a predilection for females. The embryology, incidence, signs and symptoms, diagnostic methods and management are discussed. (author)

  15. Cytodiagnosis of papillary thyroid carcinoma--a study of 37 cases at RIMS Hospital, Imphal.

    Science.gov (United States)

    Sharma, A Barindra; Laishram, Sharmila; Singh, A Meina; Sharma, L Durlav Chandra

    2007-04-01

    Papillary carcinoma is the most common malignant tumour of thyroid gland which can occur in any age group with most tumours diagnosed in the third and fifth decades predominantly in the females. FNAC is emerging as the first line of investigation for any thyroid enlargement including tumours as a safe, rapid and cost -effective procedure. Many studies have reported diagnostic accuracy of FNAC in detecting neoplasms. The present study aims to evaluate the diagnostic accuracy of FNAC in the cytodiagnosis of papillary carcinoma and to highlight the clinco-pathologic correlation. A total of 37 cases were diagnose cytologically as papillary carcinoma, out ofwhich 28 cases were histologically proved. The remaining 9 cases were not available for biopsy. It was observed that careful cytomorphologic assessment with particular attention to cellular arrangement and nuclear characteristics aided in the correct diagnosis.

  16. Proposal for dose measurement in the crystalline lens and thyroid in computerized tomography of paranasal sinuses

    International Nuclear Information System (INIS)

    Mello, Ana Caroline; Machado Neto, Vicente

    2014-01-01

    With the evolution of diagnostic imaging equipment, a computerized tomography (CT) has become one of the most used tests to assess pathologies affecting the paranasal sinuses. This work aims at presenting a method of obtaining measurements of dose in the eye lenses and thyroid, from the execution of CT of the paranasal sinuses protocol. Experimental procedure will be used in an object simulator (phantom) head and neck made with accessible materials and thermoluminescent dosimeters (TLDs) of LiF: Mg,Ti for the absorbed dose in the regions of interest, when exposed to radiation in a CT scanner 16 channels. After the dosimetric evaluation with phantom use, this methodology will be applied in vivo, or in patients with medical request for the examination and approval by the Ethics Committee. Thus, at the end of this survey protocols and actions aimed at reducing the absorbed dose in the eye lenses and thyroid without impairing the diagnostic image quality can be proposed. (author)

  17. Relations between pathological markers and radioiodine can and {sup 18}F-FDG PET/CT findings in papillary thyroid cancer patients with recurrent cervical nodal metastases

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Won [Dept. of Nuclear Medicine, Catholic Kwandong University International St. Mary' s Hospital, Seoul (Korea, Republic of); Min, Hye Sook [Dept. of athology, Seoul National University Hospital, Seoul (Korea, Republic of); Lee, Sang Mi [Dept. of Nuclear Medicine, Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of); Kwon, Hyun Woo; Chung, June Key [Dept. of Nuclear Medicine,Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2015-06-15

    The aim of this study was to investigate relationships between the immunohistochemical results and radioiodine scan and {sup 18}F-FDG PET findings in papillary thyroid cancer (PTC) patients with recurrent cervical nodal metastases. A total of 46 PTC patients who had undergone a radioiodine scan and/or {sup 18}F-FDG PET/CT and a subsequent operation on recurrent cervical lymph nodes were enrolled. Twenty-seven patients underwent {sup 18}F-FDG PET/CT, 8 underwent radioiodine scans, and 11 underwent both scans. In all surgical specimens, the immunoexpressions of thyroglobulin (Tg), sodium-iodide symporter (NIS), glucose transporter 1 (Glut-1), and somatostatin receptor 1 and 2A (SSTR1 and SSTR2A) were assessed, and associations between these expressions and radioiodine scan and {sup 18}F-FDG PET findings were evaluated. Of the 38 patients who underwent {sup 18}F-FDG PET/CT, all patients with weak Tg expression had positive {sup 18}F-FDG uptake, while only 45 % of the patients with moderate or strong Tg expression showed positive uptake (p = 0.01). The proportion of patients with positive {sup 18}F-FDG uptake increased as the degree of Glut-1 expression with luminal accentuation increased. Of the 19 patients who underwent a radioiodine scan, the proportion with positive radioiodine uptake was greater among patients with strong NIS and SSTR2A expression than among patients expressing these markers at weak levels (p = 0.04 for all). All three patients with weak Tg expression were negative for radioiodine uptake. The {sup 18}F-FDG uptakes of recurrent cervical nodes are related to strong Glut-1 expression with luminal accentuation and weak Tg expression, whereas radioiodine uptake is related to the strong expressions of NIS and SSTR2A.

  18. Pattern of thyroid diseases in central Sudan: Nuclear medicine ...

    African Journals Online (AJOL)

    Thyroid scintigraphy using Tc-99m pertechnetate is a frequently performed procedure in routine nuclear medicine practice in addition to thyroid hormonal assay by radioimmunoassay (RIA). There is no clear description of thyroid diseases pattern in Sudan using nuclear medicine as a diagnostic tool. The aim of this ...

  19. Thyroid diseases

    International Nuclear Information System (INIS)

    Noma, Koji

    1992-01-01

    This chapter reviews the correlation between thyroid disease, other than cancer, and radiation in the literature. Radiation-induced thyroid disturbance is discussed in the context of external and internal irradiation. External irradiation of 10 to 40 Gy may lower thyroid function several months or years later. Oral administration of I-131 is widely given to patients with Basedow's disease; it may also lower thyroid function with increasing radiation doses. When giving 70 Gy or more of I-131, hypothyroidism has been reported to occur in 20-30% and at least 10%. Thyroiditis induced with internal I-131 irradiation has also been reported, but no data is available concerning external irradiation-induced thyroiditis. The incidence of nodular goiter was found to be several ten times higher with external irradiation than internal irradiation. Thyroid disturbance is correlated with A-bomb survivors. A-bomb radiation can be divided into early radiation within one minute after A-bombing and the subsequent residual radiation. Nodular goiter was significantly more frequent in the exposed group than the non-exposed group; it increased with increasing radiation doses and younger age (20 years or less) at the time of exposure. The incidence of decrease in thyroid function was higher with increasing radiation doses. However, in the case of Nagasaki, the incidence of hypothyroidism was significantly higher in the low-dose exposed group, especially A-bomb survivors aged 10-39 at the time of exposure and women. (N.K.)

  20. [Clinico-pathological diagnostic agreement among 429 autopsies from the Instituto Nacional de la Nutrición Salvador Zubirán].

    Science.gov (United States)

    Angeles-Angeles, A; Quintanilla Martínez, L; Muñoz Fernández, L; Espinoza Vázquez, B; Victoría Peralta, P

    1992-01-01

    Comparison of clinical and autopsy findings of the cases studied between 1984 and 1988, were made at the Department of Pathology of the Instituto Nacional de la Nutricion Salvador Zubiran in Mexico City. The goal was to determine the accuracy of clinical diagnoses. The total number of cases was 429. A decreasing number of autopsies as a function of time was observed. Thus, in 1985, 34.65% of the deaths was autopsied, whereas in 1988, the number dropped to 21.16%, overall mean of 27.31%. In 229 autopsies (53.8%), 353 findings of clinical significance were found; of these, 86 were in the main diagnoses and 267 in the causes of death. There were 171 overdiagnoses with therapeutic implications, 38 in the main diagnoses and 133 in the causes of death. Overdiagnoses and underdiagnoses were most common in infectious diseases, followed by respiratory and digestive diseases, while endocrinologic and rheumatologic diseases had the highest diagnostic concordance. It was also found that the diagnostic accuracy did not improve with time of hospitalization. A brief analyses of the probable causes of the decrease in the number of autopsies is made. It is concluded that, in spite of the great advances in clinical and technological knowledge, the high frequency of disagreements between clinical and anatomical diagnoses, indicate that autopsy continues playing a key role in the quality control of medical practice. This justifies by itself the performance of necropsies.

  1. Evaluation of the diagnostic capacity of the DETEC-PC for the attract of iodine in thyroid; Evaluacion de la capacidad de diagnostico del DETEC-PC para la captacion de iodo en tiroides

    Energy Technology Data Exchange (ETDEWEB)

    Alonso A, D. [CPHR, Calle 20 No. 4113 e/41 y 47. Playa C.P. 11300, La Habana (Cuba); Arista R, E. [CEADEN, A.P. 6195, C.P. 10600, La Habana (Cuba); Alonso A, A. [Hasselt University, Building D, 3590 Diepenbeek (Belgium)]. e-mail: lola@cphr.edu.cu

    2006-07-01

    A comparative study whose main objective is the evaluation of the diagnoses capacity of the DETEC - PC, a detection-measurement system for the reception of iodine in thyroid, with it presumptive diagnostic is presented. To such effect a clinical essay was designed in which all the patients included in the study were evaluated using the new equipment (DETEC - PC) and the standard diagnoses procedure well-known for the initials RIA. The sample size was calculated in a such way that the percent of gross coincidence among both methods could be estimate with a precision of 1% at a trust level of 95%. In total 110 patients were included in the essay. For the analysis of the agreement in the diagnostic it was used the Kappa statistician. The obtained results showed a high grade of gross agreement and an agreement level among moderate and substantial when it was corrected by possible random agreement among both procedures. (Author)

  2. Pathways to the diagnosis of thyroid cancer in New South Wales: a population-based cross-sectional study.

    Science.gov (United States)

    Kahn, Clare; Simonella, Leonardo; Sywak, Mark; Boyages, Steven; Ung, Owen; O'Connell, Dianne

    2012-01-01

    Over the past few decades, an increase in the incidence of thyroid cancer has been recorded in many countries around the world including Australia. Heightened medical surveillance and increased technological sensitivity could be contributing to greater detection of asymptomatic disease. To describe the pathways to diagnosis of thyroid cancer for a cohort of newly diagnosed patients in New South Wales (NSW), Australia, and compare these pathways by age, sex, place of residence, ethnic background, medical insurance status, and disease characteristics. A total of 452 newly diagnosed cases of thyroid cancer were recruited through the population-based NSW Central Cancer Registry. Participants completed a questionnaire and diary of doctor visits and investigations that led to their diagnosis. Tumor characteristics were obtained from pathology reports. Forty percent of patients initially presented to their doctor with a lump or symptom specific to thyroid cancer and 60% had their cancer detected incidentally during a medical encounter. Men were more likely than women to be diagnosed after imaging for another health concern versus reporting a thyroid lump or symptom (p = 0.001). Thyroid cancer diagnosis after imaging for another health concern increased with age (p = 0.023), and larger tumors were less likely to be diagnosed after treatment for a benign thyroid disease (p = 0.040). As the majority of participants had incidental diagnoses, the reported incidence of thyroid cancer is likely to be influenced by diagnostic technology and medical surveillance practices. This, however, probably only partly explains the observed rise in the incidence of thyroid cancer in NSW.

  3. correlation between cytology and thyroid function test

    African Journals Online (AJOL)

    Damary

    2006-10-01

    Oct 1, 2006 ... Background: Thyroid dysfunction can be evaluated by measuring serum thyroid stimulating hormone (TSH), total tri-iodothyronine (T3) and total thyroxine (T4) which will establish euthyroidism, hyperthyroidism and hypothyroidism. Fine needle aspiration (FNA) is the diagnostic test of choice in determining ...

  4. Imaging strategy in differentiated thyroid cancer

    NARCIS (Netherlands)

    Phan, Thi Thanh Ha

    2007-01-01

    This thesis focuses on clinical dilemmas, which the clinician faces in the management of patients with differentiated thyroid cancer (DTC) with a specific emphasis on the role of current and new diagnostic imaging. Thyroid cancer is a rare disease, but it is the most common endocrine malignancy of

  5. Uncommon observation of bifocal giant subchondral cysts in the hip: diagnostic role of CT arthrography and MRI, with pathological correlation.

    Science.gov (United States)

    Gonzalez-Espino, Pauline; Van Cauter, Maïté; Gossing, Louis; Galant, Christine C; Acid, Souad; Lecouvet, Frederic E

    2018-04-01

    Subchondral cysts (or geodes) are common in osteoarthritis (OA), usually in association with other typical signs, i.e., joint space narrowing, subchondral bone sclerosis, and osteophytosis. However, large lesions without the typical signs of OA or lesions located outside the weight-bearing areas are unusual and may be confused for other conditions, in particular, those of tumoral origin. We report the findings in a 48-year-old man who had been complaining of left buttock pain for 3 years, getting worse over the last year, and an evolutive limited range of motion of the hip. The pain was increased by weight-bearing and was not relieved by nonsteroidal anti-inflammatory drugs. Radiographs and CT showed a large multilocular lytic lesion within the femoral head and a large lytic lesion in the left ilio-ischiatic ramus, raising the question of bifocal tumoral involvement. On MRI, the lesions had low signal intensity on T1- and high signal intensity on T2-weighted MR images, with subtle peripheral enhancement on post-contrast T1-weighted images. CT arthrography, by demonstrating a communication between the femoral head and ischiatic cysts and the joint space allowed us to definitively rule out malignant conditions and to make the diagnosis of subchondral bone cysts. Total hip arthroplasty was performed. Pathological analysis of the resected femoral head and of material obtained at curettage of the ischiatic lesion confirmed the diagnosis of degenerative geodes. This case illustrates an atypical bifocal location of giant subchondral cysts in the hip joint mimicking lytic tumors, in the absence of osteoarthritis or rheumatoid arthritis, and highlights the role of CT arthrography in identifying this condition.

  6. Comparison of lipase activity in peritoneal fluid of dogs with different pathologies--a complementary diagnostic tool in acute pancreatitis?

    Science.gov (United States)

    Guija de Arespacochaga, A; Hittmair, K M; Schwendenwein, I

    2006-04-01

    A clinical diagnosis of acute pancreatitis is often difficult to obtain. Histopathology remains the gold standard, whereas clinical signs, diagnostic imaging and laboratory testing, even in combination, may be insufficient. In a prospective study, lipase activity in ascitic fluid of various aetiologies was determined in 44 dogs in order to investigate its performance in cases of acute pancreatitis. Data of simultaneously determined blood lipase activities were available in 27 dogs. Lipase activity was measured by a colorimetric assay. A complete peritoneal fluid analysis was performed. Dogs were divided into four groups, according to their final diagnosis: acute pancreatitis (A), abdominal trauma (B), abdominal neoplasia (C) and others (hepatic or cardiac diseases) (D). Dogs with acute pancreatitis had a significantly higher peritoneal lipase activity than those in other groups (P or = 0.734). Blood lipase activity as well as protein content and total cell count of the ascitic fluid did not show any significant difference between groups. Data show that determination of lipase activity in dogs that develop ascites may be useful in complementing the diagnosis of acute pancreatitis.

  7. The Study on the Thyroid Disease

    International Nuclear Information System (INIS)

    Lee, Mun Ho

    1982-01-01

    Several recent advances in our knowledge of thyroid physiology have broad application to the diagnosis and management of thyroid disorders. For in the thyroid, more than other end-ocrine organs, pathophysiology can be translated directly into the diagnosis and management of thyroid disease. Graves' disease is a syndrome including goiter with hyperthyroidism, exophthalmos and dermatopathy. The pathogenesis of Graves' disease is not yet clearly identified, but various autoantibodies to the thyroid gland and immunapathalogic studied indicate that autoimmune processes are involved in the pathogenesis of the disease. The diagnosis and management of Graves' disease are largely dependent on radionuclide technique as radioimmunoassay, radioactive iodine therapy and so on. Several laboratory tests are also developed to determine the remission of this disease including TRH stimulation test, T 3 , suppression test and detection of thyroid stimulating immunoglobulins. Autoimmune thyroiditis is almost certainly a primary immunologic disease and the incidence tends to increase recently, mainly due to the application of biopsy technique is thyroid diseases. Thyroid nodules have been a great challenge to physicians because of the possibility of malignancy. But recently, cytologic examination of thyroid aspirate provides a very simple and also reliable diagnostic method in patients with thyroid nodules. In 163 patients with thyroid nodules, only 19.3% was revealed to be malignant. Therefore cytologic examination of thyroid aspirate and thyroid biopsy should be included in the diagnosis of nodular patients prior to surgical intervention. In this paper, a comprehensive review is presented on the pathogenesis, clinical features, laboratory findings and therapeutic modalities of various thyroid diseases on the basis of over 80 researches performed during the past 20 years at radioisotope clinic, Seoul National University Hospital.

  8. Clinical evaluation of echography in diagnosis of thyroid disease

    International Nuclear Information System (INIS)

    Fritzsche, H.; Braendle, J.

    1983-01-01

    In 63 patients echography of thyroid was performed additionally to case history, palpation, scintigraphy and hormone tests for evaluating clinical significance of this method. The benefit of this technique is rapid measurement of thyroid size, demonstration of nodules in palpable diffuse goiters and differentiating of solid or cystic nodules of the thyroid. For diagnosis of autonomous areas in the thyroid scintigrahy remains the method of choice. Also there is no correlation of ultrasound findings and thyroid function. In routine diagnostic procedure of thyroid disease echography may replace scintigraphy only in diffuse goiter and if radionuclide imaging is not possible. Nevertheless ultrasonic evaluation of the thyroid is an important additional method in diagnostic of thyroid diseases. (Author)

  9. Evaluation of thyroid function tests in non-thyroidal illness

    International Nuclear Information System (INIS)

    Schutte, D.P.

    1988-01-01

    Normal thyroid physiology and pathophysiology with reference to non-thyroidal illness (NTI) is reviewed including specific disease states and drugs and their effect on thyroid function tests. The diagnostic utility of two new highly sensitive thyrotrophin (TSH) assays as screening tests for thyroid dysfunction are evaluated and compared with conventional thyroid function assays. A group of 40 patients with NTI was studied. This group was compared to a group of normal controls and a group of thyrotoxic patients. Conventional thyroid function tests yielded many values outside the reference range in the NTI group. The general pattern that emerged was decreased total triiodothyronine levels in 70% of NTI patients, normal to low thyroxine values, increased mean free thyroxine values (dialysis), low mean values for the free thyroxine index and varying results for newer commercial assays for free thyroxine according to methodology. The TSH response to intravenous thyroliberin (TRH) was found to be blunted compared to controls. Basal TSH levels were measured with two ultasensitive TSH assays. The immunoradiometric assays yielded fewer values outside the reference range in the NTI group than conventional thyroid function tests. This assay yielded undetectable basal TSH levels in all thyrotoxic patients and could reliably separate thyrotoxic patients from the NTI group. Basal TSH levels with ultrasensitive TSH assays correlated well with the TSH response to TRH (TSH) and could obviate the need for TRH tests. Ultrasensitive TSH assays are promising first line screening tests in NTI. 120 refs., 13 figs., 7 tabs

  10. Our experience with radioiodine therapy of thyroid functional autonomies

    International Nuclear Information System (INIS)

    Kraft, Otakar

    2005-01-01

    Full text: In this paper the author presents his experience with radioiodine therapy of thyroid functional autonomies. The objectives of this study were to establish the efficacy and determine the adverse effects of radioiodine therapy of patients with thyroid functional autonomies. The main pathologic attribute of thyroid functional autonomies is the loss of regulation in the axis of hypothalamus-hypophysis-thyroid. The main cause of functional autonomy of the thyroid is iodine deficiency. Over a period of 30 years (1974-2004) 799 patients (age from 33 to 86 years; average age 58.7 years; the female: male ration was 7.4:1) with unifocal functional autonomy (UFA), multifocal functional autonomy (MFA) and disseminated functional autonomy (DFA) received at least one treatment of radioiodine. For diagnostics and the evaluation of radioiodine therapeutic effect of functional autonomies a thyroid scintigraphy is the basic and necessary procedure. In some patients a common scintigraphy with special imaging modulation, in some patients a scintigraphy after suppression or stimulation by means of thyroid hormones or TSH were done. We have also performed a thyroid ultrasonography, an assessment of a serum level of a total and free thyroxine, total triiodothyronine, TSH, radioiodine accumulation test, estimation of radioiodine effective half-life, in some patients TRH-TSH test. The follow-up examinations were done in all patients after 4-6 months, another examination after one year in 545 patients and after two years in 254 patients. One therapeutic dose received 733 patients (91.74%) and it was sufficient for an elimination of functional autonomies. Some patients were retreated if there was the evidence of small or no treatment effect and no elimination of functional autonomies. Two radioiodine treatments received 62 patients (7.76%) and three treatments 4 patients (0.5%). We advocate individual pre-therapeutic dosimetry to determine the activity necessary to achieve a

  11. The Role of Conventional Ultrasound in the Assessment of Thyroid Nodule in Erbil City

    Science.gov (United States)

    Musa, Sarbast Ismail; Hanary, Salah Mohammad

    2016-01-01

    Background: Nodular thyroid disease is relatively common although thyroid cancer is rare. The aim of this study is to evaluate the advantage and reliability of conventional ultrasound in correlating sonographic characteristics of thyroid nodule with US-FNAC guided result as a diagnostic aid in thyroid nodule. Method: 111 patients were examined by…

  12. Approach and management of thyroid nodule. A literature review = Nódulo tiroideo, enfoque y manejo. Revisión de la literatura

    Directory of Open Access Journals (Sweden)

    Román-González, Alejandro

    2013-04-01

    Full Text Available Introduction: Thyroid nodules are commonly found, and their incidence is increasing. The main objective during the evaluation of these nodules is to determine if they are benign or malignant. Materials and methods: We made a narrative review of the literature by searching Ovid, Medline and Lilacs from 1950 to 2010. Results: Most thyroid nodules are benign, but in 4% to 8% of cases they may be malignant, hence the importance of appropriate study and management. Nodules larger than 1 cm should undergo fine needle aspirate; however, the clinical features of the patient and the characteristics of the nodule on ultrasound assessment should always be taken into account. The following are risk factors associated with the presence of thyroid nodules: age over 45 years, female gender and smoking. The measurement of tumor markers in the initial study of patients with thyroid nodule is not recommended.Conclusion: Ultrasound and thyroid fine needle aspirate are the most important diagnostic methods in the evaluation of thyroid nodules, because they enable to make changes in therapeutic decisions thus decreasing the number of unnecessary thyroidectomies. Treatment and prognosis of thyroid nodules will depend on the patient´s risk factors and the cytological and pathological findings.

