WorldWideScience

Sample records for malignant thyroid neoplasms

  1. NDRG1 protein overexpression in malignant thyroid neoplasms

    Renê Gerhard

    2010-06-01

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

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

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

    2011-01-01

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

  3. Malignant neoplasms of the head and neck.

    Dickson, Paxton V; Davidoff, Andrew M

    2006-05-01

    Head and neck masses represent a common clinical entity in children. In general, these masses are classified as developmental, inflammatory, or neoplastic. Having a working knowledge of lesions within this region and conducting a thorough history and physical examination generally enables the clinician to facilitate an appropriate workup and establish a diagnosis. The differential diagnosis is broad, and expeditiously distinguishing benign from malignant masses is critical for instituting a timely multidisciplinary approach to the management of malignant lesions. Neoplasms of the head and neck account for approximately 5% of all childhood malignancies. A diagnosis of malignancy may represent a primary tumor or metastatic foci to cervical nodes. In this review, we discuss the general approach to evaluating suspicious masses and adenopathy in the head and neck region and summarize the most common malignant neoplasms of the head and neck with regard to their incidence, clinical presentation, diagnostic evaluation, staging, and management. Thyroid, parathyroid, and salivary gland tumors are discussed elsewhere in this issue of Seminars in Pediatric Surgery.

  4. THYROID NEOPLASMS AND PERITUMORAL MORPHOLOGY IN THYROIDECTOMY SPECIMENS

    Padmavathi

    2015-10-01

    Full Text Available Thyroid neoplasms represent the most common malignancies of the endocrine system. They are known to occur in association with benign lesions of the thyroid, like multinodular goitre and Hashimoto thyroiditis. AIMS AND OBJECTIVES : To study the neoplasms of thyroid and their peritumoral morphology. MATERIALS AND METHODS : All thyroidectomy specimens received in the Department of Pathology, RRMCH over a period of three years from June 2011 to May 2014 were included in the study. Thyro idectomies for non - neoplastic lesions were also extensively sampled and morphologically studied, with focus on peritumoral morphology, in neoplasms. RESULTS : Of the one hundred and fifty four thyroidectomy specimens received over three years, one hundred a nd thirteen (73.4% were non - neoplastic, and forty one were neoplastic (26.6%. Colloid goitre and lymphocytic infiltrate were the most common features in the peritumoral thyroid tissue, followed by multinodular goitre . Hashimoto thyroiditis and Hurthle cell change were noted in 11.5% of cases. Tumors were multicentric in 11.5% of cases. Malignancy was detected in eight of the fifty nine thyroidectomies performed for multinodular goitre . Of the thirty four surgeries for Hashimoto thyroiditis, four were reported as malignant on histopathology. CONCLUSION : All thyroidectomies, including those operated for benign lesions, need to be extensively sampled and morphology studied due to the possibility of occult malignancy. Larger series need to be st udied to find a causal association between the two.

  5. Metastases of Renal Cell Carcinoma to the Thyroid Gland with Synchronous Benign and Malignant Follicular Cell-Derived Neoplasms

    Carlos Zamarrón

    2013-01-01

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

  6. RASSF7 and RASSF8 proteins are predictive factors for development and metastasis in malignant thyroid neoplasms

    Xi Li

    2013-01-01

    Conclusions: RASSF7 and RASSF8 expression was increased in PTC and MTC compared to NTG, and this may be linked to the development and progression of thyroid carcinoma. In addition, these proteins were correlated with more advanced tumor stages, tumor size, and metastasis.

  7. 钙化对甲状腺肿瘤良恶性判断的意义及其分子生物学机制%The analysis of the calcification in differentiating malignant thyroid neoplasm and the molecular mechanisms for the formation of the calcification

    龚婷; 王家东

    2012-01-01

    Summary The purpose of this review is to investigate the value of the calcification in differentiating malignant thyroid neoplasm and the molecular mechanisms for the formation of the calcification. Many published reports have proved the presence of calcifications in thyroid neoplasm and calcified nodules in these studies are more frequently malignant than noncalcified nodules. Through viewing the related references. we found that psammoma bodies(PBs). Runx2. osteocalcin, osteopontin, CD44v6 play an important role in the molecular mechanisms in the formation of the calcification in PTC. But further study is required for elucidating the mode of action.

  8. Simultaneous Occurrence of Different Follicular Neoplasms within the Same Thyroid Gland

    Şefika Burçak Polat

    2016-06-01

    Full Text Available Purpose: Neoplasms of the thyroid gland are classified according to the cells they originate from and commonly develop from cells of follicular origin. The most common differentiated thyroid cancers (DTC are papillary and follicular carcinomas. Coexistence of two different histological types of primary follicular thyroid neoplasm is a rare condition. There are previous reports of concomitant medullary and papillary thyroid cancers. However, there is scarce data about the simultaneous occurrence of the two different histological types of primary follicular thyroid tumors and this is the first study on that subject. Material and Method: From January 2007 to September 2014, our institutional database was reviewed for patients who underwent thyroid surgery for various indications. Medical records and cytopathology reports of those patients were examined retrospectively. Simultaneous neoplasms of follicular origin were noted. Results: A total of 3.700 patients were operated. Histopathological examination revealed a benign pattern in 2.686 (73% patients and a malignant pattern in 1.014 (27% patients. Among the patients with the diagnosis of DTC, only 20 (1.9% had a concomitant neoplasm within the same thyroid gland. Discussion: Such simultaneous tumors may be a part of a familial tumor syndrome or an unidentified novel gene mutation playing role in the pathogenesis of more than one type of tumor. Based on the current evidence, the synchronous occurrence of those neoplasms in a given patient is likely coincidental in the literature. Further studies on larger patient population with standardized genetic characterization are needed.

  9. Thyrotropin receptor-adenylate cyclase function in human thyroid neoplasms.

    Saltiel, A R; Powel-Jones, C H; Thomas, C G; Nayfeh, S N

    1981-06-01

    The action of thyrotropin (TSH) on plasma membranes was studied to elucidate the mechanism of hormonal regulation of malignant versus normal human thyroid tissue. Thyroid plasma membranes of six specimens of papillary or follicular carcinoma and six of adenoma, as well as adjacent normal tissue obtained from these patients, were evaluated with respect to binding of 125I-labeled TSH and stimulation of adenylate cyclase. Scatchard analysis of TSH binding revealed the presence of two species of binding sites in normal thyroid of different affinities and capacities. In 11 of 12 tumors studied, the high-affinity binding site remained intact; however, the total number of low-affinity sites was markedly lower than normal tissue. Other parameters of binding were not altered in neoplastic thyroid. In each of these tissues, the hormone responsiveness and kinetics of adenylate cyclase activation were essentially identical to those observed in normal tissue, although basal activity was typically greater in the neoplasm. One carcinoma was totally deficient in both 125I-labeled TSH binding and TSH-stimulatable adenylate cyclase, although basal activity was detected. Furthermore, adenylate cyclase of this specimen was not activated by prostaglandin, in contrast to normal thyroid and other thyroid tumors. These results suggest that: (a) clinical behavior of thyroid carcinomas may not be reflected by TSH receptor-adenylate cyclase function; (b) lack of clinical response as manifest by tumor regression cannot be ascribed to the absence of functional TSH receptors or adenylate cyclase; and (c) decreased low-affinity binding present in tumors is not correlated with altered hormone responsiveness of adenylate cyclase but may reflect more general cancer-induced changes in membrane structure or composition.

  10. Cholesteryl esters in human malignant neoplasms.

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

    2003-01-01

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

  11. Morbidity and mortality of malignant neoplasms in Macedonia

    Vukovikj, Viktorija; Markovski, Velo

    2015-01-01

    Introductions: Malignant neoplasms are the second cause of death among the population in Republic of Macedonia with representation of and represent 19.0% in the structure of total deaths. Objective: To analyze the morbidity and mortality of the most common malignant neoplasms in Republic of Macedonia. Material and methods: Were used a data from the Institute of Public Health of the Republic of Macedonia, National institute for statistic of Republic Macedonia. Results and discussions:...

  12. Malignant lymphoma and the thyroid gland

    Becker, W.; Reiners, C.; Boerner, W.; Mueller, H.A.; Wuensch, P.H.; Schaeffer, R.; Gunzer, U.

    1983-04-01

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

  13. Second Malignant Neoplasms After Treatment of Childhood Acute Lymphoblastic Leukemia

    Schmiegelow, Kjeld; Levinsen, Mette Frandsen; Attarbaschi, Andishe; Baruchel, Andre; Devidas, Meenakshi; Escherich, Gabriele; Gibson, Brenda; Heydrich, Christiane; Horibe, Keizo; Ishida, Yasushi; Liang, Der-Cherng; Locatelli, Franco; Michel, Gérard; Pieters, Rob; Piette, Caroline; Pui, Ching-Hon; Raimondi, Susana; Silverman, Lewis; Stanulla, Martin; Stark, Batia; Winick, Naomi; Valsecchi, Maria Grazia

    2013-01-01

    Purpose Second malignant neoplasms (SMNs) after diagnosis of childhood acute lymphoblastic leukemia (ALL) are rare events. Patients and Methods We analyzed data on risk factors and outcomes of 642 children with SMNs occurring after treatment for ALL from 18 collaborative study groups between 1980 and 2007. Results Acute myeloid leukemia (AML; n = 186), myelodysplastic syndrome (MDS; n = 69), and nonmeningioma brain tumor (n = 116) were the most common types of SMNs and had the poorest outcome (5-year survival rate, 18.1% ± 2.9%, 31.1% ± 6.2%, and 18.3% ± 3.8%, respectively). Five-year survival estimates for AML were 11.2% ± 2.9% for 125 patients diagnosed before 2000 and 34.1% ± 6.3% for 61 patients diagnosed after 2000 (P < .001); 5-year survival estimates for MDS were 17.1% ± 6.4% (n = 36) and 48.2% ± 10.6% (n = 33; P = .005). Allogeneic stem-cell transplantation failed to improve outcome of secondary myeloid malignancies after adjusting for waiting time to transplantation. Five-year survival rates were above 90% for patients with meningioma, Hodgkin lymphoma, thyroid carcinoma, basal cell carcinoma, and parotid gland tumor, and 68.5% ± 6.4% for those with non-Hodgkin lymphoma. Eighty-nine percent of patients with brain tumors had received cranial irradiation. Solid tumors were associated with cyclophosphamide exposure, and myeloid malignancy was associated with topoisomerase II inhibitors and starting doses of methotrexate of at least 25 mg/m2 per week and mercaptopurine of at least 75 mg/m2 per day. Myeloid malignancies with monosomy 7/5q− were associated with high hyperdiploid ALL karyotypes, whereas 11q23/MLL-rearranged AML or MDS was associated with ALL harboring translocations of t(9;22), t(4;11), t(1;19), and t(12;21) (P = .03). Conclusion SMNs, except for brain tumors, AML, and MDS, have outcomes similar to their primary counterparts. PMID:23690411

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

    Dimitrios Hadjidakis

    2012-01-01

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

  15. Thyroid Malignancies in Survivors of Hodgkin Lymphoma

    Michaelson, Evan M. [Department of Radiation Oncology, Brigham and Women' s Hospital, Dana-Farber Cancer Institute, and the Children' s Hospital, Boston, Massachusetts (United States); Chen, Yu-Hui [Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Silver, Barbara; Tishler, Roy B.; Marcus, Karen J. [Department of Radiation Oncology, Brigham and Women' s Hospital, Dana-Farber Cancer Institute, and the Children' s Hospital, Boston, Massachusetts (United States); Stevenson, Mary Ann [Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts (United States); Ng, Andrea K., E-mail: ang@lroc.harvard.edu [Department of Radiation Oncology, Brigham and Women' s Hospital, Dana-Farber Cancer Institute, and the Children' s Hospital, Boston, Massachusetts (United States)

    2014-03-01

    Purpose: To quantify the incidence of thyroid cancer after Hodgkin lymphoma (HL) and determine disease characteristics, risk factors, and treatment outcomes. Methods and Materials: Thyroid cancer cases were retrospectively identified from a multi-institutional database of 1981 HL patients treated between 1969 and 2008. Thyroid cancer risk factors were evaluated by a Poisson regression model. Results: With a median follow-up duration of 14.3 years (range, 0-41.2 years), 28 patients (1.4%) developed a thyroid malignancy. The overall incidence rate (expressed as the number of cases per 10,000 person-years) and 10-year cumulative incidence of thyroid cancer were 9.6 and 0.26%, respectively. There were no observed cases of thyroid malignancy in patients who received neck irradiation for HL after age 35 years. Age <20 years at HL diagnosis and female sex were significantly associated with thyroid cancer. The incidence rates of females aged <20 at HL diagnosis in the first 10 years, ≥10 years, ≥15 years, and ≥20 years after treatment were 5, 31, 61, and 75 cases per 10,000 person-years of follow-up, respectively. At a median follow-up of 3.5 years after the thyroid cancer diagnosis, 26 patients (93%) were alive without disease, 1 (4%) was alive with metastatic disease, and 1 (4%) died of metastatic disease, at 6 and 3.6 years after the thyroid cancer diagnosis, respectively. Conclusions: Although HL survivors have an increased risk for thyroid cancer, the overall incidence is low. Routine thyroid cancer screening may benefit females treated at a young age and ≥10 years from HL treatment owing to their higher risk, which increases over time.

  16. [Oral complications of chemotherapy of malignant neoplasms].

    Obralić, N; Tahmiscija, H; Kobaslija, S; Beslija, S

    1999-01-01

    Function and integrity disorders of the oral cavity fall into the most frequent complication of the chemotherapy of leucemias, malignant lymphomas and solid tumors. Complications associated with cancer chemotherapy can be direct ones, resulting from the toxic action of antineoplastic agents on the proliferative lining of the mouth, or indirect, as a result of myelosuppression and immunosuppression. The most frequent oral complications associated with cancer chemotherapy are mucositis, infection and bleeding. The principles of prevention and management of oral complications during cancer chemotherapy are considered in this paper.

  17. Peripheral papillary tumor of type-II pneumocytes: a rare neoplasm of undetermined malignant potential.

    Dessy, E; Braidotti, P; Del Curto, B; Falleni, M; Coggi, G; Santa Cruz, G; Carai, A; Versace, R; Pietra, G G

    2000-03-01

    Peripheral papillary adenomas of the lung are uncommon neoplasms (only ten cases have been described so far in the English literature) composed predominantly of type-II pneumocytes and generally considered benign. We describe here two additional cases of this lung tumor. In both cases histological examination revealed an encapsulated papillary neoplasm with invasion of the capsule and, in one case, invasion of the adjacent alveoli and visceral pleura too. The proliferative index (Ki67) was less than 2% and the epithelial cells were positive for cytokeratins, surfactant apoproteins (SP), and nuclear thyroid transcription factor-1 (TTF- 1). Ultrastructurally, the epithelial cells showed the characteristic surface microvilli and cytoplasmic lamellar inclusions of type-II cells. Review of the literature has revealed two other cases of peripheral papillary adenoma of type-II pneumocytes with infiltrative features. Thus, we propose replacing the term peripheral papillary adenoma with peripheral papillary tumor of undetermined malignant potential.

  18. Malignancies associated with intraductal papillary mucinous neoplasm of the pancreas

    Terumi Kamisawa; Yuyang Tu; Naoto Egawa; Hitoshi Nakajima; Kouji Tsuruta; Atsutake Okamoto

    2005-01-01

    AIM: As intraductal papillary mucinous neoplasm (IPMN)has a favorable prognosis, associated malignancies have potential significance in these patients. We examined the incidence and characteristics of pre-existing, coexisting and subsequent malignancies in patients with IPMN. METHODS: Seventy-nine cases of IPMN were diagnosed by detection of mucous in the pancreatic duct during endoscopic retrograde pancreatography. Histological diagnosis was confirmed in 30 cases (adenoma (n = 19)and adenocarcinoma (n = 11). Other primary malignancies associated with IPMN, occurring in the prediagnostic or postdiagnostic period, were investigated. Postdiagnostic follow-up period was 3.3±0.5 years (range, 0.2-20 years).RESULTS: Other 40 malignancies occurred in 28 patients (35%). They were found before (n = 15), at (n = 19) and after (n = 6) the diagnosis of IPMT. Major associated malignancies were gastric cancer (n = 12), colonic cancer (n = 7), esophageal cancer (n = 4), pulmonary cancer (n = 4), and independent pancreatic cancer (n = 3).Pancreatic cancer was synchronous with IPMN in two patients and metachronous in one (3 years after diagnosis of IPMN). Thirty-one lesions were treated surgically or endoscopically. Fourteen patients died of associated cancers. Development of other malignancies was related to age (71.9±8.2 vs66.8±9.3, P<0.05), but not to gender or site of the tumor.CONCLUSION: IPMN is associated with a high incidence of other malignancies, particularly gastric and colonic cancers. Common genetic mechanisms between IPMN and other associated malignancies might be present. Clinicians should pay attention to the possibility of associated malignancies in preoperative screening and follow-up of patients with IPMN.

  19. Thyroidal malignancy and scintigraphy; Schilddrsenmalignitaet und Szintigrafie

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

    2008-09-15

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

  20. Dermoscopy of benign and malignant neoplasms in the pediatric population.

    Haliasos, Helen C; Zalaudek, Iris; Malvehy, Josep; Lanschuetzer, Christoph; Hinter, Helmut; Hofmann-Wellenhof, Rainer; Braun, Ralph; Marghoob, Ashfaq A

    2010-12-01

    Dermoscopy is a noninvasive technique that enables visualization of subsurface colors and structures within the skin that are imperceptible to the naked eye. The dermatoscope allows the physician to examine both the macroscopic and microscopic primary morphology of skin lesions, identify subtle clinical clues, confirm naked-eye clinical diagnoses, and monitor treatment progress while posing little threat to the young patient. Dermoscopic findings have been formulated into diagnostic criteria that assist experienced clinicians in differentiating benign and malignant neoplasms. In this review, clinical morphology of melanocytic nevi and melanoma in the pediatric population is examined and the relevant dermoscopic findings and histopathologic correlates that aid in the diagnosis and management of these lesions are described.

  1. Imaging spectrum of primary malignant renal neoplasms in children

    Rama Anand

    2012-01-01

    Full Text Available Wilms′ tumor (WT is the most common abdominal tumor in children. Many pediatric renal tumors in the past were categorized as WT; however, in recent years, several specific renal tumors have been recognized as distinct pathological entities. The age and clinical presentation of the child and distinctive imaging features may help in reaching a specific diagnosis in most cases. This is important as it has implications on the pre-operative diagnostic work-up and prognosis of the child. However, it is often not possible to differentiate one from the other pediatric renal tumor on the basis of imaging alone, and the final diagnosis is often made at histological examination of the surgical specimen. This article reviews the imaging features of primary malignant renal neoplasms in children along with their clinical presentation and pathological features.

  2. [Riedel thyroiditis: two cases report].

    Zhou, Rongjin; Wang, Junguo

    2014-10-01

    Riedel thyroiditis is a benign disease, which is often self-limited. Examinations, such as CT and histologic diagnosis can distinguish it from malignant neoplasms and hashimoto's thyroiditis. Riedel thyroiditis is an uncommon form of chronic thyroiditis in which the thyroid gland is replaced by fibrous tissue. It can be cured by surgery and medicine.

  3. Second Malignant Neoplasms After Treatment of Childhood Acute Lymphoblastic Leukemia

    Schmiegelow, K.; Levinsen, Mette Frandsen; Attarbaschi, Andishe

    2013-01-01

    PURPOSE: Second malignant neoplasms (SMNs) after diagnosis of childhood acute lymphoblastic leukemia (ALL) are rare events. PATIENTS AND METHODS: We analyzed data on risk factors and outcomes of 642 children with SMNs occurring after treatment for ALL from 18 collaborative study groups between 1980...... and 2007. RESULTS: Acute myeloid leukemia (AML; n = 186), myelodysplastic syndrome (MDS; n = 69), and nonmeningioma brain tumor (n = 116) were the most common types of SMNs and had the poorest outcome (5-year survival rate, 18.1% ± 2.9%, 31.1% ± 6.2%, and 18.3% ± 3.8%, respectively). Five-year survival...... estimates for AML were 11.2% ± 2.9% for 125 patients diagnosed before 2000 and 34.1% ± 6.3% for 61 patients diagnosed after 2000 (P survival estimates for MDS were 17.1% ± 6.4% (n = 36) and 48.2% ± 10.6% (n = 33; P = .005). Allogeneic stem-cell transplantation failed to improve outcome...

  4. Microvessel and mast cell densities in malignant laryngeal neoplasm

    Balica Nicolae Constantin

    2014-01-01

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

  5. Thyroid malignancies: diagnostic strategy; Primaerdiagnostik des Schilddruesenkarzinoms

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

    1999-12-01

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

  6. [The application of the social economic zoning in the study of malignant neoplasm mortality].

    Gaĭdarov, G M; Makarov, S V

    2008-01-01

    The results of the application of the social economic zoning approach in studying the mortality of malignant neoplasms of digestive apparatus on the Irkutsk oblast territories with low population density are discussed.

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

    Okada Masafumi

    2007-07-01

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

  8. Unusual malignant solid neoplasms of the kidney: Cross-sectional imaging findings

    Karaosmanoglu, Ali Devrim; Hahn, Peter F. [Dept. of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston (United States); Shirkhoda, Ali [Dept. of Radiology, University of California School of Medicine, Irvine (United States); Onur, Mehmet Ruhi; Ozmen, Mustafa [Dept. of Radiology, University of Hacettepe School of Medicine, Ankara (Turkmenistan)

    2015-08-15

    Malignant kidney neoplasms are the most frequently encountered solid kidney masses. Although renal cell carcinoma is the major renal malignancy, other solid malignant renal masses should be considered in the differential diagnosis of solid renal masses that do not contain a macroscopic fatty component. In this pictorial essay, we present the imaging findings of a primitive neuroectodermal tumor, primary liposarcoma of the kidney, primary neuroendocrine tumor, leiomyosarcoma, synovial sarcoma, malignant fibrous histiocytoma, sclerosing fibrosarcoma and renal metastasis of osteosarcoma.

  9. Molecular imaging with {sup 99m}Tc-MIBI and molecular testing for mutations in differentiating benign from malignant follicular neoplasm: a prospective comparison

    Giovanella, L.; Treglia, G.; Ceriani, L. [Oncology Institute of Southern Switzerland, Department of Nuclear Medicine and Thyroid Centre, Bellinzona (Switzerland); Campenni, A. [Policlinico Universitario, Istituto di Medicina Nucleare, Messina (Italy); Verburg, F.A. [RWTH University Hospital Aachen, Department of Nuclear Medicine, Aachen (Germany); Trimboli, P. [Oncology Institute of Southern Switzerland, Department of Nuclear Medicine and Thyroid Centre, Bellinzona (Switzerland); Ospedale Israelitico, Sezione di Endocrinologia e Diabetologia, Roma (Italy); Bongiovanni, M. [Centre Hopitalier Universitaire Vaudouise, Institut de Pathologie, Lausanne (Switzerland)

    2016-06-15

    To compare mutation analysis of cytology specimens and {sup 99m}Tc-MIBI thyroid scintigraphy for differentiating benign from malignant thyroid nodules in patients with a cytological reading of follicular neoplasm. Patients ≥18 years of age with a solitary hypofunctioning thyroid nodule (≥10 mm), normal thyrotropin and calcitonin levels, and a cytological diagnosis of follicular neoplasm were prospectively enrolled. Mutation analysis and {sup 99m}Tc-MIBI scintigraphy were performed and patients were subsequently operated on to confirm or exclude a malignant lesion. Mutations for KRAS, HRAS and NRAS and for BRAF and translocations of PAX8/PPARγ, RET/PTC1 and RET/PTC3 were investigated. Static thyroid scintigraphic images were acquired 10 and 60 min after intravenous injection of 200 MBq of {sup 99m}Tc-MIBI and visually assessed. Additionally, the MIBI washout index was calculated using a semiquantitative method. In our series, 26 % of nodules with a follicular pattern on cytology were malignant with a prevalence of follicular carcinomas. {sup 99m}Tc-MIBI scintigraphy was found to be significantly more accurate (positive likelihood ratio 4.56 for visual assessment and 12.35 for semiquantitative assessment) than mutation analysis (positive likelihood ratio 1.74). A negative {sup 99m}Tc-MIBI scan reliably excluded malignancy. In patients with a thyroid nodule cytologically diagnosed as a follicular proliferation, semiquantitative analysis of {sup 99m}Tc-MIBI scintigraphy should be the preferred method for differentiating benign from malignant nodules. It is superior to molecular testing for the presence of differentiated thyroid cancer-associated mutations in fine-needle aspiration cytology sample material. (orig.)

  10. Breast cancer as second malignant neoplasm after acute myeloid leukemia: A rare occurrence

    Govind Babu

    2016-01-01

    Full Text Available Cancer survivors after successful treatment of hematological and lymphoid malignancies are at an increased risk for second malignant neoplasms. As the overall survival has increased in these cancers, solid tumors are emerging as a serious long-term complication. In this article, we describe such a rare occurrence, in literature, of breast cancer after the treatment of acute myeloid leukemia.

  11. Malignant Perivascular Epithelioid Cell Neoplasm (PEComa) of the Pelvis: A Case Report.

    D'Andrea, David; Hanspeter, Esther; D'Elia, Carolina; Martini, Thomas; Pycha, Armin

    2016-05-01

    Perivascular epithelioid cell neoplasms (PEComa) are rare mesenchymal tumors that can occur in any part of the body and have unpredictable pathological behavior. They are usually benign, but may be malignant. We present a case of malignant PEComa of the pelvic retroperitoneum treated with radical surgery.

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

    Eranga Himalee Siriweera; Neelakanthi Vajira Illangakoon Ratnatunga

    2010-01-01

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

  13. Radioiodine treatment for malignant thyroid disease

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

    2006-12-15

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

  14. Osteosarcoma as Malignant Mural Nodule in Ovarian Mucinous Neoplasms of Intestinal Type: Report of 2 Cases.

    McFarland, Marie; Dina, Roberto; Fisher, Cyril; McCluggage, W Glenn

    2015-07-01

    Mural nodules, which may be benign or malignant, are well recognized in ovarian mucinous neoplasms, especially of borderline type. Malignant mural nodules most commonly comprise anaplastic carcinoma but sarcomas of various types have been reported. We report 2 cases of osteosarcoma occurring in young women (aged 18 and 34) as malignant mural nodules in a Grade 1 ovarian mucinous carcinoma of intestinal type and a borderline mucinous tumor of intestinal type. Primary osteosarcomas of the ovary have been described either arising within a teratoma or as a pure neoplasm but, to the best of our knowledge, osteosarcoma occurring as a mural nodule in an ovarian mucinous neoplasm has not been reported. In both our cases, the tumor was Stage 1 at presentation and the patients were treated with surgery without adjuvant chemotherapy. Both patients are free of disease with follow-up of 12 and 18 mo.

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

    Ahmed Marwan

    2009-04-01

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

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

    Marwan, Ahmed; Christein, John D

    2009-04-17

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

  17. Thyroid neoplasms after radiation therapy for adolescent acne vulgaris. [X radiation

    Paloyan, E.; Lawrence, A.M.

    1978-01-01

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

  18. Primary malignant melanoma of female urethra: a rare neoplasm.

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

    2014-01-01

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

  19. Primary malignant melanoma of female urethra: A rare neoplasm

    Praveen K Pandey

    2014-01-01

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

  20. Endoscopic Ultrasound Fine-Needle Aspiration Characteristics of Primary Adenocarcinoma versus Other Malignant Neoplasms of The Pancreas

    Veronika Gagovic

    2012-01-01

    Full Text Available BACKGROUND: Endoscopic ultrasound (EUS with fine-needle aspiration (FNA is often used to assist in the evaluation of pancreatic lesions and may help to diagnose benign versus malignant neoplasms. However, there is a paucity of literature regarding comparative EUS characteristics of various malignant pancreatic neoplasms (primary and metastatic.