  13. Detection surgical treatment and its results in children's thyroid gland

    International Nuclear Information System (INIS)

    Polyakov, V.G.; Lebedev, V.I.; Belkina, B.M.; Shishkov, R.V.; Makarova, I.S.; Durnov, L.A.

    1995-01-01

    208 patients with thyroid gland cancer were observed in 1975-1993 . The morphological investigations point to an absolute prevalence of highly differentiated forms of thyroid gland cancer in children. The radiation diagnostic techniques included ultrasound investigations of neck organs, chest roentgenography, thyroid gland scintigraphy. It is shown that the surgical method is the basic technique of treating thyroid gland cancer in children. 5-year survival rate of patients depending on the stage of disease development and scope of surgical treatment is analysed

  14. Diagnostic Value and Cost Considerations of Routine Fine-Needle Aspirations in the Follow-Up of Thyroid Nodules with Benign Readings

    NARCIS (Netherlands)

    van Roosmalen, Jeroen; van Hemel, Bettien; Suurmeijer, Albert; Groen, Henk; Ruitenbeek, Teus; Links, Thera P.; Plukker, John T. M.

    2010-01-01

    Background: Fine-needle aspiration (FNA) is the most accurate tool to identify malignancy in solitary thyroid nodules. Although some recommend routinely repeating FNA for nodules that are initially read as benign, there is no consensus. We evaluated clinical relevancy and considered costs of routine

  15. Thyroid effects

    International Nuclear Information System (INIS)

    Maxon, H.; Thomas, S.; Buncher, C.; Book, S.; Hertzberg, V.

    1985-01-01

    Risk coefficients for thyroid disorders have been developed for both 131 I 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 131 I 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

  16. Likelihood ratio-based differentiation of nodular Hashimoto thyroiditis and papillary thyroid carcinoma in patients with sonographically evident diffuse hashimoto thyroiditis: preliminary study.

    Science.gov (United States)

    Wang, Liang; Xia, Yu; Jiang, Yu-Xin; Dai, Qing; Li, Xiao-Yi

    2012-11-01

    To assess the efficacy of sonography for discriminating nodular Hashimoto thyroiditis from papillary thyroid carcinoma in patients with sonographically evident diffuse Hashimoto thyroiditis. This study included 20 patients with 24 surgically confirmed Hashimoto thyroiditis nodules and 40 patients with 40 papillary thyroid carcinoma nodules; all had sonographically evident diffuse Hashimoto thyroiditis. A retrospective review of the sonograms was performed, and significant benign and malignant sonographic features were selected by univariate and multivariate analyses. The combined likelihood ratio was calculated as the product of each feature's likelihood ratio for papillary thyroid carcinoma. We compared the abilities of the original sonographic features and combined likelihood ratios in diagnosing nodular Hashimoto thyroiditis and papillary thyroid carcinoma by their sensitivity, specificity, and Youden index. The diagnostic capabilities of the sonographic features varied greatly, with Youden indices ranging from 0.175 to 0.700. Compared with single features, combinations of features were unable to improve the Youden indices effectively because the sensitivity and specificity usually changed in opposite directions. For combined likelihood ratios, however, the sensitivity improved greatly without an obvious reduction in specificity, which resulted in the maximum Youden index (0.825). With a combined likelihood ratio greater than 7.00 as the diagnostic criterion for papillary thyroid carcinoma, sensitivity reached 82.5%, whereas specificity remained at 100.0%. With a combined likelihood ratio less than 1.00 for nodular Hashimoto thyroiditis, sensitivity and specificity were 90.0% and 92.5%, respectively. Several sonographic features of nodular Hashimoto thyroiditis and papillary thyroid carcinoma in a background of diffuse Hashimoto thyroiditis were significantly different. The combined likelihood ratio may be superior to original sonographic features for

  17. Total Thyroidectomy for Thyroid Cancer Followed by Thyroid Storm due to Thyrotropin Receptor Antibody Stimulation of Metastatic Thyroid Tissue

    DEFF Research Database (Denmark)

    Folkestad, Lars; Brandt, Frans; Brix, Thomas

    2017-01-01

    BACKGROUND: Graves disease (GD) is an autoimmune condition characterized by the presence of antibodies against the thyrotropin receptor (TRAB), which stimulate the thyroid gland to produce excess thyroid hormone. Theoretically, TRAB could stimulate highly differentiated thyroid cancer tissue and....../or metastases to produce thyroid hormone. CASE: A 68-year-old male, with weight loss and palpitations, was diagnosed with thyrotoxicosis. A later MRI, due to persistent shoulder pain, revealed multiple bone metastases. A biopsy was diagnostic for follicular variant of papillary thyroid carcinoma, and total...... treatment continued until after the fourth RAI dose. Hypothyroidism did not occur until following the fifth RAI treatment. SUMMARY AND CONCLUSIONS: We present a patient initially diagnosed with thyrotoxicosis and subsequently with metastatic follicular variant of papillary thyroid cancer. It is suggested...

  18. HYPOTHYROIDISM FOLLOWING THYROID SURGERY

    Directory of Open Access Journals (Sweden)

    M. Lankarani

    2008-06-01

    Full Text Available Postsurgical hypothyroidism and its incidence has not been fully investigated. In this study, the incidence of hypothyroidism and its possible risk factors at Shariati Hospital was assessed. One hundred and two patients with benign thyroid diseases, who had undergone thyroidectomy, were investigated with regards to thyroid function profile during period of one year after the operation every three months with post-operative sample as the baseline. Hypothyroidism was developed in 36 patients (35.2% on average 5 ± 3.2 months after surgery. Factors such as increased age, operation type, histopathologic type, underlying disease, lymphocytic infiltration and use of levothyroxine before surgery were associated with the increased incidence of hypothyroidism. It seems that use of indicators such as Graves' disease and lymphocytic infiltration in pathologic specimens should be helpful in projecting the potential occurrence of hypothyroidism in patients undergoing thyroidectomy.

  19. EPIDEMIOLOGY OF THYROID LESIONS IN WARDHA DISTRICT OF CENTRAL INDIA

    Directory of Open Access Journals (Sweden)

    Samarth Shukla

    2015-02-01

    Full Text Available AIMS: To establish a significant predominance of thyroid lesions in and around Wardha district, and to establish specific etiological link for the predominance the thyroid lesions. MATERIALS AND METHOD S : This was a hospital based analytical prospective study, conducted in Acharya Vinobha Bhave Rural Hospital (A.V.B.R.H. involving 108 patients. The study was carried over a duration of 1 year January 2010 to December 2010. Patients attending endocrinological clinics and the newly detected cases of thyroid lesions, within set parameters of study, were the subjects of this study. OBSERVATION: Thyroid lesions which we came across in the course of the study were Thyrotoxicosis, Myxoedema, Thyroiditis, Diffuse goitre, Nodular Goitre and Carcinoma Thyroid . These were correlated with epidemiological factors like Age, Sex, Region, Diet and Iodine Intake. Significant relationship between thyroid function, age of patient, diet was seen in comparison to individual thyroid lesions. CONCLUSION : G oitre was the commest pathology encountered . Almost all of the thyroid lesions were of hypothyroid in their function with exception of thyrotoxicosis and carcinoma. Thyroid lesions were found predominantly in females, Age related lesion pathology was significant, and vegetarian and non - vegetarian diets along with low and high iodine salt uptake had obvious pathological effects on thyroid

  20. Thyroid Function Tests

    Science.gov (United States)

    ... hyperthyroid patient, the most likely diagnosis is autoimmune thyroid disease. THYROGLOBULIN Thyroglobulin (Tg) is a protein produced by ... Anaplastic Thyroid Cancer Complementary and Alternative Medicine in Thyroid Disease FNA Biopsy of Thyroid Nodules Goiter Graves’ Disease ...

  1. Thyroid and Weight

    Science.gov (United States)

    ... Thyroid and Weight Thyroid and Weight FAQs THYROID, BMR & WEIGHT WHAT IS THE RELATIONSHIP BETWEEN THYROID AND ... it is known as the basal metabolic rate (BMR). Indeed, measurement of the BMR was one of ...

  2. Chronic thyroiditis (Hashimoto disease)

    Science.gov (United States)

    ... common in people with a family history of thyroid disease. In very rare cases, the disease may be ... syndrome - Hashimoto; PGA II - Hashimoto Images Endocrine glands Thyroid enlargement - scintiscan Hashimoto's disease (chronic thyroiditis) Thyroid gland References Amino N, Lazarus ...

  3. Pediatric Thyroid Cancer

    Science.gov (United States)

    ... Find an ENT Doctor Near You Pediatric Thyroid Cancer Pediatric Thyroid Cancer Patient Health Information News media interested in ... and neck issues, should be consulted. Types of thyroid cancer in children: Papillary : This form of thyroid cancer ...

  4. Thyroid cancer - medullary carcinoma

    Science.gov (United States)

    Thyroid - medullary carcinoma; Cancer - thyroid (medullary carcinoma); MTC; Thyroid nodule - medullary ... National Cancer Institute. PDQ thyroid cancer treatment. Bethesda, ... February 4, 2016. www.cancer.gov/cancertopics/pdq/treatment/ ...

  5. [Positron emission tomography-computed tomography with (18)F-fluorodeoxyglucose in patients with recurrent differentiated thyroid carcinoma and negative radioiodine scan. Diagnostic performance and relation with tyroglobulin levels].

    Science.gov (United States)

    Mariscal Labrador, E; García Burillo, A; Castell-Conesa, J; Obiols Alfonso, G; Kisiel González, N; Barios Profitós, M; Aguadé-Bruix, S; Mesa Manteca, J

    2013-01-01

    To assess the diagnostic performance of (18)F-FDG PET-CT scan and its relation to serum thyroglobulin (Tg) levels in patients with differentiated thyroid carcinoma with suspicion of persistence or recurrence of the disease and negative radioiodine scans. This is a retrospective analysis of 35 PET-CT studies in 25 patients (17 women, average age 48.8±15.2 years). The results were confirmed by histology or by ultrasonography and clinical follow-up. We analyzed the relationship between the diagnostic performance of the PET-CT scans and three levels of Tg: ≤2ng/ml; between 2 and 10 ng/ml, and >10ng/ml. We obtained 26 true-positives (TP), one false-positive (FP), 3 true-negatives (TN) and 5 false-negatives (FN). Of the 18 patients with PET-CTs classified as TP, 3 showed lesions at the post-thyroidectomy bed, 15 showed lymph node metastases and 5 were distant metastases. Sensitivity was 83.9% (95%CI: 69.3%-98.4%) and specificity was 75% (95%CI: 20%-100%). Regarding the three intervals of Tg, PET-CT scan showed TP rates of 37.5%, 83% and 100% in patients with Tg levels 10ng/ml, respectively. (18)F-FDG PET-CT demonstrates high diagnostic yield in local disease and distant lesions for the population of patients with differentiated thyroid carcinoma and persistence of the disease with negative radioiodine scans at Tg levels above 2ng/ml. Copyright © 2011 Elsevier España, S.L. y SEMNIM. All rights reserved.

  6. Recurrent High-Flow Arterio-Venous Malformation of the Thyroid Gland.

    Science.gov (United States)

    Borchert, D H; Massmann, A; Kim, Y J; Bader, C A; Wolf, G; Eisele, R; Minko, P; Bücker, A; Glanemann, M

    2015-09-01

    Vascular malformations and hemangiomas of the thyroid gland are rare disorders. The first case of a patient with recurrent high-flow arterio-venous malformation of the right thyroid gland involving the right endolarynx is presented. In June 2013, a 42-year-old female patient presented to the surgical department with recurrent hoarseness and a soft, vibrating mass on the right side of her neck. In 1993, she underwent right subtotal hemithyroidectomy with embolization on the day before surgery for a high-flow arterio-venous malformation of the thyroid gland. Diagnostic work-up in 2013 demonstrated a complex recurrent high-flow arterio-venous malformation on the right side of her neck involving the endolarynx. Full function of the right vocal fold could not be ascertained. The lesion was embolized again and excised the following day. Intraoperative gross bleeding and scar tissue prevented visualization and monitoring of the recurrent laryngeal nerve. Gross bleeding was also noted on hemithyroidectomy after embolization in 1993. No therapy was needed for the endolaryngeal part of the lesion. Histology showed large arterio-venous malformations with thyroid tissue. She remains well without signs of recurrence 18 month later but with a definitive voice handicap. This is the first report of a recurrent high-flow arterio-venous malformation originally developing from the right thyroid gland involving the right endolarynx. Counseling, diagnostic, and therapeutic work-up of the patient was possible only with an interdisciplinary team. The endolaryngeal part of the hemangioma dried out after embolization and completion hemithyroidectomy. Her hoarseness has greatly improved but a definitive voice handicap remains. High-flow arterio-venous malformations of the thyroid gland are a rare disease, and recurrent lesions have not been reported. Interdisciplinary management of these patients is mandatory due to the complex nature of the underlying pathology. Recurrence might develop

  7. Thyroid gland removal

    Science.gov (United States)

    Total thyroidectomy; Partial thyroidectomy; Thyroidectomy; Subtotal thyroidectomy; Thyroid cancer - thyroidectomy; Papillary cancer - thyroidectomy; Goiter - thyroidectomy; Thyroid nodules - thyroidectomy

  8. Final diagnosis in children with subclinical hypothyroidism and mutation analysis of the thyroid peroxidase gene (TPO).

    Science.gov (United States)

    Turkkahraman, Doga; Alper, Ozgul M; Aydin, Funda; Yildiz, Akin; Pehlivanoglu, Suray; Luleci, Guven; Akcurin, Sema; Bircan, Iffet

    2009-09-01

    To determine the final diagnosis of patients with subclinical hypothyroidism (SCH), and to perform mutation screening of the thyroid peroxidase gene (TPO). Infants with SCH without an identified etiology were included in the study. Patients with thyroid dysgenesis were excluded. Children > or = 2 years of age, and still on L-thyroxine (LT4) treatment underwent a diagnostic algorithm. After LT4 was discontinued for 4 weeks, thyroid function tests (TFT) were obtained. A perchlorate discharge test (PDT) was performed in patients with normal thyroid ultrasound but abnormal TFT. Sequence analysis of TPO was studied in all children who underwent a PDT. Forty-eight patients (23 males and 25 females) completed the trial. Among these children, 19 (39.5%) had transient SCH, and 29 (60.5%) had permanent SCH. Among patients with permanent SCH, 19 had thyroid hypoplasia, six had partial iodide organification defect with positive PDT, and four had other dyshormonogenesis with negative PDT. Mean LT4 dose before the medication ceased was 1.2 +/- 0.5 microg/kg/day in transient cases, and 1.7 +/- 0.4 in those with permanent SCH (p TPO mutation was detected. However, in five patients, seven different previously known TPO polymorphisms were detected: c.102C > G, L4L; > A, A576A; c.2088C > T, D666D; c.2263A > C, T725P; c.2630 T >C, V847A. LT4 treatment should be stopped after the age of 2 years in infants with SCH without a definite pathology of the thyroid gland to exclude cases with transient hypothyroidism. Additionally, we should consider particularly thyroid gland hypoplasia, and also partial defects in iodide organification in infants with SCH.

  9. Hyperfunction thyroid nodules: Their risk for becoming or being associated with thyroid cancers

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Sun; Kim, Ji Hoon; Na, Dong Gyu; Paeng, Jin Chul; Min, Hye Sook; Choi, Seung Hong; Sohn, Chul Ho; Chang, Ki Hyun [Seoul National University Hospital, Seoul (Korea, Republic of)

    2013-08-15

    To retrospectively evaluate the risk of thyroid cancer in patients with hyperfunctioning thyroid nodules through ultrasonographic-pathologic analysis. Institutional review board approval was obtained and informed consent was waived. From 2003 to 2007, 107 patients consecutively presented with hot spots on thyroid scans and low serum thyroid-stimulating hormone levels. Among them, 32 patients who had undergone thyroid ultrasonography were analyzed in this study. Thyroid nodules depicted on ultrasonography were classified based on size and categorized as benign, indeterminate, or suspicious malignant nodules according to ultrasonographic findings. The thyroid nodules were determined as either hyperfunctioning or coexisting nodules and were then correlated with pathologic results. In 32 patients, 42 hyperfunctioning nodules (mean number per patient, 1.31; range, 1-6) were observed on thyroid scans and 68 coexisting nodules (mean, 2.13; range, 0-7) were observed on ultrasonography. Twenty-five patients (78.1%) had at least one hyperfunctioning (n = 17, 53.1%) or coexisting (n = 16, 50.0%) nodule that showed a suspicious malignant feature larger than 5 mm (n = 8, 25.0%), or an indeterminate feature 1 cm or greater (n = 20, 62.5%) in diameter, which could have been indicated by using fine needle aspiration (FNA). Seven patients were proven to have 11 thyroid cancers in 3 hyperfunctioning and 8 coexisting nodules. All of these had at least one thyroid cancer, which could have been indicated by using FNA. The estimated minimal risk of thyroid cancer was 6.5% (7/107). Patients with hyperfunctioning nodules may not be safe from thyroid cancer because hyperfunctioning nodules can coexist with thyroid cancer nodules. To screen out these cancers, ultrasonography should be performed.