  1. Imaging of the thyroid in benign and malignant disease.

    Intenzo, Charles M; Dam, Hung Q; Manzone, Timothy A; Kim, Sung M

    2012-01-01

    The thyroid gland was one of the first organs imaged in nuclear medicine, beginning in the 1940s. Thyroid scintigraphy is based on a specific phase or prelude to thyroid hormone synthesis, namely trapping of iodide or iodide analogues (ie, Tc99m pertechnetate), and in the case of radioactive iodine, eventual incorporation into thyroid hormone synthesis within the thyroid follicle. Moreover, thyroid scintigraphy is a reflection of the functional state of the gland, as well as the physiological state of any structure (ie, nodule) within the gland. Scintigraphy, therefore, provides information that anatomical imaging (ie, ultrasound, computed tomography [CT], magnetic resonance imaging) lacks. Thyroid scintigraphy plays an essential role in the management of patients with benign or malignant thyroid disease. In the former, the structure or architecture of the gland is best demonstrated by anatomical or cross-sectional imaging, such as ultrasound, CT, or even magnetic resonance imaging. The role of scintigraphy, however, is to display the functional state of the thyroid gland or that of a clinically palpable nodule within the gland. Such information is most useful in (1) patients with thyrotoxicosis, and (2) those patients whose thyroid nodules would not require tissue sampling if their nodules are hyperfunctioning. In neoplastic thyroid disease, thyroid scintigraphy is often standard of care for postthyroidectomy remnant evaluation and in subsequent thyroid cancer surveillance. Planar radioiodine imaging, in the form of the whole-body scan (WBS) and posttherapy scan (PTS), is a fundamental tool in differentiated thyroid cancer management. Continued controversy remains over the utility of WBS in a variety of patient risk groups and clinical scenarios. Proponents on both sides of the arguments compare WBS with PTS, thyroglobulin, and other imaging modalities with differing results. The paucity of large, randomized, prospective studies results in dependence on consensus

  2. Elastography in Distinguishing Benign from Malignant Thyroid Nodules

    Bulent Colakoglu

    2016-01-01

    Full Text Available Aim: The aim of this study is to test the diagnostic success of strain elastography in distinguishing benign from malignant thyroid nodules. Materials and Methods: The size, echogenicity, and halo integrity of 293 thyroid nodules and the presence of microcalcification in these nodules were evaluated on gray-scale examination. Doppler characteristics and elastography patterns were also evaluated and recorded. Nodules were classified in four categories (patterns 1-4 based on elastographic examination. Results: According to the cytopathological findings, 222 nodules were benign, and 71 nodules were malignant. The risk of a nodule to be malignant was 3.8 times increased by hypoechogenicity, 7.7 times increased by the presence of microcalcification, and 11.5 times increased by the absence of halo. On Doppler patterns, the presence of central vascularity increased the malignancy risk of a nodule by 5.8 times. According to the receiver operating characteristic analysis, patterns 3 and 4 were malignant, and patterns 1 and 2 were benign. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of elastography were 100%, 80.2%, 61.7%, 100%, and 85%, respectively. Conclusion: Strain elastography can be used as a noninvasive method in distinguishing benign from malignant thyroid nodules and in identifying the patients who would undergo surgery.

  3. Elastography in Distinguishing Benign from Malignant Thyroid Nodules

    Colakoglu, Bulent; Yildirim, Duzgun; Alis, Deniz; Ucar, Gokhan; Samanci, Cesur; Ustabasioglu, Fethi Emre; Bakir, Alev; Ulusoy, Onur Levent

    2016-01-01

    Aim: The aim of this study is to test the diagnostic success of strain elastography in distinguishing benign from malignant thyroid nodules. Materials and Methods: The size, echogenicity, and halo integrity of 293 thyroid nodules and the presence of microcalcification in these nodules were evaluated on gray-scale examination. Doppler characteristics and elastography patterns were also evaluated and recorded. Nodules were classified in four categories (patterns 1–4) based on elastographic examination. Results: According to the cytopathological findings, 222 nodules were benign, and 71 nodules were malignant. The risk of a nodule to be malignant was 3.8 times increased by hypoechogenicity, 7.7 times increased by the presence of microcalcification, and 11.5 times increased by the absence of halo. On Doppler patterns, the presence of central vascularity increased the malignancy risk of a nodule by 5.8 times. According to the receiver operating characteristic analysis, patterns 3 and 4 were malignant, and patterns 1 and 2 were benign. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of elastography were 100%, 80.2%, 61.7%, 100%, and 85%, respectively. Conclusion: Strain elastography can be used as a noninvasive method in distinguishing benign from malignant thyroid nodules and in identifying the patients who would undergo surgery. PMID:28123841

  4. Detection of telomerase activity in malignant neoplasms and nonmalignantepithelial tissues of human esophagus

    Shah Min Yang; Tian Jiao Wang; Bao Yu Li; Yuan Huan Wu

    2000-01-01

    AIM To study the expression of telomerase activity in malignant esophageal neoplasms and normal humanesophageal epithelia.METHODS Telomerase activity was assayed by the telomere repeat amplification protocol (TRAP)method. All the neoplasms and epithelia of esophagus were confirmed by routine pathological diagnosis.RESULTS Telomerase activity was assayed in 18 normal esophageal epithelial tissues and in 35 malignantneoplasms of esophagus, including 27 cases of esophageal carcinoma and 8 cases of cardiac carcinoma.Telomerase activity was detected in most of malignant neoplasms of esophagus (91.4%, 32/35) and in allthe normal esophageal epithelial tissues except one (18/19).CONCLUSION The results suggest that in addition to contributing to proliferation of immortal blast cellsand neoplastic cells, telomerase activity may also play a similar role in regeneration of normal epithelia ofhuman esophagus. The potential use of telomerase activity as a diagnostic marker in human esophagealneoplasm might not be suitable.

  5. Ninety-four cases of encapsulated follicular variant of papillary thyroid carcinoma: A name change to Noninvasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features would help prevent overtreatment.

    Thompson, Lester Dr

    2016-07-01

    Encapsulated follicular variant of papillary thyroid carcinoma is a common thyroid gland cancer, with a highly indolent behavior. Recently, reclassification as a non-malignant neoplasm has been proposed. There is no comprehensive, community hospital based longitudinal evaluation of encapsulated follicular variant of papillary thyroid carcinoma. Ninety-four cases of encapsulated follicular variant of papillary thyroid carcinoma were identified in a review of all thyroid gland surgeries performed in 2002 within the Southern California Permanente Medical Group. All histology slides were reviewed and follow-up obtained. Seventy-five women and nineteen men, aged 20-80 years (mean 45.6 years), had a single (n=61), multiple (same lobe; n=20), or bilateral (n=13) tumor(s), ranging in size from 0.7 to 9.5 cm in diameter (mean 3.3 cm). Histologically, all cases demonstrated a well-formed tumor capsule, with capsular and/or lymphovascular invasion in 17 and no invasion in 77 cases. Lymph node metastases were not identified. The tumors had a follicular architecture, without necrosis or >3 mitoses/10 high-power fields (HPFs). Classical papillary thyroid carcinoma nuclear features were seen in at least three HPFs per 3 mm of tumor diameter, including enlarged, elongated, crowded, and overlapping nuclei, irregular nuclear contours, nuclear grooves, and nuclear chromatin clearing. Lobectomy alone (n=41), thyroidectomy alone (n=34), or completion thyroidectomy (n=19) was the initial treatment combined with post-op radioablative iodine in 25 patients. All patients were without evidence of disease after a median follow-up of 11.8 years. Encapsulated follicular variant of papillary thyroid carcinoma showed benign behavior, supporting conservative surgery alone and reclassification of these tumors to Noninvasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features (NIFTP).

  6. Diffusion weighted imaging for the differential diagnosis of benign vs. malignant ovarian neoplasms.

    Meng, Xiang-Fu; Zhu, Shi-Cai; Sun, Shao-Juan; Guo, Ji-Cai; Wang, Xue

    2016-06-01

    In order to assess the diagnostic accuracy of diffusion weighted imaging (DWI) in differentiating between benign and malignant ovarian neoplasms, a systemic meta-analysis was conducted. Relevant studies were retrieved from scientific literature databases, including the PubMed, Wiley, EBSCO, Ovid, Web of Science, Wanfang, China National Knowledge Infrastructure and VIP databases. Following a multi-step screening and study selection process, the relevant data was extracted for use in the present study. Statistical analyses were performed using Meta-disc software version 1.4 and STATA statistical software version 12.0. A total of 285 articles were retrieved from the database searches. Following a careful screening process, 10 case-control studies were selected for the present meta-analysis. The 10 studies investigated the efficacy of DWI in diagnosing ovarian neoplasms, and included a combined total of 1,159 subjects, of which 559 patients had malignant lesions and 600 had benign lesions. The results showed that the pooled sensitivity, pooled specificity, pooled positive likelihood ratio, pooled negative likelihood ratio, pooled diagnostic odds ratio (DOR) and area under the curve of the summary receiver operating characteristics curve of DWI for differentiating between benign and malignant ovarian neoplasms were 0.93, 0.89, 7.58, 0.10, 85.33 and 0.95, respectively. A subgroup analysis based on ethnicity revealed no significant difference between Asians and Caucasians. Another subgroup analysis by magnetic resonance imaging (MRI) type showed that the DORs for GE Healthcare Life Sciences and Siemens AG machines were 100.76 [95% confidence interval (CI), 65.28-155.53] and 30.85 (95% CI, 10.40-91.53), respectively; this indicates that the diagnostic efficiency of the GE Healthcare Life Sciences MRI is superior compared with the Siemens AG MRI. The DWI demonstrated an excellent diagnostic performance in discriminating between benign and malignant ovarian neoplasms, and

  7. Segmental neurofibromatosis and cancer: report of triple malignancy in a woman with mosaic Neurofibromatosis 1 and review of neoplasms in segmental neurofibromatosis.

    Cohen, Philip R

    2016-07-15

    BackgroundSegmental neurofibromatosis, referred to as mosaic neurofibromatosis 1, patients present with neurofibromas or café au lait macules or both in a unilateral segment of the body.PurposeA woman with segmental neurofibromatosis and triple cancer (renal cell carcinoma, mixed thyroid carcinoma, and lentigo maligna) is described and cancers observed in patients with segmental neurofibromatosis are reviewed.MethodsPubMed was used to search the following terms, separately and in combination: cancer, malignancy, mosaic, neoplasm, neurofibroma, neurofibromatosis, segment, segmental, tumor.ResultsMalignancy (13 cancers) has been observed in 11 segmental neurofibromatosis patients; one patient had three different cancers. The most common neoplasms were of neural crest origin {malignant peripheral nerve sheath tumor (3 patients) and melanoma (3 patients)] and gastrointestinal tract origin [colon (1 patient) and gastric (1 patient)]. Breast cancer, Hodgkin lymphoma, lung cancer, kidney cancer, and thyroid cancer each occurred in one patient.ConclusionsSimilar to patients with von Recklinghausen neurofibromatosis 1, individuals with segmental neurofibromatosis also have a genodermatosis-associated increased risk of developing cancer.

  8. Thyroid function following neck irraidation for malignant lymphoma

    Kim, Y.H.; Fayos, J.V.; Sisson, J.C.

    1980-01-01

    Thyroid function tests for T/sub 3/ resin (T/sub 3/-r), serum thyroxine (T/sub 4/), and serum thyroid stimulating hormone (TSH) were measured in 70 consecutive patients who had previously undergone lymphangiography and neck irradiation for malignant lymphoma. All were in remission and clinically euthyroid. The abnormalities found were: 23 (33%) patients hypothyroid by TSH, 14 (20%) with subnormal T/sub 4/, and 21 (30%) with subnormal T/sub 3/-r values. None of the patients were biochemically hyperthyroid. The prevalence and magnitude of abnormalities were highest during the third year after irradiation, thereafter decreasing with time.

  9. Partially Cystic Thyroid Nodules: Ultrasound Findings of Malignancy

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

    2012-09-15

    To seek for the ultrasound (US) findings of partially cystic thyroid nodules that are associated with malignancy. We reviewed the US characteristics of 22 surgically confirmed partially cystic papillary carcinomas, and compared them with those of 80 benign partially cystic nodules. The review cases were selected in a random order from a total of 1029 partially cystic nodules that were diagnosed with an US-guided fine needle aspiration biopsy over a period of 8 years (June 2003 to October 2010) at our institution. In partially cystic thyroid nodules, a taller-than-wide shape (100%, p<0.001) and spiculated or microlobulated margin (58.3%, p 0.003) were significantly associated with malignancy. In terms of internal solid portion of the nodule, eccentric configuration (68.0%, p<0.001), non-smooth margin (81.3%, p<0.001), hypoechogenecity (30.0%, p<0.042), and microcalcification (89.5%, p<0.001) were more frequently demonstrated in malignant nodules than benign ones. In partially cystic thyroid nodules, understanding the characteristics of US findings is important to make a precise diagnosis of malignant nodules.

  10. Cardiac tamponade - unusual clinical manifestation of undiagnosed malignant neoplasm.

    Perek, B; Tomaszewska, I; Stefaniak, S; Katynska, I; Jemielity, M

    2016-01-01

    Cardiac tamponade may be the first or predominant symptom of some pathologies but its etiology is not uncommonly unknown on admission to hospital. The purpose of this study was to evaluate the predominant causes of cardiac tamponade in previously healthy patients treated emergently in a single cardiac surgical center. The study involved 81 patients with the mean age of 58.1±16.0 years who underwent emergent subxyphoid pericardiotomy due to cardiac tamponade. Pericardial effusion was analyzed macro- and microscopically. Examinations done in the cardiac surgical department revealed pericarditis secondary to infection (n=17) or autoimmunologic processes (n=2) and malignancy in 18 patients (predominantly of the lungs (n=11)). Pericardial effusion obtained from patients with viral and autoimmunologic-induced pericarditis was straw-color and odorless while with bacterial infections dark yellow, iridescent and usually malodorous. Additional workup in the regional hospitals enabled to reveal malignant tumors in 29 patients, leukemia or lymphoma in 5 subjects. In all but one of the neoplastic cases, pericardial fluid was turbid and dark red or plummy. In 10 patients etiology of tamponade remained unknown. In conclusion, cardiac tamponade in previously healthy patients may be occasionally the predominant symptom of cancer, especially of the lungs. Macroscopic intraoperative appearance of pericardial fluid may be helpful in identification of causative condition of cardiac tamponade.

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

    J Sen

    2010-01-01

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

  12. [Diffuse sclerosing papillary carcinoma mimicking chronic lymphocytic thyroiditis. A unusual neoplasm variant].

    Pino Rivero, V; Pardo Romero, G; González Palomino, A; Pantoja Hernández, C G; Trinidad Ramos, G; Marcos García, M; Blasco Huelva, A

    2006-01-01

    We report the clinical case of a 39 years old female diagnosed as a chronic lymphocytic tiroiditis by F.N.A.B. with multinodular goiter of long evolution. The patient was operated by total thyroidectomy and her final anatomopathologic result was papillary carcinoma diffuse sclerosing variant. During the surgical act several cervical nodes were detected and removed being informed the most of them as metastasic. A review of the literature at respect of this malignant neoplasm is performed.

  13. Malignant lymphatic and hematopoietic neoplasms mortality in Serbia, 1991-2010: a joinpoint regression analysis.

    Milena Ilic

    Full Text Available BACKGROUND: Limited data on mortality from malignant lymphatic and hematopoietic neoplasms have been published for Serbia. METHODS: The study covered population of Serbia during the 1991-2010 period. Mortality trends were assessed using the joinpoint regression analysis. RESULTS: Trend for overall death rates from malignant lymphoid and haematopoietic neoplasms significantly decreased: by -2.16% per year from 1991 through 1998, and then significantly increased by +2.20% per year for the 1998-2010 period. The growth during the entire period was on average +0.8% per year (95% CI 0.3 to 1.3. Mortality was higher among males than among females in all age groups. According to the comparability test, mortality trends from malignant lymphoid and haematopoietic neoplasms in men and women were parallel (final selected model failed to reject parallelism, P = 0.232. Among younger Serbian population (0-44 years old in both sexes: trends significantly declined in males for the entire period, while in females 15-44 years of age mortality rates significantly declined only from 2003 onwards. Mortality trend significantly increased in elderly in both genders (by +1.7% in males and +1.5% in females in the 60-69 age group, and +3.8% in males and +3.6% in females in the 70+ age group. According to the comparability test, mortality trend for Hodgkin's lymphoma differed significantly from mortality trends for all other types of malignant lymphoid and haematopoietic neoplasms (P<0.05. CONCLUSION: Unfavourable mortality trend in Serbia requires targeted intervention for risk factors control, early diagnosis and modern therapy.

  14. THE ANALYSIS OF STATISTICAL DATA ON MALIGNANT NEOPLASMS ASSOCIATED WITH HUMAN P APILLOMAVIRUS

    A. A. Kostin

    2016-01-01

    Full Text Available In this study of statistical data for the first time in Russia the analysis of the morbidity and mortality of patients with malignant neoplasms that may be associated with human papilloma virus (HPV is performed: cervical cancer (cervical cancer, cancer of the vulva and vagina, cancer of penis, cancer of the rectum, anal canal and rectosigmoid junction cancer, cancer of the pharynx and larynx.

  15. Predictive factors associated with malignancy of intraductal papillary mucinous pancreatic neoplasms

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

    2010-01-01

    AIM:To identify preoperative predictive factors associated with malignancy of intraductal papillary mucinous neoplasms(IPMNs) of the pancreas.METHODS:Between April 1995 and April 2010,129 patients underwent surgical resection for IPMNs at our institute and had confirmed pathologic diagnoses.The medical records were retrospectively reviewed and immunohistochemical staining for mucin(MUC) in pancreatic tissues was performed.RESULTS:Univariate analysis showed that the following five variables were closely asso...

  16. Benign and malignant nodular thyroid disease in acromegaly. Is a routine thyroid ultrasound evaluation advisable?

    Jordi L Reverter

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

  17. Stromal p16 expression is significantly increased in malignant ovarian neoplasms.

    Yoon, Nara; Yoon, Gun; Park, Cheol Keun; Kim, Hyun-Soo

    2016-10-04

    Alterations in p16 protein expression have been reported to be associated with tumor development and progression. However, p16 expression status in the peritumoral stroma has been rarely investigated. We investigated the stromal p16 expression in ovarian neoplasms using immunohistochemistry, and differences in the expression status depending on the degree of malignancy and histological type were analyzed. This study included 24, 21, and 46 cases of benign, borderline, and malignant ovarian lesions, respectively, of which 29, 25, and 32 cases were serous, mucinous, and endometriosis-associated lesions. Most benign lesions showed negative or weak expression, whereas borderline lesions showed focal, moderate expression. Malignant lesions showed markedly elevated stromal p16 expression compared with benign or borderline lesions. There were significant differences in stromal p16 expression between benign and borderline lesions (P p16 expression among the histological types were not significant. Stromal p16 expression in ovarian neoplasms was absent or weak in benign and focal, moderate in borderline lesions, whereas malignant lesions exhibited diffuse, moderate-to-strong p16 immunoreactivity. Our observations suggest that stromal p16 expression is involved in the development of ovarian carcinoma. Further studies are necessary to confirm our preliminary results.

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

    M. Mokhtari

    2005-05-01

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

  19. Esophageal and stomach malignant neoplasms characterization at Conjunto Hospitalar de Sorocaba

    Mauro Razuk Filho

    2014-04-01

    Objectives: the aim of this study is to collect and organize data on the incidence and prevalence of patients with malignant neoplasms of the esophagus and stomach in Conjunto Hospitalar de Sorocaba of the past six years. Methods: we conducted a survey of data on incidence, prevalence, age and sex of patients with malignant neoplasms of the esophagus and stomach that were admitted, treated and/or surgery at Conjunto Hospitalar de Sorocaba, in the last six years. Results: we analyzed the cases of 179 patients hospitalized in Conjunto Hospitalar de Sorocaba between the years 2007 and 2012, with the diagnosis of malignancy of the esophagus and/or stomach. Of this total, 131 are male and 48 female, 106 were operated (total or subtotal gastrectomy, esophagectomy, esophagogastrectomy, 73 were diagnosed with esophageal cancer (ICD10: C15, C15 0 to 9 and 118 with cancer stomach (ICD10: C16, C16 0 to 9 and 54 died. The average age of patients was 59.74 years (being 60.32 years for males and 58.18 years for women. Conclusions: based on these data, we conclude that our record of cases is lower than expected in the literature.

  20. NEOPLASMS

    1997-01-01

    970246 Detection of point mutations of p53 gene bynon-isotopic PCR-SSCP in paraffin-embedded malig-nant mesothelioma tissue. LUO Suqiong(罗素琼), etal. Pneumoconiosis Res Unit, Public Health Sch,West-China Med Univ, Chengdu, 610041. Chin J Ind

  1. Metastasis of leiomyosarcoma to the thyroid

    DENG Xiao-rong; WANG Gang; KUANG Chun-jing; PENG Gui-zu; CHEN Ren-sheng

    2005-01-01

    @@ Leiomyosarcoma metastatic to the thyroid is extremely rare. Despite the fact that the thyroid gland is one of the largest vascular organs in the body, clinical and surgical cases have given an incidence of only 3% for secondary malignancies of the organ. Nevertheless,thyroid metastases are not an exceptional finding at autopsy, they are encountered in 2% to 24% of the patients with malignant neoplasms.1 We report a man with right leg leiomyosarcoma metastatic to the thyroid gland.

  2. Successful selective internal radiotherapy (SIRT) in a patient with a malignant solid pseudopapillary pancreatic neoplasm (SPN).

    Krug, S; Bartsch, D K; Schober, M; Librizzi, D; Pfestroff, A; Burbelko, M; Moll, R; Michl, P; Gress, T M

    2012-01-01

    Solid pseudopapillary neoplasms of the pancreas (SPNs, Gruber-Frantz-Tumor) are a rare entity representing 1-5% of all exocrine pancreatic tumors. The pseudocystic lesions preferentially affect young females SIRT). Four years after SIRT and 10 years after initial diagnosis of metastatic SPN, the patient is in a good condition without any evidence for hepatic recurrence. This case represents a rare clinical course of a malignant and invasive SPN with an exceptionally long survival despite of high initial tumor burden. The selective internal radiotherapy is a suitable approach for inducing long-term remissions of the strongly vascularized liver metastases.

  3. Difficulty with diagnosis of malignant pancreatic neoplasms coexisting with chronic pancreatitis

    Ting-Kai Leung; Chi-Ming Lee; Fong-Chieh Wang; Hsin-Chi Chen; Hung-Jung Wang

    2005-01-01

    Chronic pancreatitis is a relatively common disease. We encountered two different cases of belatedly demonstrated pancreatic carcinoma featuring underlying chronic pancreatitis. The first case was one that was highly suspected as that of a malignancy based upon imaging study, but unfortunately, it could not be confirmed by intra-operative cytology at that time. Following this, the surgeon elected to perform only conservative bypass surgery for obstructive biliary complication. Peritoneal carcinomatosis was later noted and the patient finally died. The second case, a malignant mucinous neoplasm,was falsely diagnosed as a pseudocyst, based upon the lesion's sonographic appearance and associated elevated serum amylase levels. After suffering repeated hemoptysis,the patient was found to exhibit lung metastasis and peritoneal seeding. We reviewed some of the literature,including those studies discussing chronic pancreatitis predisposing to a malignant change. These two case analyses illustrate clearly that the diagnosis for such conditions, which is simply based upon imagery or pathological considerations may end up being one of a mistaken malignancy. Some of our suggestions for the treatment of such malignancies as revealed herein include,total pancreatomy for univocal mass lesion, and needle aspiration of lesion-contained tissue for amylase, CA199and CEA levels for a suspicious cystic pancreatic mass.

  4. A novel distinguishing system for the diagnosis of malignant pancreatic cystic neoplasm

    Shen, Xiaoyong, E-mail: shanlixinc@163.com [Department of Radiology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou (China); Lu, Di, E-mail: lcyxld@126.com [Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou (China); Xu, Xiao, E-mail: zdyyxx@163.com [Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou (China); Wang, Jianguo, E-mail: 21118059@zju.edu.cn [Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou (China); Wu, Jian, E-mail: drwujian@hotmail.com [Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou (China); Yan, Sheng, E-mail: shengyan@zju.edu.cn [Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou (China); Zheng, Shu-sen, E-mail: zyzss@zju.edu.cn [Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou (China)

    2013-11-01

    Purpose: To explore a simple and reliable non-invasive distinguishing system for the pre-operative evaluation of malignancy in pancreatic cystic neoplasm (PCN). Methods: This study first enrolled an observation cohort of 102 consecutive PCN patients. Demographic information, results of laboratory examinations, and computed tomography (CT) presentations were recorded and analyzed to achieve a distinguishing model/system for malignancy. A group of 21 patients was then included to validate the model/system prospectively. Results: Based on the 11 malignancy-related features identified by univariate analysis, a distinguishing model for malignancy in PCN was established by multivariate analysis: PCN malignant score = 2.967 × elevated fasting blood glucose (FBG) (≥6.16 mmol/L) ± 4.496 × asymmetrically thickened wall (or mural nodules ≥ 4 mm) ± 1.679 × septum thickening (≥2 mm) − 5.134. With the optimal cut-off value selected as −2.8 in reference to the Youden index, the proposed system for malignant PCN was established: septum thickening (>2 mm), asymmetrically thickened wall (or mural nodules > 4 mm), or elevated FBG (>6.16 mmol/L, accompanying commonly known malignant signs), the presence of at least one of these 3 features indicated malignancy in PCN. The accuracy, sensitivity and specificity of this system were 81.4%, 95.8% and 76.9%, respectively. MRI was performed on 32 patients, making correct prediction of malignancy explicitly in only 68.8% (22/32). The subsequent prospective validation study showed that the proposed distinguishing system had a predictive accuracy of 85.7% (18/21). Moreover, a higher model score, or aggregation of the features in the proposed system, indicated a higher grade of malignancy (carcinoma) in PCN. Conclusion: Elevated FBG (>6.16 mmol/L), asymmetrically thickened wall (or mural nodules > 4 mm) and septum thickening (>2 mm) are of great value in differentiating the malignancy in PCN. The developed distinguishing system is

  5. O-GlcNAcylation enhances anaplastic thyroid carcinoma malignancy.

    Cheng, Y U; Li, Honglun; Li, Jianlin; Li, Jisheng; Gao, Yan; Liu, Baodong

    2016-07-01

    O-linked N-acetylglucosamine (O-GlcNAc) glycosylation (O-GlcNAcylation), a dynamic post-translational modification of nuclear and cytoplasmic proteins, may have a critical role in the regulation of biological cell processes and human cancer. O-GlcNAcylation is dynamically regulated by O-GlcNAc transferase (OGT) and O-GlcNAc hydrolase (OGA). Accumulating evidence suggests that O-GlcNAcylation is involved in a variety of types of human cancer. However, the exact role of O-GlcNAcylation in tumor pathogenesis or progression remains to be established. Computed tomography scans of patients with anaplastic thyroid carcinoma (ATC) reveal a rapid growth rate and invasion. The present study demonstrated that O-GlcNAcylation accelerates the progression of ATC. The global O-GlcNAc level of intracellular proteins was increased by overexpression of OGT or downregulation of OGA activity with the specific inhibitor Thiamet-G. By contrast, the global O-GlcNAc level was decreased by silencing of OGT. MTT assay indicated that O-GlcNAcylation significantly promotes cell proliferation. Furthermore, O-GlcNAcylation enhanced cellular biological functions, such as colony formation ability, migration and invasion, of ATC cells in vitro. The findings of the present study suggest that O-GlcNAcylation is associated with malignant properties of thyroid cancer, and may be a potential target for the diagnosis and treatment of thyroid cancer.

  6. NEOPLASMS

    1995-01-01

    950253 The characteristics of bone metastatic tumorsin the elderly-a report of 163 cases.LI Xiaoying(李小鹰),et al.General Hosp,PLA,Beijing,100853.ChinJ Geriatr 1994;13(6):333-334.A study of bone metastatic tumors(BMT) was car-ried out in 163 cases with age of 60 years and over.The characteristics of BMT in the elderly were as fol-lows:1.the elderly patients with BMT made up 7.9percent of all the patients with primary malignant tu-

  7. A novel BAP1 mutation is associated with melanocytic neoplasms and thyroid cancer.

    McDonnell, Kevin J; Gallanis, Gregory T; Heller, Kathleen A; Melas, Marilena; Idos, Gregory E; Culver, Julie O; Martin, Sue-Ellen; Peng, David H; Gruber, Stephen B

    2016-03-01

    Germline mutations in the tumor suppressor gene, BRCA-1 associated protein (BAP1), underlie a tumor predisposition syndrome characterized by increased risk for numerous cancers including uveal melanoma, melanocytic tumors and mesothelioma, among others. In the present study we report the identification of a novel germline BAP1 mutation, c.1777C>T, which produces a truncated BAP1 protein product and segregates with cancer. Family members with this mutation demonstrated a primary clinical phenotype of autosomal dominant, early-onset melanocytic neoplasms with immunohistochemistry (IHC) of these tumors demonstrating lack of BAP1 protein expression. In addition, family members harboring the BAP1 c.1777C>T germline mutation developed other neoplastic disease including thyroid cancer. IHC analysis of the thyroid cancer, as well, demonstrated loss of BAP1 protein expression. Our investigation identifies a new BAP1 mutation, further highlights the relevance of BAP1 as a clinically important tumor suppressor gene, and broadens the range of cancers associated with BAP1 inactivation. Further study will be required to understand the full scope of BAP1-associated neoplastic disease.