  10. Malignant-looking thyroid nodules with size reduction: Core needle biopsy results

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ha Young; Baek, Jung Hwan; Ha, Eun Jun; Park, Jee Won; Lee, Jeong Hyun; Song, Dong Eun; Shong, Young Kee [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2016-08-15

    The aim of this study was to evaluate whether malignant-looking thyroid nodules with size reduction were malignant or not. From November 2010 to July 2011, we retrospectively enrolled 16 patients with 16 nodules (11 females and five males; mean age, 55 years) who underwent core needle biopsy (CNB), and whose thyroid nodules had malignant ultrasonographic (US) features, although they showed size reduction (>20% decrease in maximum diameter) during the follow-up period (mean, 37±27 months). The histologic findings of the CNB specimen were reviewed and correlated with the US findings. US studies were analyzed for their internal content, shape, margin, echogenicity, the presence of microcalcification and macrocalcification, inner isoechoic rim, and low-echoic halo. All nodules were confirmed as benign by CNB. Pathologic analysis was available for 12 CNB specimens. US imaging showed central hypoechogenicity or marked hypoechogenicity in all cases and a peripheral isoechoic rim in 15 nodules. US-pathologic correlation showed that the central hypoechoic area was primarily composed of fibrosis (12/12) and hemorrhage (8/12) and that the isoechoic rim was composed of follicular cells. In our study, the CNB results of all of the malignant-looking thyroid nodules with size reduction were benign and were primarily composed of internal fibrosis and hemorrhage. Understanding these US and pathologic features could prevent repeated fine-needle aspiration or unnecessary diagnostic surgery.

  11. Quantification of microangiopathic lesions in brain parenchyma and age-adjusted mean scores for the diagnostic separation of normal from pathological values in senile dementia

    International Nuclear Information System (INIS)

    Hentschel, F.; Kreis, M.; Damian, M.; Krumm, B.; Froelich, F.

    2005-01-01

    Purpose: to quantify microangiopathic lesions in the cerebral white matter and to develop age-corrected cut-off values for separating normal from dementia-related pathological lesions. Materials and methods: in a memory clinic, 338 patients were investigated neuropsychiatrically by a psychological test battery and by MRI. Using a FLAIR sequence and a newly developed rating scale, white matter lesions (WMLs) were quantified with respect to localization, number and intensity, and these ratings were condensed into a score. The WML scores were correlated with the mini-mental state examination (MMSE) and clinical dementia rating (CDR) score in dementia patients. A non-linear smoothing procedure was used to calculate age-related mean values and confidence intervals, separate for cognitively intact subjects and dementia patients. Results: the WML scores correlated highly significantly with age in cognitively intact subjects and with psychometric scores in dementia patients. Age-adjusted WML scores of cognitively intact subjects were significantly different from those of dementia patients with respect to the whole brain as well as to the frontal lobe. Mean value and confidence intervals adjusted for age significantly separated dementia patients from cognitively intact subjects over an age range of 54 through 84 years. Conclusion: a rating scale for the quantification of WML was validated and age-adjusted mean values with their confidence intervals for a diagnostically relevant age range were developed. This allows an easy to handle, fast and reliable diagnosis of the vascular component in senile dementia. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-01-15

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

  13. IR Spectroscopic signs of malignant neoplasms in the thyroid gland

    Science.gov (United States)

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

    2012-03-01

    We use Fourier transform IR spectroscopy to study thyroid tumor tissues which were removed during surgery. The IR spectra of the tissues with pathological foci are compared with data from histologic examination. In the region of N-H, C-H, and C = O stretching vibrations, the IR spectra of the tissues for thyroid cancer are different from the IR spectra of tissues without malignant formations. We identify the spectral signs of thyroid cancer. We show that IR analysis is promising for identification of thyroid pathology at the molecular level.

  14. Thyroid sonomorphology, thyroid peroxidase antibodies and thyroid function: new epidemiological data in unselected German employees.

    Science.gov (United States)

    Döbert, N; Balzer, K; Diener, J; Wegscheider, K; Vaupel, R; Grünwald, F

    2008-01-01

    Employees of Sanofi-Aventis Deutschland GmbH underwent thyroid screening in 2006 to assess new data about the prevalence of irregular sonomorphological pattern, elevated thyroid peroxidase antibodies (TPO AB) and thyroid function in an unselected adult German population. The examination included 700 unselected employees. Blood samples were analyzed for serum TSH and TPO AB, and ultrasound of the thyroid was performed. In 40.7% of the participants (n = 285) an irregular sonomorphological pattern was detected: goiter in 13.7%, nodules in 35.6%, nodular goiter in 8.6% and a hypoechogenic pattern of the thyroid gland in 20.4%. Serum TSH was increased in 3.9% and decreased in 0.6%. Elevated TPO AB values were observed in 13%. Only 1.4% (n = 10) showed elevated TPO AB combined with a TSH increase. Sonomorphological abnormalities were associated with increased TPO AB in 7.1%. Elevated TPO AB was observed significantly more often in combination with sonomorphological pathology (54.9%) than without (45.1%) (p = 0.003). Sonomorphological disorders are still very common in Germany and our results are comparable with previous screening examinations. Elevated TPO AB correlated significantly with the sonomorphological pattern of nodules and goiter. This may reflect an improved iodine supply or a hypertrophic stage of autoimmune thyroiditis in some cases.

  15. Screening for thyroid cancer in children

    International Nuclear Information System (INIS)

    Nagataki, S.; Ashizawa, K.

    1996-01-01

    In the screening of the thyroid diseases in the radiation exposed cohort, it is essential to make correct diagnosis and to measure radiation dose in every subjects in the cohort and to analyze the dose response relationship by the most appropriate statistical method. Thus, thyroid cancer, thyroid adenoma and autoimmune hypothyroidism were confirmed to be radiation-induced thyroid diseases among atomic bomb survivors. A group of investigators from Nagasaki university have been working in the thyroid part of Chernobyl Sasakawa Health and Medical Cooperation Project, and more than 80000 children were screened in 5 diagnostic centers (Mogilev, Gomel, Kiev, Korosten and Klincy). In order to make correct diagnosis, thyroid echo-tomography, measurements of serum levels of free thyroxine, TSH, titers of anti-thyroid antibodies were performed in every children in the cohort and aspiration biopsy was performed when necessary. Whole body Cs 137 radioactivity was also determined in every subjects. Children with thyroid cancer confirmed by histology (biopsy or operation) were 2 in Mogilev, 19 in Gomel, 6 in Kiev, 5 in Korosten and 4 in Klincy (until 1994). Since children screened in each center were less than 20000, prevalence of thyroid cancer was remarkably high (lowest 100 and highest 1000/million children) when compared to the other parts of the world (0.2 to 5/million/year). However, there was no dose response relationship between the prevalence of cancer or nodule and whole body Cs 137 radioactivity. Although a significant correlation between thyroid cancer and reconstructed thyroid I 131 dose was presented, there are no previous reports to prove that I 131 produces thyroid cancer in human. Investigation on external radiation and short lived isotopes along with I 131 may be important to elucidate the cause of thyroid cancer

  16. Analysis of the bethesda system for reporting thyroid cytopathology and similar precursor thyroid cytopathology reporting schemes.

    Science.gov (United States)

    Wong, Lawrence Q; Baloch, Zubair W

    2012-09-01

    The Bethesda System for Reporting Thyroid Cytopathology is a standardized reporting system for classifying thyroid fine-needle aspiration results comprising of 6 diagnostic categories with unique risks of malignancy and recommendations for clinical management. The majority of thyroid nodules are benign; however, up to 30% of fine-needle aspiration of thyroid nodule results are equivocal. Until 2007, various diagnostic terms were used to classify such cases, including "atypical," "indeterminate," and rule-out or cannot exclude malignancy. A literature review of 13 original studies was conducted to evaluate whether utilization of the Bethesda System for Reporting Thyroid Cytopathology nomenclature represent an improvement over thyroid cytopathology reporting schemes used before 2007 in diagnosing thyroid malignancy. The sensitivity and specificity of thyroid fine-needle aspiration was high in the studies that assessed the measures. However, a selection bias exists and most studies do not include indeterminate diagnosis in their calculations. Although the Bethesda System for Reporting Thyroid Cytopathology recommends a repeat fine-needle aspiration to follow-up nondiagnostic specimens, in the majority of studies, an appreciable number of cases underwent follow-up surgical biopsy or thyroidectomy. The diagnostic category of atypia/follicular lesion of undetermined significance remains heterogenous in terms of usage and clinical outcome. The majority of the studies that utilize the Bethesda System for Reporting Thyroid Cytopathology in this literature review retrospectively reclassified thyroid fine-needle aspiration into the Bethesda System for Reporting Thyroid Cytopathology nomenclature with reported malignancy rates that are similar between cases reclassified as atypia/follicular lesion of undetermined significance and follicular neoplasm/suspicious for follicular neoplasm.

  17. Thyroid Cancer Presenting with Concomitant Metastatic Breast Cancer in the Thyroid

    Directory of Open Access Journals (Sweden)

    Chung-Chen Wang

    2014-12-01

    Full Text Available The thyroid is an unusual site to find cancer metastasis. When it does occur, such cancer spread is often manifested in multiple metastases and generally suggests a poor prognosis. We presented here a 49-year-old woman recently diagnosed with thyroid cancer, who had been treated for stage IIA breast cancer 8 years ago. After radical right thyroidectomy and left subtotal thyroidectomy, her pathological report showed papillary thyroid carcinoma, right thyroid, with concomitant metastatic breast carcinoma. This is the first case of which we are aware involving coexisting thyroid cancer and metastatic breast cancer in the ipsilateral lobe. Moreover, the circumstances of this case show a very unique clinical course compared with previous studies. Given the unusual circumstances of our case, we further discuss the relationship between thyroid cancer and breast cancer.

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

    Science.gov (United States)

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

    2014-12-01

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

  19. The association between thyroid malignancy and chronic lymphocytic thyroiditis: should it alter the surgical approach?

    Science.gov (United States)

    Büyükaşık, Oktay; Hasdemir, Ahmet Oğuz; Yalçın, Erol; Celep, Bahadır; Sengül, Serkan; Yandakçı, Kemal; Tunç, Gündüz; Küçükpınar, Tevfik; Alkoy, Seval; Cöl, Cavit

    2011-01-01

    The relation between thyroid neoplasms and chronic lymphocytic thyroiditis (CLT) is controversial. While it is accepted that focal lymphocytic thyroiditis develops secondarily to malignancy, it is not clear whether diffuse lymphocytic thyroiditis has a tendency to develop into thyroid cancer. The aim of this study was to investigate the relation between CLT and malignant tumours of the thyroid and evaluate the surgical approach to CLT cases. In this study, 917 patients operated on for thyroid diseases were investigated retrospectively. Seventy-seven (8.4%) patients histopathologically diagnosed as having CLT (either non-specific or Hashimoto's thyroiditis) were investigated for any concurrent malignant neoplasm. Fifteen patients in whom CLT and thyroid malignancy were coexisting were included in the study. In the pathological evaluation of 917 cases, malignancy in the thyroid was found in 97 (10.6%) cases. Seventy-seven cases were categorised as CLT. Of these 77, 16 (20.8%) were Hashimoto's thyroiditis (specific CLT) and the other 61 (79.2%) were non-specific CLT. In 15 cases, thyroid malignancy was found to be concurrent with CLT. Of the malignities, nine (60%) were papillary carcinoma, three (20%) medullar carcinoma, one (6.6%) follicular carcinoma, one (6.6%) Hurthle cell carcinoma, and one (6.6%) lymphoma. In our series, the rate of the development of malignancy against the background of CLT was 19.48%, while the rate in the groups without CLT was 9.76%, with a statistically significant difference between the groups (p = 0.008). CLT cases should be evaluated more carefully in terms of malignancy. If a nodule is detected on thyroiditis, the minimal surgical intervention should be lobectomy. Total thyroidectomy should be considered as preferable to subtotal thyroidectomy because of its many advantages such as controlling thyroiditis, removing the probability of reoperation, and hormonal stability.

  20. Guidelines for a national epidemiological surveillance system of thyroid cancer in France; Recommandations pour la mise en place d'un dispositif de surveillance epidemiologique nationale des cancers thyroidiens

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-10-01

    At the request of the French Department of Health, a multidisciplinary Thyroid Cancer Committee, coordinated by the French Public Health Agency analysed the observed increase of thyroid cancer incidence in France and outlined the limits of the present case registration system. This Committee set up guidelines to improve the national surveillance system of thyroid cancer. The Committee analysed 4 models for the incidence survey, 3 of which have been excluded: a poor cost-benefit ratio precludes the constitution of a national registry dedicated to thyroid cancer; however, the Committee has recommended this model that still exists for thyroid cancer of the youth(under 19 years old), a national system base exclusively on pathological data would only be relevant after significant improvement of data collection, obligatory of all cases of thyroid cancer is inappropriate considering the fit prognosis of this cancer. A two level system is proposed with continuous registration of incident caes through the National Hospital Discharge survey, specific focused analysis of clinical and pathological data in case of a cluster alert in any given area. Whatever the system, it seems necessary to in general: propose a unique health registration number per patient, improve access to medical data, organize a national standardised collection of pathological findings, follow up the diagnosis practices related to thyroid cancer that have an impact on incidence rates. In conclusion, a reliable incidence survey and a follow up of diagnostic practices and of risk factors may provide a relevant model of epidemiological survey of thyroid cancers in France but such a system requires a long lasting strategic and financial involvement. (author)

  1. pattern of subclinical thyroid disease

    International Nuclear Information System (INIS)

    Ijaz, A.; Marri, M.H.; Qureshi, A.H.; Qamar, M.A.; Ali, N.

    2002-01-01

    Objective: To evaluate the prevalence of subclinical thyroid disease (SCTD) in local population visiting a hospital laboratory for thyroid function tests. Design: It was a hospital - based study carried in consecutive patients who reported for thyroid function tests in the hospital laboratory. Place and duration of study: The study was conducted in combined military Hospital, Quetta during June 1999 to September 2000. Subject and methods: Serum samples of 917 patients living in Quetta and its surrounding were analysed for thyroid stimulating hormone (TSH) free thyroxin (FT4), and total tri-iodothyronine (T3) concentration using chemiluminescence technique on hormone auto analyser (LIA-Mat - Sangtech Germany). Results: Out of 917 patients, 287 (23%) were found to be having SCTD while overt thyroid disease was found in 288 (31%) patients. Prevalence of sub-clinical hypothyroidism (SCO) and sub-clinical hyperthyroidism (sce) was found to be almost equal with a profound female preponderance in both the groups. SCO was more common in children (<12 years of age). Conclusion: Almost every fourth patient reporting for thyroid function tests was diagnosed as having SCTD - a disease entity that is still not well known and that poses diagnostic and management problems for the pathologists and clinicians. (author)

  2. Progress in molecular-based management of differentiated thyroid cancer

    Science.gov (United States)

    Xing, Mingzhao; Haugen, Bryan R; Schlumberger, Martin

    2014-01-01

    Substantial developments have occurred in the past 5–10 years in clinical translational research of thyroid cancer. Diagnostic molecular markers, such as RET-PTC, RAS, and BRAFV600E mutations; galectin 3; and a new gene expression classifier, are outstanding examples that have improved diagnosis of thyroid nodules. BRAF mutation is a prognostic genetic marker that has improved risk stratification and hence tailored management of patients with thyroid cancer, including those with conventionally low risks. Novel molecular-targeted treatments hold great promise for radioiodine-refractory and surgically inoperable thyroid cancers as shown in clinical trials; such treatments are likely to become a component of the standard treatment regimen for patients with thyroid cancer in the near future. These novel molecular-based management strategies for thyroid nodules and thyroid cancer are the most exciting developments in this unprecedented era of molecular thyroid-cancer medicine. PMID:23668556

  3. Pathological Gambling Subtypes

    Science.gov (United States)

    Vachon, David D.; Bagby, R. Michael

    2009-01-01

    Although pathological gambling (PG) is regarded in the 4th edition of the "Diagnostic and Statistical Manual of Mental Disorders" (American Psychiatric Association, 1994) as a unitary diagnostic construct, it is likely composed of distinct subtypes. In the current report, the authors used cluster analyses of personality traits with a…

  4. The AQUA-FONTIS study: protocol of a multidisciplinary, cross-sectional and prospective longitudinal study for developing standardized diagnostics and classification of non-thyroidal illness syndrome

    Directory of Open Access Journals (Sweden)

    Klein Harald H

    2008-10-01

    Full Text Available Abstract Background Non-thyroidal illness syndrome (NTIS is a characteristic functional constellation of thyrotropic feedback control that frequently occurs in critically ill patients. Although this condition is associated with significantly increased morbidity and mortality, there is still controversy on whether NTIS is caused by artefacts, is a form of beneficial adaptation, or is a disorder requiring treatment. Trials investigating substitution therapy of NTIS revealed contradictory results. The comparison of heterogeneous patient cohorts may be the cause for those inconsistencies. Objectives Primary objective of this study is the identification and differentiation of different functional states of thyrotropic feedback control in order to define relevant evaluation criteria for the prognosis of affected patients. Furthermore, we intend to assess the significance of an innovative physiological index approach (SPINA in differential diagnosis between NTIS and latent (so-called "sub-clinical" thyrotoxicosis. Secondary objective is observation of variables that quantify distinct components of NTIS in the context of independent predictors of evolution, survival or pathophysiological condition and influencing or disturbing factors like medication. Design The approach to a quantitative follow-up of non-thyroidal illness syndrome (AQUA FONTIS study is designed as both a cross-sectional and prospective longitudinal observation trial in critically ill patients. Patients are observed in at least two evaluation points with consecutive assessments of thyroid status, physiological and clinical data in additional weekly observations up to discharge. A second part of the study investigates the neuropsychological impact of NTIS and medium-term outcomes. The study design incorporates a two-module structure that covers a reduced protocol in form of an observation trial before patients give informed consent. Additional investigations are performed if and after

  5. Sudden unexpected death associated with lymphocytic thyroiditis

    DEFF Research Database (Denmark)

    Vestergaard, Vibeke; Drostrup, Dorthe Høj; Thomsen, Jørgen L

    2007-01-01

    A forensic autopsy study comprising 125 cases was carried out retrospectively in order to evaluate pathological changes in the thyroid gland in different groups of death. The five groups selected consecutively were: (i) opiate addicts who died from an overdose, (ii) alcoholics who died as a result...... of their alcohol abuse, (iii) cases of fatal poisoning other than opiate addicts, (iv) unknown cause of death and (v) controls without prior disease. Tissue samples from the thyroid gland were cut and stained with haematoxylin and eosin and van Gieson. Histology examinations were subsequently performed blind...... infiltration of the thyroid parenchyma in five of the 124 cases, of which four belonged in the group of 'unknown cause of death'. This discovery leads to reflections regarding lymphocytic thyroiditis as a cause of death, either by itself or in combination with other disorders. Silent (painless) thyroiditis...

  6. A two miRNA classifier differentiates follicular thyroid carcinomas from follicular thyroid adenomas

    DEFF Research Database (Denmark)

    Stokowy, Tomasz; Wojtaś, Bartosz; Krajewska, Jolanta

    2015-01-01

    The inherent diagnostic limitations of thyroid fine needle aspiration (FNA), especially in the "indeterminate" category, can be partially overcome by molecular analyses. We aimed at the identification of miRNAs that could be used to improve the discrimination of indeterminate FNAs. miRNA expression...... in cytology material for its capability to discriminate (mutation negative) indeterminate cytologies and thereby improving the pre-surgical diagnostics of thyroid nodules....

  7. Thyroid stimulating hormone and subclinical thyroid dysfunction

    International Nuclear Information System (INIS)

    Guo Yongtie

    2008-01-01

    Subclinical thyroid dysfunction has mild clinical symptoms. It is nonspecific and not so noticeable. It performs only for thyroid stimulating hormone rise and decline. The value of early diagnosis and treatment of thyroid stimulating hormone in subclinical thyroid dysfunction were reviewed. (authors)

  8. [Autoimmune thyroiditis and thyroid cancer].