  8. The diagnostic value of multiple tumor markers in malignant ovarian neoplasms

    Wang Xiaoli; Zhang Youzhong; Cui Baoxia; Jiang Jianting

    2005-01-01

    Objective:To study the diagnostic value of multiple tumor markers in malignant ovarian neoplasm.Methods:Sera obtained from 430 patients with ovarian masses (110 cases were malignant ovarian tumors,320 cases were benign ovarian tumors) before operation,and from 50 healthy women as control.Serologic examination of tumor markers included CA125,TSGF,SA,CEA,AFP,HCG and Fer.Results:The serum levels of CA125,TSGF,SA and Fer in patients with ovarian cancer were higher than those in patients with benign ovarian tumors (P<0.05),also in control group (P<0.05).In the diagnostic value of application for malignant ovarian neoplasm,CA125,TSGF and SA were better than the others.The sensitivity,specificity and accuracy in diagnosis of ovarian cancer were 86.4%,82.8%and 83.7% respectively for CA125 alone,78.2%,81.3%and 80.5% for TSGF alone,74.5%,81.9%and 80.0% for SA alone,whereas 95.5%,45.6%and 58.4% for multiple tumor markers combined in which 1 or more indices showed positive,93.6%,80.6%and 84.0% for that in which 2 or more indices showed positive,and 87.3%,90.3%and 89.5% for that in which 3 or more indices show positive.Conclusion:multiple tumor markers examination could improve the diagnosis of ovarian cancer,and examination of CA125,TSGF and SA combined is most ideal.

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

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

    2011-10-15

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

  10. Multiple primary malignant neoplasms of three early cancer lesions: a case report

    ZHANG Wan-jun; Sumio Watanabe; QIAN Xiao-ping; SHI Yu; PAN Wen-sheng; XU Xiang; YE Zai-yuan; WU Liang-qin; Takeshi Terai; Nobuhiro Sato

    2011-01-01

    Multiple primary malignant neoplasms (MPMNs) are rarely reported and it is important to give early diagnosis and proper therapy for these patients. Here reported a case of 62-year-old man with concomitant three early stage cancer lesions in upper gastrointestinal tract, all of which were detected by endoscopy. The first one was an llc-type lesion at angular part of stomach under endoscopy, which was histologically confirmed to be a mucosal well-differentiated adenocarcinoma.The patient underwent a standard radical gastrectomy for the lesion after the failure of endoscopic treatment. The other two neoplasms were observed during follow-up and were indicated as early stage lesions by synthesizing information from endoscopy, endoscopic ultrasonography, computed tomography and biopsy. One displayed as a hyperemic patch (3cm×4 cm in size) located at the part of esophagus 27 cm away from the incisor teeth and was proved to be moderately differentiated squamous cancer by histopathological examination. The other was an llc-type lesion (3.0 cm×3.5 cm in size) located at the part of esophagus 36 cm away from the incisor teeth, and the biopsy result showed a poorly differentiated squamous carcinoma. Both the two lesions were treated with radical radiation because the patient refused surgery management. No recurrence of former lesions or occurrence of novel lesions were observed during post-treatment follow-up, suggesting radical radiation might be effective for this patient.

  11. Malignant neurogenic neoplasms of the head and neck; Zlosliwe nowotwory neurogenne glowy i szyi

    Kuczkowski, J.; Starzynska, A. [Akademia Medyczna, Gdansk (Poland)

    1996-12-31

    The authors present 17 cases of malignant neurogenic neoplasms of the head and neck observed in the Department of Otolaryngology in the years 1948-1993. The latest opinions on etiopathology, diagnosis and treatment of these tumors were described. Age and sex of patients, localization of tumor, symptoms histopathology and treatment were analyzed. Progressions of the disease were estimated retrospectively. It has been proved that these tumors develop quickly, give pain and paresthesia. Their diagnosis is very difficult because of their submucosal growth and difficult histopathological interpretation. A characteristic feature of these neurogenic tumors is the ability to give distant metastases. This feature differentiates them from squamous neoplasms, which give mainly nodal metastases. All the patients were subjected to surgery combined with conventional or high voltage radiotherapy. The positive effect of combined chemotherapy in cases of esthesioneuroblastoma is worthy of note. The prognosis in these tumors is often unfavorable. In the group under discussion 13 patients died because of recurrences, two patients are considered to be cured and the remaining 2 patients have had no recurrence for 2 and 3 years. (author) 15 refs, 2 figs, 2 tabs

  12. Voluminous Incidental Oncocytic Neoplasm of the Adrenal Gland With Uncertain Malignant Potential

    Marouene Chakroun

    2016-09-01

    Full Text Available A 74-year-old man presented with right flank pain and a palpable mass in the left flank. Blood pressure was normal. Contrastenhanced computed tomography (CT showed a 17 × 16 × 12 cm retroperitoneal mass over the left kidney, solid and heterogeneous. There were also 3 retro aortic lymph nodes and bilateral renal lithiasis. Twenty four-hour urinary metanephrines and normetanephrines were normal. The patient underwent a resection of the mass with left adrenalectomy by a lumbar incision. Histological findings revealed an adrenal oncocytic neoplasm (AON with uncertain malignant potential. Six months after surgery, CT control showed neither local nor distant recurrence.

  13. Second Malignant Neoplasms in Childhood Cancer Survivors Treated in a Tertiary Paediatric Oncology Centre.

    Lim, Jia Wei; Yeap, Frances Sh; Chan, Yiong Huak; Yeoh, Allen Ej; Quah, Thuan Chong; Tan, Poh Lin

    2017-01-01

    Introduction: One of the most feared complications of childhood cancer treatment is second malignant neoplasms (SMNs). This study evaluates the incidence, risk factors and outcomes of SMNs in a tertiary paediatric oncology centre in Singapore. Materials and Methods: A retrospective review was conducted on patients diagnosed with childhood cancer under age 21 and treated at the National University Hospital, Singapore, from January 1990 to 15 April 2012. Case records of patients with SMNs were reviewed. Results: We identified 1124 cases of childhood cancers with a median follow-up of 3.49 (0 to 24.06) years. The most common primary malignancies were leukaemia (47.1%), central nervous system tumours (11.7%) and lymphoma (9.8%). Fifteen cases developed SMNs, most commonly acute myeloid leukaemia/myelodysplastic syndrome (n = 7). Median interval between the first and second malignancy was 3.41 (0.24 to 18.30) years. Overall 20-year cumulative incidence of SMNs was 5.3% (95% CI, 0.2% to 10.4%). The 15-year cumulative incidence of SMNs following acute lymphoblastic leukaemia was 4.4% (95% CI, 0% to 8.9%), significantly lower than the risk after osteosarcoma of 14.2% (95% CI, 0.7% to 27.7%) within 5 years (P <0.0005). Overall 5-year survival for SMNs was lower than that of primary malignancies. Conclusion: This study identified factors explaining the epidemiology of SMNs described, and found topoisomerase II inhibitor use to be a likely risk factor in our cohort. Modifications have already been made to our existing therapeutic protocols in osteosarcoma treatment. We also recognised the importance of other risk management strategies, including regular long-term surveillance and early intervention for detected SMNs, to improve outcomes of high risk patients.

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

    So Hyun Park

    2014-01-01

    Full Text Available

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

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

    Park, So Hyun [Dept. of Radiology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul (Korea, Republic of); Ryu, Chang Woo; Kim, Gou Young; Shim, Kye Shik [Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul (Korea, Republic of)

    2014-03-15

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

  16. Shear wave elastography of thyroid nodules for the prediction of malignancy in a large scale study

    Park, Ah Young; Son, Eun Ju [Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul (Korea, Republic of); Han, Kyunghwa [Biostatistics Collaboration Unit, Gangnam Medical Research Center, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul (Korea, Republic of); Youk, Ji Hyun [Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul (Korea, Republic of); Kim, Jeong-Ah, E-mail: chrismd@hanmail.net [Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul (Korea, Republic of); Park, Cheong Soo [Department of Surgery, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul (Korea, Republic of)

    2015-03-15

    Highlights: •Elasticity indices of malignant thyroid nodules were higher than those of benign. •High elasticity indices were the independent predictors of thyroid malignancy. •SWE evaluation could be useful as adjunctive tool for thyroid cancer diagnosis. -- Abstract: Objectives: The purpose of this study is to validate the usefulness of shear wave elastography (SWE) in predicting thyroid malignancy with a large-scale quantitative SWE data. Methods: This restrospective study included 476 thyroid nodules in 453 patients who underwent gray-scale US and SWE before US-guided fine-needle aspiration biopsy (US-FNA) or surgical excision were included. Gray-scale findings and SWE elasticity indices (EIs) were retrospectively reviewed and compared between benign and malignant thyroid nodules. The optimal cut-off values of EIs for predicting malignancy were determined. The diagnostic performances of gray-scale US and SWE for predicting malignancy were analyzed. The diagnostic performance was compared between the gray-scale US findings only and the combined use of gray-scale US findings with SWEs. Results: All EIs of malignant thyroid nodules were significantly higher than those of benign nodules (p ≤ .001). The optimal cut-off value of each EI for predicting malignancy was 85.2 kPa of E{sub mean}, 94.0 kPa of E{sub max}, 54.0 kPa of E{sub min}. E{sub mean} (OR 3.071, p = .005) and E{sub max} (OR 3.015, p = .003) were the independent predictors of thyroid malignancy. Combined use of gray-scale US findings and each EI showed elevated sensitivity (95.0–95.5% vs 92.9%, p ≤ .005) and AUC (0.820–0.834 vs 0.769, p ≤ .005) for predicting malignancy, compared with the use of only gray-scale US findings. Conclusions: Quantitative parameters of SWE were the independent predictors of thyroid malignancy and SWE evaluation combined with gray-scale US was adjunctive to the diagnostic performance of gray-scale US for predicting thyroid malignancy.

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

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

    2013-09-01

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

  18. Evaluation of Diagnostic Efficiency of Ultrasound Features on Malignant Thyroid Nodules in Chinese Patients

    Ru-Qiang Li

    2016-01-01

    Conclusions: We should be alert with taller-than-wide shape and microcalcifications. Intranodular flow was a weak predictor of malignancy. According to Youden indexes and ROC analysis, irregular margins and hypoechogenicity combined with solid component or taller-than-wide shapes or microcalcifications have a high predicative value for malignant thyroid nodules in Chinese patients.

  19. Metastatic malignant struma ovarii with coexistence of Hashimoto’s thyroiditis

    Russo, Marco; Marturano, Ilenia; Masucci, Romilda; Caruso, Melania; Fornito, Maria Concetta; Tumino, Dario; Tavarelli, Martina; Squatrito, Sebastiano

    2016-01-01

    Summary Struma ovarii is a rare ovarian teratoma characterized by the presence of thyroid tissue as the major component. Malignant transformation of the thyroidal component (malignant struma ovarii) has been reported in approximately 5% of struma ovarii. The management and follow-up of this unusual disease remain controversial. We report the case of a woman with a history of autoimmune thyroiditis and a previous resection of a benign struma ovarii that underwent hystero-annexiectomy for malignant struma ovarii with multiple papillary thyroid cancer foci and peritoneal involvement. Total thyroidectomy and subsequent radioiodine treatment lead to complete disease remission after 104 months of follow-up. The diagnosis and natural progression of malignant struma ovarii are difficult to discern, and relapses can occur several years after diagnosis. A multidisciplinary approach is mandatory; after surgical excision of malignant struma, thyroidectomy in combination with 131I therapy should be considered after risk stratification in accordance with a standard approach in differentiated thyroid cancer patients. Learning points Malignant struma ovarii is a rare disease; diagnosis is difficult and management is not well defined. Predominant sites of metastasis are adjacent pelvic structures. Thyroidectomy and 131I therapy should be considered after risk stratification in accordance with standard approaches in DTC patients. PMID:27224256

  20. Squamous cell carcinoma of esophagus masquerading as solitary thyroid nodule

    Basu S

    2005-01-01

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

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

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

    1984-07-01

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

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

    Taddei, Phillip J; Howell, Rebecca M; Krishnan, Sunil; Scarboro, Sarah B; Mirkovic, Dragan; Newhauser, Wayne D, E-mail: ptaddei@mdanderson.or [Division of Radiation Oncology, Unit 1202, University of Texas M D Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030 (United States)

    2010-12-07

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

  3. The epidemiology of malignant neoplasms of the stomach in Canada during the period 1931-1984.

    Ayiomamitis, A

    1988-01-01

    Morbidity patterns in Canada for malignant neoplasms of the stomach were examined for the period 1970-1980 and mortality patterns for the period 1931-1984. Age-standardized morbidity rates (ASMR) have declined significantly in males (p = 0.011) and females (p = 0.0011) during the period studied by, on average, 0.20 fewer new cases per 100,000 population per yr. The significant declines in ASMRs are attributable to significant declines in age-specific rates for males aged 35-44 (p = 0.013) and 55-64 (p = 0.046) and females aged 55-64, 65-74, and 75-84 yr (p less than 0.015). Significant declines in age-standardized death rates (ASDR) have also occurred in both males and females (p = 0.0001), with 15 of the 16 age-sex groups studied showing significant rates of decline (p less than 0.0005). The greatest rates of decline were noted for males and females aged 75-84, where age-specific rates have declined by more than 4.2 deaths per 100,000 population per yr since 1931.

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

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

    2010-12-01

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

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

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

    1984-07-01

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

  6. Role of Duplex Power Doppler Ultrasound in Differentiation between Malignant and Benign Thyroid Nodules

    Algin, Oktay [Ataturk Training and Research Hospital Bilkent, Ankara (Turkmenistan); Algin, Efnan [Gazi University Medical Faculty, Ankara (Turkmenistan); Gokalp, Gokhan; Ocakog, Gokhan; Erdog an, Cuneyt; Saraydaroglu, Ozlem; Ercan Tuncel, Prof [Uludag University Medical Faculty, Bursa (Turkmenistan)

    2010-12-15

    To evaluate the usage of duplex power Doppler ultrasound (PDUS) for the differentiation of benign and malignant thyroid nodules. We prospectively examined 77 thyroid nodules in 60 patients undergoing ultrasound-guided fine needle aspiration biopsy (FNAB). Each nodule was described according to size, inner structure, borders, parenchymal echogenicity, peripheral halo formation, and the presence of calcification (Bmode ultrasound findings). Vascularity as determined by PDUS imaging was defined as non-vascular, peripheral, central, or of mixed type. For each nodule, the pulsatility index (PI) and resistive index (RI) values were obtained. Results of FNAB and surgical pathological examination (if available) were used as a proof of final diagnosis to categorize all nodules as benign or malignant. A receiver operating characteristic (ROC) curve analysis was performed to establish cut-off, sensitivity, and specificity values associated with RI-PI values. A significant relationship was observed between malignancy and irregular margins, microcalcifications, and hypoechogenicity on ultrasound examination (p < 0.05). The pattern of vascularity as determined by PDUS analysis was not a statistically significant criterion to suggest benign or malignant disease in this study (p > 0.05). The central, peripheral, and mean RI-PI values were higher in malignant nodules when compared to the other cytologies (p < 0.05). Vascularity is not a useful parameter for distinguishing malignant from benign thyroid nodules. However, RI and PI values are useful in distinguishing malignant from benign thyroid nodules

  7. Value of thyroid nodule ultrasonic strain elastography quantitative analysis in judging benignancy or malignancy of nodules

    Hai-Yun Zhao; Hai-Xia Liu; Wei Tong; Jin-Zhong Huang; Chun Xiang

    2016-01-01

    Objective:To analyze the value of thyroid nodule ultrasonic strain elastography quantitative analysis in judging benignancy or malignancy of nodules.Methods: Patients diagnosed with thyroid nodule and receiving ultrasonic strain elastography quantitative analysis in our hospital were selected for study and divided into benign group and malignant group according to fine needle biopsy or the pathological results after surgical resection; mean strain values of quantitative indicators, blue region area and disorder of ultrasonic strain elastography, expression levels of malignant biological molecules in nodule tissue as well as the contents of serum tumor markers were detected.Results:Mean strain value of malignant group was lower than that of benign group, blue region area and disorder were higher than those of benign group, and standard deviation, complexity, kurtosis, skewness, contrast, equality, consistency and correlation were without significant differences; mRNA contents ofFascin-1, S100A4, STAT3, TC-1, MUC1 andMUC15 in thyroid nodules as well as serum Midkine, Galectin-3, CEACAM1 and TFF3 contents of malignant group were significantly higher than those of benign group, negatively correlated with mean strain value and positively correlated with blue region area and disorder.Conclusions:Mean strain values of quantitative indicators, blue region area and disorder of thyroid nodule ultrasonic strain elastography can judge benign or malignant nodules and assess the malignant degree.

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

    Benisvy Danielle

    2009-04-01

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

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

    Kristensen Annemarie T

    2009-12-01

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

  10. Metastatic malignant struma ovarii with coexistence of Hashimoto’s thyroiditis

    Marco Russo

    2016-05-01

    Full Text Available Struma ovarii is a rare ovarian teratoma characterized by the presence of thyroid tissue as the major component. Malignant transformation of the thyroidal component (malignant struma ovarii has been reported in approximately 5% of struma ovarii. The management and follow-up of this unusual disease remain controversial. We report the case of a woman with a history of autoimmune thyroiditis and a previous resection of a benign struma ovarii that underwent hystero-annexiectomy for malignant struma ovarii with multiple papillary thyroid cancer foci and peritoneal involvement. Total thyroidectomy and subsequent radioiodine treatment lead to complete disease remission after 104 months of follow-up. The diagnosis and natural progression of malignant struma ovarii are difficult to discern, and relapses can occur several years after diagnosis. A multidisciplinary approach is mandatory; after surgical excision of malignant struma, thyroidectomy in combination with 131I therapy should be considered after risk stratification in accordance with a standard approach in differentiated thyroid cancer patients.

  11. Real-Time US Diagnosis for Perithyroidal Invasion of Thyroid Malignancy

    Heo, Young Jin; Kim, Dong Wook [Dept. of Radiology, Busan Paik Hospital, Inje University School of Medicine, Busan (Korea, Republic of)

    2011-07-15

    To assess the diagnostic accuracy of real-time ultrasound (US) for perithyroidal invasion of thyroid malignancy. From January 2009 to December 2009, real-time US was performed on malignant thyroid nodules (largest diameter {>=} 10 mm) located in the isthmus or attached to the adjacent tracheal wall, by a single radiologist who prospectively determined the presence or absence of perithyroidal invasion. Of the 60 malignant thyroid nodules examined, intraglandular location (n = 0), capsular attachment with clear perithyroidal fat (n = 15), perithyroidal fat infiltration without tracheal invasion (n = 43), and tracheal invasion (n = 2) were prospectively determined. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of real-time US diagnosis for perithyroidal invasion were 80%, 90%, 94.1%, 69.2% and 83.3%, respectively when the pathological result was used as reference standard. Real-time US accuracies for intraglandular location, capsular attachment with clear perithyroidal fat, perithyroidal fat infiltration without tracheal invasion, and tracheal invasion were 76.6%, 53.3%, 51.7%, and 85.0%, respectively. The results of the real-time US diagnoses indicate that this method may be useful for diagnosing perithyroidal invasion of thyroid malignancies. Hence, further research is needed to prove the use of diagnosing perithyroidal invasion of thyroid malignancies.

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

    Eduardo Cambruzzi

    2013-02-01

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

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

    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.

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

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

    2014-04-01

    Malignant peripheral nerve sheath tumors (MPNST) derive from the Schwann cell or perineurial cell lineage and occur either sporadically or in association with the tumor syndrome neurofibromatosis type 1 (NF1). MPNST often pose a diagnostic challenge due to their frequent lack of pathognomonic morphological or immunohistochemical features. Mutations in the NF1 tumor suppressor gene are found in all NF1-associated and many sporadic MPNST. The presence of NF1 mutation may have the potential to differentiate MPNST from several morphologically similar neoplasms; however, mutation detection is hampered by the size of the gene and the lack of mutational hot spots. Here we describe a newly developed monoclonal antibody binding to the C-terminus of neurofibromin (clone NFC) which was selected for optimal performance in routinely processed formalin-fixed and paraffin-embedded tissue. NFC immunohistochemistry revealed loss of neurofibromin in 22/25 (88 %) of NF1-associated and 26/61 (43 %) of sporadic MPNST. There was a strong association of neurofibromin loss with deletions affecting the NF1 gene (P < 0.01). In a series of 256 soft tissue tumors of different histotypes NFC staining showed loss of neurofibromin in 2/8 myxofibrosarcomas, 2/12 (16 %) pleomorphic liposarcomas, 1/16 (6 %) leiomyosarcomas, and 4/28 (14 %) unclassified undifferentiated pleomorphic sarcomas. However, loss of neurofibromin was not observed in 22 synovial sarcomas, 27 schwannomas, 23 solitary fibrous tumors, 14 low-grade fibromyxoid sarcomas, 50 dedifferentiated liposarcomas, 27 myxoid liposarcomas, 13 angiosarcomas, 9 extraskeletal myxoid chondrosarcomas, and 7 epitheloid sarcomas. Immunohistochemistry using antibody NFC may substantially facilitate sarcoma research and diagnostics.

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

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

    2013-01-01

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

  16. Dual malignancy in adolescence: A rare case report of metachronous papillary carcinoma of thyroid following dysgerminoma of ovary

    Suvadip Chakrabarti

    2016-01-01

    Full Text Available Dual malignancy is rare in adolescents. Dual malignancy with the second malignancy of thyroid is rare. No association has been reported between dysgerminoma of ovary and carcinoma thyroid in medical literature. Despite a thorough PubMed search (key words - Papillary carcinoma of thyroid, metachronous, dysgerminoma ovary, we were unable to find a previous reported case of metachronous papillary carcinoma of thyroid (PTC following dysgerminoma of the ovary. After surgery, the patient is being regularly followed up for recurrence/development of new primary. We report this unusual and rare case in a 17-year-old female patient.

  17. Expression of alpha-methylacyl-CoA racemase (P504s) in various malignant neoplasms and normal tissues: astudy of 761 cases.

    Jiang, Zhong; Fanger, Gary R; Woda, Bruce A; Banner, Barbara F; Algate, Paul; Dresser, Karen; Xu, Jiangchun; Chu, Peiguo G

    2003-08-01

    Alpha-methylacyl CoA racemase (AMACR), also known as P504S, plays an important role in peroxisomal beta-oxidation of branched-chain fatty acids. It has recently been shown that AMACR is highly expressed in prostate cancer and that it may be an important diagnostic marker for prostate carcinoma. However, little is known about expression of AMACR in normal tissues and other malignant tumors. In this study, we investigated expression of AMACR in 539 malignant tumors and 222 normal human tissues of various types by immunohistochemical analysis. mRNA levels of AMACR in normal organs and in selected tumors were assessed by real time PCR. In normal tissue, high expression of AMACR mRNA was identified in liver, kidney and salivary gland, while AMACR protein was detected in liver (hepatocytes), kidney (tubular epithelial cells), lung (only bronchial epithelial cells), and gallbladder (only mucosal epithelial cells). High expression of AMACR mRNA was found in prostate, liver, and kidney cancers but rarely in stomach and bladder cancers. A high percent of adenocarcinomas arising from these organs express AMACR, including 17 of 21 (81%) of hepatocellular carcinomas and 18 of 24 (75%) of renal cell carcinomas. In addition, carcinomas arising from tissues normally not expressing AMACR were also positive for the antigen, including 17 of 18 (94%) prostate carcinomas, 9 of 29 (31%) of urothelial carcinomas, and 4 of 15 (27%) of gastric adenocarcinomas. Two hundred and fifty cases of adenocarcinomas from lung, breast, pancreas, bile duct, adrenal gland, salivary gland, ovary, thyroid and endometrium were negative or rarely positive for AMACR. Neuroendocrine carcinomas rarely expressed AMACR. Melanomas, squamous cell carcinomas, basal cell carcinomas, soft tissue tumors (including epithelioid sarcomas and synovial sarcoma), thymomas, and germ cell tumors were negative for AMACR. Our data provide important baseline information for using AMACR in clinical practice and also are valuable

  18. Implications of imaging criteria for the management and treatment of intraductal papillary mucinous neoplasms - benign versus malignant findings

    Walter, Thula Cannon; Steffen, Ingo G.; Stelter, Lars H.; Hamm, Bernd; Denecke, Timm; Grieser, Christian [Charite - Universitaetsmedizin Berlin, Klinik fuer Radiologie, Campus Virchow-Klinikum, Berlin (Germany); Maurer, Martin H. [Universitaetsklinik Bern, Universitaetsinstitut fuer Radiologe, Inselspital, Bern (Switzerland); Bahra, Marcus; Faber, Wladimir; Klein, Fritz [Charite - Universitaetsmedizin Berlin, Klinik fuer Allgemein-, Viszeral- und Transplantationschirurgie Campus Virchow-Klinikum, Berlin (Germany); Blaeker, Hendrik [Charite - Universitaetsmedizin Berlin, Institut fuer Pathologie, Campus Charite Mitte, Berlin (Germany)

    2015-05-01

    Evaluation of computed tomography (CT) and magnetic resonance imaging (MRI) for differentiation of pancreatic intraductal papillary mucinous neoplasm (IPMN) subtypes based on objective imaging criteria. Fifty-eight patients with 60 histologically confirmed IPMNs were included in this retrospective study. Eighty-three imaging studies (CT,n = 42; MRI,n = 41) were analysed by three independent blinded observers (O1-O3), using established imaging criteria to assess likelihood of malignancy (-5, very likely benign; 5, very likely malignant) and histological subtype (i.e., low-grade (LGD), moderate-grade (MGD), high-grade dysplasia (HGD), early invasive carcinoma (IPMC), solid carcinoma (CA) arising from IPMN). Forty-one benign (LGD IPMN,n = 20; MGD IPMN,n = 21) and 19 malignant (HGD IPMN,n = 3; IPMC,n = 6; solid CA,n = 10) IPMNs located in the main duct (n = 6), branch duct (n = 37), or both (n = 17) were evaluated. Overall accuracy of differentiation between benign and malignant IPMNs was 86/92 % (CT/MRI). Exclusion of overtly malignant cases (solid CA) resulted in overall accuracy of 83/90 % (CT/MRI). The presence of mural nodules and ductal lesion size ≥30 mm were significant indicators of malignancy (p = 0.02 and p < 0.001, respectively). Invasive IPMN can be identified with high confidence and sensitivity using CT and MRI. The diagnostic problem that remains is the accurate radiological differentiation of premalignant and non-invasive subtypes. (orig.)

  19. Thyroid nodules with minimal cystic changes have a low risk of malignancy

    Na, Dong Gyu; Kim, Dae Sik; Kim, Soo Jin [Dept. of Radiology, Human Medical Imaging and Intervention Center, Seoul (Korea, Republic of); Kim, Ji Hoon [Dept. of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2016-03-15

    The goal of this study was to determine the risk of malignancy of thyroid nodules with minimal cystic changes. A total of consecutive 1,000 thyroid nodules (≥1 cm) with final diagnoses from two institutions were included in this study. The risk of malignancy of thyroid nodules was analyzed according to the internal content, which was categorized as purely solid, minimally cystic (cystic changes ≤10%), and partially cystic (cystic changes >10%). We also assessed the risk of malignancy of nodules with minimal cystic changes depending on echogenicity and presence of any suspicious ultrasonografic (US) features. The overall frequency of purely solid, minimally cystic, and partially cystic nodules was 730/1,000 (73%), 61/1,000 (6.1%), and 209/1,000 (20.9%), respectively, with risks of malignancy of 14.8% (108/730), 3.3% (2/61), and 3.3% (7/209), respectively. The risk of malignancy of nodules with minimal cystic changes was significantly lower than that of purely solid nodules (P=0.013). The risk of malignancy of nodules with minimal cystic changes was also lower than that of purely solid nodules in the group of hypoechoic nodules (P=0.063) and in the group of nodules with suspicious US features (P=0.028), but was not significantly different from that of partially cystic nodules regardless of echogenicity or the presence of suspicious US features (P≥0.652). Thyroid nodules with minimal cystic changes have a low risk of malignancy, similar to that of partially cystic nodules regardless of echogenicity or the presence of suspicious US features. The US lexicon could define solid nodules as nodules with purely solid internal content in order to enhance the accuracy of estimated risks of malignancy.

  20. Inter-Institutional Comparison of Personalized Risk Assessments for Second Malignant Neoplasms for a 13-Year-Old Girl Receiving Proton versus Photon Craniospinal Irradiation

    Taddei, Phillip J., E-mail: pt06@aub.edu.lb [Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Unit 1202, 1515 Holcombe Blvd, Houston, TX 77030 (United States); The University of Texas Graduate School of Biomedical Sciences at Houston, P.O. Box 20334, Houston, TX 77225 (United States); Department of Radiation Oncology, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El Solh, Beirut 1107 2020 (Lebanon); Khater, Nabil [Department of Radiation Oncology, Hôtel-Dieu de France Hospital, University of St. Joseph, P.O. Box 166830, Alfred Naccache Blvd, Beirut (Lebanon); Zhang, Rui [Medical Physics Program, Department of Physics and Astronomy, Louisiana State University, 202 Nicholson Hall, Tower Dr., Baton Rouge, LA 70803 (United States); Department of Physics, Mary Bird Perkins Cancer Center, 4950 Essen Lane, Baton Rouge, LA 70809 (United States); Geara, Fady B. [Department of Radiation Oncology, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El Solh, Beirut 1107 2020 (Lebanon); Mahajan, Anita [Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Unit 1202, 1515 Holcombe Blvd, Houston, TX 77030 (United States); The University of Texas Graduate School of Biomedical Sciences at Houston, P.O. Box 20334, Houston, TX 77225 (United States); Jalbout, Wassim [Department of Radiation Oncology, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El Solh, Beirut 1107 2020 (Lebanon); Pérez-Andújar, Angélica [Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Unit 1202, 1515 Holcombe Blvd, Houston, TX 77030 (United States); Youssef, Bassem [Department of Radiation Oncology, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El Solh, Beirut 1107 2020 (Lebanon); Newhauser, Wayne D. [Medical Physics Program, Department of Physics and Astronomy, Louisiana State University, 202 Nicholson Hall, Tower Dr., Baton Rouge, LA 70803 (United States); Department of Physics, Mary Bird Perkins Cancer Center, 4950 Essen Lane, Baton Rouge, LA 70809 (United States)

    2015-03-10

    Children receiving radiotherapy face the probability of a subsequent malignant neoplasm (SMN). In some cases, the predicted SMN risk can be reduced by proton therapy. The purpose of this study was to apply the most comprehensive dose assessment methods to estimate the reduction in SMN risk after proton therapy vs. photon therapy for a 13-year-old girl requiring craniospinal irradiation (CSI). We reconstructed the equivalent dose throughout the patient’s body from therapeutic and stray radiation and applied SMN incidence and mortality risk models for each modality. Excluding skin cancer, the risk of incidence after proton CSI was a third of that of photon CSI. The predicted absolute SMN risks were high. For photon CSI, the SMN incidence rates greater than 10% were for thyroid, non-melanoma skin, lung, colon, stomach, and other solid cancers, and for proton CSI they were non-melanoma skin, lung, and other solid cancers. In each setting, lung cancer accounted for half the risk of mortality. In conclusion, the predicted SMN risk for a 13-year-old girl undergoing proton CSI was reduced vs. photon CSI. This study demonstrates the feasibility of inter-institutional whole-body dose and risk assessments and also serves as a model for including risk estimation in personalized cancer care.

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

    Pui-Jen Tsai

    2011-01-01

    Spatial analytical techniques and models are often used in epidemiology to identify spatial anomalies (hotspots) in disease regions.These analytical approaches can be used to identify not only the location of such hotspots,but also their spatial patterns.We used spatial autocorrelation methodologies,including Global Moran's I and Local Getis-Ord statistics,to describe and map spatial clusters and areas in which nine malignant neoplasms are situated in Taiwan.In addition,we used a logistic regression model to test the characteristics of similarity and dissimilarity between males and females and to formulate the common spatial risk.The mean found by local spatial autocorrelation analysis was used to identify spatial cluster patterns.We found a significant relationship between the leading malignant neoplasms and welldocumented spatial risk factors.For instance,in Taiwan,the geographic distribution of clusters where oral cavity cancer in males is prevalent was closely correspond to the locations in central Taiwan with serious metal pollution.In females,clusters of oral cavity cancer were closely related with aboriginal townships in eastern Taiwan,where cigarette smoking,alcohol drinking,and betel nut chewing are commonplace.The difference between males and females in the spatial distributions was stark.Furthermore,areas with a high morbidity of gastric cancer were clustered in aboriginal townships where the occurrence of Helicobacter pylori is frequent.Our results revealed a similarity between both males and females in spatial pattern.Cluster mapping clarified the spatial aspects of both internal and external correlations for the nine malignant neoplasms.In addition,using a method of logistic regression also enabled us to find differentiation between gender-specific spatial patterns.

  2. A Prospective Study to Evaluate the Reliability of Thyroid Imaging Reporting and Data System in Differentiation between Benign and Malignant Thyroid Lesions

    M Naren Satya Srinivas

    2016-01-01

    Full Text Available Objectives: To evaluate diagnostic reliability of the daily use of thyroid imaging reporting and data system (TIRADS classification proposed by Kwak et al., in differentiating between a benign and a malignant thyroid lesion, to calculate inter-observer variability in the interpretation of each of the TIRADS ultrasound features and to evaluate role of TIRADS system in reducing unnecessary biopsies of benign lesions. Materials and Methods: Three hundred and sixty-five patients with clinically suspected thyroid lesions during the period from November 1, 2011, to August 31, 2015, were prospectively scanned on gray-scale and Doppler imaging by six radiologists separately. We used GE VOLUSON 730 PRO machine (GE healthcare, Milwaukee, USA equipped with a 7.5-12 MHz high-frequency linear array transducer with color and power Doppler capability. We evaluated five sonological features: Internal composition, echogenicity, margins, presence and type of calcification, and shape of the lesion. Based on the TIRADS proposed by Kwak et al., we determined categories of the thyroid lesions. The diagnostic performance of TIRADS classification system was evaluated by comparison with the fine-needle aspiration cytology (FNAC reports which were subsequently obtained after taking informed consent from the patients. All follicular neoplasms on FNAC were further followed up with excision biopsy and histology. The cytopathological report was used as the standard final diagnosis for comparison. The P value and odds ratio were determined to quantify how strongly the presence or absence of a particular ultrasound feature was associated with benignity or malignancy in the study population. The risk of malignancy was stratified for each TIRADS category-based on the total number of benign and malignant lesions in that category. Cervical lymph nodes were also evaluated for their size, loss of the central, echogenic hilum, presence of irregular and indistinct margin

  3. A Druggable TCF4- and BRD4-Dependent Transcriptional Network Sustains Malignancy in Blastic Plasmacytoid Dendritic Cell Neoplasm.

    Ceribelli, Michele; Hou, Zhiying Esther; Kelly, Priscilla N; Huang, Da Wei; Wright, George; Ganapathi, Karthik; Evbuomwan, Moses O; Pittaluga, Stefania; Shaffer, Arthur L; Marcucci, Guido; Forman, Stephen J; Xiao, Wenming; Guha, Rajarshi; Zhang, Xiaohu; Ferrer, Marc; Chaperot, Laurence; Plumas, Joel; Jaffe, Elaine S; Thomas, Craig J; Reizis, Boris; Staudt, Louis M

    2016-11-14

    Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is an aggressive and largely incurable hematologic malignancy originating from plasmacytoid dendritic cells (pDCs). Using RNAi screening, we identified the E-box transcription factor TCF4 as a master regulator of the BPDCN oncogenic program. TCF4 served as a faithful diagnostic marker of BPDCN, and its downregulation caused the loss of the BPDCN-specific gene expression program and apoptosis. High-throughput drug screening revealed that bromodomain and extra-terminal domain inhibitors (BETis) induced BPDCN apoptosis, which was attributable to disruption of a BPDCN-specific transcriptional network controlled by TCF4-dependent super-enhancers. BETis retarded the growth of BPDCN xenografts, supporting their clinical evaluation in this recalcitrant malignancy.

  4. Intraductal Papillary Mucinous Neoplasms of the Pancreas: Clinical Surveillance and Malignant Progression, Multifocality and Implications of a Field-Defect

    Helen Elaine Remotti

    2012-03-01

    Full Text Available Intraductal papillary mucinous neoplasms (IPMNs are a heterogeneous group of mucin producing cystic tumors that involve the main pancreatic duct and/or branch ducts and may be associated with invasive carcinoma. Predicting the risk of malignant transformation of an IPMN lesion can be challenging. The Sendai criteria, based in large part on radiographic imaging features, help guide surgical intervention based on the stratification of cysts into high and low risk lesions for malignancy. Invasive carcinoma may develop in the index IPMN lesion or in a separate site within the pancreas, supporting the concept of a field defect in IPMN tumorigenesis. This stresses the importance of evaluation of the entire pancreas upon diagnosis of IPMN and continued surveillance of the residual pancreas following resection. Herein, the authors summarize the data presented at the 2012 ASCO Gastrointestinal Cancers Symposium regarding prevalence and site of invasive carcinoma detected in patients undergoing surveillance for IPMN (Abstract #152.

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

    Eranga Himalee Siriweera

    2010-01-01

    Full Text Available Hashimoto's thyroiditis has been reported to be associated with many neoplastic and nonneoplastic thyroid pathologies. This retrospective study aims to determine the demographic profile of Hashimoto's thyroiditis in Sri Lankans, document ancillary pathologies in Hashimoto's thyroiditis, and determine whether there is an increased risk of occurrence of malignancies, benign neoplasms, and nonneoplastic benign lesions in Hashimoto's thyroiditis by comparing with thyroids showing multinodular goiters, follicular adenomas, and colloid nodules. The mean age of Hashimoto's thyroiditis is 43.3 years with the majority in the 41 to 60 year age group and a female to male ratio of 10.3 : 1. This study revealed a statistically significant increase of thyroid malignancies in association with Hashimoto's thyroiditis. The association of Papillary carcinoma, Non-Hodgkin's lymphoma, and Hurthle cell adenoma with Hashimoto's thyroiditis was statistically significant.

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

    Siriweera, Eranga Himalee; Ratnatunga, Neelakanthi Vajira Illangakoon

    2010-10-10

    Hashimoto's thyroiditis has been reported to be associated with many neoplastic and nonneoplastic thyroid pathologies. This retrospective study aims to determine the demographic profile of Hashimoto's thyroiditis in Sri Lankans, document ancillary pathologies in Hashimoto's thyroiditis, and determine whether there is an increased risk of occurrence of malignancies, benign neoplasms, and nonneoplastic benign lesions in Hashimoto's thyroiditis by comparing with thyroids showing multinodular goiters, follicular adenomas, and colloid nodules. The mean age of Hashimoto's thyroiditis is 43.3 years with the majority in the 41 to 60 year age group and a female to male ratio of 10.3 : 1. This study revealed a statistically significant increase of thyroid malignancies in association with Hashimoto's thyroiditis. The association of Papillary carcinoma, Non-Hodgkin's lymphoma, and Hurthle cell adenoma with Hashimoto's thyroiditis was statistically significant.

  7. Comparison of 2 monoclonal antibodies for immunohistochemical detection of BRAF V600E mutation in malignant melanoma, pulmonary carcinoma, gastrointestinal carcinoma, thyroid carcinoma, and gliomas.

    Routhier, Caitlin Ann; Mochel, Mark C; Lynch, Kerry; Dias-Santagata, Dora; Louis, David N; Hoang, Mai P

    2013-11-01

    BRAF mutation is seen in a variety of human neoplasms including cutaneous malignant melanoma, papillary thyroid carcinoma, colorectal carcinoma, non-small cell lung carcinoma, pleomorphic xanthoastrocytoma, and others. Currently, there are 2 commercially available monoclonal antibodies for the detection of BRAF V600E mutation; however, a full and practical comparison of their performance in various tumor types on an automated staining platform has not been done. We investigated their sensitivity and specificity in detecting the BRAF V600E mutation in a series of 152 tumors including 31 malignant melanomas, 25 lung carcinomas, 32 gastrointestinal carcinomas, 23 thyroid carcinomas, 35 gliomas, and 6 other malignancies. In this series, the concordance rate between immunohistochemistry (IHC) and mutational analyses was 97% (148/152) for VE1 and 88% (131/149) for anti-B-Raf. The sensitivity and specificity were 98% (60/61) and 97% (88/91) for monoclonal VE1 and 95% (58/61) and 83% (73/88) for anti-B-Raf, respectively. There were 4 cases with discordant IHC and mutational results for monoclonal VE1 in contrast to 18 cases for anti-B-Raf. Our studies showed that IHC with monoclonal VE1 has a better performance compared with anti-B-Raf in an automated staining platform and confirmed that clone VE1 provides excellent sensitivity and specificity for detecting the BRAF V600E mutation in a variety of tumor types in a clinical setting.

  8. Malignant-looking thyroid nodules with size reduction: Core needle biopsy results

    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.

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

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

    2011-11-15

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

  10. Malignant-looking thyroid nodules with size reduction: core needle biopsy results

    Ha Young Lee

    2016-10-01

    Full Text Available Purpose The aim of this study was to evaluate whether malignant-looking thyroid nodules with size reduction were malignant or not. Methods 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. Results 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. Conclusion 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. The Evolution of a Malignancy Risk Prediction Model for Thyroid Nodules Using the Artificial Neural Network

    Shahram Paydar

    2016-01-01

    Full Text Available Background: Clinically frank thyroid nodules are common and believed to be present in 4% to 10% of the adult population in the United States. In the current literature, fine needle aspiration biopsies are considered to be the milestone of a model which helps the physician decide whether a certain thyroid nodule needs a surgical approach or not. A considerable fact is that sensitivity and specificity of the fine needle aspiration varies significantly as it remains highly dependent on the operator as well as the cytologist’s skills. Practically, in the above group of patients, thyroid lobectomy/isthmusectomy becomes mandatory for attaining a definitive diagnosis where the majority (70%-80% have a benign surgical pathology. The scattered nature of clinically gathered data and analysis of their relevant variables need a compliant statistical method. The artificial neural network is a branch of artificial intelligence. We have hypothesized that conduction of an artificial neural network applied to certain clinical attributes could develop a malignancy risk assessment tool to help physicians interpret the fine needle aspiration biopsy results of thyroid nodules in a context composed of patient’s clinical variables, known as malignancy related risk factors. Methods: We designed and trained an artificial neural network on a prospectively formed cohort gathered over a four year period (2007-2011. The study population comprised 345 subjects who underwent thyroid resection at Nemazee and Rajaee hospitals, tertiary care centers of Shiraz University of Medical Sciences, and Rajaee Hospital as a level I trauma center in Shiraz, Iran after having undergone thyroid fine needle aspiration. Histopathological results of the fine needle aspirations and surgical specimens were analyzed and compared by experienced, board-certified pathologists who lacked knowledge of the fine needle aspiration results for thyroid malignancy. Results: We compared the preoperative

  12. Virtual touch tissue quantifications in the differential diagnosis of benign and malignant thyroid nodules

    Ha, Seung Mi; Cho, Seong Whi [Dept. of Radiology, Kangwon National University Hospital, Chuncheon (Korea, Republic of)

    2016-06-15

    The aim of this study was to evaluate the diagnostic utility of the virtual touch tissue quantification (VTQ) technology for differentiating between benign and malignant thyroid nodules. 198 nodules (168 benign and 30 malignant nodules) identified in 164 patients with available VTQ velocity data and fine-needle aspiration cytology or post-surgical pathological results were included. The VTQ velocities of nodules and adjacent thyroid tissue were examined. Malignant nodules had a significantly higher VTQ velocity (3.06 ± 1.04 m/s, range: 1.90-6.46 m/s) than that of benign nodules (2.40 ± 0.85 m/s, range: 0.69-8.09 m/s) (p = 0.002). The VTQ velocity ratio between malignant nodules and adjacent thyroid tissue (1.39 ± 0.43, range: 0.89-2.65) was also statistically higher than that of benign nodules (1.15 ± 0.44, range: 0.26-3.47) (p = 0.008). The area under the receiver operating characteristic curve for the VTQ velocity was 0.72 with a cutoff point of 2.37 m/s and that of the VTQ velocity ratio was 0.68 with a cutoff point of 1.26. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the VTQ velocity were 86.7%, 50.6%, 23.9%, 95.5%, and 56.1%, respectively and 60.0%, 72.0%, 27.7%, 91.0%, and 70.2%, respectively for the VTQ velocity ratio. VTQ may be helpful in differentiating malignant and benign thyroid nodules with high negative predictive value.

  13. Utility of gray-scale ultrasound to differentiate benign from malignant thyroid nodules

    Manju Bala Popli

    2012-01-01

    Full Text Available Objective: The objective was to assess the utility of gray-scale USG to identify patterns of thyroid nodules and to correlate the characteristics of benign and malignant nodules with pathological diagnosis. Materials and Methods: From September 2009 to August 2010, a total of 203 patients (17 males and 186 females, with 240 nodules detected at USG, were included in this study. The characteristics of each nodule were determined. The results were then compared with fine needle aspiration (FNA/histopathological diagnosis. Results: Of the 240 nodules examined, 44 (18.33% were found to be malignant on cytopathology. The malignant nodules demonstrated solid or predominantly solid composition (sensitivity 88.6%, specificity 53.5%; presence of microcalcification (sensitivity 65.9%, specificity 97.9%; irregular or poorly defined margins (sensitivity 84%, specificity 88.7%; anteroposterior (AP diameter > transverse diameter (sensitivity 77.2%, specificity 80.1%; absent or thick incomplete halo (sensitivity 70.4%, specificity 65.8%; and markedly hypoechoic character (sensitivity 65.9%, specificity 84.6%. Among males, malignant nodules were found in 36.8%, whereas in females the occurrence was 16.7%. Conclusion: Gray-scale USG features of thyroid nodules are useful to distinguish patients with clinically significant thyroid nodules from those with innocuous nodules despite the overlap of findings. From our study, it is apparent that the USG findings of poorly defined margins, marked hypoechogenicity, microcalcifications, and a taller-than-wider shape have a high diagnostic accuracy for identifying malignant thyroid nodules.

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

    Marcelo Monteros Alvi

    2009-10-01

    variables and methods of diagnosis in thyroid nodules of follicular type with the aim of defining risk of neoplasm. Ninety two patients with nodular goiters, of follicular origin by cytology, previously submitted to surgical treatment were analyzed. The studied variables were: sex, age, size of the nodule, ultrasound characteristics, cytological diagnosis, TSH level and results of the scintigraphy. Of 92 cases, 74 were neoplastic nodules (56 adenomas and 18 differentiated thyroid cancer and 18 were non neoplastic nodules. Markers, that were related to high risk of follicular neoplasm corresponded to the cytological diagnosis of proliferation of high follicular degree, in iso or hypoechoic, and hypofunctioning nodules with I131. The carcinomas presented cytology of follicular proliferation of high degree, in hipoechoic nodules, of irregular edges with microcalcifications and hypofunctioning, in male patients or patients younger than 20 years. The presence of macrocalcifications and hypercaptation would be in favor of nodules of benign origin.The correlation of diagnostic methods and clinical variables in thyroid nodules of follicular type would allow us to differentiate the risk of neoplasm or carcinoma, and plan surgical selective treatments.

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

    Chutintorn Sriphrapradang

    2014-01-01

    Full Text Available Background. Fine-needle aspiration (FNA can cause misdiagnosis of cytomorphological findings between parathyroid and thyroid lesions. Case Presentation. A 31-year-old man presented with a palpable neck mass on the right thyroid lobe. FNA cytology was reported as intrathyroidal lymphoid hyperplasia. After 5 years, repeated FNA was done on the enlarged nodule with result of Hürthle cell lesion. Prior to right lobectomy, laboratories revealed elevated serum calcium and parathyroid hormone (PTH. Careful history taking revealed chronic knee pain and ossifying fibroma at the maxilla. Ultrasonography showed a 2.8 cm mass inferior to right thyroid lobe. Pathology from en bloc resection was parathyroid carcinoma and immunohistochemical study revealed positivity for PTH. Genetic analysis found somatic mutation of CDC73 gene in exon1 (c.70delG which caused premature stop codon in amino acid 26 (p.Glu24Lysfs2*. The final diagnosis was hyperparathyroidism-jaw tumor syndrome. Conclusions. FNA cytology of parathyroid can mimic thyroid lesion. It is important to consider and correlate the entire information from clinical history, laboratory, imaging, and FNA.

  16. Endoscopic surgery and photodynamic therapy for behign and malignant neoplasms of colon

    А. А. Razzhivina

    2013-01-01

    Full Text Available The review of literature for current methods of endoscopic treatment for colon epithelial neoplasms is represented. Such types of endoscopic interventions as loop electroresection, submucosal dissection, coagulation and destruction of tumors and combination of several options depending on efficiency of previous therapy is analyzed. Limitations of every method, its special aspects and possible complications are described. Special focus is on specifics of neoplasms for which selected methods may be the most effective. Thus, hot biopsy and destruction using high-energy laser is efficient for small flat neoplasms, endoscopic electroexcision – far small pedunculated lesions, and fragmentation is adequate for exophytic tumors more than 2.0 cm. Long-term results of endoscopic treatment, recurrence rates after different options are represented. The literature for photodynamic therapy consists mostly articles about development (on pre-clenecal stage of new photosensitizers which are effective for colon cancer, new methods of treatment including combination with hyperthermia in low-dose light irradiation etc. The literature data shows the prospectivity of subsequent developments in this field. 

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

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

    2006-02-15

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

  18. BRMS1 and Cx43 expression in fine needle aspiration thyroid cancer tissue and their correlation with tumor malignancy

    Jian-Guo Sheng; Bin Wang; Zong-Ping Diao; Kun-Kun Cao; Sai Zhang; Zheng-Guo Pu

    2016-01-01

    Objective:To study the BRMS1 and Cx43 expression in fine needle aspiration thyroid cancer tissue and their correlation with tumor malignancy.Methods:Patients undergoing thyroid fine needle aspiration biopsy in our hospital from April 2012 to October 2015 were selected for study, 60 patients with thyroid cancer and 60 patients with benign thyroid tumor were screened after pathological diagnosis, biopsy tissue was collected to determine the expression of BRMS1 and Cx43, and serum specimens were collected to determin Gal-3, CEACAM1, MMP2 and MMP9 content.Results: mRNA levels and positive expression rate of BRMS1 andCx43in thyroid cancer tissue were significantly lower than those in benign thyroid tumor tissue; mRNA levels ofBRMS1andCx43in thyroid cancer tissue with different pathological types and tumor diameters were not different, mRNA level ofCx43in thyroid cancer tissue with TNM III-IV stage was significantly lower than that in thyroid cancer tissue with TNM I-II stage, mRNA levels ofBRMS1 in thyroid cancer tissue with different TNM stages were not different, and mRNA levels ofBRMS1andCx43in thyroid carcinoma tissue with lymph node metastasis were significantly lower than those in thyroid carcinoma tissue without lymph node metastasis; serum Gal-3, CEACAM1, MMP2 and MMP9 levels in patients with positive BRMS1 and Cx43 expression in thyroid cancer tissue were significantly lower than those in patients with negative BRMS1 and Cx43 expression in thyroid cancer tissue.Conclusions:Lower expression of BRMS1 and Cx43 in fine needle aspiration thyroid cancer tissue is associated with the distant metastasis and malignant degree of tumor, and lower expression of Cx43 is also associated with the growth of tumor and cancer cell proliferation.

  19. A model to discriminate malignant from benign thyroid nodules using artificial neural network.

    Lu-Cheng Zhu

    Full Text Available OBJECTIVE: This study aimed to construct a model for using in differentiating benign and malignant nodules with the artificial neural network and to increase the objective diagnostic accuracy of US. MATERIALS AND METHODS: 618 consecutive patients (528 women, 161 men with 689 thyroid nodules (425 malignant and 264 benign nodules were enrolled in the present study. The presence and absence of each sonographic feature was assessed for each nodule - shape, margin, echogenicity, internal composition, presence of calcifications, peripheral halo and vascularity on color Doppler. The variables meet the following criteria: important sonographic features and statistically significant difference were selected as the input layer to build the ANN for predicting the malignancy of nodules. RESULTS: Six sonographic features including shape (Taller than wide, p<0.001, margin (Not Well-circumscribed, p<0.001, echogenicity (Hypoechogenicity, p<0.001, internal composition (Solid, p<0.001, presence of calcifications (Microcalcification, p<0.001 and peripheral halo (Absent, p<0.001 were significantly associated with malignant nodules. A three-layer 6-8-1 feed-forward ANN model was built. In the training cohort, the accuracy of the ANN in predicting malignancy of thyroid nodules was 82.3% (AURO  = 0.818, the sensitivity and specificity was 84.5% and 79.1%, respectively. In the validation cohort, the accuracy, sensitivity and specificity was 83.1%, 83.8% and 81.8%, respectively. The AUROC was 0.828. CONCLUSION: ANN constructed by sonographic features can discriminate benign and malignant thyroid nodules with high diagnostic accuracy.

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

    Mohsen Naraghi

    2009-07-01

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

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

    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.

  2. Risk factors for malignancy in patients with solitary thyroid nodules and their impact on the management

    Jun D Tai

    2012-01-01

    Full Text Available Background: Presently it is difficult to differentiate malignancy for thyroid nodules by palpation, ultrasonography and fine-needle aspiration cytology (FNAC at the outpatient department, especially for solitary thyroid nodule (STN. So a great emphasis should be placed on the STN. AIms: The objective of this study was to investigate the predictive clinicopathological risk factors for malignancy in patients with STN and further to provide an appropriate clinical management. Materials and Methods: The records were reviewed from 265 patients with STN who had undergone thyroidectomy in our hospital. All cases were classified as two independent groups in terms of the final pathological results to assess the independent risk factors using a multinomial logistic regression analysis. Results: A multinomial logistic analysis revealed that the male gender, microcalcification and cervical lymphadenopathy were independent risk factors related to malignancy in patients with STN. The incidence of malignancy in patients with 0,1,2,3 risks was 10.71%, 26.6%, 61.43%, and 100%, respectively. Conclusions: Male gender, microcalcification and lymphadenopathy were independent risk factors for predicting the malignancy in patients with STN. Patients with more than two of those risk factors should be subjected to further examination or thyroidectomy. The findings may provide a simple and reasonable management for the STN.

  3. Multidetector computed tomography analysis of benign and malignant nodules in patients with chronic lymphocytic thyroiditis.

    Zhu, Caisong; Liu, Wei; Yang, Jun; Yang, Jing; Shao, Kangwei; Yuan, Lixin; Chen, Hairong; Lu, Wei; Zhu, Ying

    2016-07-01

    The aim of the present study was to compare the multidetector computed tomography (MDCT) features of benign and malignant nodules in patients with chronic lymphocytic thyroiditis (CLT). MDCT findings, including the size, solid percentage, calcification, margin, capsule, anteroposterior-transverse diameter ratio as well as the mode and the degree of enhancement of 137 thyroid nodules in 127 CLT cases were retrospectively analyzed. Furthermore, the correlation between MDCT findings and pathological results combined with the CT perfusion imaging was analyzed for the differences between benign and malignant nodules. A total of 77.5% (31/40) of malignant nodules were completely solid, and 33% (32/97) of benign nodules were predominantly cystic. Compared with the benign nodules, micro-calcification and internal calcification were more frequently observed in the malignant nodules (P0.05). MDCT features are useful in differentiating the benign and malignant nodules in CLT patients, and it may be essential for a radiologist to review the MDCT characteristics of nodules in the clinical practice.

  4. ARRANGEMENT OF HIGH-TECH CARE FOR PATIENTS WITH MALIGNANT NEOPLASMS OF THE ORGAN OF VISION AT THE EXAMPLE OF CHELYABINSK REGION

    D. A. Vazhenina

    2015-01-01

    Full Text Available The articles raises the issues that occur in the course of diagnostics of malignant neoplasms of the organ of vision. Description of structural units and personnel of the formed oncological ophthalmology center is provided. Research, therapeutic, and diagnostic activities of each structural unit of the center is described. Characteristics of the ultrasonic and computed tomography method of examination are provided. Peculiarities of the ultrasonic and computed tomography examination results are described regarding patients with malignant neoplasms of the organ of vision of the periorbital, intraocular, and orbital localization. Results of reorganization of the oncological ophthalmology service are assessed (detailed description of management of patients with malignant neoplasms of the organ of vision at different stages before and after formation of the specialized oncological ophthalmology center is provided with illustrative diagrams that demostrate the need for integration of ophthalmic services in oncology, scientifically grounded and statistically proven results of quality of specialized care at the prehospital and the hospital stage, as well as changes in the structure of stages of patients with malignant neoplasms of the organ of vision. The feasibility of creation of specialized oncological ophthalmology centers is justified on the basis of the results received.