    Science.gov (United States)

    Krátký, Jan; Jiskra, Jan

    2015-10-01

    Association between autoimmune thyroiditis (CLT) and thyroid cancer remains not clear. Although both diseases often occur simultaneously in histological samples, it is not yet clear whether CLT can be regarded as a risk factor for thyroid malignancy. This review focus on the known epidemiological and molecular genetics links between both diseases. Most studies have shown a significant association between thyroid cancer and positive antibodies to thyroglobulin and histological evidence of CLT, as well. Both disorders share some risk factors (greater incidence in women, in areas with adequate supply of iodine and in patients after radiotherapy of the neck) and molecular genetics linkage. For example: RET/PTC rearrangements could be more often found in carcinomas associated with CLT, but this mutation could be found in benign lesions such as CLT, as well. CLT seems to be a positive prognostic factor in patients with differentiated thyroid cancer. It is associated with less invasive forms of tumor, lower occurrence of infiltrated lymphatic nodes and a lower risk of recurrence.

  9. A case of metastatic renal cell carcinoma to thyroid gland.

    Science.gov (United States)

    Lee, Jae-Geun; Yang, Youngro; Kim, Kwang Sik; Hyun, Chang Lim; Lee, Ji Shin; Koh, Gwanpyo; Lee, Daeho

    2011-08-01

    Metastasis to the thyroid gland from distant cancer is rare, and, in some cases, is a diagnostic challenge. Here, we report a case of metastatic renal cell carcinoma of the thyroid gland. A 77-year-old man presented with a neck mass detected about 1 month previously. He had undergone a right nephrectomy owing to renal cell carcinoma 14 years previously. Fine needle aspiration cytology showed a few atypical follicular cells with nuclear atypia. Under a tentative diagnosis of papillary thyroid carcinoma, a total thyroidectomy was performed. The histologic and immunohistochemical studies of the surgical specimens indicated that the thyroid masses were metastatic renal cell carcinoma to the thyroid.

  10. Radioiodine concentration by the thymus in differentiated thyroid carcinoma: report of five cases

    Energy Technology Data Exchange (ETDEWEB)

    Mello, Maria Eduarda; Flamini, Rodrigo C.; Corbo, Rossana; Mamede, Marcelo [Instituto Nacional do Cancer (INCa), Rio de Janeiro, RJ (Brazil). Servico de Medicina Nuclear], e-mail: mamede@inca.gov.br

    2009-10-15

    The radioactive iodine has been used with great value as a diagnostic and therapeutic method in patients with differentiated thyroid carcinoma previously submitted to total thyroidectomy. False-positive whole-body scans may occur due to misinterpretation of the physiologic distribution of the radioisotope or lack of knowledge on the existence of other pathologies that could eventually present radioiodine uptake. Thymic uptake is an uncommon cause of false-positive whole-body scan, and the mechanism through which it occurs is not completely understood. The present paper reports five cases of patients with differentiated thyroid cancer who presented a mediastinum uptake of radioiodine in a whole-body scan during follow-up. The patients had either histological or radiological confirmation of the presence of residual thymus gland. It is very important to know about the possibility of iodine uptake by the thymus in order to avoid unnecessary treatment, such as surgery or radioiodine therapy. (author)

  11. Hyponatremia after Thyroid Hormone Withdrawal in a Patient with Papillary Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Hyo Jin Jo

    2014-03-01

    Full Text Available Hyponatremia is an electrolyte abnormality commonly found in clinical practice. It is important to diagnose the underlying etiology of the hyponatremia and correct it appropriately because severe hyponatremia can cause serious complications and substantially increase the risk of mortality. Although hypothyroidism is known to be a cause of hyponatremia, it is rare that hyponatremia occurs in relation to hypothyroidism induced by thyroid hormone withdrawal in patients with differentiated thyroid cancer. We report a case of a 76-year-old woman with papillary thyroid carcinoma presenting with severe hyponatremia related to hypothyroidism induced by thyroid hormone withdrawal for radio-active iodine whole-body scanning, who was treated by thyroid hormone replacement and hydration. Considering that the incidence of differentiated thyroid cancer is rapidly increasing, physicians should be aware that, although uncommon, hyponatremia can occur in patients undergoing radioiodine therapy or diagnostic testing.

  12. Biochemical and molecular characterization of thyroid tissue by micro-Raman spectroscopy and gene expression analysis

    Science.gov (United States)

    Neto, Lázaro P. M.; Martin, Aírton A.; Soto, Claudio A. T.; Santos, André B. O.; Mello, Evandro S.; Pereira, Marina A.; Cernea, Cláudio R.; Brandão, Lenine G.; Canevari, Renata A.

    2016-02-01

    Thyroid carcinomas represent the main endocrine malignancy and their diagnosis may produce inconclusive results. Raman spectroscopy and gene expression analysis have shown excellent results on the differentiation of carcinomas. This study aimed to improve the discrimination between different thyroid pathologies combining of both analyses. A total of 35 thyroid tissues samples including normal tissue (n=10), goiter (n=10), papillary (n=10) and follicular carcinomas (n=5) were analyzed. Confocal Raman spectra was obtain by using a Rivers Diagnostic System, 785 nm laser excitation and CCD detector. The data was processed by the software Labspec5 and Origin 8.5 and analyzed by Minitab® program. The gene expression analysis was performed by qRT-PCR technique for TG, TPO, PDGFB, SERPINA1, LGALS3 and TFF3 genes and statistically analyzed by Mann-Whitney test. The confocal Raman spectroscopy allowed a maximum discrimination of 91.1% between normal and tumor tissues, 84.8% between benign and malignant pathologies and 84.6% among carcinomas analyzed. Significant differences was observed for TG, LGALS3, SERPINA1 and TFF3 genes between benign lesions and carcinomas, and SERPINA1 and TFF3 genes between papillary and follicular carcinomas. Principal component analysis was performed using PC1 and PC2 in the papillary carcinoma samples that showed over gene expression when compared with normal sample, where 90% of discrimination was observed at the Amide 1 (1655 cm-1), and at the tyrosine spectra region (856 cm-1). The discrimination of tissues thyroid carried out by confocal Raman spectroscopy and gene expression analysis indicate that these techniques are promising tools to be used in the diagnosis of thyroid lesions.

  13. New Approaches to Thyroid Hormones and Purinergic Signaling

    OpenAIRE

    Silveira, Gabriel Fernandes; Buffon, Andréia; Bruno, Alessandra Nejar

    2013-01-01

    It is known that thyroid hormones influence a wide variety of events at the molecular, cellular, and functional levels. Thyroid hormones (TH) play pivotal roles in growth, cell proliferation, differentiation, apoptosis, development, and metabolic homeostasis via thyroid hormone receptors (TRs) by controlling the expression of TR target genes. Most of these effects result in pathological and physiological events and are already well described in the literature. Even so, many recent studies hav...

  14. Medullary carcinoma arising in a thyroid with Hashimoto's disease.

    Science.gov (United States)

    Weiss, L M; Weinberg, D S; Warhol, M J

    1983-10-01

    A 51-year-old woman presented with a large goiter and on pathologic examination was found to have both Hashimoto's thyroiditis and medullary carcinoma of the thyroid. To our knowledge, this is the first well-documented case of the coexistence of these two entities in the same patient in the English literature. The association of Hashimoto's disease and carcinoma of the thyroid is reviewed and its relevance discussed.

  15. Clinical significance of endogenously labelled thyroid hormones in the diagnosis of thyroidal autonomy

    International Nuclear Information System (INIS)

    Waters, W.; Kutzim, H.

    1983-01-01

    The clinical value of the determination of 123 I concentration in serum 48 hrs after tracer administration ( 123 I) 48 is investigated with special regard to thyroidal autonomy. Serum radioiodine concentration, thyroid radioiodide uptake at 4 and at 48 hrs were measured in 74 healthy subjects and patients with simple goiter, in 36 patients with thyroidal autonomy (diagnosis by thyroid suppression test), and in 20 hyperthyroid patients. 83% of the patients with elevated radioiodine concentration belonged to the group of thyroidal autonomy. The product of radioiodine concentration and thyroid radioiodide uptake is a much better parameter. 95% of the patients in which this product was elevated, belonged to the autonomy group (5% diagnostic error). Also in the control group the diagnostic error was 5%. The combination of ( 123 I) 48 with the result of the TRH-test is very useful in excluding thyroidal autonomy, if ( 123 I) 48 is normal and the TRH-test is positive (100% of the patients have regulated thyroid glands.) 94% of the patients having elevated ( 123 I) 48 and a negative TRH-test belonged to the group of thyroidal autonomy. A very useful combination for the diagnosis of borderline hyperthyroidism is the determination of the product of ( 123 I) 48 and the uptake together with the pulse rate or fine tremor of the fingers (or TRH-test). The results suggest that the determination of ( 123 I) 48 is a very good parameter of thyroidal autonomy beside the thyroid suppression test. It may be used alone for the diagnosis of thyroidal autonomy if the suppression test is contraindicated. In the diagnosis of borderline hyperthyroidism its determination makes the suppression test unnecessary in many instances. (orig.) [de

  16. Virtual touch tissue quantification of acoustic radiation force impulse: a new ultrasound elastic imaging in the diagnosis of thyroid nodules.

    Directory of Open Access Journals (Sweden)

    Yi-Feng Zhang

    Full Text Available OBJECTIVE: Virtual touch tissue quantification (VTQ of acoustic radiation force impulse (ARFI is a new quantitative technique to measure tissue stiffness. The study was aimed to assess the usefulness of VTQ in the diagnosis of thyroid nodules. METHODS: 173 pathologically proven thyroid nodules in 142 patients were included and all were examined by conventional ultrasound (US, conventional elasticity imaging (EI and VTQ of ARFI. The tissue stiffness for VTQ was expressed as shear wave velocity (SWV (m/s. Receiver-operating characteristic curve (ROC analyses were performed to assess the diagnostic performance. Intra- and inter-observer reproducibility of VTQ measurement was assessed. RESULTS: The SWVs of benign and malignant thyroid nodules were 2.34±1.17 m/s (range: 0.61-9.00 m/s and 4.82±2.53 m/s (range: 2.32-9.00 m/s respectively (P20 mm and lowest for those ≤10 mm. The correlation coefficients were 0.904 for intraobserver measurement and 0.864 for interobserver measurement. CONCLUSIONS: VTQ of ARFI provides quantitative and reproducible information about the tissue stiffness, which is useful for the differentiation between benign and malignant thyroid nodules. The diagnostic performance of VTQ is higher than that of conventional EI.

  17. Interventions in patients with thyroid disease

    International Nuclear Information System (INIS)

    Sisson, J.C.

    1985-01-01

    Because sodium iodide I 131 was the first radiopharmaceutical available for clinical use, and because thyroid hormonogenesis is dependent on iodide, the earliest tests in nuclear medicine were aimed at the diagnosis of thyroid diseases. Two types of the early thyroid tests required intervention - pharamacologic manipulation of the patient - to express diagnostic information: (1) the suppression test in which thyroid hormone was given, and (2) the stimulation test wherein thyrotropin (TSH) was injected. As happens in the evolution of medical practice, newer procedures replace the old, and both the suppression and stimulation tests of thyroid function now are rarely used; the data sought can usually be obtained by other safer or more accurate procedures. However, a suppression test or a stimulation test may still be of indispensible value in certain patients

  18. A rare case of chronic lymphocytic leukemia/small lymphocytic lymphoma presenting in the thyroid gland.

    Science.gov (United States)

    Shin, Joyce; Chute, Deborah; Milas, Mira; Mitchell, Jamie; Siperstein, Allan; Berber, Eren

    2010-09-01

    Lymphoma involving the thyroid gland is rare. Diffuse large B-cell lymphoma and mucosa-associated lymphoid tissue lymphoma are the two most common histologic subtypes of primary thyroid lymphoma. Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) presenting initially as a thyroid abnormality is extremely rare, with very few reported cases in the literature. We report a case of a patient with a long history of Hashimoto's thyroiditis and goiter who presented with a recent enlargement of her thyroid gland. The sonographic finding of a distinct thyroid nodule in the heterogeneous background of chronic lymphocytic thyroiditis led to the performance of a fine-needle aspiration biopsy and flow cytometry, with a high index of suspicion for thyroid lymphoma. Subsequent surgical removal of the thyroid gland, prompted by the patient's history of head and neck radiation, confirmed the diagnosis of CLL/SLL. The patient's systemic illness was recognized only after the management of her thyroid disease. Although thyroiditis has long been associated with lymphoma arising in the thyroid gland, CLL/SLL involving the thyroid has not been linked to chronic lymphocytic thyroiditis. Therefore, the patient also had coexisting thyroiditis. Due to the rarity of thyroid lymphomas, our experience in the detection and management of this disease is limited. Primary thyroid lymphoma should be suspected in a patient with a history of chronic lymphocytic thyroiditis presenting with a rapidly enlarging neck mass. The initial diagnostic method for thyroid lymphoma should consist of a fine-needle aspiration biopsy with the use of ancillary techniques such as flow cytometry and immunohistochemistry for improved diagnostic accuracy. Although controversial, the treatment of thyroid lymphoma is typically guided by the histologic subtype and extent of disease. CLL/SLL is one of the rarest subtypes of lymphoma that can involve the thyroid gland. Diagnosis of this entity is difficult

  19. Lipid profile pattern in thyroid disorders in northeastern Nigeria ...

    African Journals Online (AJOL)

    Objectives: To determine lipid pattern in thyroid disorders in northeastern Nigeria. Methods: 18 simple goiter, 41 thyrotoxicosis patients, and 41 control subjects were recruited at the surgery clinic and department of Chemical Pathology of University of Maiduguri Teaching Hospital. Thyroid function test and lipid profile were ...

  20. Quantitative assessment of thyroid gland elasticity with shear-wave elastography in pediatric patients with Hashimoto's thyroiditis.

    Science.gov (United States)

    Kandemirli, Sedat Giray; Bayramoglu, Zuhal; Caliskan, Emine; Sari, Zeynep Nur Akyol; Adaletli, Ibrahim

    2018-01-18

    Hashimoto's thyroiditis is the most common autoimmune thyroid disorder in the pediatric age range. Measurement of thyroid gland size is an essential component in evaluation and follow-up of thyroid pathologies. Along with size, tissue elasticity is becoming a more commonly used parameter in evaluation of parenchyma in inflammatory diseases. The aim of the current study was to assess thyroid parenchyma elasticity by shear-wave elastography in pediatric patients with Hashimoto's thyroiditis; and compare the elasticity values to a normal control group. In this study; thyroid glands of 59 patients with a diagnosis of Hashimoto's thyroiditis based on ultrasonographic and biochemical features, and 26 healthy volunteers without autoimmune thyroid disease and thyroid function disorders, were evaluated with shear-wave elastography. Patients with Hashimoto thyroiditis were further subdivided into three categories based on gray-scale ultrasonography findings as focal thyroiditis (grade 1), diffuse thyroiditis (grade 2), and fibrotic thyroid gland (grade 3). Patients with Hashimoto's thyroiditis (n = 59) had significantly higher elasticity values (14. 9 kPa; IQR 12.9-17.8 kPa) than control subjects (10.6 kPa; IQR 9.0-11.3 kPa) (p thyroiditis, 23 patients had focal thyroiditis involving less than 50% of the gland categorized as grade 1, 24 patients had diffuse involvement of the thyroid gland categorized as grade 2, and 12 patients had marked hyperechoic septations and pseudonodular appearance categorized as grade 3 on gray-scale ultrasound. Based on elastography, grade 3 patients had significantly higher elasticity values (19.7 kPa; IQR 17.8-21.5 kPa) than patients with grade 2 (15.5 kPa; IQR 14.5-17.8 kPa) and grade 1 thyroiditis (12.8 kPa; IQR 11.9-13.1 kPa) (p thyroiditis had significantly higher elasticity values than those with grade 1 thyroiditis (p thyroiditis. Our results indicate that shear-wave elastography could be used to evaluate the degree of

  1. Thyroid Disorders (For Kids)

    Science.gov (United States)

    ... it keeps the temperature just right. What Is Thyroid Disease? There are two main kinds of thyroid disorder ... into the kid's bloodstream. Why Do Kids Get Thyroid Disease? In most cases, doctors and scientists can't ...

  2. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... the limitations of the Thyroid Scan and Uptake? What is a Thyroid Scan and Uptake? A thyroid ... body converts food to energy. top of page What are some common uses of the procedure? The ...

  3. Thyroid gland removal - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000293.htm Thyroid gland removal - discharge To use the sharing features ... surgery. This will make your scar show less. Thyroid Hormone Replacement You may need to take thyroid ...

  4. Hyperthyroidism (Overactive Thyroid)

    Science.gov (United States)

    Hyperthyroidism (overactive thyroid) Overview Hyperthyroidism (overactive thyroid) is a condition in which your thyroid gland produces too much of the hormone thyroxine. Hyperthyroidism can accelerate your body's metabolism significantly, ...

  5. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... scan and thyroid uptake provide information about the structure and function of the thyroid. The thyroid is ... computer, create pictures offering details on both the structure and function of organs and tissues in your ...

  6. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... of the Thyroid Scan and Uptake? What is a Thyroid Scan and Uptake? A thyroid scan is ... taking our brief survey: Survey Do you have a personal story about radiology? Share your patient story ...

  7. Thyroid cancer - papillary carcinoma

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000331.htm Thyroid cancer - papillary carcinoma To use the sharing features on ... does not increase the risk of developing thyroid cancer. Symptoms Thyroid cancer often begins as a small lump (nodule) ...

  8. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... typically performed on people who have or had thyroid cancer. A physician may perform these imaging tests to: ... such as lumps (nodules) or inflammation determine whether thyroid cancer has spread beyond the thyroid gland evaluate changes ...

  9. Anaplastic thyroid cancer

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000352.htm Anaplastic thyroid cancer To use the sharing features on this page, ... carcinoma is a rare and aggressive form of cancer of the thyroid gland. Causes Anaplastic thyroid cancer is an invasive ...

  10. Autoimmune Thyroiditis and Myasthenia Gravis

    Directory of Open Access Journals (Sweden)

    Angela Lopomo

    2017-07-01

    Full Text Available Autoimmune diseases (AIDs are the result of specific immune responses directed against structures of the self. In normal conditions, the molecules recognized as “self” are tolerated by immune system, but when the self-tolerance is lost, the immune system could react against molecules from the body, causing the loss of self-tolerance, and subsequently the onset of AID that differs for organ target and etiology. Autoimmune thyroid disease (ATD is caused by the development of autoimmunity against thyroid antigens and comprises Hashimoto’s thyroiditis and Graves disease. They are frequently associated with other organ or non-organ specific AIDs, such as myasthenia gravis (MG. In fact, ATD seems to be the most associated pathology to MG. The etiology of both diseases is multifactorial and it is due to genetic and environmental factors, and each of them has specific characteristics. The two pathologies show many commonalities, such as the organ-specificity with a clear pathogenic effect of antibodies, the pathological mechanisms, such as deregulation of the immune system and the implication of the genetic predisposition. They also show some differences, such as the mode of action of the antibodies and therapies. In this review that focuses on ATD and MG, the common features and the differences between the two diseases are discussed.