  5. Clinical features and experience of diagnosis and treatment of thyroid neoplasm in children%儿童甲状腺肿瘤的临床特征及诊治体会

    常实; 邓桢翰; 董超; 张志鹏; 廖辉军; 王志明

    2011-01-01

    Objective To study the clinical features, diagnosis and therapy of thyroid neoplasm in children. Methods A retrospective study was performed on 32 children with thyroid nodular who were underwent operation in Xiangya Hospital between January 2002 and December 2010. Results Of the 32 cases, there were 23 girls and 9 boys. Six cases were diagnosed as nodular Goiter adenoma and 26 cases were diagnosed as thyroid papillary carcinoma. B-ultrasonic examination showed a 100% accurate rate for the diagnosis of thyroid carcinoma. Fourteen children (44%,) were proven to have concurrent Hashimoto's thyroiditis. Twenty-two (69% ) children with thyroid carcinoma were found to have lymph metastasis in the lateral neck. The children younger than 10 years showed a high rate of metastasis than those older one (94% vs 56% , P < 0.05 ). All 32 children received a surgical therapy. Subtotal thyroidectomy was performed on the 6 children with nodular Goiter adenoma. Total thyroidectomy (17 cases) or ipsilateral thyroidectomy (9 cases) was performed according to the stage of thyroid carcinoma. The surgical outcomes were followed up for 3 months to 9 years and no recurrence or death occurred. The development and growth were normal in the children. Conclusions Childhood thyroid nodular attacks girls more than boys, and the frequency of malignancy is high. Hashimoto's thyroiditis is a common concurrent disease. The incidence of local lymph metastasis is high in those younger than 10 years. The surgical therapy for thyroid neoplasm may lead satisfactory outcomes in children.%目的 探讨儿童甲状腺肿瘤的临床特征及诊断与治疗.方法 回顾性分析2002年1月至2010年12月中南大学湘雅医院经手术治疗的32例甲状腺肿瘤患儿的临床资料.结果 32例患儿中,女性23例,男性9例.经病理证实良性肿瘤6例,恶性26例.良性病例均诊断为腺瘤性结节性甲状腺肿,恶性均为甲状腺乳头状癌.B超对甲状腺

  6. Information theoretical methods to deconvolute genetic regulatory networks applied to thyroid neoplasms

    Hernández-Lemus, Enrique; Velázquez-Fernández, David; Estrada-Gil, Jesús K.; Silva-Zolezzi, Irma; Herrera-Hernández, Miguel F.; Jiménez-Sánchez, Gerardo

    2009-12-01

    Most common pathologies in humans are not caused by the mutation of a single gene, rather they are complex diseases that arise due to the dynamic interaction of many genes and environmental factors. This plethora of interacting genes generates a complexity landscape that masks the real effects associated with the disease. To construct dynamic maps of gene interactions (also called genetic regulatory networks) we need to understand the interplay between thousands of genes. Several issues arise in the analysis of experimental data related to gene function: on the one hand, the nature of measurement processes generates highly noisy signals; on the other hand, there are far more variables involved (number of genes and interactions among them) than experimental samples. Another source of complexity is the highly nonlinear character of the underlying biochemical dynamics. To overcome some of these limitations, we generated an optimized method based on the implementation of a Maximum Entropy Formalism (MaxEnt) to deconvolute a genetic regulatory network based on the most probable meta-distribution of gene-gene interactions. We tested the methodology using experimental data for Papillary Thyroid Cancer (PTC) and Thyroid Goiter tissue samples. The optimal MaxEnt regulatory network was obtained from a pool of 25,593,993 different probability distributions. The group of observed interactions was validated by several (mostly in silico) means and sources. For the associated Papillary Thyroid Cancer Gene Regulatory Network (PTC-GRN) the majority of the nodes (genes) have very few links (interactions) whereas a small number of nodes are highly connected. PTC-GRN is also characterized by high clustering coefficients and network heterogeneity. These properties have been recognized as characteristic of topological robustness, and they have been largely described in relation to biological networks. A number of biological validity outcomes are discussed with regard to both the

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

    Shokouh Taghipour Zahir

    2013-01-01

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

  8. Evaluation of Diagnostic Efficiency of Ultrasound Features on Malignant Thyroid Nodules in Chinese Patients

    Ru-Qiang Li; Ge-Heng Yuan; Ming Chen; Yi-Min Shao; Sai-Nan Zhu; Jun-Qing Zhang; Xiao-Hui Guo

    2016-01-01

    Background:The aim of this study was to evaluate the efficacy of ultrasonic features in predicting the malignancy of thyroid nodules in a group of Chinese patients.Methods:In all,762 patients with thyroid nodules (424 malignant and 338 benign) underwent ultrasound (US) check and surgery between March 2011 and July 2014 at Peking University First Hospital were identified.Univariate and receiver operating characteristic (ROC)analyses were performed to calculate the sensitivity,specificity,negative and positive predictive values of each US feature,and the accuracy of their combinations for prediction of malignancy.Results:Patients with malignant nodules were younger and without obvious risk history than those in the benign group (P < 0.001,P =0.93).No individual US sign was fully predictive of a malignant lesion.The Youden indexes of irregular margins and hypoechogenicity were the first and second highest in all US features,which were 51.9% and 45.2%,respectively.The sensitivity of solid components (89.7%) and hypoechogenicity (89.2%) and the specificity of taller-than-wide shape (98.5%) and microcalcifications (90.6%) were the first and second highest in all US features.Intranodular flow on a color Doppler examination was a weak predictor of malignancy.Under ROC analysis excepting intranodular flow,the 95% confidence interval (CI) of areas under the curves of hypoechogenicity and irregular margins with any one of the US features were overlapped that of five-feature combinations (95% CI:0.850-0.901).Conclusions:We should be alert with taller-than-wide shape and microcalcifications.lntranodular flow was a weak predictor of malignancy.According to Youden indexes and ROC analysis,irregular margins and hypoechogenicity combined with solid component or taller-than-wide shapes or microcalcifications have a high predicative value for malignant thyroid nodules in Chinese patients.

  9. Divergent differentiation in malignant soft tissue neoplasms: the paradigm of liposarcoma and malignant peripheral nerve sheath tumor.

    Pytel, Peter; Taxy, Jerome B; Krausz, Thomas

    2005-01-01

    In tumors clonality does not always translate into morphologic uniformity. While most sarcomas exhibit only one line of histologic differentiation, a minority may display a strikingly diverse phenotype in addition to the main lineage. This phenomenon not only presents a diagnostic problem but also raises questions about the commitment of tumor cells toward a specific phenotype. Among sarcomas, malignant peripheral nerve sheath tumor (MPNST) and dedifferentiated liposarcoma are two entities in which divergent differentiation is a relatively frequent event. Diagnostically it is crucial to recognize the "primary" sarcoma in such tumors correctly and distinguish it from the "secondary" divergent elements. The presence of the latter could be the first morphologic clue to a specific sarcoma type. Even though it may be difficult to explain the pathogenesis of divergent differentiation, divergence still illustrates that the phenotype of a tumor cell is not set in stone but can be modulated or switched by a number of factors.

  10. Clinical Significance of Cannabinoid Receptors CB1 and CB2 Expression in Human Malignant and Benign Thyroid Lesions

    Eleftheria Lakiotaki

    2015-01-01

    Full Text Available The endocannabinoid system is comprised of cannabinoid receptors (CB1 and CB2, their endogenous ligands (endocannabinoids, and proteins responsible for their metabolism participate in many different functions indispensable to homeostatic regulation in several tissues, exerting also antitumorigenic effects. The present study aimed to evaluate the clinical significance of CB1 and CB2 expression in human benign and malignant thyroid lesions. CB1 and CB2 proteins’ expression was assessed immunohistochemically on paraffin-embedded thyroid tissues obtained from 87 patients with benign (n=43 and malignant (n=44 lesions and was statistically analyzed with clinicopathological parameters, follicular cells’ proliferative capacity, and risk of recurrence rate estimated according to the American Thyroid Association (ATA staging system. Enhanced CB1 and CB2 expression was significantly more frequently observed in malignant compared to benign thyroid lesions (p=0.0010 and p=0.0005, resp.. Enhanced CB1 and CB2 expression was also significantly more frequently observed in papillary carcinomas compared to hyperplastic nodules (p=0.0097 and p=0.0110, resp.. In malignant thyroid lesions, elevated CB2 expression was significantly associated with the presence of lymph node metastases (p=0.0301. Enhanced CB2 expression was also more frequently observed in malignant thyroid cases with presence of capsular (p=0.1165, lymphatic (p=0.1989, and vascular invasion (p=0.0555, as well as in those with increased risk of recurrence rate (p=0.1165, at a nonsignificant level though, whereas CB1 expression was not associated with any of the clinicopathological parameters examined. Our data suggest that CB receptors may be involved in malignant thyroid transformation and especially CB2 receptor could serve as useful biomarker and potential therapeutic target in thyroid neoplasia.

  11. Clinical Significance of Cannabinoid Receptors CB1 and CB2 Expression in Human Malignant and Benign Thyroid Lesions.

    Lakiotaki, Eleftheria; Giaginis, Constantinos; Tolia, Maria; Alexandrou, Paraskevi; Delladetsima, Ioanna; Giannopoulou, Ioanna; Kyrgias, George; Patsouris, Efstratios; Theocharis, Stamatios

    2015-01-01

    The endocannabinoid system is comprised of cannabinoid receptors (CB1 and CB2), their endogenous ligands (endocannabinoids), and proteins responsible for their metabolism participate in many different functions indispensable to homeostatic regulation in several tissues, exerting also antitumorigenic effects. The present study aimed to evaluate the clinical significance of CB1 and CB2 expression in human benign and malignant thyroid lesions. CB1 and CB2 proteins' expression was assessed immunohistochemically on paraffin-embedded thyroid tissues obtained from 87 patients with benign (n = 43) and malignant (n = 44) lesions and was statistically analyzed with clinicopathological parameters, follicular cells' proliferative capacity, and risk of recurrence rate estimated according to the American Thyroid Association (ATA) staging system. Enhanced CB1 and CB2 expression was significantly more frequently observed in malignant compared to benign thyroid lesions (p = 0.0010 and p = 0.0005, resp.). Enhanced CB1 and CB2 expression was also significantly more frequently observed in papillary carcinomas compared to hyperplastic nodules (p = 0.0097 and p = 0.0110, resp.). In malignant thyroid lesions, elevated CB2 expression was significantly associated with the presence of lymph node metastases (p = 0.0301). Enhanced CB2 expression was also more frequently observed in malignant thyroid cases with presence of capsular (p = 0.1165), lymphatic (p = 0.1989), and vascular invasion (p = 0.0555), as well as in those with increased risk of recurrence rate (p = 0.1165), at a nonsignificant level though, whereas CB1 expression was not associated with any of the clinicopathological parameters examined. Our data suggest that CB receptors may be involved in malignant thyroid transformation and especially CB2 receptor could serve as useful biomarker and potential therapeutic target in thyroid neoplasia.

  12. Diagnostic Criteria and Accuracy of Categorizing Malignant Thyroid Nodules by Ultrasonography and Ultrasound Elastography with Pathologic Correlation.

    Elsayed, Naglaa Mostafa; Elkhatib, Yasser Atta

    2016-03-01

    Thyroid nodules are a common medical and surgical concern. Thyroid ultrasound (US) is the primary imaging modality used for initial evaluation and assortment of nodules for fine needle aspiration (FNA) cytology/biopsy. Ultrasound elastography (USE) is believed to improve the diagnostic accuracy of US in distinguishing benign from malignant nodules. The aim of the work described here is to evaluate the diagnostic criteria and accuracy of US and USE in the diagnosis of malignant thyroid nodules. A prospective study of 88 patients who have thyroid nodules was performed. US, color Doppler, and USE were evaluated using a Philips iU22 equipped with a 5 to 12 MHz, linear transducer, followed by FNA of the each scanned nodule. The most sensitive US criteria for malignant nodules were a height-to-width ratio greater than one and the absence of a halo sign (sensitivity 0.875% and 1.000%, respectively). The most specific criteria for malignancy were a spiculated/blurred margin and the presence of microcalcifications (specificity 0.968% and 0.888%, respectively). The receiver operating characteristic curve showed that the cutoff diagnostic criteria of malignancy are two US characteristics and an elastography score of 4. The diagnostic accuracy of US for malignant thyroid nodules increases by combining US and USE.

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

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

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

    2012-12-15

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

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

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

    2012-03-01

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

  16. ECOLOGICAL AND GEOGRAPHICAL PRINCIPLES OF PROGNOSING THE MORBIDITY BY MALIGNANT NEOPLASMS OF POPULATION OF DAGHESTAN REPUBLIC

    G. M. ABDURAKHMANOV

    2010-01-01

    Full Text Available The work is a complex ecological and geographical research of natural and anthropogenic components in regions and towns of Daghestan republic for revealing the dependence between the state of environment and dynamics of morbidity. For the first time for the South Russia in Daghestan the complex ecological monitoring of malignant morbidities the important possibilities of its use for bioindication are shown.

  17. The reliability of fine-needle aspiration biopsy in terms of malignancy in patients with Hashimoto thyroiditis.

    Kapan, Murat; Onder, Akin; Girgin, Sadullah; Ulger, Burak Veli; Firat, Ugur; Uslukaya, Omer; Oguz, Abdullah

    2015-02-01

    The aim of this study was to analyze the presence of malignancy in patients with Hashimoto's thyroiditis and to investigate the reliability of preoperative fine-needle aspiration biopsy (FNAB). The retrospective study included 44 patients who were operated on for nodular goiter between December 2010 and October 2011. The patients underwent thyroidectomy following a cytologic analysis plus FNAB. Hashimoto's thyroiditis was confirmed on histopathology in all patients. FNAB results were defined as benign in 14 (31.8%), suspicion for malignancy in 17 (38.6%), malignant in 9 (20.5%), and inadequate in 4 (9.1%). Following the thyroidectomy, presence of papillary thyroid carcinoma and follicular variant of papillary thyroid carcinoma were detected in 10 patients (22.7%) and 1 (2.3%) patient, respectively. The FNAB results were interpreted in terms of malignancy, which revealed the sensitivity as 80%; specificity, 40%; false positives, 69.2%; false negatives, 14.3%; positive predictive value, 31.8%; negative predictive value, 85.7%; and diagnostic accuracy, 50%. The coexistence of Hashimoto's thyroiditis with papillary thyroid carcinoma is quite common. The FNAB results for such cases are hard to evaluate, and they are likely to increase the number of false positives.

  18. The role of selenium, vitamin C, and zinc in benign thyroid diseases and of selenium in malignant thyroid diseases: Low selenium levels are found in subacute and silent thyroiditis and in papillary and follicular carcinoma

    Starzinger Matthias

    2008-01-01

    Full Text Available Abstract Background Thyroid physiology is closely related to oxidative changes. The aim of this controlled study was to evaluate the levels of nutritional anti-oxidants such as vitamin C, zinc (Zn and selenium (Se, and to investigate any association of them with parameters of thyroid function and pathology including benign and malignant thyroid diseases. Methods This controlled evaluation of Se included a total of 1401 subjects (1186 adults and 215 children distributed as follows: control group (n = 687, benign thyroid disease (85 children and 465 adults; malignant thyroid disease (2 children and 79 adults. Clinical evaluation of patients with benign thyroid disease included sonography, scintigraphy, as well as the determination of fT3, fT4, TSH, thyroid antibodies levels, Se, Zn, and vitamin C. Besides the routine oncological parameters (TG, TSH, fT4, ultrasound Se was also determined in the cases of malignant disease. The local control groups for the evaluation of Se levels were taken from a general practice (WOMED as well as from healthy active athletes. Blood samples were collected between 8:00 and 10:30 a.m. All patients lived in Innsbruck. Statistical analysis was done using SPSS 14.0. The Ho stated that there should be no differences in the levels of antioxidants between controls and thyroid disease patients. Results Among the thyroid disease patients neither vitamin C, nor Zn nor Se correlated with any of the following parameters: age, sex, BMI, body weight, thyroid scintigraphy, ultrasound pattern, thyroid function, or thyroid antibodies. The proportion of patients with benign thyroid diseases having analyte concentrations below external reference cut off levels were 8.7% of cases for vitamin C; 7.8% for Zn, and 20.3% for Se. Low Se levels in the control group were found in 12%. Se levels were significantly decreased in cases of sub-acute and silent thyroiditis (66.4 ± 23.1 μg/l and 59.3 ± 20.1 μg/l, respectively as well as in

  19. Association between malignant tumors of the thyroid gland and exposure to environmental protective and risk factors.

    Frentzel-Beyme, R; Helmert, U

    2000-01-01

    Risk factors for thyroid carcinomas and adenomas were investigated using a standard questionnaire in a case-control study in Southwestern Germany, a known iodine deficiency area. A clinical registry, set up after the Chernobyl accident at the University hospital Mannheim, served as the basis for 174 incident cases of each diagnostic group. Interview data were compared within and with prevalences from a population-based matched control group of equal size from the entire area. The protective role of coffee drinking and the consumption of cruciferous vegetables, such as broccoli, were confirmed for both genders. A high consumption of tomatoes (> 200/year) was associated with an elevated risk of > 2.5 for malignant tumors but not for benign tumors in both genders. In both genders, both treatment for goiter (hyperthyroidism) and decaffeinated coffee consumption were associated with an increased risk for malignant tumors, but less so for adenomas. In women, early menarche (iodine substitution, but did analyze the consumption of freshwater fish and seafood. Multivariate analyses of the most prominent risk factors confirmed the persistence of tomato consumption as a risk factor. In view of experimental evidence on the carcinogenicity of organophosphates and the neurotoxicant effect of certain agrochemicals on neuroendocrinologically regulated organs, we postulate that in Germany, importing off-season tomatoes from areas with a known history of possible inexperienced use of agrochemicals may be associated with a promoting effect for malignant neoplasias of the thyroid gland in terms of promoting already existent proliferating tissue growth.

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

    R G Sharma

    2009-01-01

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

  1. The Cytological Grading of Malignant Neoplasms of The Breast and Its Correlation With The Histological Grading

    Vasudev, Vidya; R., Rangaswamy; V., Geethamani

    2013-01-01

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

  2. Pattern of recurrence in children with midline posterior fossa malignant neoplasms

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

    2000-02-01

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

  3. Primary thyroid lymphoma: A rare disease

    Deepti Verma

    2014-01-01

    Full Text Available Primary thyroid lymphomas are rare neoplasms comprising of 1-5% of thyroid malignancies. These are predominantly B-cell in origin. Here, we report a case of 60 years lady, a known case of lymphocytic thyroiditis, diagnosed as thyroid lymphoma (diffuse large B-cell on fine needle aspiration and confirmed histopathogically and immunohistochemically. She presented with a sudden increase in thyroid swelling. Fine needle aspiration performed showed highly cellular smears comprising predominantly of the monomorphic population of medium to large sized lymphoid cells with high nuclear/cytoplasmic ratio and scant cytoplasm. A possibility of thyroid lymphoma possibly diffuse large B-cell lymphoma was suggested which was later confirmed on biopsy. Fine needle aspiration provides an easy mode for diagnosing large cell lymphoma like diffuse large B-cell. Hence, an early diagnosis is possible for a timely intervention. Also, cases of lymphocytic thyroiditis should be regularly followed for the development of lymphoma.

  4. [Effect of radioactive, toxic, and combined radiation and toxic pollution of the environment on the incidence of malignant neoplasms in children of the Briansk region].

    Korsakov, A V; Troshin, V P; Mikhalev, V P

    2012-01-01

    Comparative evaluation of the frequency of incidence of all forms of primary malignant tumors in the child population over the fourteen-year period (1995-2008.) is presented. Evaluation was carried out in ecologically unfavorable territories of the Bryansk region with varying density of radioactive (from 28.1 to 661.9 kBq/m2 for 137Cs), toxic (from 1.47 to 183.6 kg/person/year for gaseous toxic substances) and combined environment pollution. Statistically significant differences of incidence of malignant neoplasms in children in ecologically unfavorable areas have been established.

  5. Glioblastoma multiforme and papillary thyroid carcinoma - A rare combination of multiple primary malignancies

    Swaroopa Pulivarthi

    2015-01-01

    Full Text Available We are describing a 19-year-old white woman who presented with two synchronous primary cancers, namely glioblastoma multiforme and papillary thyroid cancer. The patient was admitted with dizziness, headache, and vomiting. CT head revealed acute intraparenchymal hematoma in the right cingulate gyrus and the splenium of the corpus callosum. Carotid and cerebral angiogram were unremarkable. MRI of the brain demonstrated a non-enhancing and non-hemorrhagic component of the lesion along the lateral margin of the hemorrhage just medial to the atrium of the right lateral ventricle that was suspicious for a tumor or metastasis. Brain biopsy confirmed it as glioblastoma mutiforme. CT chest was done to rule out primary cancer that revealed a 11 mm hypodense lesion in the left lobe of the thyroid and ultrasound-guided fine-needle aspiration biopsy confirmed it as papillary thyroid carcinoma. We should evaluate for multiple primary malignancies in young patients who are found to have primary index cancer.

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

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

    2013-08-01

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

  7. The value of HIC1 and SIRT1 expression levels in thyroid nodule for assessing benign or malignant nodules

    Chuan-Hua Fang; Ying-Jie Xu; Hui-Ming Sheng

    2016-01-01

    Objective:To study the value of HIC1 and SIRT1 expression levels in thyroid nodule for assessing benign or malignant nodules.Method: 70 cases of surgically removed thyroid cancer tissue samples were collected as pathology group, 70 cases of corresponding para-carcinoma tissue specimens were collected as control group, immunohistochemistry was used to detect HIC1 and SIRT1 protein expression levels, and fluorescence quantitative PCR was used to detect the mRNA expression levels of HIC1 and SIRT1 as well as OXTR, CDH1, RASSF1A, TIMP3, MMP13, S100A4, CCNG2 and MK.Results: HIC1 expression levels in thyroid carcinoma tissue of pathology group were significantly lower than those of control group while SIRT1 expression levels were significantly higher than those of control group; compared with thyroid cancer tissue with TNM I-II stage, negative ductal infiltration and negative lymph node metastasis, HIC1 expression levels significantly decreased while SIRT1 expression levels significantly increased in thyroid cancer tissue with TNM III-IV stage, positive ductal infiltration and positive lymph node metastasis; in thyroid cancer tissue with positive HIC1 expression, OXTR, CDH1, RASSF1A and TIMP3 expression levels were significantly higher than those in thyroid cancer tissue with negative HIC1 expression; in thyroid cancer tissue with positive SIRT1 expression, MMP13, S100A4, CCNG2 and MK expression levels were significantly higher than those in thyroid cancer tissue with negative SIRT1 expression. Conclusion:HIC1 expression deletion and SIRT1 expression increase in thyroid nodule tissue are associated with the occurrence and development of thyroid carcinoma, and methylation and deacetylation may be epigenetic mechanism of HIC1 and SIRT1 to regulate cell proliferation, invasion and angiogenesis.

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

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

    2012-07-15

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

  9. Is radioactive iodine-{sup 131} treatment related to the occurrence of non-synchronous second primary malignancy in patients with differentiated thyroid cancer?

    Souza, Marcelo Cruzick de; Momesso, Denise P.; Vieira Neto, Leonardo; Vaisman, Mario, E-mail: dmomesso@terra.com.br [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, (Brazil). Servico de Endocrinologia; Vaisman, Fernanda; Corbo, Rossana [Instituto Nacional do Cancer (INCA), Rio de Janeiro, RJ (Brazil). Servico de Endocrinologia; Martins, Rosangela Aparecida Gomes [Hospital Universitario Clementino Fraga Filho (HUCFF), Rio de Janeiro, RJ (Brazil). Divisao de Pesquisa

    2016-02-15

    Objective: Much controversy relates to the risk of non-synchronous second primary malignancies (NSSPM) after radioactive iodine treatment (RAI-131) in differentiated thyroid cancer (DTC) patients. This study evaluated the relationship between RAI-131 and NSSPM in DTC survivors with long-term follow-up. Materials and methods: Retrospective analysis of 413 DTC cases was performed; 252 received RAI-131 and 161 were treated with thyroidectomy alone. Exclusion criteria were: prior or synchronous non-thyroidal malignancies (within the first year), familial syndromes associated to multiple neoplasms, ionizing radiation exposure or second tumors with unknown histopathology. Results: During a mean follow-up of 11.0 ± 7.5 years, 17 (4.1%) patients developed solid NSSPM. Patients with NSSPM were older than those without (p = 0.02). RAI-131 and I-131 cumulative activity were similar in patients with and without NSSPM (p = 0.18 and p = 0.78, respectively). Incidence of NSSPM was 5.2% in patients with RAI-131 treatment and 2.5% in those without RAI-131 (p = 0.18). Using multivariate analysis, RAI-131 was not significantly associated with NSSPM occurrence (p = 0.35); age was the only independent predictor (p = 0.04). Under log rank statistical analysis, after 10 years of follow-up, it was observed a tendency of lower NSSPM-free survival among patients that received RAI-131 treatment (0.96 vs. 0.87; p = 0.06), what was not affected by age at DTC diagnosis. Conclusion: In our cohort of DTC survivors, with a long-term follow-up period, RAI-131 treatment and I-131 cumulative dose were not significantly associated with NSSPM occurrence. A tendency of premature NSSPM occurrence among patients treated with RAI-131 was observed, suggesting an anticipating oncogenic effect by interaction with other risk factors. (author)

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

    Kabayegit Ozlem

    2008-07-01

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

  11. [Thyroiditis].

    Buffet, Camille; Groussin, Lionel

    2013-02-01

    The diagnosis of thyroiditis encompasses a broad spectrum of thyroid disorders. Analysis of signs and symptoms, biochemical changes, neck ultrasound characteristics and radioactive iodine uptake values allows an accurate diagnosis. Recent studies of the whole genome have helped to identify many susceptibility genes for autoimmune thyroiditis. However, none of these genes contribute to a significant increase in risk of developing this thyroiditis. Clinical awareness of the characteristic presentations of exceptional thyroiditis (acute suppurative thyroiditis, Riedel's thyroiditis) is an important issue. Selenium administration seems to be beneficial for reducing the incidence of thyroiditis. Finally, certain drug-induced thyroiditis remains a therapeutic challenge for the physician.

  12. A study of malignancy rates in different diagnostic categories of the Bethesda system for reporting thyroid cytopathology: An institutional experience

    P. Arul

    2015-12-01

    Conclusion: Our study validated the efficacy of TBSRTC. In conclusion, the malignancy rate of AUS/FLUS in this study was higher than the risk mentioned in TBSRTC and other published studies. Hence, AUS/FLUS category patients in our setup warrant further workup including ultrasound and/or thyroid scan in addition to immediate repeat FNAC.

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

    Asotra Sarita

    2008-01-01

    Full Text Available Background: Fine needle aspiration has an important role in diagnosis of thyroid neoplasm. However, it is difficult to differentiate between follicular adenoma and follicular carcinoma by cytology alone. Recently, silver staining has been performed for nucleolar organizer regions (AgNORs to differentiate various tumors. Aims: The present study was undertaken to see if the AgNOR technique could distinguish between benign and malignant lesions, particularly, follicular neoplasm. Materials and Methods: One hundred forty cases of thyroid lesions were examined, which included colloid goiter (n = 36, multinodular goiter (n = 38, subacute thyroiditis (n = 6, Hashimoto′s thyroiditis (n = 17, lymphocytic thyroiditis (n = 3, follicular neoplasm (n = 18, Hurthle cell neoplasm (n = 3, papillary carcinoma (n = 16, and medullary carcinoma (n = 3. Diagnosis was confirmed by histopathology in 80 cases. The usual one-step silver colloidal reaction was performed at room temperature for 35 minutes and intranuclear dots of silver deposits were counted in 100 cells. Results: AgNOR counts of benign and malignant lesions were compared and were found to be statistically significant (P < 0.001. The mean AgNOR counts were higher in neoplastic lesions. Conclusions: AgNOR counting in fine needle aspiration smears is a simple, sensitive, and cost-effective method for differentiating benign from malignant thyroid follicular neoplasms.

  14. Etiopathogenesis of Differentiated Thyroid Carcinomas

    Tanja Makazlieva

    2016-08-01

    Full Text Available INTRODUCTION: Thyroid malignomas are a heterogeneous group of neoplasm consisting of most frequent differentiated encountered carcinomas, papillary and follicular thyroid carcinoma, then medullary thyroid carcinoma originating from neuroendocrine calcitonin-producing C-cells and rare forms of thyroid lymphomas arising from intrathyroidal lymphatic tissue, thyroid sarcomas and poorly differentiated anaplastic thyroid carcinoma. There are increasing numbers of epidemiological studies and publications that have suggested increased incidence rate of thyroid carcinomas. We have read, analysed and compare available reviews and original articles investigating different etiological factors in the development of thyroid carcinomas through Google Scholar and PubMed Database. DISCUSSION: Aetiology involved in the development of thyroid carcinomas is multifactorial and includes external influences, as well as constitutional predispositions and genetic etiological factors. The actual effect of environmental and constitutional factors is on promoting genetic and epigenetic alterations which result in cell proliferation and oncogenesis. Until now are identified numerous genetic alterations, assumed to have an important role in oncogenesis, with MAPK and PI3K-AKT as crucial signalling networks regulating growth, proliferation, differentiation and cell survival/apoptosis. CONCLUSION: This new molecular insight could have a crucial impact on diagnosis and also on improving and selecting an appropriate treatment to the patients with thyroid malignancies.

  15. Differential Profile of Ultrasound Findings Associated with Malignancy in Mixed and Solid Thyroid Nodules in an Elderly Female Population

    María Inés Vera

    2014-01-01

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

  16. Can the microRNA signature distinguish between thyroid tumors of uncertain malignant potential and other well-differentiated tumors of the thyroid gland?

    Lassalle, Sandra; Hofman, Véronique; Ilie, Marius; Bonnetaud, Christelle; Puisségur, Marie-Pierre; Brest, Patrick; Loubatier, Céline; Guevara, Nicolas; Bordone, Olivier; Cardinaud, Bruno; Lebrigand, Kévin; Rios, Géraldine; Santini, Joseph; Franc, Brigitte; Mari, Bernard; Al Ghuzlan, Abir; Vielh, Philippe; Barbry, Pascal; Hofman, Paul

    2011-10-01

    The term 'thyroid tumors of uncertain malignant potential' (TT-UMP) was coined by surgical pathologists to define well-differentiated tumors (WDT) showing inconclusive morphological evidence of malignancy or benignity. We have analyzed the expression of microRNA (miRNA) in a training set of 42 WDT of different histological subtypes: seven follicular tumors of UMP (FT-UMP), six WDT-UMP, seven follicular thyroid adenomas (FTA), 11 conventional papillary thyroid carcinomas (C-PTC), five follicular variants of PTC (FV-PTC), and six follicular thyroid carcinomas (FTC), which led to the identification of about 40 deregulated miRNAs. A subset of these altered miRNAs was independently validated by qRT-PCR, which included 18 supplementary TT-UMP (eight WDT-UMP and ten FT-UMP). Supervised clustering techniques were used to predict the first 42 samples. Based on the four possible outcomes (FTA, C-PTC, FV-PTC, and FTC), about 80% of FTA and C-PTC and 50% of FV-PTC and FTC samples were correctly assigned. Analysis of the independent set of 18 WDT-UMP by quantitative RT-PCR for the selection of the six most discriminating miRNAs was unable to separate FT-UMP from WDT-UMP, suggesting that the miRNA signature is insufficient in characterizing these two clinical entities. We conclude that considering FT-UMP and WDT-UMP as distinct and specific clinical entities may improve the diagnosis of WDT of the thyroid gland. In this context, a small set of miRNAs (i.e. miR-7, miR-146a, miR-146b, miR-200b, miR-221, and miR-222) appears to be useful, though not sufficient per se, in distinguishing TT-UMP from other WDT of the thyroid gland.

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

    Shweel, Mohamed, E-mail: mohshweel@yahoo.com [Radiology Department, El Minia University Hospital, El Minia (Egypt); Mansour, Ehab, E-mail: Ehabrad71@yahoo.com [Radiology Department, Assiut University Hospitals, Assiut (Egypt)

    2013-06-15

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

  18. Fine-Needle Aspiration, Touch Imprint, and Crush Preparation Cytology for Diagnosing Thyroid Malignancies in Thyroid Nodules

    Ahmadinejad, Mojtaba; Aliepour, Asghar; Anbari, Khatereh; Kaviani, Mojhgan; Ganjizadeh, Hasan; Nadri, Sedigheh; Foroutani, Niloufar; Meysami, Masoumeh; Almasi, Vahid

    2013-01-01

    Several methods are used to evaluate the thyroid nodules. The aim of this study was to determine the sensitivity, specificity, false positive and negative rates, positive predictive value (PPV), and negative predictive value (NPV) of touch imprint, crush preparation, and fine-needle aspiration (FNA) methods. This cross-sectional study was done in Shohada-ye Ashayer University Hospital in Khorramabad. All the patients who underwent thyroid surgery due to thyroid nodules in this hospital betwee...

  19. Cytologic diagnosis of low-grade papillary urothelial neoplasms (low malignant potential and low-grade carcinoma) in the context of the 1998 WHO/ISUP classification.

    Whisnant, Richard E; Bastacky, Sheldon I; Ohori, N Paul

    2003-04-01

    The 1998 World Health Organization/International Society of Urological Pathology (WHO/ISUP) classification of urothelial neoplasms introduced a category called papillary neoplasm of low malignant potential (LMP) and separated it from low-grade papillary urothelial carcinoma (LGPUC), which was thought to yield abnormal cells in cytology specimens. The objective of our study was to evaluate the effectiveness of urine cytology in diagnosing these lesions. Eighty-six paired transurethral surgical biopsy and corresponding urine cytology specimens representing the spectrum of urothelial papillary lesions were examined. Consensus diagnosis on each biopsy was made, and the distribution was as follows: 16 benign urothelium, 27 LMP, 28 LGPUC, and 15 high-grade papillary urothelial carcinoma (HGPUC). This was followed by a blinded independent review of the urine cytology specimens by three observers. Each cytology case was marked as negative, atypical, suspicious, or positive for malignant cells by using previously published cytologic criteria. When the negative and atypical diagnoses were grouped together as "benign" and the suspicious and malignant diagnoses as "malignant," the detection rate of "malignancy" of the lesions was as follows: LMP, 37%; LGPUC, 25%; and HGPUC, 53%. The false positive rate was 6%, and the positive predictive value (PPV) was 94%. Detection rates of cells that were at least "atypical" were as follows: LMP, 74%; LGPUC, 79%; and HGPUC, 100%. While most of the LMP and LGPUC cases yielded cells that were at least "atypical," there was no significant difference in the distribution of cytologic diagnoses for LMP and LGPUC cases (P > 0.05). Urine cytology in the context of the 1998 WHO/ISUP classification appears to be useful as a screening tool but does not appear to discriminate LMP effectively from LGPUC.

  20. Risk of Thyroid Nodular Disease and Thyroid Cancer in Patients with Acromegaly – Meta-Analysis and Systematic Review

    Kosma Wolinski; Agata Czarnywojtek; Marek Ruchala

    2014-01-01

    INTRODUCTION: Acromegaly is a quite rare chronic disease caused by the increased secretion of growth hormone (GH) and subsequently insulin - like growth factor 1. Although cardiovascular diseases remains the most common cause of mortality among acromegalic patients, increased prevalence of malignant and benign neoplasms remains a matter of debate. The aim of this study is to evaluate the risk of thyroid nodular disease (TND) and thyroid cancer in patients with acromegaly. MATERIALS AND METHOD...

  1. Methotrexate/6-mercaptopurine maintenance therapy influences the risk of a second malignant neoplasm after childhood acute lymphoblastic leukemia: results from the NOPHO ALL-92 study

    Schmiegelow, Kjeld; Al-Modhwahi, Ibrahim; Andersen, Mette Klarskov;

    2009-01-01

    acute myeloid leukemias or myelodysplastic syndromes had monosomy 7 (n = 7) or 7q deletions (n = 2). In Cox multivariate analysis, longer duration of oral 6-mercaptopurine (6MP)/methotrexate (MTX) maintenance therapy (P = .02; longest for standard-risk patients) and presence of high hyperdiploidy (P......Among 1614 children with acute lymphoblastic leukemia (ALL) treated with the Nordic Society for Paediatric Haematology and Oncology (NOPHO) ALL-92 protocol, 20 patients developed a second malignant neoplasm (SMN) with a cumulative risk of 1.6% at 12 years from the diagnosis of ALL. Nine of the 16...

  2. VEGF-C Is a Thyroid Marker of Malignancy Superior to VEGF-A in the Differential Diagnostics of Thyroid Lesions.

    Kosma Woliński

    Full Text Available Thyroid nodular goiter is one of the most common medical conditions affecting even over a half of adult population. The risk of malignancy is rather small but noticeable-estimated by numerous studies to be about 3-10%. The definite differentiation between benign and malignant ones is a vital issue in endocrine practice. The aim of the current study was to assess the expression of vascular endothelial growth factor A (VEGF-A and VEGF-C on the mRNA level in FNAB washouts in case of benign and malignant thyroid nodules and to evaluate the diagnostic value of these markers of malignancy.Patients undergoing fine-needle aspiration biopsy (FNAB in our department between January 2013 and May 2014 were included. In case of all patients who gave the written consent, after ultrasonography (US and fine-needle aspiration biopsy (FNAB performed as routine medical procedure the needle was flushed with RNA Later solution, the washouts were frozen in -80 Celsius degrees. Expression of VEGF-A and VEGF-C and GADPH (reference gene was assessed in washouts on the mRNA level using the real-time PCR technique. Probes of patients who underwent subsequent thyroidectomy and were diagnosed with differentiated thyroid cancer (DTC; proved by post-surgical histopathology were analyzed. Similar number of patients with benign cytology were randomly selected to be a control group.Thirty one DTCs and 28 benign thyroid lesions were analyzed. Expression of VEGF-A was insignificantly higher in patients with DTCs (p = 0.13. Expression of VEGF-C was significantly higher in patients with DTC. The relative expression of VEGF-C (in comparison with GAPDH was 0.0049 for DTCs and 0.00070 for benign lesions, medians - 0.0036 and 0.000024 respectively (p<0.0001.Measurement of expression VEGF-C on the mRNA level in washouts from FNAB is more useful than more commonly investigated VEGF-A. Measurement of VEGF-C in FNAB washouts do not allow for fully reliable differentiation of benign and

  3. Thyroid nodules with isolated macrocalcification: Malignancy and diagnostic efficacy of fine-needle aspiration and core needle biopsy

    Na, Dong Gyu; Kim, Dae Sik; Kim, Soo Jin [Dept. of Radiology, Human Medical Imaging and Intervention Center, Seoul (Korea, Republic of); Ryoo, Jae Wook [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Jung, So Lyung [Dept. of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2016-07-15

    This study was performed to determine the malignancy risk of thyroid nodules with isolated macrocalcification and to evaluate the diagnostic efficacy of fine-needle aspiration (FNA) and core needle biopsy (CNB). From May 2008 to December 2014, a total of 44 patients with isolated macrocalcifications were enrolled from 4,081 consecutive patients who underwent FNA or CNB at a single institution. We assessed the malignancy risk of nodules with isolated macrocalcification. We compared the diagnostic results between FNA and CNB, and the diagnostic efficacy of each procedure was evaluated by the rate of inconclusive results. We compared the diagnostic performance for malignancy between FNA and CNB with a criterion of malignant or atypia/follicular lesion of undetermined significance (indeterminate) diagnostic results. We investigated whether the ultrasonographic feature of isolated macrocalcification was predictive of malignancy. The malignancy risk of nodules with isolated macrocalcification was 16.1% in 31 nodules with final diagnoses and 11.4% in all nodules. CNB demonstrated a significantly lower rate of nondiagnostic and inconclusive results than FNA (7.7% vs. 53.8%, P=0.002 and 15.4% vs. 57.7%, P=0.003, respectively) in 26 nodules that underwent both FNA and CNB. CNB showed a marginally higher diagnostic performance for identifying malignancy than FNA (P=0.067). The ultrasonographic features of the anterior margin of isolated macrocalcification were not predictive of malignancy (P>0.999). Thyroid nodules with isolated macrocalcification had a low to intermediate malignancy risk and should not be considered benign nodules. CNB showed a higher diagnostic efficacy than FNA in these nodules.

  4. Functional polymorphisms in antioxidant genes in Hurthle cell thyroid neoplasm - an association of GPX1 polymorphism and recurrent Hurthle cell thyroid carcinoma

    Krhin Blaz

    2016-09-01

    Full Text Available Hurthle cells of the thyroid gland are very rich in mitochondria and oxidative enzymes. As a high level oxidative metabolism may lead to higher level of oxidative stress and can be associated with an increased risk for cancer, we investigated whether common functional polymorphisms in antioxidant genes (SOD2, CAT, GPX, GSTP1, GSTM1 and GSTT1 are associated with the development or clinical course of Hurthle cell thyroid carcinoma (HCTC.

  5. Second malignancies in patients with differentiated thyroid carcinoma treated with low and medium activities of radioactive I-131

    PICIU, DOINA; PESTEAN, CLAUDIU; BARBUS, ELENA; LARG, MARIA IULIA; PICIU, ANDRA

    2016-01-01

    Background and aim This study aimed at determining whether there is a risk regarding the development of second primary malignancies after patient exposure to the low and medium radioiodine activity used during the treatment of differentiated thyroid cancers (DTC). Methods Second primary malignancies that occurred after DTC were detected in 1,990 patients treated between 1970 and 2003. The mean long-term follow-up period was 182 months. Results Radioiodine I-131was administrated at a mean dose of 63.2 mCi. There were 93 patients with at least one second primary malignancy. The relative risk of development of second malignancy in DTC patients was increased (pDTC, but not to exposure to the low and medium activities of radioiodine administered as adjuvant therapy. PMID:27547058

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

    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 tumor cells, can be identified from OCT and OCM images and are clearly differentiable from normal or benign 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.

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

    Gopinath, Balasubramanian; Shanthi, Natesan

    2013-06-01

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

  8. Thyroid nodules with highly suspicious ultrasonographic features, but with benign cytology on two occasions: is malignancy still possible?

    Rosario, Pedro Weslley; Calsolari, Maria Regina, E-mail: pedrowsrosario@gmail.com [Santa Casa de Belo Horizonte, MG (Brazil)

    2016-11-01

    There is no information about the frequency of malignancy specifically in the case of thyroid nodules with highly suspicious sonographic features, but with two fine needle aspiration (FNA) showing benign cytology. This was the objective of the study. Subjects and methods: We report the results of 105 patients with thyroid nodules considered 'highly suspicious' according to the ultrasonographic classification of American Thyroid Association, in whom FNA revealed benign cytology on two occasions (interval of 6 months). Results: Thyroidectomy was performed in 11 cases due to desire of the patient or significant growth of the nodule. In these patients, cytology continued to be benign in 9, was non-diagnostic in 1, and suspicious in 1. Histology revealed papillary carcinoma in only one nodule. In patients in whom a third FNA was obtained for this study (n = 94), cytology continued to be benign in 86, became non-diagnostic in 5, indeterminate in 2, and suspicious in 1. The last 8 patients (with non-benign cytology) were submitted to thyroidectomy and histology revealed malignancy in only one nodule. Conclusion: The rate of malignancy found here for nodules with highly suspicious sonographic features, even after two FNA showing benign cytology, was 2%. We believe that in these cases, the continuation of follow-up consisting of ultrasound at intervals of 2 years may still be adequate. (author)

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

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

    2011-03-01

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

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

    Milazzo Francesca

    2011-08-01

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

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

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

    2012-10-15

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

  12. ULTRASOUND EVALUATION OF THYROID DISEASES

    Battula

    2016-04-01

    Full Text Available AIMS & OBJECTIVES: 1. To differentiate cystic lesions from solid lesions. 2. The possibility to differentiate the intrinsic thyroid lesions from those arising from adjoining structures. 3. To evaluate the neoplasms and to differentiate benign from malignant lesions by USG characteristics and to correlate with FNAC reports. 4. Role of USG in rapidly growing thyroid lesions: To differentiate haemorrhage into the cystic lesions and rapidly growing malignant tumours. 5. Compare the results of our study with similar studies available in the present literature. MATERIALS & METHODS This study included 75 patients who attended outpatient departments of the Endocrinology, Medical and Surgical Units and also those who were inpatients. RESULTS Broadly pathological conditions of thyroid glands can be divided into nodular and diffuse thyroid diseases. Among Nodular Diseases Majority are benign, only few are malignant. Characteristics of benign lesions are: 1. Well-differentiated margins. 2. Thin complete peripheral sonolucent halo. 3. Coarse peripheral calcifications. Characteristics of malignant nodules are: 1. Ill-defined margins. 2. Thick incomplete peripheral halo. 3. Fine punctuate calcifications. Diffuse Thyroid Diseases 1. Hashimoto’s thyroiditis: Painless diffuse enlargement of thyroid gland usually in women with coarse echotexture and no normal gland tissue. There may be discrete hypoechoic nodules within it with cervical lymphadenopathy. 2. Goitres: a Simple diffuse goitre: Symmetrical enlargement of gland without tenderness or bruit or lymphadenopathy, T3, T4 and TSH are within normal limits and no thyroid autoantibodies in the serum. a Diffuse Toxic goitre: Diffuse enlargement of gland with increased vascularity on colour Doppler study. b Multinodular goitre: Multiple hypoechoic nodule within normal thyroid parenchyma. c Colloid goitre: Present as single or multiple swellings in the thyroid gland. CONCLUSION USG is the fast and cost effective

  13. Cytological analysis of small branch-duct intraductal papillary mucinous neoplasms provides a more accurate risk assessment of malignancy than symptoms

    Jill Ono

    2011-01-01

    Full Text Available Objectives: The Sendai guidelines for management of patients with clinically suspected intraductal papillary mucinous neoplasms (IPMN recommend resection of cysts > 30 mm, a dilated main pancreatic duct (MPD > 6 mm, a mural nodule (MN, symptoms or positive cytology. Although sensitive, asymptomatic cysts, nonspecific symptoms, and a high threshold for positive cytology limit the specificity of the guidelines. We have assessed the value of cytology relative to symptom for predicting malignancy in IPMNs without high-risk imaging features. Materials and Methods: We retrospectively reviewed the clinical, radiological, and cytological data of 31 small branch-duct IPMNs without a MN. The cytological presence of high-grade atypical epithelial cells (HGA was considered true positive, with a corresponding histology of high-grade dysplasia or invasive carcinoma. The performance of cytology versus symptoms was evaluated by calculating the sensitivity, specificity, negative predictive value (NPV, positive predictive value (PPV, and accuracy. Results: The sensitivity (0.80, specificity (0.85, and accuracy (0.84 of HGA were higher than the corresponding performance characteristics of symptoms (0.60, 0.45, and 0.48, respectively. The NPV of no HGA on cytology was > 95%. Conclusions: Cytology is a better predictor of malignancy than symptoms, for the conservative management of small branch-duct IPMNs. Cytology contributes to a highly accurate triple negative test for malignancy in small IPMN: No dilated MPD, MN or HGA.

  14. Evaluating the Degree of Conformity of Papillary Carcinoma and Follicular Carcinoma to the Reported Ultrasonographic Findings of Malignant Thyroid Tumor

    Jeh, Su Kyoung; Jung, So Lyung; Kim, Bum Soo; Lee, Yoen Soo [The Catholic Medial Center, Seoul (Korea, Republic of)

    2007-06-15

    We wanted to evaluate the degree of conformity of papillary carcinoma and follicular carcinoma to the reported ultrasonographic findings of malignant thyroid tumor. Between January 2003 and December 2004, fine needle aspiration biopsy was performed in 1,036 patients with palpable and nonpalpable thyroid lesions. We retrospectively reviewed the ultrasonographic findings of patients with papillary carcinomas (n = 127) and follicular carcinomas (n 23) that were proven by operation or fine needle aspiration biopsy. We analyzed the ultrasonographic findings of these nodules based on the reported ultrasonographic findings of malignant thyroid tumor: hypoechogenicity, a taller than wide orientation, a microlobulated or irregular margin, a thick hypoechoic rim (halo sign), microcalcification and cystic change. The echogenicity was hypoechoic in 72.4% (92/127) of the papillary carcinomas, but it was isoechoic in 65.2% (15/23) of the follicular carcinomas (p < 0.001). The nodule shape was tall or round in 74.1% of the papillary carcinomas, but it was flat in 72.7% of the follicular carcinomas (p < 0.001). The tumor margin was microlobulated or irregular in 92.9% of the papillary carcinomas and in 60.9% of the follicular carcinomas (p < 0.001). A hypoechoic rim was seen in 26% of the papillary carcinomas (thin rim: 13.4%, thick rim: 12.6%) and in 86.6% of the follicular carcinomas (thin rim: 39.1%, thick rim: 47.8%, p < 0.001). Microcalcifications were demonstrated in 33.9% of the papillary carcinomas and in none of the cases of follicular carcinoma (p < 0.001). A solid mass without cystic change were seen in 98.4% of the papillary carcinomas and in 82.6% of the follicular carcinomas (p < 0.001). The previously reported ultrasonography findings of malignant thyroid tumor are in conformity with most of the papillary carcinomas, but not with follicular carcinomas. The current ultrasonographic features for thyroid malignancy should be cautiously applied as the indication for

  15. FINE NEEDLE ASPIRATION CYTOLOGY AND HISTOPATHOLOGICAL CORRELATION OF NODULAR LESIONS OF THYROID: A STUDY

    Shanthi

    2016-06-01

    Full Text Available piration Cytology in diagnosing the nature of thyroid lesions and comparing its results with histopathological findings. It was observed that FNAC is the investigation of choice in thyroid swellings and has excellent patient compliance, is simple and quick to perform in outpatient department and is cost effective with high degree of sensitivity and specificity. MATERIALS AND METHODS This is a retrospective study comparing cytology and corresponding histopathology reported in 60 cases of nodular thyroid lesions. The statistical analysis included sensitivity and specificity and accuracy in nodular thyroid lesions. RESULTS On cytological examination of the 671 cases, initial diagnosis/impression as non-neoplastic was given for 616 cases (91.80% and neoplastic for 47 cases (7.00% in which 17 cases (36.17% were benign and 28 cases (59.57% were given as malignant, 5 cases were reported as suspicious for malignancy and for 5 cases samples were inadequate for a cytological diagnosis. Sensitivity of FNA in non-neoplasm lesions 92.5%, follicular neoplasm 87.5% and malignancies 68.42%. The specificity of FNA in non-neoplastic lesion is 100%, in follicular neoplasm is 96% and in malignancy 100%. Accuracy in FNAC for non-neoplastic lesion and follicular neoplasm 95% and malignancy 91%. CONCLUSION It was observed that FNAC is a vital reliable tool, safe and accurate method to evaluate nodular thyroid lesions. It greatly influences the treatment decision. In spite of accuracy of FNAC in differentiating between benign and malignant lesions, certain pitfalls were highlighted in diagnosing follicular neoplasm, which constitutes a “Gray zone” and papillary carcinoma and follicular carcinoma. We hope that a better understanding of these pitfalls wound help avoiding them in future and will contribute to better patient care.

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

    Shadi Barakat

    2014-11-01

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

  17. Evaluation the Relationship Between Thyroid Nodule Size with Malignancy and Accuracy of Fine Needle Aspiration Biopsy (FNAB)

    Godazandeh, Gholamali; Kashi, Zahra; Zargarnataj, Sadegh; Fazli, Mehran; Ebadi, Robab; Kerdabadi, Ensiyeh Hajializadeh

    2016-01-01

    Introduction: Some studies have shown largest thyroid nodule size, especially ≥4cm that can predict malignancy and reduce fine needle aspiration biopsy (FNAB) accuracy. Therefore, this study is designed to evaluate relationship between thyroid nodule sizes with malignancy and its effect on FNBA accuracy. Materials and Methods: a retrospective analytical study design aims to investigate all patients with thyroid nodules who referred to surgery department of Imam-Khomeini Hospital of Mazandaran University of Medical Sciences in Sari from 20 March 2008 to 22 March 2014. We collected patient’s demographic data, nodules size, FNAB reports and final pathology (after surgery) reports from their medical records. All data were analyses performed by SPSS18. Results: 167 patients (153 women) with mean age of 41.56±13.24 years old were enrolled for this study. In final pathology; 38 patients (22.8%) had malignant nodules. The mean age of patients with or without malignant nodules were 34.93±11.86 and 42.37±12.26 years old, respectively (P=0.002). The mean size of benign and malignant nodules were 2.91±1.29 cm and 3.38±1.86 cm, respectively (P=0.15). 25.2% of <4 cm nodules and 17.9% of ≥4 cm nodules were diagnosed as a malignant (P=0.29). FNAB was done on 95 patients that reported benign in 60 patients (63.2%), malignant in 18 patients (18.9%) and suspicious in 17 patients (17.9%). Positive and negative results of FNAB in all nodules were 3.5% and 6.3%, in <4cm nodules were 5.8% and 6.2% and in ≥4cm nodules were zero and 6.7%, respectively. The sensitivity, specificity, Positive predict value (PPV), negative predict value (NPV) and overall accuracy (OA) of FNAB in all nodules were 76.19%, 96.49%, 88.88%, 91.66% and 91.02%, and in <4cm nodules were 78.57%, 94.11%, 84.61%, 91.42% and 89.58%, and in ≥4cm nodules were 71.4%, 100%, 100%, 92% and 93.33%, respectively. Conclusion: the results of this study revealed that the size of the thyroid nodules is not reliable at

  18. Patterns of Benign and Malignant Lesions of the Thyroid in Two Wilayahs of Northeastern Algeria

    Mona Guidoum

    2015-01-01

    Full Text Available The aim of this study is to compare histological patterns and to estimate the burden of thyroid cancers in the two Wilayahs (departments of El-Taref and Guelma in northeast of Algeria (total population 0.9 million, locally reputed as having different rates of endemic thyroid diseases and cancer. A retrospective analysis of central pathology registers and clinical records of patients with thyroid diseases, covering the period 2008–2012, was conducted. A total of 145 cases of thyroid cancers with histological confirmation were registered in the two Wilayahs during the period, with a female to male ratio of 5.9 : 1. Estimates of crude incidence rates suggested that thyroid cancers were twice as frequent in the Wilayah of Guelma compared to El-Taref (p<0.05 with a tendency to occur at a younger age in resident of the Wilayah of El-Taref. Diagnoses of thyroid adenoma were more frequent in the Wilayah of Guelma, whereas the prevalence of other thyroid lesions, including goitre, was similar in the two Wilayahs. This first descriptive study on geographic variations in thyroid cancer in Northern Africa suggests that significant differences may occur in relation with environmental and lifestyle exposures.

  19. Epidemiological characteristics of thyroid nodules and risk factors for malignant nodules: a retrospective study from 6 304 surgical cases

    Huan Qin; Wang Kun; Lou Fuchen; Zhang Li; Huang Qingxian; Han Yunfeng; Sun Hancheng

    2014-01-01

    Background The prevalence of thyroid nodules (TN) is increasing rapidly.This study analyzed the epidemiological and clinical characteristics of TN in surgically treated patients and identified the risk factors for malignant nodules (MN) to provide more understanding of the differential diagnosis of TN.Methods A total of 6 304 TN cases who underwent thyroid surgery were included in this retrospective study.The clinical data were collected to evaluate the clinical and epidemiological characteristics and related risk factors for MN.The nature of TN (benign nodules (BN) or MN),medical records,laboratory data,and imaging data were analyzed.The risk factors for MN were screened using Spearman's rank correlation analysis and nonconditional binary Logistic regression analysis.Results The number of surgically treated TN cases increased yearly.A total of 34.33% of cases were MN and 65.67% were BN.Up to 56.74% of these cases underwent unnecessary surgery.Among the MN cases,papillary thyroid carcinoma accounted for 94%,in which 46.71% coexisted with benign thyroid disease and 32.28% with multiple foci.Single-related factor analysis showed that age,employment,disease duration,history of breast nodules and/or hypertension,the levels of serum thyroid-stimulating hormone (TSH),thyroglobulin antibody (TgAb),and thyroid peroxidase antibody (TPoAb),and ultrasound features of TN were related to MN.Stepwise nonconditional binary Logistic regression analysis showed that 13 factors may be the independent risk factors for MN,including <40 years old,previous history of breast nodules and/or hypertension,disease duration <1 month,employment,hypoechoic nodule,irregular nodules,nodule calcification,solid echo nodule,fuzzy boundary,rich blood flow within nodules,abnormal lymph nodes around the neck,nodule diameter <1 cm,and abnormally high TgAb.Conclusions Our results demonstrate a rapid increase in surgically treated TN cases and ratio of MN and indicate unnecessary

  20. 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

    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

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

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

    2013-09-01

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

  2. Large Bowel Obstruction in a Young Woman Simulating a Malignant Neoplasm: A Case Report of Actinomyces Infection

    Nissi, R.; Blanco Sequeiros, R. B.; Lappi-Blanco, E.; Karjula, H.; Talvensaari-Mattila, A.

    2013-01-01

    Pelvic and intra-abdominal Actinomycosis can be difficult to diagnose preoperatively and it may also mimic many other diseases, including malignancies. We present a patient with pelvic Actinomycosis probably caused by a long-standing intrauterine device (IUD). We emphasize the challenges in diagnostic process and stress that though a rare disease, intra-abdominal Actinomycosis should be suspected in cases with intra-abdominal mass of uncertain etiology. The early recognition may spare the patient from extensive surgical operation. PMID:23936699

  3. Large Bowel Obstruction in a Young Woman Simulating a Malignant Neoplasm: A Case Report of Actinomyces Infection

    2013-01-01

    Pelvic and intra-abdominal Actinomycosis can be difficult to diagnose preoperatively and it may also mimic many other diseases, including malignancies. We present a patient with pelvic Actinomycosis probably caused by a long-standing intrauterine device (IUD). We emphasize the challenges in diagnostic process and stress that though a rare disease, intra-abdominal Actinomycosis should be suspected in cases with intra-abdominal mass of uncertain etiology. The early recognition may spare the pat...

  4. Large bowel obstruction in a young woman simulating a malignant neoplasm: a case report of actinomyces infection.

    Nissi, R; Blanco Sequeiros, R B; Lappi-Blanco, E; Karjula, H; Talvensaari-Mattila, A

    2013-01-01

    Pelvic and intra-abdominal Actinomycosis can be difficult to diagnose preoperatively and it may also mimic many other diseases, including malignancies. We present a patient with pelvic Actinomycosis probably caused by a long-standing intrauterine device (IUD). We emphasize the challenges in diagnostic process and stress that though a rare disease, intra-abdominal Actinomycosis should be suspected in cases with intra-abdominal mass of uncertain etiology. The early recognition may spare the patient from extensive surgical operation.

  5. Contrast-enhanced ultrasound with perfusion analysis for the identification of malignant and benign tumours of the thyroid gland.

    Wendl, C M; Janke, M; Jung, W; Stroszczysnski, C; Jung, E M

    2015-10-27

    The aim of our study was to evaluate, whether the analysis of time intensity curves (TIC) of contrast enhanced ultrasound (CEUS) could help to differentiate between thyroid adenomas and carcinomas in daily clinical routine.B-mode, Colour Coded Doppler Sonography (CCDS), Power Doppler (PD) and CEUS were applied for 50 patients (27 men, 23 women; mean age 51 years, range 16-81 years).CEUS cine-sequences were analysed using time intensity curves (TIC) and calculating time to peak (TTP) as well as the area under the curve (AUC).All 20 patients with carcinomas presented with a complete wash-out in the late phase of CEUS while this occurred only in three out of the 30 patients with adenomas.Marked differences were observed between adenomas and carcinomas concerning the mean AUC in the surrounding thyroid tissue (p = 0.041). In addition, TTP differed clearly between the centre and the surrounding of the carcinomas (p thyroid nodules and is helpful for the differentiation of benign and malignant nodules.