  11. Autoimmune Thyroiditis and Myasthenia Gravis

    Science.gov (United States)

    Lopomo, Angela; Berrih-Aknin, Sonia

    2017-01-01

    Autoimmune diseases (AIDs) are the result of specific immune responses directed against structures of the self. In normal conditions, the molecules recognized as “self” are tolerated by immune system, but when the self-tolerance is lost, the immune system could react against molecules from the body, causing the loss of self-tolerance, and subsequently the onset of AID that differs for organ target and etiology. Autoimmune thyroid disease (ATD) is caused by the development of autoimmunity against thyroid antigens and comprises Hashimoto’s thyroiditis and Graves disease. They are frequently associated with other organ or non-organ specific AIDs, such as myasthenia gravis (MG). In fact, ATD seems to be the most associated pathology to MG. The etiology of both diseases is multifactorial and it is due to genetic and environmental factors, and each of them has specific characteristics. The two pathologies show many commonalities, such as the organ-specificity with a clear pathogenic effect of antibodies, the pathological mechanisms, such as deregulation of the immune system and the implication of the genetic predisposition. They also show some differences, such as the mode of action of the antibodies and therapies. In this review that focuses on ATD and MG, the common features and the differences between the two diseases are discussed. PMID:28751878

  12. The role of thyroid scanning in hyperthyroidism

    International Nuclear Information System (INIS)

    Fogelman, I.; Cooke, S.G.; Maisey, M.N.

    1986-01-01

    Radionuclide thyroid imaging was performed in 872 consecutive patients with hyperthyroidism. Of these, 84% were found to have diffuse toxic hyperplasia (Graves' disease), while 12% had autonomously functioning nodules (Plummer's disease), 3% had Graves' disease developing in a multinodular gland, and in the remaining 1%, either a clear diagnosis could not be established or the hyperthyroidism was due to thyroiditis or the Jod-Basedow phenomenon. It was found that a thyroid scan seldom provides additional diagnostic information in patients with Graves' disease when a diffuse goitre is present. However, if patients are to be treated with radioiodine ( 131 I), thyroid imaging with tracer quantitation can replace a 24-h 131 I uptake measurement, this having the advantages that the patients are required to attend only once, and that the gland size can be measured. In addition, visual confirmation of tracer uptake by the thyroid is obtained and patients with thyroiditis will not receive inappropriate therapy. When single or multiple thyroid nodules are palpated, a thyroid scan is crucial in establishing an accurate diagnosis, as it is not otherwise possible to differentiate between Plummer's disease and Graves' disease developing in a multinodular gland. Indeed, in 20 of our 63 patients (32%) with single autonomously functioning nodules, the initial clinical assessment had been incorrect. (orig.)

  13. Thyroid carcinoma

    International Nuclear Information System (INIS)

    Lambertini, Roberto; Dalurzo, Liliana; Jaen, Ana del V.

    2008-01-01

    In this document the case of a 66-year old woman is presented, with record of multi nodular goiter of 5 year of evolution, which is derived to scan ultrasound office to make a puncture-aspiration with thin needle because of the growth of nodular thyroid injuries. The ultrasound scan examination made before the puncture determine multiple dominant nodules of hyperplasia aspect between 15 and 25 mm of diameter and a small nodule of 6 mm suspected proliferate process. Despite its size, it was decided to include small nodule in injuries to a biopsy. The cytological study reveals nodular hyperplasia with carcinoma in the small nodule of 6 mm. A thyroidectomy is practiced on the patient. The deferred histological study of the thyroid gland confirms the finding of multi-nodular goiter with a small focus of papillar carcinoma. The ganglions examined were negative in the deferred examination [es

  14. Characteristic of thyroid diseases in participants of Chernobyl accident clean-up

    International Nuclear Information System (INIS)

    Afanas'jeva, N.Yi.

    1996-01-01

    The study involved 309 liquidators of the accident at the Chernobyl Atomic Power Plant (192 patients were investigated in 1990-1991 and 117 in 1992-1994). Nodular goiter and autoimmune thyroiditis (diffuse and nodular forms) against the background of thyroid hyperplasia occupy the leading place among the thyroid diseases in these patients. Thyroid cancer developed mainly in those liquidators who stayed in the zone of the accident during 'iodine' period. The incidence of thyroid pathology (mainly that autoimmune character and thyroid cancer) have increased in the participants of the Chernobyl accident clean-up recently

  15. Ultrasonic imaging of metastatic carcinoma in thyroid gland

    International Nuclear Information System (INIS)

    Bai Ling; Yang Tao; Tang Ying; Mao Jingning; Chen Wei; Wang Wei

    2008-01-01

    Objectives: To explore the ultrasonic findings of metastatic thyroid carcinoma and to evaluate the diagnostic value of the ultrasonic imaging for patients with metastatic thyroid neoplasm. Methods: The ultrasonic imaging characteristics of ten patients who were diagnosed with metastatic thyroid carcinoma were retrospectively analyzed. In all the cases, fine-needle aspiration cytology (FNAC) of the thyroid was performed during the clinical diagnosis. Results: The ultrasonic images of the ten patients fell into four types: multiple nodules in the thyroid, single nodule in the thyroid, diffuse calcification and heterogeneous echo. Seven cases showed speckled calcific foci. Abnormal blood flow signal was found in 9 cases. Conclusion: The ultrasonic findings of metastatic carcinoma in the thyroid gland are various and non-specific. Color Doppler ultrasound may provide ample evidence. The diagnosis depends on FNAC. (authors)

  16. Thyroid function after mantle irradiation in Hodgkin's disease

    International Nuclear Information System (INIS)

    Smith, R.E. Jr.; Adler, R.A.; Clark, P.; Brinck-Johnsen, T.; Tulloh, M.E.; Colten, T.

    1981-01-01

    The thyroid function of 64 patients with Hodgkin's disease who received mantle irradiation during the period 1966 to 1976 was studied. More than two-thirds (44 to 64) had some thyroid dysfunction. Twenty had mild dysfunction manifested by an abnormal thyroid-stimulating hormone response to thyrotropin-releasing hormone. Twenty had what could be termed compensated hypothyroidism while four were overtly hypothyroid. The severity of dysfunction was not related to age, sex, or chemotherapy. We found, however, that decreased thyroid function was inversely proportional to the length of time between a diagnostic lymphangiogram and the radiation therapy. These results are consistent with the hypothesis that the iodine load of the lymphangiogram renders the thyroid gland more radiosensitive. Thyroxine suppression of the thyroid gland during the period from the lymphangiogram through the termination of radiation therapy is suggested as a means of avoiding thyroid injury

  17. Thyroid metastasectomy.

    Science.gov (United States)

    Montero, Pablo H; Ibrahimpasic, Tihana; Nixon, Iain J; Shaha, Ashok R

    2014-01-01

    Metastases to the thyroid gland are uncommon. Renal, lung, breast, and colon cancer and melanoma are the most common primary diseases implicated. Few retrospective series have been reported. Treatment decisions must be individualized, and will depend on the state of systemic disease. Selected patients could benefit from surgical treatment. Although most patients selected for surgery will not be cured, the aim of surgery is to avoid the complications of uncontrolled central neck disease. © 2013 Wiley Periodicals, Inc.

  18. Use of recombinant human thyrotropin (rh TSH) as a method of preparation for radioiodine therapy in thyroid disorders; Utilisation de la thyreostimuline humaine recombinante dans la preparation au traitement par iode-131 des pathologies thyroidiennes

    Energy Technology Data Exchange (ETDEWEB)

    Taieb, D.; Guillet, B.A.; Tessonnier, L.; Mundler, O. [Centre Hospitalo-Universitaire de la Timone, Service Central de Biophysique et de Medecine Nucleaire, 13 - Marseille (France)

    2008-02-15

    The introduction of recombinant human TSH (rh TSH) as a method of preparation for radioiodine therapy of follicular-derived thyroid tumors (benign and malignant) is a significant medical advance. Rh TSH has been approved for use in remnants ablation after total thyroidectomy for carcinoma. There are other potential uses for rh TSH that have not yet been licensed. The use of rh TSH allows to reduce administrated doses in goiters through an increase of iodine uptake and a more homogeneous distribution of radioiodine in the gland. Rh TSH also improves thyroid cancer patients quality of life by avoiding hypothyroidism. (authors)

  19. A Case of Metastatic Renal Cell Carcinoma to Thyroid Gland

    OpenAIRE

    Lee, Jae-Geun; Yang, Youngro; Kim, Kwang Sik; Hyun, Chang Lim; Lee, Ji Shin; Koh, Gwanpyo; Lee, Daeho

    2011-01-01

    Metastasis to the thyroid gland from distant cancer is rare, and, in some cases, is a diagnostic challenge. Here, we report a case of metastatic renal cell carcinoma of the thyroid gland. A 77-year-old man presented with a neck mass detected about 1 month previously. He had undergone a right nephrectomy owing to renal cell carcinoma 14 years previously. Fine needle aspiration cytology showed a few atypical follicular cells with nuclear atypia. Under a tentative diagnosis of papillary thyroid ...

  20. Stem Cell Pathology.

    Science.gov (United States)

    Fu, Dah-Jiun; Miller, Andrew D; Southard, Teresa L; Flesken-Nikitin, Andrea; Ellenson, Lora H; Nikitin, Alexander Yu

    2018-01-24

    Rapid advances in stem cell biology and regenerative medicine have opened new opportunities for better understanding disease pathogenesis and the development of new diagnostic, prognostic, and treatment approaches. Many stem cell niches are well defined anatomically, thereby allowing their routine pathological evaluation during disease initiation and progression. Evaluation of the consequences of genetic manipulations in stem cells and investigation of the roles of stem cells in regenerative medicine and pathogenesis of various diseases such as cancer require significant expertise in pathology for accurate interpretation of novel findings. Therefore, there is an urgent need for developing stem cell pathology as a discipline to facilitate stem cell research and regenerative medicine. This review provides examples of anatomically defined niches suitable for evaluation by diagnostic pathologists, describes neoplastic lesions associated with them, and discusses further directions of stem cell pathology.

  1. Does thyroid gland examination by palpation alter serum hormone levels?

    Science.gov (United States)

    Toros, Sema Zer; Ozel, Leyla; Yekrek, Mehmet Murat; Toros, Ahmet Burak; Naiboglu, Baris; Kara, Melih; Erdoğdu, Erdal; Egeli, Erol; Titiz, Izzet

    2010-07-01

    The goal of this study was to investigate the effects of routine thyroid gland palpation on serum thyroid hormone levels. Prospective study at Haydarpaşa Numune Research and Education Hospital, Istanbul, Turkey. This study was carried out in two groups with a total of 50 consecutive adults. Group I consisted of 20 patients (12 female and 8 male, aged 20-48 years) with a diagnosis of nodular thyroid disease confirmed by ultrasound imaging techniques. The second group consisted of 30 otherwise healthy subjects (17 female and 13 male, aged 18-50 years) referred for neck and thyroid ultrasound and with no thyroid pathology detected. Thyroid gland palpations were performed by the same physician. Blood samples were obtained before and 2 hours after thyroid gland palpation. Serum total T3 (TT3), total T4 (TT4), free T3 (FT3), free T4 (FT4), thyroid stimulating hormone (TSH), and thyroglobulin (TG) measurements were made. We found that routine palpation in the first group caused a significant increase in serum TT3 (P .05). Preliminary data proposing a possible effect of routine thyroid gland palpation on serum thyroid hormone levels suggest that serum thyroid hormone measurements should be performed before any manipulation of the gland, including palpation, to avoid misdiagnosis.

  2. Comparison of diagnostic and prognostic capabilities of 18F-FDG-PET/CT, 131I-scintigraphy, and diffusion-weighted magnetic resonance imaging for postoperative thyroid cancer

    International Nuclear Information System (INIS)

    Nagamachi, Shigeki; Wakamatsu, Hideyuki; Kiyohara, Shogo

    2011-01-01

    The first aim of this study was to compare the detectability of metastasis of postoperative differentiated thyroid cancer (DTC) among 131 I whole body scintigraphy (IWBS), fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT), and diffusion-weighted magnetic resonance imaging (DWI). The second aim was to clarify the association between the image pattern and prognosis. We evaluated 70 postoperative DTC patients on both a patient basis and an organ basis (lymph nodes, lung, bone), and we analyzed the correlation between the image pattern and the prognosis. For the patient-basis analysis, the detectability by IWBS, PET/CT, and DWI was 67.1%, 84.2%, and 57.6%, respectively. IWBS provided complementary information to that provided by PET/CT in 11 of 70 (15.7%) cases. For the organ-basis analysis, IWBS was the best detector for lymph node metastasis (72.4%). PET/CT was superior to IWBS for detecting metastasis of bone (85.7% vs. 71.4%) and lung (94.1% vs. 62.7%). For the correlation analysis, PET and DWI positivity were the factors predicting a poor prognosis. PET/CT was the best modality for detecting metastases in postoperative DTC patients, although IWBS provided complementary information. Because PET/CT and DWI gave similar information (exempli gratia (e.g.), positivity) suggesting poor prognoses, the combination of IWBS and DWI might be the method of choice for monitoring postoperative DTC. (author)

  3. Differential phase analysis of laser images of a polycrystalline component of blood plasma in diagnostics of pathological changes in mammary gland

    Science.gov (United States)

    Mintser, O. P.; Zabolotna, N. I.; Oliinychenko, B. P.; Komada, P.

    2013-01-01

    The present work is devoted to investigation of diagnostic potentiality of differential phase tomography of blood plasma. The data of further statistical, correlation and fractal analysis of phase tomograms for determining objective criteria of diagnostics of physiological state of a patient is provided.

  4. Pendrin and NIS antibodies are absent in healthy individuals and are rare in autoimmune thyroid disease

    DEFF Research Database (Denmark)

    Brix, Thomas H; Hegedüs, Laszlo; Weetman, Anthony P

    2014-01-01

    OBJECTIVE: Antibodies against thyroglobulin, thyroid peroxidase and the TSH receptor are accepted as pathophysiological and diagnostic biomarkers in autoimmune thyroid disease (AITD). In contrast, the prevalence, aetiology and clinical relevance of autoantibodies against the human sodium...... prevalence than the controls: NISAb: 17% vs 0% (P disease (GD) and 14% (5/37) of patients with Hashimoto's thyroiditis (HT) had NISAb, (P

  5. Thyroid disease: thyroid function tests and interpretation

    African Journals Online (AJOL)

    Diseases of the thyroid are among the most prevalent of medical conditions, especially in women, but the symptoms can be relatively nonspecific or mild. For this reason, clinicians have been placing increased reliance on the laboratory for assistance in the diagnosis of thyroid disorders. In the 1950s, only one thyroid test ...

  6. Metastatic papillary carcinoma of the thyroid in a patient previously ...

    African Journals Online (AJOL)

    ... the patient was referred to our nuclear medicine department with a clinical diagnosis of suspected metastatic lymph nodes presumably from a thyroid malignancy.She had an 123I diagnostic whole body scan that showed 123I avid areas in the thyroid bed as well as left cervical lymph nodes, which later turned out to be.

  7. Metastatic papillary carcinoma of the thyroid in a patient previously ...

    African Journals Online (AJOL)

    She had an 123I diagnostic whole body scan that showed 123I avid areas in the thyroid bed as well as left cervical lymph nodes, which later turned out to be metastatic papillary carcinoma of the thyroid on histology. She was treated with therapeutic doses of 131I. Follow-up radioactive iodine scans and serum thyroglobulin ...

  8. Discordance Rate between Thyroid Fine Needle Aspiration Cytology ...

    African Journals Online (AJOL)

    Discordance Rate between Thyroid Fine Needle Aspiration Cytology and Histopathologic Diagnosis. Wondwossen Ergete, Daniel Abebe. Abstract. Fine Needle Aspiration (FNA) of the thyroid is a low cost procedure, which can give an accurate diagnosis promptly. The objective of this study was to assess the diagnostic ...

  9. Protocol for thyroid remnant ablation after recombinant TSH in thyroid carcinoma

    International Nuclear Information System (INIS)

    Pitoia, F.; Salvai, M.E.; Niepomniszcze, H.; Tamer, E. El

    2009-01-01

    In some countries, in order to perform rhTSH-aided thyroid remnant ablation (TRA) after surgery, it is generally necessary to confirm that thyroidectomy has been almost complete. Otherwise, the nuclear medicine specialist will not administer a high radioiodine dose because it might be hazardous due to the possibility of thyroid remnant actinic thyroiditis. Considering this, it would be necessary to use two rhTSH kits (one for diagnostic purposes and the other one to administer the 131 I dose). In this study, we used an alternative protocol for TRA with the use of one kit of rhTSH in twenty patients diagnosed with low risk papillary thyroid carcinoma. All patients had negative titers of anti-thyroglobulin antibodies. Successful thyroid remnant ablation was confirmed with an undetectable rhTSH stimulated thyroglobulin level ( [es

  10. [Mediastinal pathology: pathological treatment of frozen section].

    Science.gov (United States)

    Saint-Blancard, P; Jancovici, R

    2010-10-01

    Tumoral pathology of the mediastinum is extremely varied, with different prognoses and treatments. The pathological examination is essential, both etiologically and prognostically. Mediastinoscopy is generally used to check for lymph node metastases, bronchopulmonary carcinoma, but also, to a lesser degree, for the exploration of isolated mediastinal adenopathy. Finally, this technique enables a diagnostic approach to mediastinal tumours. The frozen section has its place, at the first indication, making it possible to prescribe neoadjuvant chemotherapy, and in the other situations to make sure that the quantity of material removed is sufficient or even to carry out complementary techniques. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  11. Application of the Voxeldose software for dosimetric evaluation on the thyroid during thorax-AP irradiation considering the peak voltages (k Vp) most used in diagnostic X-ray

    International Nuclear Information System (INIS)

    Vieira, I.F.; Vieira, J.W.; Leal Neto, V.

    2009-01-01

    The evaluation of the absorbed dose distribution can be obtained through a computational model of exposures (ECM), being one the main difficulties at the specific dosimetric evaluation such as the radiodiagnostic, coupling the Monte Carlo computer code, developed for general use, to a anthropomorphic model. This problem can be solved by the software used in this paper, the VoxelDose, and it consists of an algorithm for X-ray diagnostic sources with the Monte Carlo EGS4 code coupled to the voxel anthropomorphic phantoms MAX (Male Adult voXel) and FAX (Female Adult voXel). The graphic interface allows the user to insert the mos common exams parameters, and to execute the simulation, obtaining conversion coefficients and the estimative of the deposited energy on organs/tissues radio sensible during the routine procedures. The data obtained were organized into graphics showing the thyroid equivalent dose, which is a radio sensible with 20 g mass and a weight factor of 5 %, compared with the effective dose during an irradiation of thorax-AP

  12. Impact of Fibrotic Tissue on Shear Wave Velocity in Thyroid: An Ex Vivo Study with Fresh Thyroid Specimens

    Directory of Open Access Journals (Sweden)

    Takahiro Fukuhara

    2015-01-01

    Full Text Available We sought to elucidate the correlation between shear wave velocity (SWV and fibrosis in thyroid by precisely assessing pathological structures inside 5 × 5 mm2 regions of interest (ROIs of resected specimens, under conditions that excluded physical artifacts. The materials were unselected thyroid and lymph node specimens resected during thyroid surgery. Immediately after surgery, fresh unfixed thyroid and metastatic lymph node specimens were suspended in gel phantoms, and SWV was measured. Upon pathological examination of each specimen, the extent of fibrosis was graded as none, moderate, or severe. A total of 109 specimens were evaluated: 15 normal thyroid, 16 autoimmune thyroiditis, 40 malignant nodules, 19 benign thyroid nodules, and 19 metastatic lymph nodes. When all specimens were classified according to the degree of fibrosis determined by pathological imaging, the mean SWV was 1.49±0.39 m/s for no fibrosis, 2.13±0.66 m/s for moderate fibrosis, and 2.68±0.82 m/s for severe fibrosis. The SWVs of samples with moderate and severe fibrosis were significantly higher than those of samples without fibrosis. The results of this study demonstrate that fibrosis plays an important role in determining stiffness, as measured by SWV in thyroid.