  6. Risk of malignancy in thyroid incidentalomas detected by (18)f-fluorodeoxyglucose positron emission tomography

    Soelberg, Kerstin; Bonnema, Steen Joop; Brix, Thomas Heiberg

    2012-01-01

    Background: The expanding use of (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) has led to the identification of increasing numbers of patients with an incidentaloma in the thyroid gland. We aimed to review the proportion of incidental thyroid cancers found by (18)F-FDG PET...... or PET/computed tomography imaging. Methods: Studies evaluating thyroid carcinomas discovered incidentally in patients or healthy volunteers by (18)F-FDG PET were systematically searched in the PubMed database from 2000 to 2011. The main exclusion criteria were known thyroid disease, lack of assigned...... diagnoses, investigation of diffuse uptake only, or investigation of patients with head and neck cancer, or cancer in the upper part of the thorax. Results: Twenty-two studies met our criteria comprising a total of 125,754 subjects. Of these, 1994 (1.6%) had unexpected focal hypermetabolic activity, while...

  7. A Very Rare Cause of Subglottic Stenosis: Non-Malignant Intratracheal Thyroid Tissue

    Ümit Aydogmus

    2014-08-01

    Full Text Available We present a case of subglottic stenosis associated with benign thyroid tissue involvement due to relapse of multinodular goiter despite surgery 14 years ago.The patient had undergone bilateral subtotal thyroidectomy 14 years ago and the pathology report had been multinodular thyroid tissue at the time. The patient recently presented to an emergency service due to sudden development of respiratory distress and was then directed to our center. Cervical tomography showed bilateral thyroid tissue that narrowed the tracheal diameter by 80% by invading the trachea from the left wall at the level of the thyroid gland. The patient required urgent tracheostomy due to serious respiratory trouble. The trachea was incised vertically about 2.5 cm below the cricoid cartilage. A 2 cm endotracheal lesion with margins that could not be distinguished from the left vocal cord was observed and biopsies were taken from both this lesion and the tissue surrounding the trachea. A Montgomery T-tube extending from the subglottic area to the distal section was placed. Pathology evaluation revealed histopathological findings that matched normal thyroid tissue. Although infrequent, tracheal invasion associated with a thyroid cancer is known to occur. We present a case with postoperative intratracheal relapse due to a benign cause and the emergency treatment.

  8. Large Bowel Obstruction in a Young Woman Simulating a Malignant Neoplasm: A Case Report of Actinomyces Infection

    R. Nissi

    2013-01-01

    Full Text Available Pelvic and intra-abdominal Actinomycosis can be difficult to diagnose preoperatively and it may also mimic many other diseases, including malignancies. We present a patient with pelvic Actinomycosis probably caused by a long-standing intrauterine device (IUD. We emphasize the challenges in diagnostic process and stress that though a rare disease, intra-abdominal Actinomycosis should be suspected in cases with intra-abdominal mass of uncertain etiology. The early recognition may spare the patient from extensive surgical operation.

  9. Surgical intervention in chronic (Hashimoto's) thyroiditis

    Thomas, C.G. Jr.; Rutledge, R.G.

    1981-06-01

    Experience with 260 thyroidectomies at the North Carolina Memorial Hospital performed between 1875 and 1980 for a dominant thyroid mass was reviewed to determine the reliability of criteria for diagnosis and the indications for surgical treatment. Using the criteria of clinical findings, complemented by laboratory studies. Four patients had Hashimoto's thyroiditis coincidental to another disease for which thyroidectomy was performed. In seven patients Hashimoto's thyroiditis alone constituted the indications for operation. The indications for operation in these patients were: autonomous function with mild hyperthyroidism (2 patients); associated cold nodule (2 patients); thyromegaly unresponsive to suppressive therapy (2 patients); and rapidly enlarging mass simulating a neoplasm (1 patient). Only one of 71 patients with well differentiated carcinoma had Hashimoto's thyroiditis. One patient with Hashimoto's thyroiditis had associated lymphoma. In most patients, Hashimoto's thyroiditis can be identified using appropriate clinical and laboratory criteria without resorting to thyroidectomy to differentiate between thyroiditis and a neoplasm. Operations are indicated in patients with suspected or established chronic thyroiditis for: 1) the presence of a dominant mass with incomplete regression on suppressive therapy. 2) Progression of thyromegaly despite suppressive therapy. 3) Historic or physical findings suggest a malignancy. 4) Indeterminant findings on cutting needle biopsy.

  10. Fine Needle Aspiration Cytology of Pediatric Thyroid Nodules

    Ayper KAÇAR

    2010-05-01

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

  11. (18)F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography in Malignancies of the Thyroid and in Head and Neck Squamous Cell Carcinoma

    Lauridsen, Jeppe Kiilerich; Rohde, Max; Thomassen, Anders

    2015-01-01

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

  12. Differentiation of benign and malignant thyroid nodules based on the proportion of sponge-like areas on ultrasonography: imaging-pathologic correlation

    Jee Young Kim

    2015-10-01

    Full Text Available Purpose: The purpose of this study was to determine whether it is possible to differentiate benign from malignant thyroid nodules according to the proportion of sponge-like appearance within the nodules. Methods: A total of 201 thyroid nodules containing sponge-like appearance from 195 patients (157 women and 38 men were included this study. Each thyroid nodule was classified into one of three grades by real-time ultrasonography (US based on the areas with a sponge-like appearance within nodule: grade I had sponge-like areas occupying 75%. We evaluated whether a correlation existed between these grades and cytopathologic diagnoses. Results: Of the 201 nodules, 196 were benign and five were malignant, and according to the US classification, 101 nodules were grade I, 45 were grade II, and 55 were grade III. Of the five malignant nodules, four were grade I, and one was grade II. No statistically significant difference was found in the rate of malignancy between grade III and grades I and II, due to insufficient statistical power. A sponge-like appearance was correlated with follicles filled with colloid and cholesterol granules in benign nodules and with papillary fronds around the dilated cystic spaces in malignant nodules. Conclusion: No malignancies were found in thyroid nodules with >75% sponge-like appearance. Due to the overall low incidence of malignancy and the limited number of patients, a statistically significant difference could not be found in the prevalence of malignancy depending on the proportion of sponge-like areas within the nodule.

  13. CT-guided percutaneous ethanol injection with disposable curved needle for treatment of malignant liver neoplasms and their metastases in retroperitoneal lymph nodes

    Chang-Jing Zuo; Pei-Jun Wang; Cheng-Wei Shao; Min-Jie Wang; Jian-Ming Tian; Yi Xiao; Fang-Yuan Ren; Xi-Yan Hao; Min Yuan

    2004-01-01

    AIM: To explore the feasibility of computed tomography (CT)-guided percutaneous ethanol injection (PEI) using a disposable curved needle for treatment of malignant liver neoplasms and their metastases in retroperitoneal lymph nodes.METHODS: CT-guided PEI was conducted using a disposable curved needle in 26 malignant liver tumors smaller than 5 cm in diameter and 5 lymph node metastases of liver cancer in the retroperitoneal space. The disposable curved needle was composed of a straight trocar (21G) and stylet, a disposable curved tip (25 G) and a fine stylet. For the tumors found in deep sites and difficult to reach, or for hepatic masses inaccessible to the injection using a straight needle because of portal vein and bile ducts, the straight trocar was used at first to reach the side of the tumor. Then, the disposable curved needle was used via the trocar. When the needle reached the tumor center, appropriate amount of ethanol was injected. For relatively large malignant liver tumors,multi-point injection was carried out for a better distribution of the ethanol injected throughout the masses. The curved needle was also used for treatment of the metastasis in retroperitoneal lymph nodes blocked by blood vessels and inaccessible by the straight needle.RESULTS: All of the 26 liver tumors received 2 or more times of successful PEI, through which ethanol was distributed throughout the whole tumor mass. Effect of the treatment was monitored by contrast-enhanced multi-phase CT and magnetic resonance imaging (MRI) examinations three months later. Of the 18 lesions whose diameters were smaller than 3 cm, the necrotic change across the whole mass and that in most areas were observed in 15 and 3 tumors,respectively. Among the 8 tumors sizing up to 3 cm, 5 were completely necrotic and 3 largely necrotic. Levels of tumor seromarkers were significantly reduced in some of the cases.In 5 patients with metastases of liver cancer in retroperitoneal lymph nodes who received 1 to 3

  14. THE INCIDENCE OF THYROID MALIGNANCY IN NODULAR GOITER: A RETROSPECTIVE ANALYSIS IN A MEDICAL COLLEGE HOSPITAL

    Praveen Kumar

    2015-09-01

    Full Text Available The incidence of malignancy in nodular goiter has been found to vary from 4% to 17%. Our aim is to determine the incidence of malignancy in nodular goiter by doing the histopathological examination of thyroidectomy specimens. MATERIALS AND METHODS: This retrospective, observational study was carried out on patients who are undergone thyroidectomy for clinically diagnosed nodular goiter in Fr . Muller Medical College Hospital during 2012 - 2014 (3 yrs. All the operated specimens were subjected to a histopathological examination to determine the incidence of malignancy. RESULTS: Among the 258 nodular goitre cases which were studied, 21 (8.1% cases contained malignant foci. Among them, papillary carcinoma was the most common type of malignancy observed. CONCLUSION: The risk of malignancy in nodular goitre should not to be underestimated. Total/ Near - total thyroidectomy is the preferred operation. All the operated specimens should be sent for histopathological examination

  15. Comparison between Thin-Slice 3-D Volumetric Ultrasound and Conventional Ultrasound in the Differentiation of Benign and Malignant Thyroid Lesions.

    Li, Wen-Bo; Zhang, Bo; Zhu, Qing-Li; Jiang, Yu-Xin; Sun, Jian; Yang, Meng; Li, Jian-Chu

    2015-12-01

    We explored the efficacy of thin-slice volumetric 3-D ultrasound (3-DUS) in distinguishing between benign and malignant thyroid nodules. A total of 103 thyroid nodules were evaluated prospectively using 3-D gray-scale ultrasonography. The shape, margin, halo and potential capsular invasion of the nodules were compared with the findings of conventional 2-D ultrasound (2-DUS). Of the 103 thyroid nodules, there were 50 pathologically confirmed benign lesions and 53 malignant lesions (51.5%). Shape irregularity, ill-defined margins and capsular invasion provided sensitivities of 90.0%, 47.2% and 39.6% and specificities of 88.0%, 84.0% and 100%, respectively, for the malignant lesions. The diagnosis of thyroid cancer was improved in 3-DUS compared with 2-DUS, with a sensitivity of 88.7%, specificity of 90.0%, positive predictive value of 90.4%, negative predictive value of 88.2% and accuracy of 89.3%. The sensitivity of detection for lesions with capsular invasion increased to 39.6% with 3-DUS, more than twice that of 2-DUS. Three-dimensional US is highly accurate in diagnosing thyroid nodules, particularly those with capsular invasion.

  16. Malignancy is associated with microcalcification and higher AP/T ratio in ultrasonography, but not with Hashimoto's thyroiditis in histopathology in patients with thyroid nodules evaluated as Bethesda Category III (AUS/FLUS) in cytology.

    Topaloglu, Oya; Baser, Husniye; Cuhaci, Fatma Neslihan; Sungu, Nuran; Yalcin, Abdussamed; Ersoy, Reyhan; Cakir, Bekir

    2016-10-01

    The predictors of malignancy are important for the decision of appropriate management in nodules with atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS). Our aim was to determine the ultrasonographical, clinical, and biochemical predictors of malignancy in these patients. A total of 427 patients with cytologically Bethesda Category III (AUS/FLUS) thyroid nodules were included in this retrospective study. We divided the nodules into two subgroups according to the histopathology as benign and malignant, and compared the preoperative ultrasonographical, clinical, and biochemical findings. In overall, 427 patients with 449 AUS/FLUS nodules who had undergone surgery, the rate of malignancy was 23.4 % (105/449). When evaluated separately, the rate of malignancy was 25.8 % in nodules with AUS (82/318) and 17.6 % in nodules with FLUS (23/131) (p = 0.061). The vast majority of malignant specimens in histopathology consisted of papillary thyroid carcinoma (PTC) (n = 91, 86.7 %). Preoperative ultrasonographic features of 105 malignant nodules in histopathology were compared with the 344 benign nodules in histopathology. Anteroposterior/Transverse (AP/T) ratio was significantly higher in malignant group compared to benign group (p = 0.013). In multiple logistic analysis, we found that higher AP/T ratio and microcalcification were independently associated with malignancy (p Hashimoto's thyroiditis in histopathology in multivariate analysis (p > 0.05). In Bethesda Category III nodules with higher AP/T ratio and microcalcification, surgery might be considered as a first therapeutic option instead of repeat fine-needle aspiration biopsy or observation.

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

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

    2010-12-07

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

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

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

    2010-12-01

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

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

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

    2010-12-01

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

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

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

    2014-01-01

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

  1. Hashimoto's Thyroiditis and Medullary Carcinoma of Thyroid.

    Dasgupta, S; Chakrabarti, S; Mandal, P K; Das, S

    2014-01-01

    Hashimoto's thyroiditis (HT) has been found to be associated with lymphoma, papillary carcinoma and Hürthle cell neoplasms of thyroid. In contrast, there are only a few reports of co-existence of HT with medullary carcinoma of thyroid. An overall prevalence of medullary carcinoma of only 0.35% has been reported in HT patients. Such a rare combination is being presented here. A 33 year old female presented with history of goiter for one year. Fine needle aspiration cytology (FNAC) of the swelling revealed cytological features suggestive of medullary carcinoma of thyroid. Histopathological examination of total thyroidectomy specimen revealed Hashimoto's thyroiditis along with medullary carcinoma of thyroid. Although Hashimoto's thyroiditis can uncommonly co-exist with thyroid neoplasm, its association with medullary carcinoma is extremely rare and hence being presented.

  2. Prevalence of malignancy in multinodular goiter and solitary thyroid nodule: a histopathological audit

    Seetu Palo

    2016-06-01

    Conclusions: We conclude that the prevalence of cancer was significantly higher in STN than MNG. But, since the prevalence of malignancy in MNG was also quite high, every effort should be made to pre-operatively identify any malignant focus in patients presenting with MNG. [Int J Res Med Sci 2016; 4(6.000: 2319-2323

  3. Oncocytic follicular nodules of the thyroid with or without chronic lymphocytic thyroiditis: An institutional experience

    Sule Canberk

    2013-01-01

    Full Text Available Background : Oncocytic follicular (OF cells can be a prominent component of fine needle aspiration (FNA specimens from neoplasms (adenomas and carcinomas and nodules arising in multinodular goiter and chronic lymphocytic thyroiditis (CLT. Because OF cells can be present in non-neoplastic and neoplastic thyroid lesions it can be challenging to differentiate between these two in FNA specimens. The aims of this study were to determine the risk of malignancy in cases diagnosed as either oncocytic follicular neoplasm (OFN or hyperplastic/adenomatoid nodule with OF on FNA and to identify clinicopathologic features that may help in predicting malignancy in such cases, especially the presence or absence of CLT. Design : We retrospectively searched the computerized laboratory information system at our institution between 1998 and 2009 for thyroid US guided FNA specimens in which the term "oncocytic/oncocytes" was mentioned in the final cytopathologic diagnosis. A total of 340 cases were selected for this study. The following data points were collected: Patient demographics, site of thyroid biopsy, size of lesion, FNA diagnosis, histopathologic follow-up and presence of CLT. Surgical pathology follow-up (SPFU was available in 269 (79% cases. Results : Two hundred and sixty patients were females and 80 males (average age 53 years. The lesion size was <3.0 cm in 241 (71% and ≥ 3.0 cm in 99 (29% cases. Cytologic diagnoses included: Follicular neoplasm with oncocytic features (FNOF 321 and suggestive of FNOF 19 cases; a secondary cytologic diagnosis of CLT was made in 20 cases. SPFU was available in 269 (79% cases; it was benign in 213 (213/267 = 79% and malignant in 56 (56/269 = 21% cases. The background thyroid showed CLT in 67 (25% cases; 24% (48/196 neoplasms occurred with versus 76% (147/196 without CLT. The rate of malignancy was lower in nodules measuring less than 3.0 cm as compared to those equal or greater than 3.0 cm in size (17% vs. 28

  4. Malignant Transformation of a Mature Cystic Ovarian Teratoma into Thyroid Carcinoma, Mucinous Adenocarcinoma, and Strumal Carcinoid: A Case Report and Literature Review

    Hilary D. Hinshaw

    2012-01-01

    Full Text Available Malignant transformation of a mature cystic teratoma (MCT is an infrequent, often asymptomatic event. We report the first example of a struma ovarii with a focus of follicular variant of papillary thyroid carcinoma (a, mucinous adenocarcinoma (b, and strumal carcinoid tumor (c—all three arising in one mature cystic teratoma of the ovary. From our reviews, we found limited data to guide management when these malignant foci occur within an MCT. Consideration should be given to thyroidectomy followed by total-body scanning and serum studies for foci of thyroid carcinoma and adjuvant therapy with thyroidectomy and radioablation if residual disease is identified (a. Additionally, extrapolating from data for mucinous adenocarcinomas, consideration could be given to adjuvant chemotherapy after appropriate staging (b. Strumal carcinoid tumors should be treated as tumors of low malignant potential. Observation is appropriate if after complete staging, no invasive implants are noted (c.

  5. CYTOLOGICAL PATTERNS OF THYROID LESIONS: A HOSPITAL-BASED STUDY

    Dharmakanta Kumbhakar

    2016-08-01

    lesions in the study, FNA smears of 05 thyroid lesions were inadequate for cytological reporting either due to inadequate aspirated materials or haemorrhagic smears. Out of remaining 95 thyroid lesions in the study, which had adequate FNA smears for cytological reporting, there were 84 (88.42% non-neoplastic lesions and 11 (11.58% neoplastic lesions with a non-neoplastic and neoplastic ratio of 7.64:1. Colloid goitres were the commonest non-neoplastic thyroid lesions in the study. Out of the 8 thyroid lesions diagnosed as thyroiditis in the study, granulomatous thyroiditis (04 were the commonest. Benign tumours (6.32% were found to be more common than malignant ones (4.21% with a benign and malignant tumours ratio of 1.50:1 in the study. Follicular neoplasms were the commonest benign tumours and papillary thyroid carcinomas were the commonest malignant tumours amongst the studied thyroid lesions. One thyroid lesion of medullary carcinoma was also diagnosed. Among all thyroid lesions in the study, with adequate FNA smears for cytological reporting, 70 (73.68% thyroid lesions were goitres with or without secondary changes, 06 (6.32% thyroid lesions were benign neoplasms, 01 (1.05% thyroid lesion was suspicious and 04 (4.21% thyroid lesions were malignant neoplasms. FNAC studies done only on 15 thyroid lesions in the study group were available for histopathological studies and showed 93.33% diagnostic accuracy. The histopathological findings of that 15 thyroid lesions showed 11 non-neoplastic (73.33% and 04 (26.67% neoplastic lesions. On comparison of FNAC and histopathology study reports of these 15 thyroid lesions, histopathology confirmed all the 11 non-neoplastic lesions (10 were simple colloid goitres and 1 thyroglossal cyst and 3 out of 4 neoplastic lesions diagnosed on FNAC. Out of 3 thyroid lesions diagnosed as follicular neoplasms on FNAC, 2 thyroid lesions confirmed the diagnosis, but one was confirmed as follicular variant of papillary carcinoma on histopathology

  6. Diagnosis and treatment of chronic lymphocytic thyroiditis coexistent with thyroid malignancy%慢性淋巴细胞性甲状腺炎合并甲状腺恶性肿瘤的临床诊治观察

    曹晓征

    2014-01-01

    ObjectiveTo explore the principles of diagnosis and treatment of chronic lymphocytic thyroiditis (CLT) coexistent with thyroid malignancy.MethodsThe clinical data of 38 patients with CLT, including clinic opathologic features, treatment, and prognosis were retrospectively analyzed.Results Chronic lymphocytic thyroiditis with papillary carcinoma 29 cases, the merger medullary carcinoma 3 cases, combined lymphoma 6 cases. 35 cases received follow-up, the treatment effect of 86.84% patients was good.ConclusionChronic lymphocytic thyroiditis thyroid malignant tumor in the combining more papillary carcinoma (29/38). Preoperative thyroid function, serum thyroid antibody detection, B ultrasonic and intraoperative and postoperative biopsy can improve the diagnosis and treatment, and help to choose the right operation method.%目的:对慢性淋巴细胞性甲状腺炎(CLT)合并甲状腺恶性肿瘤的临床诊治方法进行探讨。方法回顾性分析38例CLT合并甲状腺恶性肿瘤患者的诊断及治疗过程。结果CLT合并乳头状癌29例,CLT合并髓样癌3例,CLT合并淋巴瘤6例。其中35例获得随访,86.84%的患者治疗效果良好。结论 CLT合并甲状腺恶性肿瘤中以合并乳头状癌居多(29/38)。术前甲状腺功能、血清甲状腺抗体检测、B超及术中和术后切片检查可以提高诊断率和治疗率,并有助于选择正确的手术方式。

  7. Papillary Thyroid Carcinoma in a Branchial Cleft Cyst without a Thyroid Primary: Navigating a Diagnostic Dilemma

    Douglas S. Ruhl

    2013-01-01

    Full Text Available We report a rare case of papillary thyroid carcinoma incidentally found within a branchial cleft cyst. Only four other cases have been described in the literature. A total thyroidectomy and selective neck dissection was performed, and no evidence of occult primary disease was found after review of fine sections. Branchial cleft cysts are the most common lateral neck masses. Ectopic thyroid tissue within a branchial cleft cyst is an unusual phenomenon, and papillary thyroid carcinoma arising from this tissue is extremely rare. Clinicians are left with a diagnostic dilemma when presented with thyroid tissue neoplasm within a neck cyst in the absence of a thyroid primary—is this a case of metastatic disease with a missed primary or rather carcinoma arising in ectopic thyroid tissue? A thorough discussion of the etiologies of these lateral neck masses is reviewed including the embryogenesis of thyroid tissue in a branchial cleft cyst. The prognosis of patients with papillary thyroid carcinoma in lateral neck cysts without a primary site identified appears to be good following excision of the cyst and total thyroidectomy. Other management recommendations regarding these unique lateral neck malignancies are also presented.

  8. Positron Emission Tomography with 2-Deoxy-2-[18F] Fluoro-DGlucose in the Detection of Malignancy in Intraductal Papillary Mucinous Neoplasms of the Pancreas

    Brian KP Goh

    2007-05-01

    Full Text Available A 79-year-old Indian male was admitted with upper abdominal discomfort of 1-year duration which was associated with loss of weight and appetite. Clinical examination of the abdomen did not reveal any palpable masses. Laboratory investigations including a complete blood count, liver function tests and serum amylase were unremarkable. Standard serum tumor markers were within normal limits: carbohydrate antigen (CA 19-9, 13.4 U/mL (reference range: 3-45 U/mL; carcinoembryonic antigen (CEA, 1.4 μg/L (reference range: 0.5-3.5 μg/L and alphafetoprotein, 1.3 μg/L (reference range: 1-10 μg/L. A contrast-enhanced computed tomographic (CT scan demonstrated a cystically dilated and tortuous pancreatic duct measuring 1.9 cm, suggestive of an intraductal papillary mucinous neoplasm (IPMN. The common bile duct was dilated up to the level of the ampulla and a 3.2x2.0 cm heterogeneous soft tissue mass was observed in the head of the pancreas which extended into the duodenum, suggestive of a malignant lesion (Images 1 and 2. Fusion positron emission tomography/computed tomography (PET/CT was subsequently performed with 12.7 mCi of 2-deoxy-2-[18F] fluoro-D-glucose (18F-FDG administered intravenously. A whole body PET/CT scan was performed 60 minutes later with CT data used for attenuation correction and anatomical correlation. This confirmed a metabolically active focus within the pancreatic head mass with a standard uptake value (SUVmax of 3.5 compatible with carcinoma (Image 3.

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

    Kim Hoon

    2012-09-01

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

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

    Guhamallick M

    2008-01-01

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

  11. Comparison of muscle-to-nodule and parenchyma-to-nodule strain ratios in the differentiation of benign and malignant thyroid nodules: Which one should we use?

    Aydin, Ramazan, E-mail: raydin1984@hotmail.com [Department of Radiology, Samsun Education and Research Hospital, Samsun (Turkey); Elmali, Muzaffer, E-mail: muzafel@yahoo.com.tr [Department of Radiology, Ondokuz Mayis University, Faculty of Medicine, Samsun (Turkey); Polat, Ahmet Veysel, E-mail: veyselp@hotmail.com [Department of Radiology, Ondokuz Mayis University, Faculty of Medicine, Samsun (Turkey); Danaci, Murat, E-mail: danacim55@yahoo.com [Department of Radiology, Ondokuz Mayis University, Faculty of Medicine, Samsun (Turkey); Akpolat, Ilkser, E-mail: ilkserakpolat@yahoo.com [Department of Pathology, Ondokuz Mayis University, Faculty of Medicine, Samsun (Turkey)

    2014-03-15

    Objective: The aim of this study is to investigate the diagnostic accuracy of muscle-to-nodule strain ratio (MNSR) in the differentiation of benign and malignant thyroid nodules and to see if there was a difference between MNSR and parenchyma-to-nodule strain ratios (PNSR) in diagnosis. Methods: A total of 106 consecutive patients (88 women and 18 men; age range 19–79 years) with thyroid nodules were prospectively examined using ultrasound and sonoelastography before the fine-needle aspiration biopsy. The mean MNSR and PNSR were calculated for each nodule and the elasticity score was determined according to four-point scoring system. Results: According to the four-point scoring system, 44 of the 83 benign nodules had a score of one or two while 22 of the 23 malignant nodules had a score of three or four (p < 0.001). Using ROC analysis, the best cutoff point for MNSR 1.85 and for PNSR 3.14 was calculated. The sensitivity and specificity for the MNSR were 95.6%, 92.8%, respectively; for the PNSR were 95.6%, 93.4%, respectively, when the best cutoff points were used (p < 0.001). The κ value for the PNSR and MNSR methods was 0.87, which indicated an almost perfect agreement (p < 0.001). Conclusions: Sonoelastography has a high diagnostic accuracy in the differentiation of benign and malignant thyroid nodules. There was no significant difference between MNSR and PNSR in the differentiation of benign and malignant thyroid nodules. Therefore, we think that MNSR could safely be used in situations where PNSR could not be used.

  12. Multiparametric PET imaging in thyroid malignancy characterizing tumour heterogeneity: somatostatin receptors and glucose metabolism

    Traub-Weidinger, Tatjana [Medical University of Vienna, Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Medical University of Innsbruck, Department of Nuclear Medicine, Innsbruck (Austria); Putzer, Daniel; Bale, Reto [Medical University of Innsbruck, Department of Radiology, Innsbruck (Austria); Guggenberg, Elisabeth von; Dobrozemsky, Georg; Nilica, Bernhard; Kendler, Dorota; Virgolini, Irene Johanna [Medical University of Innsbruck, Department of Nuclear Medicine, Innsbruck (Austria)

    2015-12-15

    Radiolabelled somatostatin (SST) analogues have proven useful in diagnosing tumours positive for SST receptor (SSTR). As different subtypes of SSTR are expressed on the tumour cell surface, the choice of appropriate therapeutic SST analogue is crucial. We evaluated the SSTR status of thyroid cancer patients who had signs of progressive disease comparing different SSTR ligands for PET imaging to evaluate possible further therapeutic options. PET with {sup 68}Ga-radiolabelled SSTR ligands DOTA lanreotide (DOTA-LAN), DOTA-Tyr{sup 3} octreotide (DOTA-TOC) and {sup 18}F-FDG was performed in 31 patients with thyroid cancer (TC). These 31 patients comprised 18 with radioiodine non-avid differentiated TC (DTC) including 6 papillary TC (PTC), 8 follicular TC (FTC) and 4 oxyphilic TC (oxyTC), 5 with anaplastic TC (ATC), and 8 with medullary TC (MTC). The PET results were compared in a region-based evaluation. All patients underwent a PET study with {sup 68}Ga-DOTA-LAN, 28 patients with {sup 68}Ga-DOTA-TOC and 28 patients with {sup 18}F-FDG. A lack of SSTR expression was found in 13 of the 31 patients (42 %) with negative results with both SSTR tracers in 12 patients. Ambiguous results with both SSTR tracers were observed in one patient. High tracer uptake in SSTR PET images was seen in seven DTC patients (39 %; two PTC, three FTC, two oxyTC), in four ATC patients (80 %) and in six MTC patients (75 %). Lesions showing aerobic glycolysis on {sup 18}F-FDG PET were found in 24 of 28 patients (86 %) with corresponding positive results with {sup 68}Ga-DOTA-LAN in 35 % and with {sup 68}Ga-DOTA-TOC in 29 %. The heterogeneous SSTR profile of TC tumour lesions needs to be evaluated using different SSTR PET tracers to characterize more closely the SSTR subtype affinities in patients with progressive TC in order to further stratify therapy with SSTR therapeutics. (orig.)