  13. Updates in ophthalmic pathology.

    Science.gov (United States)

    Mendoza, Pia R; Grossniklaus, Hans E

    2017-05-01

    Ophthalmic pathology has a long history and rich heritage in the field of ophthalmology. This review article highlights updates in ophthalmic pathology that have developed significantly through the years because of the efforts of committed individuals and the confluence of technology such as molecular biology and digital pathology. This is an exciting period in the history of ocular pathology, with cutting-edge techniques paving the way for new developments in diagnostics, therapeutics, and research. Collaborations between ocular oncologists and pathologists allow for improved and comprehensive patient care. Ophthalmic pathology continues to be a relevant specialty that is important in the understanding and clinical management of ocular disease, education of eye care providers, and overall advancement of the field.

  14. Updates in ophthalmic pathology

    Directory of Open Access Journals (Sweden)

    Pia R Mendoza

    2017-01-01

    Full Text Available Ophthalmic pathology has a long history and rich heritage in the field of ophthalmology. This review article highlights updates in ophthalmic pathology that have developed significantly through the years because of the efforts of committed individuals and the confluence of technology such as molecular biology and digital pathology. This is an exciting period in the history of ocular pathology, with cutting-edge techniques paving the way for new developments in diagnostics, therapeutics, and research. Collaborations between ocular oncologists and pathologists allow for improved and comprehensive patient care. Ophthalmic pathology continues to be a relevant specialty that is important in the understanding and clinical management of ocular disease, education of eye care providers, and overall advancement of the field.

  15. Thyroid carcinoma

    International Nuclear Information System (INIS)

    Friedman, M.; Skolnik, E.M.; Baim, H.M.; Becker, S.P.; Katz, A.H.; Mantravadi, R.V.

    1980-01-01

    Differentiated thyroid carcinoma was studied with regard to mode of presentation, initial findings, treatment and survival. The classic signs, symptoms, physical and scan findings were found to be present in approximately 70% of the patients. Prognosis was found to be dependent on age of presentation more than any other factor. Patients with prior exposure to radiation were found to have more extensive disease and require more extensive surgery but ultimately had the same prognosis for 15-year cure. Treatment for distant metastatic disease by surgery, radioactive iodine and external radiation all resulted in long-term survival in certain cases

  16. An Adolescent Boy with Comorbid Anorexia Nervosa and Hashimoto Thyroiditis.

    Science.gov (United States)

    Pehlivantürk Kızılkan, Melis; Kanbur, Nuray; Akgül, Sinem; Alikaşifoğlu, Ayfer

    2016-03-05

    Low triiodothyronine syndrome is a physiological adaptation encountered in anorexia nervosa (AN) and generally improves with sufficient weight gain. However, when a primary thyroid pathology accompanies AN, both the evaluation of thyroid hormone levels and the management of the co-morbid disease become more challenging. Hashimoto thyroiditis could complicate the management of AN by causing hyper- or hypothyroidism. AN could also negatively affect the treatment of Hashimoto thyroiditis by altering body weight and metabolic rate, as well as by causing drug non-compliance. We present the case of a 15-year-old boy with comorbid AN restrictive sub-type and Hashimoto thyroiditis. In this case report, we aimed to draw attention to the challenges that could be encountered in the diagnosis, treatment, and follow-up of patients with AN when accompanied by Hashimoto thyroiditis.

  17. Autoimmunity in differentiated thyroid cancer: significance and related clinical problems

    DEFF Research Database (Denmark)

    Feldt-Rasmussen, Ulla; Rasmussen, Ase Krogh

    2011-01-01

    Coexistence of differentiated thyroid cancer (DTC) and thyroid autoimmune diseases could represent a mere coincidence due to the frequent occurrence of autoimmunity, but there may also be a pathological and causative link between the two conditions. The coincidence of DTC with Hashimoto's disease...... has been variably reported at between 0.5 and 22.5% and of DTC with Graves' disease between 0 and 9.8%. In this review available evidence for thyroid autoimmunity in DTC is summarized and it is concluded that thyroid cancer does coexist with thyroid autoimmunity, implying that patients treated...... TgAb measurements may be used as a surrogate marker for recurrence of thyroid cancer during the long-term monitoring of DTC patients....

  18. Autoimmunity in differentiated thyroid cancer: significance and related clinical problems

    DEFF Research Database (Denmark)

    Feldt-Rasmussen, Ulla; Rasmussen, Ase Krogh

    2010-01-01

    Coexistence of differentiated thyroid cancer (DTC) and thyroid autoimmune diseases could represent a mere coincidence due to the frequent occurrence of autoimmunity, but there may also be a pathological and causative link between the two conditions. The coincidence of DTC with Hashimoto's disease...... has been variably reported at between 0.5 and 22.5% and of DTC with Graves' disease between 0 and 9.8%. In this review available evidence for thyroid autoimmunity in DTC is summarized and it is concluded that thyroid cancer does coexist with thyroid autoimmunity, implying that patients treated...... TgAb measurements may be used as a surrogate marker for recurrence of thyroid cancer during the long-term monitoring of DTC patients....

  19. Clinical value of elasticity imaging and contrast-enhanced ultrasound in the diagnosis of papillary thyroid microcarcinoma.

    Science.gov (United States)

    Li, Fengsheng; Zhang, Jianlei; Wang, Yunmei; Liu, Liwen

    2015-09-01

    The present study aimed to evaluate the value of elasticity imaging and contrast-enhanced ultrasonography (CEUS) in the differential diagnosis of papillary thyroid microcarcinoma (TMC). In total, 73 patients exhibiting a total of 80 small thyroid nodules, which were difficult to diagnose using conventional ultrasonography, underwent elasticity imaging and CEUS. The diagnostic findings were subsequently clarified by intraoperative and pathological examination, and the accuracy of the 2 diagnostic methods was compared. The correct diagnostic rate of CEUS was 85% (68/80 nodules), of which 6 cases of TMC were misdiagnosed as benign lesions and 6 benign nodules were misdiagnosed as TMC. By contrast, the accuracy rate of the elasticity imaging, based on the 5-point diagnostic method, was 92.5% (74/80 nodules), of which 3 cases of TMC were misdiagnosed as benign nodules and 3 benign nodules were misdiagnosed as TMC. Furthermore, elasticity imaging in the diagnosis of TMC was determined to have sensitivity, specificity and accuracy rates of 94.0, 90.0 and 92.5%, respectively, whereas the corresponding rates for CEUS were 88.0, 80.0 and 85.0%, respectively. Thus, ultrasonographic elasticity imaging exhibited significant advantages in the diagnosis of TMC compared with CEUS (Padvantage in the diagnosis of TMC; however, an elasticity score of ≥3 is of high clinical value as a diagnostic criterion for TMC.

  20. Thyroiditis: an integrated approach.

    Science.gov (United States)

    Sweeney, Lori B; Stewart, Christopher; Gaitonde, David Y

    2014-09-15

    Thyroiditis is a general term that encompasses several clinical disorders characterized by inflammation of the thyroid gland. The most common is Hashimoto thyroiditis; patients typically present with a nontender goiter, hypothyroidism, and an elevated thyroid peroxidase antibody level. Treatment with levothyroxine ameliorates the hypothyroidism and may reduce goiter size. Postpartum thyroiditis is transient or persistent thyroid dysfunction that occurs within one year of childbirth, miscarriage, or medical abortion. Release of preformed thyroid hormone into the bloodstream may result in hyperthyroidism. This may be followed by transient or permanent hypothyroidism as a result of depletion of thyroid hormone stores and destruction of thyroid hormone-producing cells. Patients should be monitored for changes in thyroid function. Beta blockers can treat symptoms in the initial hyperthyroid phase; in the subsequent hypothyroid phase, levothyroxine should be considered in women with a serum thyroid-stimulating hormone level greater than 10 mIU per L, or in women with a thyroid-stimulating hormone level of 4 to 10 mIU per L who are symptomatic or desire fertility. Subacute thyroiditis is a transient thyrotoxic state characterized by anterior neck pain, suppressed thyroid-stimulating hormone, and low radioactive iodine uptake on thyroid scanning. Many cases of subacute thyroiditis follow an upper respiratory viral illness, which is thought to trigger an inflammatory destruction of thyroid follicles. In most cases, the thyroid gland spontaneously resumes normal thyroid hormone production after several months. Treatment with high-dose acetylsalicylic acid or nonsteroidal anti-inflammatory drugs is directed toward relief of thyroid pain.

  1. Clinical Observation on Thyroid Carcinoma

    International Nuclear Information System (INIS)

    Park, Seon Yang; Shin, Yong Tae; Cho, Bo Yun; Kim, Byung Kuk; Koh, Chang Soon; Lee, Mun Ho

    1978-01-01

    Clinical features of 147 patients with biopsy-proven thyroid carcinomas were investigated from January, 1972 to April, 1978 at the Seoul National University Hospital with the following results. 1) The incidence of thyroid carcinomas according to their histopathological classification revealed 76.2% of papillary carcinoma, 19.0% of follicular carcinoma, and 3 cases of occult sclerozing carcinoma, 1 case of giant cell carcinoma and 1 case of metastatic melanoma. 2) The ratio of male to female patients was 1:8.3 and showed no difference between papillary and follicular carcinomas. 3) The age distribution showed the peak incidence in the fourth decade (29.3%) followed by the fifth and sixth decades. 4) The average duration of illness from the onset of symptoms was about 5 years while it was 4.4 years and 7.6 years in the papillary and follicular carcinomas respectively. 5) The diameter of the thyroid masses was smaller than 5 cm in 53.6% of the patients, from 5 cm to 10 cm in 40.0% and larger than 10 cm in 6.4%. 6) In 36.4% of the patients with thyroid carcinomas the thyroid masses were fixed to adjacent tissues. 7) Metastasis to the regional lymph nodes was noted in 40.0% of the total cases, and in 45.2% and 17.6% of the papillary and follicular carcinomas respectively, while the lung and bone metastases were found in 10.0% and 4.4% in each type respectively. 8) 88.9% of the patients showed cold areas in the thyroid scans using 131 I. 9) Typical psammoma bodies were observed in 21.3% of the cases in the microscopic examination of the pathological specimens. 10) The initial diagnosis of thyroid malignancy could be made before histological confirmation in 64.5% of the patients. 11) The clinical staging slightly modified from Schulz method revealed 43.6% of the patients in stage I, 26.4% in stage II, 20.9% in stage III and 9.1% in stage IV. 12) The association with Hashimoto's thyroiditis was noted in 4 cases, with nodular goiter in 3 cases, and with follicular adenoma

  2. Clinical Observation on Thyroid Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Park, Seon Yang; Shin, Yong Tae; Cho, Bo Yun; Kim, Byung Kuk; Koh, Chang Soon; Lee, Mun Ho [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1978-09-15

    Clinical features of 147 patients with biopsy-proven thyroid carcinomas were investigated from January, 1972 to April, 1978 at the Seoul National University Hospital with the following results. 1) The incidence of thyroid carcinomas according to their histopathological classification revealed 76.2% of papillary carcinoma, 19.0% of follicular carcinoma, and 3 cases of occult sclerozing carcinoma, 1 case of giant cell carcinoma and 1 case of metastatic melanoma. 2) The ratio of male to female patients was 1:8.3 and showed no difference between papillary and follicular carcinomas. 3) The age distribution showed the peak incidence in the fourth decade (29.3%) followed by the fifth and sixth decades. 4) The average duration of illness from the onset of symptoms was about 5 years while it was 4.4 years and 7.6 years in the papillary and follicular carcinomas respectively. 5) The diameter of the thyroid masses was smaller than 5 cm in 53.6% of the patients, from 5 cm to 10 cm in 40.0% and larger than 10 cm in 6.4%. 6) In 36.4% of the patients with thyroid carcinomas the thyroid masses were fixed to adjacent tissues. 7) Metastasis to the regional lymph nodes was noted in 40.0% of the total cases, and in 45.2% and 17.6% of the papillary and follicular carcinomas respectively, while the lung and bone metastases were found in 10.0% and 4.4% in each type respectively. 8) 88.9% of the patients showed cold areas in the thyroid scans using {sup 131}I. 9) Typical psammoma bodies were observed in 21.3% of the cases in the microscopic examination of the pathological specimens. 10) The initial diagnosis of thyroid malignancy could be made before histological confirmation in 64.5% of the patients. 11) The clinical staging slightly modified from Schulz method revealed 43.6% of the patients in stage I, 26.4% in stage II, 20.9% in stage III and 9.1% in stage IV. 12) The association with Hashimoto's thyroiditis was noted in 4 cases, with nodular goiter in 3 cases, and with follicular

  3. Thyroid Tests

    Science.gov (United States)

    ... Kidney Disease Weight Management Liver Disease Urologic Diseases Endocrine Diseases Diet & Nutrition Blood Diseases Diagnostic Tests La información ... Kidney Disease Weight Management Liver Disease Urologic Diseases Endocrine Diseases Diet & Nutrition Blood Diseases Diagnostic Tests La información ...

  4. Computational Pathology

    Science.gov (United States)

    Louis, David N.; Feldman, Michael; Carter, Alexis B.; Dighe, Anand S.; Pfeifer, John D.; Bry, Lynn; Almeida, Jonas S.; Saltz, Joel; Braun, Jonathan; Tomaszewski, John E.; Gilbertson, John R.; Sinard, John H.; Gerber, Georg K.; Galli, Stephen J.; Golden, Jeffrey A.; Becich, Michael J.

    2016-01-01

    Context We define the scope and needs within the new discipline of computational pathology, a discipline critical to the future of both the practice of pathology and, more broadly, medical practice in general. Objective To define the scope and needs of computational pathology. Data Sources A meeting was convened in Boston, Massachusetts, in July 2014 prior to the annual Association of Pathology Chairs meeting, and it was attended by a variety of pathologists, including individuals highly invested in pathology informatics as well as chairs of pathology departments. Conclusions The meeting made recommendations to promote computational pathology, including clearly defining the field and articulating its value propositions; asserting that the value propositions for health care systems must include means to incorporate robust computational approaches to implement data-driven methods that aid in guiding individual and population health care; leveraging computational pathology as a center for data interpretation in modern health care systems; stating that realizing the value proposition will require working with institutional administrations, other departments, and pathology colleagues; declaring that a robust pipeline should be fostered that trains and develops future computational pathologists, for those with both pathology and non-pathology backgrounds; and deciding that computational pathology should serve as a hub for data-related research in health care systems. The dissemination of these recommendations to pathology and bioinformatics departments should help facilitate the development of computational pathology. PMID:26098131

  5. Parathyroid adenoma with concurrent toxic thyroid adenoma: A rare ...

    African Journals Online (AJOL)

    recognized phenomenon. Primary hyperparathyroidism due to parathyroid adenoma in association with thyroid adenoma is extremely rare. These cases can present a diagnostic and therapeutic challenge to the treating physician as the patient may ...

  6. Methodologic and clinical aspects of free thyroid hormone assay

    International Nuclear Information System (INIS)

    Hermans, J.; Baldewyns, P.; Beauduin, M.

    1984-01-01

    The diagnostic value of free thyroid hormones measures depends on used technic. The results gived by two different kits are compared: - Kit Le Petit with chromatographic separation, - Kit Amersham which uses an analogue [fr

  7. Vanishing thyroid gland tumors: Infarction as consequence of FNA?

    Science.gov (United States)

    Kholová, Ivana

    2016-07-01

    Fine-needle aspiration (FNA)-induced secondary changes were described in various organs. Complete replacement of tumor by necrosis causes diagnostic and management problems. Seven cases of totally or partially vanished thyroid lesions were identified from the archive of Department of Pathology, Fimlab Laboratories within 5 year period. Histopathological slides were revised in all cases. Total thyroidectomy or lobectomy samples were from 4 females and 3 males patients aged 37-83 years (mean 67.1 years). Imaging data were available in 6 cases. Cytology slides and data were available only in 3 cases: two revealed follicular neoplasm and one was insufficient according to Bethesda system. In 5 cases, final histopathology revealed total necrosis of the lesion with only one case with available cytological diagnosis of oncocytic follicular neoplasm. In remaining 2 cases, replacement by necrosis was partial. Of note, in three cases, oncocytic metaplasia was present. Total histopathological blocking with thorough check of capsular areas is recommended in necrotic tumors. Vanishing thyroid lesion phenomenon is rare, but in cases of disappearance of tumor, preoperative cytology diagnosis is the only clue for the patient management. Diagn. Cytopathol. 2016;44:568-573. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  8. [Pathology in Rostock].

    Science.gov (United States)

    Nizze, H

    2004-01-01

    The name of Rostock was first mentioned in 1161 by the Danish historian Saxo Grammaticus. As the oldest university in Northern Europe, the Alma mater rostochiensis was inaugurated in 1419 and is proudely called Light of the North ("Leuchte des Nordens"). Its Medical Faculty belonged to the three founding faculties. As elsewhere, the roots of Rostock pathology hark back to anatomy. A Theatrum anatomicum existed since 1790. First lectures on pathology were read by Johann Wilhelm Josephi (1763-1845) who was Head of Anatomy in the so-called Dissection House ("Zergliederungshaus") situated at the Old Market of Rostock. In 1844, anatomy together with its pathology rooms moved into the Garden House ("Gartenhaus") on the university yard. From 1878 to 1930, the Pathology represented one section of the downtown Medical Studies Building. From 1930 up to now, the Pathology Institute is situated in the Strempel Street at the corner of the clinical center. The Rostock Pathology Chair was established in 1865. Since that time, the institute had ten directors. Inter alios, Ernst Schwalbe (1871-1920) was a famous teratologist at the beginning of the 20th century. Walther Fischer (1882-1969) was Head of Institute for 24 years and became well-known as oncopathologist. After World War II, Alexander Bienengräber (1911-1990) reconstructed the institute in all ist compartments to a modern standard. At present, about 40 persons, with eight pathologists among them, represent the staff of the institute. 150 medical students are taught in each semester. Scientific topics concern oral, colorectal and thyroid carcinoma, pancreatitis as well as renal and transplant pathology. Nearly 15,000 histology, 20,000 cytology, and 150 autopsy cases are presently examined per year.

  9. Radiation of the thyroid during examination of patients with thyroid diseases using radioactive iodine

    Energy Technology Data Exchange (ETDEWEB)

    Zvonova, I.A.; Likhtarev, A.A.; Nikolaeva, A.A.

    1984-02-01

    Basing on 131I uptake functions in the thyroid of 109 patients irradiation doses of this organ were evaluated for persons with normal iodine metabolism and in the following diseases: hypothyrosis, moderate thyrotoxicosis, nodular toxic and nontoxic goiter, vegetative neurosis. Maximum tolerant doses of 123I, 125I, 131I and 132I are recommended for diagnostic examination of thyroid function and scanning of this organ.

  10. Dysfunctional ectopic thyroid gland: a case report.

    Science.gov (United States)

    Stokić, Edita; Kljajić, Vladimir; Idjuški, Stevan; Benc, Damir; Popović, Djordje; Protić, Mladjan; Crnobrnja, Veljko

    2014-01-01

    Lingual thyroid gland is a rare anomaly of thyroid gland development, occurring more frequently in females. If it causes local symptomatology such as dysphagia, dysphonia or dyspnea it is diagnosed in childhood, however, if it is asymptomatic it is usually diagnosed in adulthood. We present a 23-year-old female patient in whom we diagnosed lingual thyroid gland coincidentally during diagnostic procedures of a concomitant disease. The application of 131I scintigraphy showed an oval field of intensive accumulation of radio markers in the zone of medial face line, around tongue base, with the absence of thyroid gland in its physiological position. Functional testing proved primary hypothyroidism and we started the application of substitution therapy. The application of levothyroxine resulted in reaching euthyroid state and the reduction of thyroid gland size. We present a very rare anomaly of the thyroid gland, and so far there have been no clear attitudes about further treatment. The general condition of the patient, age, the size of ectopic thyroid gland and the existence of local symptomatology or complications represent the factors that have influence on the choice of treatment method.

  11. Treatment of well-differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Block, M.A.

    1981-01-01

    Improved selection of thyroid nodules for surgery and greater individualization of surgery for well-differentiated thyroid carcinoma are emphasized. Thyroid nodules are common but infrequently are manifestations of carcinoma. Needle biopsy permits better selection of patients with thyroid nodules for surgery by identifying those which are malignant or are likely to become malignant. Experience in performing diagnostic needle biopsies and in cytologic and histologic interpretation is essential. The majority of well-differentiated thyroid carcinomas are well-localized papillary carcinomas controlled by surgery, usually a lobectomy or partial thyroidectomy. Well-differentiated thyroid carcinomas include papillary and follicular types and their subsets. The extent of surgery should be individualized based on gross extent of disease, histologic variety, and age of the patient. The prognosis is reduced for patients more than 40 years of age. With appropriate early surgical treatment, the outlook is excellent. Metastatic disease can frequently also be controlled by large doses of thyroid hormone and the use of radioactive iodine

  12. THE CARDIOVASCULAR SYSTEM IN TYPE 2 DIABETES MELLITUS AND THYROID DISORDERS IN THE ABSENCE OF THYROID GLAND DYSFUNCTION.

    Science.gov (United States)

    Ballyizek, M F; Ignat'eva Pa

    The state of the cardiovascular system was studied in patients with type 2 diabetes mellitus and thyroid disorders in the absence of thyroid gland dysfunction. 76.9% of the 302 patients with DM2 had thyroid pathology; in 23,8% it was not previously diagnosed. We compared euthyroid patients with DM2 without thy'ropathies and with diffuse-nodular changes largely in the form of difuse- multinodular non-toxic goiter and autoinnnune thyroiditis (AIT). It was demonstrated that enhanced frequency of thyroid disorders is related to DM2 duration and vascular complications. The predominant thyroid pathology in DM2 was diffuse-multinodular non-toxic goiter followed by autoimnune thvroiditis. Nodular forms in AIT without DM2 are rare whereas multinodularformns in the patients with DM2 and AIT occur much more fequently. Node formation is related to such DM2 complications as diabetic nephropathy, angiopathy, and retinopathy. The study showed that the frequency of both non-specific clinical changes characteristic of thyroid dysfunction and of specific cardiological manifestations in euthyroid patients with DM2 and thyroid pathology signficantly increases especially in the presence of AIT and anti-thyreoperoxidase antibodies, regardless the form of thyropathy. It may be due to imimuno-inflammatory cross talk between thyroid and myocardial tissues. Patients with DM2 and diffuse-nodular changes in the thyroid gland more frequently presented with dif ferent forms of atrial fibrillation and high-grade ventricular extrasystole than patients with AIT or DM2 without thyropathies. It is concluded that euthyroid patients with DM2 need their thyroid function to be regularly monitored. The development of examination algorithm is an object of further studies.

  13. Thyroid disorders in Chernobyl clean-up workers from Latvia

    International Nuclear Information System (INIS)

    Kurjane, N.; Orlikovs, G.; Ritenberga, R.; Skudra, M.; Lemane, R.; Lemanis, A.; Curbakova, E.; Groma, V.; Socnevs, A.

    1999-01-01

    The condition of thyroid was examined in 2188 Chernobyl clean-up workers residing in Latvia and a control group consisting of 1041 employees of the Ministry of International Affairs. Thyroid examinations included palpation, ultrasonography, selective scintigraphy and detection of the level of thyroid hormones in blood serum:L STH (thyroid-stimulating hormone), total T3 (triiodothyronine), and T4 (thyroxine). Thyroid was registered in 394 Chernobyl clean-up workers. Of these cases, 28 patients with suspected thyroid cancer were operated, and morphological examinations revealed papillary adenocarcinoma (in 5 patients), follicular adenocarcinoma (2), nodular colloid goiter (16); toxic diffuse goiter (1), papillary-follicular adenoma (3), and chronic thyroiditis (1). It was determined that the thyroid pathology in the Chernobyl clean-up workers had a tendency to progress (27 cases in 1987 versus 394 cases in 1998 in total; and absence of thyroid cancer in 1987, compared with 7 cases in 1998); thyroid nodules increased twice (64 cases in 1997, compare with 126 cases in 1998). (author)

  14. The importance of anti peroxidase antibodies in patients with nodular thyroid goiter

    Directory of Open Access Journals (Sweden)

    Medenica Sanja

    2012-01-01

    Full Text Available Introduction: Thyroid nodular goiter Nodular goiter is clinically recognizable restricted structure changes of the thyroid gland. Numerous studies show the relationship between thyroid autoimmunity and differentiated thyroid cancer in patients with nodular thyroid goiter. One of the important clinical marker in defining thyroid autoimmunity are antibodies to thyroid peroxidase. Objective: The aim of this study was to analyze the relationship between antibodies anti peroksidaznih ii thyroid malignancies in patients with thyroid altered thyroid. Material and Methods: We retrospectively reviewed the 248 reports of thyroid FNA cytology of samples obtained by puncture of patients with nodular thyroid goiter, at Department of thyroid gland, Department of Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia in the period from October 2007. by January 2010. year. We analyzed the relationship between findings of cytopathological diagnostic categories and serum concentrations of anti peroxidase antibodies. The data were statistically processed using the computer program SPSS 12.0 software package. Results: Of total 248 patients, 148 patients (59.7% had anti-TPO antibody values in a reference limits (30 IU/ml, and 40.3% elevated anti-TPO antibodies (over 30 IU/ml. In the group of patients with elevated values of anti-TPO antibodies 7% (7/100 of patients had malignant cytologic findings, and in the group of patients with anti-TPO antibody values in the normal range only 1.4% (2/148 of patients had malignant cytologic findings. Conclusion: Defining the relationship between thyroid autoimmune disease and differentiated thyroid cancer, providing new insights in the field of immunotherapy of thyroid carcinoma. Enlightening the molecular mechanisms link autoimmune thyroid disease and thyroid cancer development in patients with thyroid nodule help find new therapeutic strategies against thyroid cancer.

  15. Preoperative Thyroid Ultrasound Is Indicated in Patients Undergoing Parathyroidectomy for Primary Hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    Cletus A. Arciero, Zita S. Shiue, Jeremy D. Gates, George E. Peoples, Alan P. B. Dackiw, Ralph P. Tufano, Steven K. Libutti, Martha A. Zeiger, Alexander Stojadinovic

    2012-01-01

    Full Text Available Background: Primary hyperaparathyroidism (pHPT is often accompanied by underlying thyroid pathology that can confound preoperative parathyroid localization studies and complicate intra-operative decision making. The aim of this study was to examine the utility of preoperative thyroid ultrasonography (US in patients prior to undergoing parathyroidectomy for pHPT.Methods: An Institutional Review Board approved prospective study was undertaken from January 2005 through July 2008. All patients with pHPT meeting inclusion criteria (n=94 underwent preoperative thyroid ultrasound in addition to standard 99mTc-sestamibi scintigraphy for parathyroid localization. Demographics, operative management and final pathology were examined in all cases.Results: Fifty-four of the 94 patients (57% were noted to have a thyroid nodule on preoperative US, of which 30 (56% underwent further examination with fine needle aspiration biopsy. Alteration of the operative plan attributable to underlying thyroid pathology occurred in 16 patients (17%, with patients undergoing either total thyroidectomy (n=9 or thyroid lobectomy (n=7. Thyroid cancer was noted in 33% of patients undergoing thyroid resection, and 6% of all patients with HPT.Conclusions: The routine utilization of preoperative thyroid ultrasound in patients prior to undergoing parathyroid surgery for pHPT is indicated. The added information from this non-invasive modality facilitates timely management of co-incidental, and sometimes malignant, thyroid pathology.

  16. Screening the Tox21 10K library for thyroid stimulating hormone receptor agonist and antagonist activity (SOT annual meeting)

    Science.gov (United States)

    Thyroid-stimulating hormone (TSH) regulates thyroid hormone (TH) production via binding to its receptor (TSHR). The roles of TSHR in human pathologies including hyper/hypothyroidism, Grave’s disease, and thyroid cancer are known, but it is currently unknown whether TSHR is an imp...

  17. Ultrasound of the Thyroid Gland

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Ultrasound - Thyroid Thyroid ultrasound uses sound waves to produce pictures ... the Thyroid? What is an Ultrasound of the Thyroid? Ultrasound is safe and painless, and produces pictures ...

  18. Significant clinical differences in primary hyperparathyroidism between patients with and those without concomitant thyroid disease

    International Nuclear Information System (INIS)

    Masatsugu, Toshihiro; Kuroki, Syoji; Tanaka, Masao

    2005-01-01

    We evaluated the differences in diagnosis and treatment for primary hyperparathyroidism (pHPT) in patients with and those without concomitant thyroid disease. One hundred and ten patients with pHPT underwent parathyroid localization and thyroid examination by ultrasonography (US) and sestamibi scintigraphy (MIBI). The clinical and biochemical findings, parathyroid localization, and operations performed were compared in 49 patients without thyroid disease and 61 patients with thyroid disease. Asymptomatic hypercalcemia was significantly more prevalent in patients with concomitant thyroid disease (88.5%) than in those without thyroid disease (49.0%) (P<0.01). The mean serum calcium was significantly higher and the inorganic phosphate level was significantly lower in patients without concomitant thyroid disease than in those with concomitant thyroid disease (P<0.05, P<0.01, respectively). The pathologic parathyroid gland was identified significantly more often in patients without concomitant thyroid disease than in those with concomitant thyroid disease both by US and MIBI (P<0.05). Unilateral exploration was performed more often in patients without thyroid disease than in those with thyroid disease (P<0.01). Primary hyperparathyroidism was diagnosed at an earlier stage in patients with concomitant thyroid disease. Thyroid disease concomitant with pHPT influenced parathyroid localization as well as the indication for minimally invasive parathyroidectomy. (author)

  19. Clinical usefulness of SPECT/CT in thyroid cancer

    International Nuclear Information System (INIS)

    Magboo, V.P.C.; Goco, G.F.L.

    2007-01-01

    Thyroid Cancer is the most common malignancy of the endocrine system with the well-differentiated tumors (papillary or follicular) being predominant. In the Philippines, it is the 7th leading cancer, three times more common in females than in males. Precise localization of the foci of I-131 uptake for the management of patients with differentiated thyroid carcinoma is made difficult due to lack of anatomical landmarks in the whole body scan. Hybrid systems are opening up a new era in SPECT imaging. A tertiary hospital in the Philippines has recently acquired the country's first hybrid imaging device combining a dual-detector, variable angle gamma camera with a low dose X-ray tube attached to the same gantry. The objective of the study is to demonstrate the clinical usefulness of I-131 SPECT/CT fusion imaging in patients with well-differentiated thyroid carcinoma. The data from whole body I-131 planar images were first interpreted alone and then re-assessed with the addition of SPECT/CT co-registered images. A total number of 42 patients were studied. Pathologic sites in 26 out 42 (62 %) patients were identified in both planar and co-registered images. SPECT/CT also provided precise anatomical localization in 10 (24 %) patients not clearly evident in planar images alone. It also enabled exclusion of the disease sites of physiologic tracer deposition in 12 (26 %) patients found suspicious in planar studies alone. Introduction of SPECT/CT imaging altered the therapeutic option, particularly with the administered therapeutic dose of I- 131 in 7 (16 %) of patients. Based on our limited experience in this field we concluded that SPECT/CT allows more precise interpretation of I-131 whole body scan thereby improving diagnostic accuracy and guiding therapeutic options. (author)

  20. Considerations of immunological and radiological affections of thyroid

    International Nuclear Information System (INIS)

    Pierach, C.A.

    1983-01-01

    Thyroid function is regulated by hypothalamic and pituitary hormones. In addition, it has become more and more evident recently that immunoglobulins can stimulate and inhibit growth and function of the thyroid, but this does not constitute a feedback mechanism. Radioactive iodine, given in diagnostic and therapeutic doses, is well tolerated. However, the massive dose of radioactive iodides expected to be released in nuclear catastrophes (for example, accidents at nuclear power plants or explosion of an atom bomb) carries a risk for the thryoid which may be diminished by the early administration of potassium iodide. Therapeutic radiation to the neck exposes the thyroid which may lead to thyroid cancer, thyroid nodules and disturbances of thyroid function. (orig.) [de

  1. The predictive value of MRI in detecting thyroid gland invasion in patients with advanced laryngeal or hypopharyngeal carcinoma.

    Science.gov (United States)

    Lin, Peiliang; Huang, Xiaoming; Zheng, Chushan; Cai, Qian; Guan, Zhong; Liang, Faya; Zheng, Yiqing

    2017-01-01

    The aim of this study was to evaluate the predictive value of magnetic resonance imaging (MRI) in detecting thyroid gland invasion (TGI) in patients with advanced laryngeal or hypopharyngeal carcinoma. In a retrospective chart review, 41 patients with advanced laryngeal or hypopharyngeal carcinoma underwent MRI scan before total laryngectomy and ipsilateral or bilateral thyroidectomy during the past 5 years. The MRI findings were compared with the postoperative pathological results. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Among the 41 patients, 3 had thyroid gland invasion in postoperative pathological results. MRI correctly predicted the absence of TGI in 37 of 38 patients and TGI in all 3 patients. The sensitivity, specificity, PPV, and NPV of MRI were 100.0, 97.4, 75.0, and 100 %, respectively, with the diagnostic accuracy of 97.6 %. In consideration of the high negative predictive value of MRI, it may help surgeons selectively preserve thyroid gland in total laryngectomy and reduce the incidence of hypothyroidism and hypoparathyroidism postoperatively.

  2. Fine-needle aspiration of the thyroid: an overview

    Directory of Open Access Journals (Sweden)

    Nguyen Gia-Khanh

    2005-06-01

    Full Text Available Abstract Thyroid nodules (TN are a common clinical problem. Fine needle aspiration (FNA of the thyroid now is practiced worldwide and proves to be the most economical and reliable diagnostic procedure to identify TNs that need surgical excision and TNs that can be managed conservatively. The key for the success of thyroid FNA consists of an adequate or representative cell sample and the expertise in thyroid cytology. The FNA cytologic manifestations of TNs may be classified into seven working cytodiagnostic groups consisting of a few heterogenous lesions each to facilitate the differential diagnosis. Recent application of diagnostic molecular techniques to aspirated thyroid cells proved to be useful in separating benign from malignant TNs in several cases of indeterminate lesions.

  3. High Prevalence of Papillary Thyroid Microcarcinoma in Danish Patients

    DEFF Research Database (Denmark)

    Rossing, Maria; Nygaard, Birte; Bennedbæk, Finn Noe

    2012-01-01

    with a cold thyroid nodule undergoing US-guided FNA were prospectively registered. 408 patients underwent thyroid surgery, resulting in 50 cancers and in addition 37 patients had an incidental finding of papillary thyroid microcarcinomas. Based on the diagnostic FNA, we found sensitivity and specificity...... for malignancy. Cancer incidence was 13% among females and 9% among males. The accuracy of a diagnostic set-up based on clinical examination, scintigraphy, US, and US-guided FNA was determined with a 48% rate of histopathological validation in the cohort. The overall thyroid cancer incidence has increased...... worldwide, but our results suggest that the most frequent occurring cancer is an incidental papillary thyroid microcarcinoma of which the clinical significance has yet to be established....

  4. The value of virtual touch tissue image (VTI) and virtual touch tissue quantification (VTQ) in the differential diagnosis of thyroid nodules

    International Nuclear Information System (INIS)

    Zhang, Feng-Juan; Han, Ruo-Ling; Zhao, Xin-Ming

    2014-01-01

    Highlights: • All nodules in the research were confirmed by histopathology. • The classification method of VTI was easy to learn. • VTQ could provide quantitative elasticity measurements for thyroid nodules. • VTI classification could provide semi-quantitative elasticity analysis. • The area ratio could show invasive extent of malignant tumor. - Abstract: Objectives: To explore the value of virtual touch tissue image (VTI) and virtual touch tissue quantification (VTQ) in the differential diagnosis of thyroid nodules. Methods: One-hundred and seven patients with 113 thyroid nodules were performed conventional ultrasound and acoustic radiation force impulse (ARFI) elastography. The stiffness of the nodules on virtual touch tissue image (VTI) was graded, and the area ratios (AR) of nodules on VTI images versus on B-mode images were calculated. Shear wave velocity (SWV) within the thyroid nodules were measured using virtual touch tissue quantification (VTQ) technique. The pathological diagnosis as the gold standard draws the receiver-operating characteristic curve (ROC) to find the cut-off point of VTI grades, AR and SWV to predict thyroid cancer. Results: The difference in VTI grades of malignant and benign nodules was statistically significant (P < 0.05), as well as in AR and SWV. There was no significant difference in the AR of nodules or the SWV of nodules in benign group or in malignant group. The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of VTI grades, AR, and SWV in the differential diagnosis of thyroid nodules were calculated. There was no significant difference in diagnostic accuracy among the three methods. Conclusion: VTI grades, AR of nodules on VTI images versus on B-mode images and SWV within the nodules can help the differential diagnosis of thyroid nodules

  5. Unilateral follicular variant of papillary thyroid carcinoma with unique KRAS mutation in struma ovarii in bilateral ovarian teratoma: a rare case report

    Directory of Open Access Journals (Sweden)

    Stanojevic Boban

    2012-06-01

    Full Text Available Abstract Background Struma ovarii (SO is a rare form of ovarian mature teratoma in which thyroid tissue is the predominant element. Because of its rarity, the differential diagnosis between benign and malignant SO has not been clearly defined. It is believed that malignant transformation of SO has similar molecular features with and its prognosis corresponds to that of malignant tumors originating in the thyroid. Case presentation We report 35-year-old woman with bilateral ovarian cysts incidentally detected by ultrasound during the first trimester of pregnancy. Four months after delivery of a healthy child without complication she was admitted to the hospital for acute abdominal pain. Laparoscopic left adnexectomy was performed initially in a regional hospital; right cystectomy was done later in a specialized clinic. Intraoperative frozen section and a final pathology revealed that the cyst from the left ovary was composed of mature teratomatous elements, normal thyroid tissue (>50% and a non-encapsulated focus of follicular variant of papillary thyroid carcinoma (PTC. Normal and cancerous thyroid tissues were tested for BRAF and RAS mutations by direct sequencing, and for RET/PTC rearrangements by RT-PCR/Southern blotting. A KRAS codon 12 mutation, the GGT → GTT transversion, corresponding to the Gly → Val amino acid change was identified in the absence of other genetic alterations commonly found in PTC. Conclusion To the best of our knowledge, this is the first time this mutation is described in a papillary thyroid carcinoma arising in struma in the ovarii. This finding provides further evidence that even rare mutations specific for PTC may occur in such tumors. Molecular testing may be a useful adjunct to common differential diagnostic methods of thyroid malignancy in SO.

  6. Shear wave velocity of the healthy thyroid gland in children with acoustic radiation force impulse elastography.

    Science.gov (United States)

    Ceyhan Bilgici, Meltem; Sağlam, Dilek; Delibalta, Semra; Yücel, Serap; Tomak, Leman; Elmalı, Muzaffer

    2018-01-01

    Acoustic radiation force impulse imaging is a kind of shear wave elastography that can be used in children for differentiating thyroid pathologies. Possible changes in the healthy thyroid gland in children may create difficulties in the use of shear wave velocities (SWV) in thyroid pathologies. The aim of this study was to define the normal values of SWV for the healthy thyroid gland in children, elucidate the correlation of the SWV values with potential influencing factors, and evaluate intra-operator reproducibility of the SWV. Between January 2015 and December 2015, a total of 145 healthy children (81 girls, 64 boys; mean age, 10.5 ± 3.14 years; range 6-17 years) were enrolled in the study. The SWV and volume of the thyroid gland were determined. The mean shear wave velocity of the thyroid gland was 1.22 ± 0.20 m/s. There was no correlation between age and the mean SWV of the thyroid gland (Spearman Rho = 0.049, p = 0.556). There was also no correlation between the thyroid gland volume or BSA and the mean SWV. The only correlation detected was between BSA and total thyroid gland volume (p thyroid gland in children was determined. There was no correlation between the SWV of the thyroid gland and age, BSA, or thyroid gland volume.

  7. Integration of next-generation sequencing in clinical diagnostic molecular pathology laboratories for analysis of solid tumours; an expert opinion on behalf of IQN Path ASBL

    NARCIS (Netherlands)

    Deans, Z.C.; Costa, J.L.; Cree, I.; Dequeker, E.; Edsjo, A.; Henderson, S.; Hummel, M.; Ligtenberg, M.J.L.; Loddo, M.; Machado, J.C.; Marchetti, A.; Marquis, K.; Mason, J.; Normanno, N.; Rouleau, E.; Schuuring, E.; Snelson, K.M.; Thunnissen, E.; Tops, B.B.; Williams, G.; Krieken, H. van; Hall, J.A.

    2017-01-01

    The clinical demand for mutation detection within multiple genes from a single tumour sample requires molecular diagnostic laboratories to develop rapid, high-throughput, highly sensitive, accurate and parallel testing within tight budget constraints. To meet this demand, many laboratories employ

  8. Integration of next-generation sequencing in clinical diagnostic molecular pathology laboratories for analysis of solid tumours; an expert opinion on behalf of IQN Path ASBL

    NARCIS (Netherlands)

    Deans, Zandra C.; Costa, Jose Luis; Cree, Ian; Dequeker, Els; Edsjo, Anders; Henderson, Shirley; Hummel, Michael; Ligtenberg, Marjolijn J. L.; Loddo, Marco; Machado, Jose Carlos; Marchetti, Antonio; Marquis, Katherine; Mason, Joanne; Normanno, Nicola; Rouleau, Etienne; Schuuring, Ed; Snelson, Keeda-Marie; Thunnissen, Erik; Tops, Bastiaan; Williams, Gareth; van Krieken, Han; Hall, Jacqueline A.

    The clinical demand for mutation detection within multiple genes from a single tumour sample requires molecular diagnostic laboratories to develop rapid, high-throughput, highly sensitive, accurate and parallel testing within tight budget constraints. To meet this demand, many laboratories employ

  9. The incidence of thyroid cancer at thyroidectomy materials in Malatya

    Directory of Open Access Journals (Sweden)

    Nurhan Şahin

    2013-12-01

    Full Text Available Objective: Thyroid cancers are the most common malignancyof the endocrine organs. It accounts for 1% of allcancer. Environmental, genetic and hormonal factors playan important role in its etiology. The aim of this study is toinvestigate the incidence of thyroid cancer and types atthyroidectomy materials in the city of Malatya.Methods: The pathology reports of thyroid surgical materials,which were sent to Inonu University Medical FacultyPathology Department retrospectively from the archivesbetween the years January 2007 and May 2013. Postoperativehistopathologic examinations of 543 cases wereevaluated for 6 years period.Results: 128 (23.5% of 543 cases male and 415 (76.5%were female. The youngest patient was 10, the oldest patientwas 89 years-old, and the average age is 48.1±15.2.Histopathological examination of 346 (64% cases of nodularhyperplasia, 20 (4% cases of diffuse hyperplasia, 13(2.4% cases of lymphocytic thyroiditis, 164 (30.2% patienthad thyroid tumors. The 164 tumors on the 57 (35%cases benign, 107 (65% cases were malign. As a typeof cancer 88 (53.6% cases papillary carcinoma, 10 (6%cases follicular carcinoma, 1 (0.6% case medullary carcinoma,3 (1.8% cases were anaplastic carcinoma.Conclusion: Thyroid cancer incidence is 19.7% at thyroidectomymaterials in the city of Malatya and most cancersis seen as a type of thyroid papillary carcinoma.Key words: Goitre, thyroid cancer, papillary carcinoma

  10. Synchronous Parathyroid and Papillary Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Shi-Dou Lin

    2005-02-01

    Full Text Available Concomitant thyroid disease is not unusual among patients with primary hyperparathyroidism. However, the simultaneous occurrence of parathyroid and thyroid carcinoma is extremely rare. We report a 38-year-old man with primary hyperparathyroidism who presented with osteitis fibrosa cystica complicated with pathologic femoral neck fracture. Preoperative investigation for exclusion of multiple endocrine neoplasia did not find evidence of medullary thyroid carcinoma or pheochromocytoma, but imaging studies revealed the presence of nodules in the right lobe and a parathyroid lesion over the left inferior pole of the thyroid gland. Total thyroidectomy, left parathyroidectomy, and bipolar hemiarthroplasty of the left hip were then performed simultaneously. The resected specimens were pathologically identified as papillary thyroid carcinoma and parathyroid carcinoma, respectively. After the operation, 131I ablation therapy was administered at a dose of 120 mCi. Additional doses of 30 mCi were given yearly as serum thyroglobulin level became elevated. Serum calcium level remained normal during yearly follow-up. Although parathyroid carcinoma is an uncommon cause of parathyroid hormone-dependent hypercalcemia, it should nonetheless be given due consideration because its surgical approach differs from that of parathyroid adenoma. As the coexistence of parathyroid and non-medullary thyroid carcinoma has previously been reported, the possibility of both malignancies must also be considered in the setting of primary hyperparathyroidism with thyroid nodules. If confirmed with preoperative parathyroid scintigraphic and other laboratory studies, an optimal outcome may be achieved with complete resection of both tumors at the time of initial operation, followed by adjunctive therapy.

  11. Targeting thyroid diseases with TSH receptor analogs.

    Science.gov (United States)

    Galofré, Juan C; Chacón, Ana M; Latif, Rauf

    2013-12-01

    The thyroid-stimulating hormone (TSH) receptor (TSHR) is a major regulator of thyroid function and growth, and is the key antigen in several pathological conditions including hyperthyroidism, hypothyroidism, and thyroid tumors. Various effective treatment strategies are currently available for many of these clinical conditions such as antithyroid drugs or radioiodine therapy, but they are not devoid of side effects. In addition, treatment of complications of Graves' disease such as Graves' ophthalmopathy is often difficult and unsatisfactory using current methods. Recent advances in basic research on both in vitro and in vivo models have suggested that TSH analogs could be used for diagnosis and treatment of some of the thyroid diseases. The advent of high-throughput screening methods has resulted in a group of TSH analogs called small molecules, which have the potential to be developed as promising drugs. Small molecules are low molecular weight compounds with agonist, antagonist and, in some cases, inverse agonist activity on TSHR. This short review will focus on current advances in development of TSH analogs and their potential clinical applications. Rapid advances in this field may lead to the conduct of clinical trials of small molecules related to TSHR for the management of Graves' disease, thyroid cancer, and thyroid-related osteoporosis in the coming years. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

  12. Influence of presence/absence of thyroid gland on the cutoff value for thyroglobulin in lymph-node aspiration to detect metastatic papillary thyroid carcinoma.

    Science.gov (United States)

    Zhao, Huan; Wang, Yong; Wang, Min-Jie; Zhang, Zhi-Hui; Wang, Hai-Rui; Zhang, Bing; Guo, Hui-Qin

    2017-04-28

    Thyroglobulin measurement with fine-needle aspiration (Tg-FNA) is a sensitive method for detecting metastatic papillary thyroid carcinoma (PTC). However, the diagnostic threshold is not well established and the influence of the thyroid gland on the cutoff value is also controversial. In this study, patients were classified into two groups according to the presence or absence of thyroid tissue, to determine an appropriate cutoff value for clinical practice. Patients with a history of thyroid nodules or surgery for PTC and with enlarged cervical lymph nodes on an FNA examination were enrolled for Tg-FNA detection. One hundred ninety-six lymph nodes (189 patients) were included: 100 from preoperative patients, 49 from patients treated with partial thyroid ablation, and 47 from patients with total thyroid ablation. In 149 lymph nodes from patient with thyroids, the cutoff value for Tg-FNA was 55.99 ng/mL (sensitivity, 95.1%; specificity, 100%), whereas in 47 lymph nodes from patients without a thyroid, it was 9.71 ng/mL (sensitivity, 96.7%; specificity, 100%). Thus, the cutoff value for Tg-FNA was higher in patients with thyroids than in patients without thyroids. The cutoff value for Tg-FNA is influenced by residual thyroid tissue, and a higher cutoff value is recommended for patients with thyroids than for patients without thyroids.

  13. [Tuberculosis of the thyroid gland mimicking thyroid carcinoma in the elderly].

    Science.gov (United States)

    Niiya, Tetsuji; Kawamoto, Eriko; Watanabe, Sayaka; Sakao, Hitomi; Manabe, Kenichi; Ogawa, Akiko; Furukawa, Shinya

    2014-01-01

    A 76-year-old woman with a 10-year history of chronic glomerulonephritis was treated at a clinic after presenting with a gradual worsening of the renal function. The patient had no history of tuberculosis. She was subsequently hospitalized for uremic symptoms and treated with internal shunt insertion and dialysis. Thyroid ultrasonography was performed to screen for secondary hyperparathyroidism, which revealed a calcified thyroid mass and cervical lymph node swelling. Fine-needle aspiration biopsy was thus conducted to assess suspected thyroid cancer. The cytological findings showed few follicular epithelial cells, without any signs of malignancy. However, a diagnosis of thyroid cancer continued to be strongly suspected based on the imaging features. Total thyroidectomy and bilateral cervical regional lymph node dissection were therefore performed, and the pathological examination of the thyroidectomy specimen disclosed scattered epithelioid granulomas with caseous necrosis in the entire right lobe as well as the cervical lymph nodes. Based on these findings, the patient was diagnosed with thyroid tuberculosis. As the symptoms and imaging findings of tuberculosis are nonspecific in elderly patients, it is necessary to consider this disease in this population. We therefore propose the inclusion of thyroid tuberculosis in the differential diagnosis of elderly patients who present with malignant thyroid tumors on aspiration biopsy cytology, regardless of whether or not they have a previous history of tuberculosis.

  14. Pathology informatics fellowship training: Focus on molecular pathology.

    Science.gov (United States)

    Mandelker, Diana; Lee, Roy E; Platt, Mia Y; Riedlinger, Gregory; Quinn, Andrew; Rao, Luigi K F; Klepeis, Veronica E; Mahowald, Michael; Lane, William J; Beckwith, Bruce A; Baron, Jason M; McClintock, David S; Kuo, Frank C; Lebo, Matthew S; Gilbertson, John R

    2014-01-01

    Pathology informatics is both emerging as a distinct subspecialty and simultaneously becoming deeply integrated within the breadth of pathology practice. As specialists, pathology informaticians need a broad skill set, including aptitude with information fundamentals, information systems, workflow and process, and governance and management. Currently, many of those seeking training in pathology informatics additionally choose training in a second subspecialty. Combining pathology informatics training with molecular pathology is a natural extension, as molecular pathology is a subspecialty with high potential for application of modern biomedical informatics techniques. Pathology informatics and molecular pathology fellows and faculty evaluated the current fellowship program's core curriculum topics and subtopics for relevance to molecular pathology. By focusing on the overlap between the two disciplines, a structured curriculum consisting of didactics, operational rotations, and research projects was developed for those fellows interested in both pathology informatics and molecular pathology. The scope of molecular diagnostics is expanding dramatically as technology advances and our understanding of disease extends to the genetic level. Here, we highlight many of the informatics challenges facing molecular pathology today, and outline specific informatics principles necessary for the training of future molecular pathologists.

  15. Accurate diagnosis of thyroid follicular lesions from nuclear morphology using supervised learning.

    Science.gov (United States)

    Ozolek, John A; Tosun, Akif Burak; Wang, Wei; Chen, Cheng; Kolouri, Soheil; Basu, Saurav; Huang, Hu; Rohde, Gustavo K

    2014-07-01

    Follicular lesions of the thyroid remain significant diagnostic challenges in surgical pathology and cytology. The diagnosis often requires considerable resources and ancillary tests including immunohistochemistry, molecular studies, and expert consultation. Visual analyses of nuclear morphological features, generally speaking, have not been helpful in distinguishing this group of lesions. Here we describe a method for distinguishing between follicular lesions of the thyroid based on nuclear morphology. The method utilizes an optimal transport-based linear embedding for segmented nuclei, together with an adaptation of existing classification methods. We show the method outputs assignments (classification results) which are near perfectly correlated with the clinical diagnosis of several lesion types' lesions utilizing a database of 94 patients in total. Experimental comparisons also show the new method can significantly outperform standard numerical feature-type methods in terms of agreement with the clinical diagnosis gold standard. In addition, the new method could potentially be used to derive insights into biologically meaningful nuclear morphology differences in these lesions. Our methods could be incorporated into a tool for pathologists to aid in distinguishing between follicular lesions of the thyroid. In addition, these results could potentially provide nuclear morphological correlates of biological behavior and reduce health care costs by decreasing histotechnician and pathologist time and obviating the need for ancillary testing. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Early results of an in vivo trial of ESS in thyroid cancer

    Science.gov (United States)

    Rosen, Jennifer E.; Goukassian, Ilona D.; A'Amar, Ousama M.; Bigio, Irving J.; Lee, Stephanie L.

    2012-02-01

    Introduction: Thyroid cancer is the most common endocrine malignancy. The current gold standard for diagnosis, fine-needle aspiration (FNA) biopsy, yields 10-25% of indeterminate cytology results, leading to patients undergoing thyroidectomy for diagnosis. We assessed the technical potential of a miniaturized in vivo ESS (elastic light scattering spectroscopy) probe, built into an FNA needle assembly, to differentiate benign from malignant thyroid nodules. Methods: Under IRB approval, 15 patients in the endocrine clinic undergoing FNAB of a thyroid nodule had collection of ESS data using our novel miniaturized FNA probe. Using final surgical pathology as our gold standard, data post processing and visual inspection was completed. Results: 225 spectra were grouped and analyzed (120 benign, 30 malignant and 75 from indeterminate cytology). ESS probes demonstrated excellent reproducibility in use. Initial analysis of these preliminary data is promising, indicating distinction of spectral ESS features between malignant and benign conditions. Conclusion(s): An in vivo trial of an invasive miniaturized integrated ESS biopsy probe is acceptable to patients, and collection of ESS data is feasible and reliable. With development of a disease-specific algorithm, ESS could potentially be used as an in-situ real time intra-operative diagnostic tool or as a minimally invasive adjunct to conventional FNA cytology.

  17. Maternal Thyroid Dysfunction and Neonatal Thyroid Problems

    Science.gov (United States)

    Ozdemir, Hulya; Akman, Ipek; Coskun, Senay; Demirel, Utku; Turan, Serap; Bereket, Abdullah; Bilgen, Hulya; Ozek, Eren

    2013-01-01

    Aim. To investigate obstetric features of pregnant women with thyroid disorders and thyroid function tests of their newborn infants. Methods. Women with hypothyroidism and having anti-thyroglobulin (ATG) and anti-thyroid peroxidase (anti-TPO) antibodies were assigned as group I, women with hypothyroidism who did not have autoantibodies were assigned as group II, and women without thyroid problems were assigned as group III. Results. Pregnant women with autoimmune hypothyroidism (group I) had more preterm delivery and their babies needed more frequent neonatal intensive care unit (NICU) admission. In group I, one infant was diagnosed with compensated hypothyroidism and one infant had transient hyperthyrotropinemia. Five infants (23.8%) in group II had thyroid-stimulating hormone (TSH) levels >20 mIU/mL. Only two of them had TSH level >7 mIU/L at the 3rd postnatal week, and all had normal free T4 (FT4). Median maternal TSH level of these five infants with TSH >20 mIU/mL was 6.6 mIU/mL. In group III, six infants (6.5%) had TSH levels above >20 mIU/mL at the 1st postnatal week. Conclusion. Infants of mothers with thyroid problems are more likely to have elevated TSH and higher recall rate on neonatal thyroid screening. Women with thyroid disorders and their newborn infants should be followed closely for both obstetrical problems and for thyroid dysfunction. PMID:23737782

  18. Maternal Thyroid Dysfunction and Neonatal Thyroid Problems

    Directory of Open Access Journals (Sweden)

    Hulya Ozdemir

    2013-01-01

    Full Text Available Aim. To investigate obstetric features of pregnant women with thyroid disorders and thyroid function tests of their newborn infants. Methods. Women with hypothyroidism and having anti-thyroglobulin (ATG and anti-thyroid peroxidase (anti-TPO antibodies were assigned as group I, women with hypothyroidism who did not have autoantibodies were assigned as group II, and women without thyroid problems were assigned as group III. Results. Pregnant women with autoimmune hypothyroidism (group I had more preterm delivery and their babies needed more frequent neonatal intensive care unit (NICU admission. In group I, one infant was diagnosed with compensated hypothyroidism and one infant had transient hyperthyrotropinemia. Five infants (23.8% in group II had thyroid-stimulating hormone (TSH levels >20 mIU/mL. Only two of them had TSH level >7 mIU/L at the 3rd postnatal week, and all had normal free T4 (FT4. Median maternal TSH level of these five infants with TSH >20 mIU/mL was 6.6 mIU/mL. In group III, six infants (6.5% had TSH levels above >20 mIU/mL at the 1st postnatal week. Conclusion. Infants of mothers with thyroid problems are more likely to have elevated TSH and higher recall rate on neonatal thyroid screening. Women with thyroid disorders and their newborn infants should be followed closely for both obstetrical problems and for thyroid dysfunction.

  19. Thyroid cancer characteristics in the population surrounding Three Mile Island.

    Science.gov (United States)

    Goyal, Neerav; Camacho, Fabian; Mangano, Joseph; Goldenberg, David

    2012-06-01

    To determine differences in disease characteristics between the thyroid cancer populations in the area around the Three Mile Island (TMI) nuclear power plant and the rest of the state of Pennsylvania. Retrospective cross-sectional study. Data from the Pennsylvania Cancer Registry from 1985 to 2008 were reviewed and information regarding age at diagnosis, sex, race, residential status, county of residence, thyroid pathology, thyroid surgery, and staging was recorded. Dauphin, Lancaster, and York counties were defined as the TMI area. Records of 26,357 thyroid cancer patients were reviewed, with 2,611 patients within the TMI area. A higher proportion of papillary thyroid cancer (P < .001) and lower proportion of follicular thyroid cancer (P < .001) were noted in the TMI area population. Thyroid cancer cases from the TMI area were found to be more likely to be diagnosed before the age of 65 years (P < .001), be Pennsylvania born (P < .001), be well differentiated (P < .001), be <10 mm in size (P < .001), and be localized without spread (P < .001). Although the TMI area shows a higher incidence of thyroid cancer as compared to the rest of the state, this was not statistically significant. The TMI population showed a higher proportion of papillary thyroid cancer and less aggressive pathology and earlier diagnosis compared to the rest of Pennsylvania. No statistically significant difference in thyroid cancer incidence was noted. Overall, the study does not show a clear link with more advanced thyroid cancer and proximity to the TMI nuclear reactors. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  20. Magnetic Resonance Imaging of Thyroid and Parathyroid

    Directory of Open Access Journals (Sweden)

    Miguel GONZALO-DOMÍNGUEZ

    2017-05-01

    Full Text Available Introduction: The assessment of the thyroid and parathyroid pathology is usually achieved with ultrasounds. There are several systems of classification that are internationally accepted in neoplastic disease, such as TIRADS system, and there are well-defined patterns for ultrasound imaging in inflammatory disease. Material and methods: However, there are specific needs that require magnetic resonance imaging. We review the main indications of MRI in the evaluation of thyroid and parathyroid in 64 patients and determine which protocols are more appropriate and which sequences are better for a proper characterization. Results: Then we review the semiology obtained by this technique, making correlation with disease processes affecting these cervical structures.