  13. Cost-effective and non-invasive automated benign and malignant thyroid lesion classification in 3D contrast-enhanced ultrasound using combination of wavelets and textures: a class of ThyroScan™ algorithms.

    Acharya, U R; Faust, O; Sree, S V; Molinari, F; Garberoglio, R; Suri, J S

    2011-08-01

    Ultrasound has great potential to aid in the differential diagnosis of malignant and benign thyroid lesions, but interpretative pitfalls exist and the accuracy is still poor. To overcome these difficulties, we developed and analyzed a range of knowledge representation techniques, which are a class of ThyroScan™ algorithms from Global Biomedical Technologies Inc., California, USA, for automatic classification of benign and malignant thyroid lesions. The analysis is based on data obtained from twenty nodules (ten benign and ten malignant) taken from 3D contrast-enhanced ultrasound images. Fine needle aspiration biopsy and histology confirmed malignancy. Discrete Wavelet Transform (DWT) and texture algorithms are used to extract relevant features from the thyroid images. The resulting feature vectors are fed to three different classifiers: K-Nearest Neighbor (K-NN), Probabilistic Neural Network (PNN), and Decision Tree (DeTr). The performance of these classifiers is compared using Receiver Operating Characteristic (ROC) curves. Our results show that combination of DWT and texture features coupled with K-NN resulted in good performance measures with the area of under the ROC curve of 0.987, a classification accuracy of 98.9%, a sensitivity of 98%, and a specificity of 99.8%. Finally, we have proposed a novel integrated index called Thyroid Malignancy Index (TMI), which is made up of texture features, to diagnose benign or malignant nodules using just one index. We hope that this TMI will help clinicians in a more objective detection of benign and malignant thyroid lesions.

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

    A. Muela Molinero

    2006-12-01

    Full Text Available Objectives: we analyzed the characteristics of patients with gastric tumors diagnosed with multiple malignant primary neoplasm (MMPN in the Health District of León. Material and methods: using the information in the Tumor Registry at León Hospital patients selected were those with gastric neoplasms diagnosed between 1993 and 2002. A follow-up was performed until December 31, 2004, and the characteristics of patients diagnosed with a second neoplasm were analyzed. Results: MMPN prevalence was 1,96%; 56% of patients had a history of cancer in first-degree relatives. The most frequent second neoplasms were digestive (26% and urologic (21%; 87% of patients were diagnosed with a second neoplasm within the first two years. No significative differences in survival were observed among patients with synchronous or metachronous MMPN. Conclusions: MMPN in patients with gastric neoplasms is a relevant problem. While external carcinogenic agents could act as promoters in the development of second neoplasms, these patients seem to have a genetic background favoring the development of MMPN. Secondary prevention is the best measure to avoid MMPN development.Objetivos: analizar las características de los pacientes con tumores gástricos diagnosticados de una neoplasia primaria maligna múltiple (NPMM en el área sanitaria de León. Pacientes y método: utilizando los datos del Registro de Tumores del Hospital de León se han seleccionado aquellos pacientes con tumores gástricos diagnosticados entre 1993 y 2002. Se realizó un seguimiento hasta el 31 de diciembre de 2004 analizando las características de los pacientes diagnosticados de una segunda neoplasia durante el periodo de seguimiento. Resultados: la prevalencia de NPMM fue del 1,96%. El 56% de los pacientes tenían antecedentes oncológicos en familiares de primer grado. Las segundas neoplasias más frecuentes fueron las digestivas (26% y las urológicas (21%. El 87% de los pacientes fueron

  15. Fine Needle Aspiration of Thyroid Nodules Using the Bethesda System for Reporting Thyroid Cytopathology: An Institutional Experience in a Rural Setting

    Kaminoh, Yuuki; Forward, Terra; Schwartz, Frank L.; Jenkinson, Scott

    2017-01-01

    Background. Fine needle aspiration (FNA) remains the first-line diagnostic in management of thyroid nodules and reduces unnecessary surgeries. However, it is still challenging since cytological results are not always straightforward. This study aimed to examine the results of thyroid FNA using the Bethesda system for reporting thyroid cytopathology (TBSRTC) to establish the level of accuracy of FNA procedures in a rural practice setting. Method. A retrospective chart review was conducted on existing thyroid FNA performed in a referral endocrine center between December 2011 and November 2015. Results. A total of 159 patients (18–88 years old) and 236 nodule aspirations were performed and submitted for evaluation. 79% were benign, 3% atypia/follicular lesion of unknown significance (AUS/FLUS), 5% follicular neoplasm/suspicious for follicular neoplasm (FN/SFN), 4% suspicious for malignancy (one case was indeed an atypical parathyroid neoplasm by surgical pathology), 2% malignant, and 7% nondiagnostic. Two cases also had advanced molecular analysis on FNA specimens before thyroidectomy. Conclusion. The diagnostic yield of FNA cytology from our practice in a rural setting suggests that accuracy and specificity are comparable to results from larger centers. PMID:28280507

  16. The utility of thyroid ultrasonography in the management of thyroid nodules

    Gamme, Gary; Parrington, Tyler; Wiebe, Edward; Ghosh, Sunita; Litt, Brendan; Williams, David C.; McMullen, Todd P.W.

    2017-01-01

    Background Ultrasonography for thyroid nodules is one of the most common imaging tests performed in the general population. Details from ultrasound reports guide biopsies and surgery. This study quantifies the completeness of these reports based on Thyroid Imaging and Reporting System (TI-RADS) criteria and considers their utility in predicting malignant disease. Methods We retrospectively reviewed ultrasound reports for 329 thyroidectomy patients and extracted data elements using the TI-RADS criteria: nodule size, echogenicity, margins, vascularity, solid/cystic composition and the presence or absence of microcalcifications and the halo sign. We assessed the reports to determine whether individual or multiple criteria were associated with malignancy. Results More than 97% of reports document nodule size; however, more than 90% of the reports noted only 3 or fewer of the 6 remaining TI-RADS criteria. The presence of microcalcifications was the most sensitive marker of malignancy (> 90%), whereas the documentation of irregular margins was the most specific indicator of malignancy (88%). Overall it was clear that microcalcifications, hypoechogenicity, irregular margins and solid nodules were significantly more likely to be found in malignant neoplasms; their absence predicted benign disease. Because so few reports consistently documented all criteria, the overall ability of thyroid ultrasonography to discriminate between lower-and higher-risk nodules is limited. Conclusion Although the accuracy of thyroid ultrasonography is good, few ultrasound reports contain the necessary information, as defined by TI-RADS, to predict malignancy and guide management. When reported, microcalcifications and/or irregular margins are the best predictors of malignancy. PMID:28338469

  17. Computer-aided diagnosis for classifying benign versus malignant thyroid nodules based on ultrasound images: A comparison with radiologist-based assessments

    Chang, Yongjun [School of Electrical Engineering, Korea Advanced Institute of Science and Technology, 291, Daehak-ro, Yuseong-gu, Daejeon 34141 (Korea, Republic of); Paul, Anjan Kumar [Funzin, Inc., 148 Ankuk-dong, Jongro-gu, Seoul 03060 (Korea, Republic of); Kim, Namkug, E-mail: namkugkim@gmail.com; Baek, Jung Hwan; Choi, Young Jun [Department of Radiology, University of Ulsan College of Medicine, 388-1 Pungnap2-dong, Songpa-gu, Seoul 05505 (Korea, Republic of); Ha, Eun Ju [Department of Radiology, Ajou University School of Medicine, Wonchon-Dong, Yeongtong-Gu, Suwon 16499 (Korea, Republic of); Lee, Kang Dae; Lee, Hyoung Shin [Department of Otolaryngology Head and Neck Surgery, Kosin University College of Medicine, 34 Amnamdong, Seu-Gu, Busan 49267 (Korea, Republic of); Shin, DaeSeock; Kim, Nakyoung [MIDAS Information Technology, Pangyo-ro 228, Bundang-gu, Seongnam-si, Gyeonggi 13487 (Korea, Republic of)

    2016-01-15

    Purpose: To develop a semiautomated computer-aided diagnosis (CAD) system for thyroid cancer using two-dimensional ultrasound images that can be used to yield a second opinion in the clinic to differentiate malignant and benign lesions. Methods: A total of 118 ultrasound images that included axial and longitudinal images from patients with biopsy-confirmed malignant (n = 30) and benign (n = 29) nodules were collected. Thyroid CAD software was developed to extract quantitative features from these images based on thyroid nodule segmentation in which adaptive diffusion flow for active contours was used. Various features, including histogram, intensity differences, elliptical fit, gray-level co-occurrence matrixes, and gray-level run-length matrixes, were evaluated for each region imaged. Based on these imaging features, a support vector machine (SVM) classifier was used to differentiate benign and malignant nodules. Leave-one-out cross-validation with sequential forward feature selection was performed to evaluate the overall accuracy of this method. Additionally, analyses with contingency tables and receiver operating characteristic (ROC) curves were performed to compare the performance of CAD with visual inspection by expert radiologists based on established gold standards. Results: Most univariate features for this proposed CAD system attained accuracies that ranged from 78.0% to 83.1%. When optimal SVM parameters that were established using a grid search method with features that radiologists use for visual inspection were employed, the authors could attain rates of accuracy that ranged from 72.9% to 84.7%. Using leave-one-out cross-validation results in a multivariate analysis of various features, the highest accuracy achieved using the proposed CAD system was 98.3%, whereas visual inspection by radiologists reached 94.9% accuracy. To obtain the highest accuracies, “axial ratio” and “max probability” in axial images were most frequently included in the

  18. 空气污染与恶性肿瘤住院人数的关联性分析%Association Between Air Pollution and Hospitalization due to Malignant Neoplasms

    郑山; 刘兴荣; 程宁; 代敏; 李海燕; 李娟生; 康峰; 王敏珍; 任晓卫

    2016-01-01

    [目的]探讨空气污染与人群恶性肿瘤住院人数的关联性. [方法]收集甘肃省金昌市2007-2010年大气污染(PM1o、SO2和NO2)及气象观测数据,以及同期金昌队列人群全部恶性肿瘤住院病例.采用半参数广义相加模型在调整混杂因素后分析大气污染物浓度与该队列人群恶性肿瘤住院人数的关联性. [结果]共收集金昌队列人群恶性肿瘤住院病例2707例.当天(L0)的SO2及平均累积滞后4天(L04)的NO2与恶性肿瘤住院人数的RR值最大,分别为1.043(1.002~1.085)及1.163(1.091~1.239),PM1o及NO2对男性及60岁以上人群的恶性肿瘤住院人数的RR值较女性和60岁及以下人群大.多因素污染物模型中,SO2及NO2对PM10的影响具有协同效应,NO2表现出显著且独立的健康效应.[结论]空气污染与金昌队列人群恶性肿瘤患病住院人数之间具有一定的关联性.%[Objective] To assess the association between air pollution and malignant neoplasms hospital admissions.[Methods] Records of meteorological factors and air pollutants (PM10,SO2,and NO2) were collected in Jinchang City,Gansu Province from 2007 to 2010.The hospitalized cases of malignant neoplasms during the same period were collected from the Jinchang cohort.A semi-parametric generalized additive model was used to assess the relationship between air pollutant concentrations and daily malignant neoplasms hospitalizations in the cohort with adjustment of confounding factors.[Results] A total of 2707malignant neoplasms hospitalized cases were collected.Greater estimates were found for SO2 on Lag 0 day (L0) and for NO2 on Lag04 day (L04),with relative risks (RRs) (95% confidence interval) of 1.043 (1.002-1.085) and 1.163 (1.091-1.239),respectively.The males and the cases at and over 60 years of age were associated more strongly with PM10 and NO2.The multiple-pollutant models showed that SO2 and NO2 were synergic to PM10,and NO2 had a significant and independent health

  19. HYALINIZING TRABECULAR ADENOMA FEIGNING PAPILLARY CARCINOMA THYROID: CASE REPORT WITH REVIEW OF LITERATURE

    Kandukuri Mahesh

    2014-05-01

    Full Text Available Hyalinizing Trabecular Adenoma (HTA of the thyroid is a rare neoplasm that was first described by Carney in 1987. It is a tumor of follicular derivation with peculiar nuclear, architectural, histochemical, and immunohistochemical features. We report a case of Hyalinizing trabecular adenoma in a 36-year-old woman with enlarged thyroid lobe. Ultrasonographic features and fine needle aspiration cytology (FNAC of the enlarged thyroid was performed and the diagnosis given was Papillary carcinoma of the thyroid. The patient underwent total thyroidectomy, with a histopathological diagnosis of hyalinizing trabecular Adenoma (HTA. We present this case in view of its rarity and to discuss the clinical and diagnostic approach, including the role of FNAC, and the pathologic features of HTA with special reference to the possible differential diagnosis and also review of literature. Although rare cases of malignant Hyalinizing trabecular adenoma (HTA have been documented, this tumor should be considered a benign neoplasm or at most, a neoplasm of extremely low malignant potential, however invasion of the capsule should be considered on histopathology. An awareness of hyalinizing trabecular adenomas and their characteristic features is valuable for their recognition and management as well as for the possible prevention of over diagnosis and over treatment for benign disease

  20. The diagnostic performance of acoustic radiation force impulse elasticity imaging to differentiate malignant from benign thyroid nodules: Comparison with conventional B- mode sonographic findings

    Jung, Won Sang; An, Yeong Yi; Ihn, Yon Kwon; Park, Young Ha [Dept. of Radiology, St. Vincent' s Hospital, The Catholic University of Korea, Suwon (Korea, Republic of)

    2016-02-15

    The purpose of this study was to evaluate the diagnostic performance of acoustic radiation force impulse (ARFI) elasticity imaging. One hundred and twenty-seven thyroid nodules were examined by both ARFI elastography and B-mode sonography. Virtual Touch tissue quantification (VTQ) values of the thyroid nodules were measured. Scoring of B-mode sonographic findings of each thyroid nodules was performed. The sums of these VTQ and the B-mode scores were determined. The comparative diagnostic performances of the VTQ value, the B-mode score, and the combined score were analyzed. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of each scoring mode were: B-mode score, 84%, 85%, 66%, 94%, and 85%; VTQ, 75%, 91%, 73%, 92%, and 86%; and combined score, 88%, 87%, 70%, 95%, and 88%. The areas under the curves for B-mode, VTQ, and combined score were 0.895, 0.837, and 0.912, respectively. Pairwise comparisons of receiver-operating characteristic curves showed no statistical differences between B-mode and VTQ, and B-mode and combined score. Combined score showed better diagnostic performance than VTQ value (p = 0.0023). ARFI VTQ value is a good diagnostic modality for differentiating malignant thyroid nodules from benign nodules. However, ARFI evaluation is not superior to B-mode sonographic evaluation, but only has a better diagnostic performance when combined with B-mode sonographic findings.

  1. [Echotomography and color-Doppler in the diagnosis of thyroid carcinoma].

    Messina, G; Viceconti, N; Trinti, B

    1996-01-01

    Ultrasound examination of the thyroid gland is used extensively in the diagnosis of thyroid carcinoma: it is easy and rapid to perform and widely available. Ultrasound enables easy identification of the image of disease foci within the gland, especially when high frequency probes (7.5-10 MHz) are used. Thyroid nodules are subdivided on the basis of their echostructure into hypoechoic solid, isoechoic solid, and hyperechoic solid, mixed, and liquid. In neoplastic pathologies, a hypoechoic echostructure is not pathognomonic of malignancy but must be regarded with suspicion, especially if it is an isolated nodule in a male patient and continues to grow during suppressive therapy. In fact, thyroid neoplasms evidence a hypoechoic echostructure in 60-70% of the cases, while a hyperechoic echostructure is present in only 2-4%. Only 15-25% of neoplasms appear as isoechoic nodules; a mixed echostructure is rarely (5-10% of the cases) seen. Color-Doppler patterns are classified into four types: I) nodules without internal or perinodular vascularization; II) nodules with vascularization confined to extranodular tissue; III) nodules with significant intra- and perinodular vascularization; IV) increased vascularization (or "thyroid inferno"). The vast majority of thyroid carcinoma (90%) presents type III vascularization. We therefore suggest the routine use of ultrasonography and color-Doppler studies in conjunction with fine-needle aspiration cytology for the diagnostic evaluation of thyroid carcinoma.

  2. Cytomorphological features of oncocytic variant of papillary thyroid carcinoma with lymphocytic thyroiditis

    Nivedita Patnaik

    2016-01-01

    Full Text Available Cytological diagnosis of hurthle cell lesions of thyroid is a diagnostic dilemma. Presence of hurthle cells on fine needle aspiration (FNA leads to a wide range of differential diagnosis including benign and malignant entities. The oncocytic variant of papillary thyroid carcinoma (PTC is one entity of the vast list of differentials of which very few cases have been reported to date. We report a case of oncocytic variant of PTC in a 28-year-old female diagnosed on cytomorphology. The findings of FNA smears of the first aspirate were not sufficient for a definitive diagnosis. Repeat FNA was done to rule out the possibility of autoimmune thyroiditis/thyroid neoplasm. The repeat FNA smears showed oncocytic cells present in papillary and loosely cohesive clusters. Many of the cells displayed nuclear features of PTC and the case was finally diagnosed as PTC; oncocytic variant. Thyroidectomy specimen revealed PTC; oncocytic variant with lymphocytic thyroiditis in the surrounding tissue. Thus, in cytology practice, concurrent autoimmune thyroiditis may pose a problem in diagnosis of PTC; oncocytic variant.

  3. 弹性成像评分联合超声造影鉴别桥本甲状腺炎背景下结节良恶性临床价值的研究%Clinical value of elastography scores combining with contrast-enhanced ultrasound in identifying benign and malignant thyroid nodules co-existed with Hashimoto′s thyroiditis

    于风霞; 王建红; 王彦华; 李萍; 牛晓燕; 王宏桥

    2016-01-01

    分析160个桥本甲状腺炎背景下结节的弹性成像及超声造影特点。良、恶性结节的弹性成像评分及造影模式差异有统计学意义。弹性成像联合超声造影能较好地鉴别诊断桥本甲状腺炎背景下结节的良恶性。%[Summary] Elastographic and contrast-enhanced ultrasonographic features were reviewed in 160 thyroid nodules co-existed with Hashimoto's thyroiditis. Significant differences in the elastography scores and enhancement pattern were found between malignant and benign thyroid nodules. For the differential diagnosis of benign and malignant thyroid nodules co-existed with Hashimoto's thyroiditis, the combined scores of elastography scores and contrast-enhanced ultrasound features may offer greater values.

  4. OLOGICAL EVALUATION OF SOLITARY THYROID NODULES TO PREDICT BENIGN OR MALIGNANT NATURE: A STUDY IN A RURAL TERTIARY CARE HOSPITAL IN SOUTH INDIA

    Madnavi

    2014-02-01

    Full Text Available rpose of this study was to assess the diagnostic accuracy of high frequency Ultrasonography to differentiate the benign and malignant thyroid nodules and to correlate the sonological findings with cytopathological diagnosis. Individual sonological c riteria to indicate the malignant nature of a nodule are discussed. MATERIALS AND METHODS: This was a retrospective study done between January , 2012 and November , 2013 in the Department of Radio - diagnosis at Maharajah’s Institute of Medical Sciences , Nelli merla , Andhra Pradesh . A total of 180 patients with solitary nodule proved on ultrasonography , followed by ultrasound guided fine needle aspiration ( FNA were included in our study. The sonological characteristics of nodules studied were size , shape , margins , echogenicity , calcification , internal composition , presence or absence of peripheral hallow and vascularity pattern. The results were compared to cytopathological findings. RESULTS: Among the 180 nodules examined , 135 nodules ( 75% were proved to be benign and 45 nodules (25% were proved to be malignant. Patients belonging to all age groups were seen with a clear female preponderance. CONCLUSION: High frequency ultrasound is of great value in characterization and differentiation of benign and mali gnant nodules. It can be successfully used as a guideline to select the patients for fine needle aspiration , in case of suspicious malignant nodule. The sonological criteria favoring malignancy are irregular margins , hypoechogenicity , taller than wide shap e , microcalcifications and internal vascularity. The combination of multiple parameters increases the pridictive value of ultrasonography

  5. [The implementation of computer model in research of dynamics of proliferation of cells of thyroid gland follicle].

    Abduvaliev, A A; Gil'dieva, M S; Khidirov, B N; Saĭdalieva, M; Khasanov, A A; Musaeva, Sh N; Saatov, T S

    2012-04-01

    The article deals with the results of computational experiments in research of dynamics of proliferation of cells of thyroid gland follicle in normal condition and in the case of malignant neoplasm. The model studies demonstrated that the chronic increase of parameter of proliferation of cells of thyroid gland follicle results in abnormal behavior of numbers of cell cenosis of thyroid gland follicle. The stationary state interrupts, the auto-oscillations occur with transition to irregular oscillations with unpredictable cell proliferation and further to the "black hole" effect. It is demonstrated that the present medical biologic experimental data and theory propositions concerning the structural functional organization of thyroid gland on cell level permit to develop mathematical models for quantitative analysis of numbers of cell cenosis of thyroid gland follicle in normal conditions. The technique of modeling of regulative mechanisms of living systems and equations of cell cenosis regulations was used

  6. Sonographic appearance of primary thyroid lymphoma-preliminary experience.

    Yu Xia

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

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

    Lawrence Julia

    2009-11-01

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

  8. Application of color Dopplar ultrasound-guided percutaneous radiofrequency ablation in treatment of thyroid neoplasms%彩超引导在经皮穿刺射频消融治疗甲状腺肿瘤中的价值

    孔爱红; 杨世财; 刘佳

    2011-01-01

    目的:评价彩超引导在经皮穿刺射频消融治疗甲状腺肿瘤中的应用价值.方法:对确诊为甲状腺腺瘤及囊腺瘤的患者30例,均采用彩超引导下进行穿刺途径的麻醉,并同时在甲状腺与颈动脉鞘之间、甲状腺与食管气管之间注射麻药,然后彩超导向将射频针刺入肿瘤的中心位置进行消融并通过超声实时观察,当肿瘤完全被强回声覆盖.确定完成治疗.结果:本组30例均成功射频消融,单次单点成功消融9例,两点消融13例,三点消融8例,最短需用3 min,最长需用10 min,平均(4.5±1.3)min,术中未出现损伤周围组织、大出血等并发症.结论:射频消融治疗甲状腺肿瘤是一种新兴的微创治疗方法,而彩色超声的实时引导并监控治疗,是手术成功的关键.%Objective: To evaluate the application value of color Dopplar ultrasound-guided percutaneous radiofrequency ablation (RFA) in treatment of thyroid neoplasms.Methods: 30 patients who were diagnosed with thyroid adenoma and sac adenoma accepted ultrasound-guided anesthesia.Anesthetic were injected between carotid scabbard and thyroid; between gullet, trachea and thyroid at the same time.Under real-time color ultrasonic guided and monitoring, RFA needles were pierced to the center location of tumor to do ablation therapy, when the tumor was completely covered with strong echo, the treatment completed.Results: The 30 cases all were successful, among them, 9 cases used single-point ablation treatment, 13 cases used two-point ablation treatment and 8 cases used three-point ablation treatment.The shortest time was 3min-utes, the longest time was 10 minutes, with an average of (4.5±1.3) minutes.In the operation, all the cases did not have the surrounding tissue damage, the massive hemorrhage or ether complications.Conclusion: Radiofrequency ablation for thyroid neoplasms is a new type of minimally invasive treatment method, and the real-time color ultrasonic guided and

  9. Less common neoplasms of the pancreas

    Abby L Mulkeen; Peter S Yoo; Charles Cha

    2006-01-01

    Recently, there has been an increased recognition of neoplasms of the pancreas other than ductal adenocarcinoma. Although not as well studied or characterized as pancreatic adenocarcinoma there are many distinct lesions which exhibit diverse biological behaviors and varying degrees of malignancy. These lesions include: endocrine neoplasms, cystic tumors, solid pseudopapillary tumors, acinar cell carcinoma, squamous cell carcinoma, primary lymphoma of the pancreas, and metastatic lesions to the pancreas. These less common neoplasms are being diagnosed more frequently as the number and sensitivity of diagnostic imaging studies increase. This review article discusses the clinical course,diagnosis, and treatment of these less common, but quite relevant, neoplasms of the pancreas.

  10. Anaplastic thyroid cancer, tumorigenesis and therapy.

    O'Neill, J P

    2010-03-01

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

  11. A clinical analysis of 56 elderly patients with primary gastrointestinal malignant neoplasms%老年消化道原发恶性肿瘤患者56例临床特点分析

    范勤; 韩全利; 张雯; 杨春敏

    2012-01-01

    目的 研究老年患者消化系统原发恶性肿瘤的临床特点.方法 选取2005~2011年我科住院的56例老年消化道原发恶性肿瘤患者,对其首发症状、诊断方法、病变部位、病理类型、合并症、治疗及预后进行分析.结果 本组患者16例(28.6%)无症状,40例(71.4%)因消化系统症状就诊;50例(89.2%)通过消化内窥镜检查诊断;胃窦(24.6%)和乙状结肠(19.3%)为好发部位;腺癌为常见病理类型(47例,83.9%);高血压(42.8%)、糖尿病(33.9%)和冠心病(25%)为本组患者的常见合并症;肺、肝为常见的血行转移部位,中位生存时间为8.5个月,最长带瘤已生存86个月.结论 消化道内窥镜是诊断老年消化道原发恶性肿瘤的重要方法,老年消化道原发性恶性肿瘤患者带瘤生存时间较长,免疫及营养支持治疗在延长患者生存期方面起到重要的作用.%Objective To investigate the Clinical features of elderly patients with primary gastrointestinal malignant neoplasms.Methods Fifty-six elderly patients with primary gastrointestinal malignant neoplasms who have been treated in our department from 2005 to 2010 were Selected, and their first clinical symptoms, diagnosis methods, disease location, pathology,complications, treatment and prognosis were analyzed. Results Of these patients, 16 patients (28.6%) are discovered with no symptoms, 40 patients (71.4%) were treated because of digestive symptoms. 50 patients (89.2%) were diagnosed by digestive endoscopy. Antrum (24.6%) and Sigmoid (19.3%) were the most common location where the tumor occurred. Adenocarcinoma (47 cases, 83.9%) was the most common pathology type. Hypertension (42.8%), diabetes (33.9%) and Coronary heart disease (25%) are the most common complications. Lung and liver are the most common organs where the cancer occurred hematogenous metastasis. The median survival time is 8.5 months; the longest survival time with tumor is 86 months. Conclusion

  12. Silent thyroiditis

    ... lymphocytic thyroiditis; Painless thyroiditis; Postpartum thyroiditis; Thyroiditis - silent; Hyperthyroidism - silent thyroiditis ... earliest symptoms result from an overactive thyroid gland ( hyperthyroidism ). These symptoms may last for up to 3 ...

  13. Metastasis of Colorectal Adenocarcinoma to the Thyroid: A Case Report and Review of the Literature

    C. Goatman

    2012-01-01

    Full Text Available Purpose. We present a rare case of colorectal metastasis to the thyroid five years following primary colonic resection. This case highlights the need to be cognisant of unusual sites of metastasis from colorectal neoplasms. Case Report. An 82-year-old male patient had a panproctocolectomy for synchronous colorectal tumours. Five years later he was found to have lung and thyroid metastases found incidentally on imaging for an acute presentation with small bowel obstruction. Conclusion. Metastases to the thyroid should be considered in the differential diagnosis of the thyroid lesion with any history of malignancy, particularly with increasing patient age and when renal cell carcinoma or lung, colon, or breast primaries are involved.

  14. Can benign and malignant thyroid nodules be differentiated with thallium 201. Le thallium 201 permet-il de differencier le nodule thyroidien benin du nodule malin

    Hermans, J.; Schmitz, A.; Merlo, P.; Bodart, F.; Beauduin, M. (Hopital de Jolimont, Haine-Saint-Paul (Belgium))

    1993-01-01

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

  15. Premalignant cystic neoplasms of the pancreas.

    Dudeja, Vikas; Allen, Peter J

    2015-02-01

    Due to increasing utilization of cross-sectional imaging, asymptomatic pancreatic cysts are frequently being diagnosed. Many of these cysts have premalignant potential and offer a unique opportunity for cancer prevention. Mucinous cystic neoplasm and intraductal papillary mucinous neoplasm are the major premalignant cystic neoplasms of pancreas. The prediction of the risk of malignancy (incidental and future risk of malignant transformation) and balancing the risks of watchful waiting with that of operative management with associated mortality and morbidity is the key to the management of these lesions. We review the literature that has contributed to the development of our approach to the management of these cystic neoplasms. We provide an overview of the key features used in diagnosis and in predicting malignancy. Particular attention is given to the natural history and management decision making.

  16. Diagnosis and reporting of follicular-patterned thyroid lesions by fine needle aspiration.

    Faquin, William C

    2009-03-01

    Over the past 3 decades, fine needle aspiration (FNA) has developed as the most accurate and cost-effective initial method for guiding the clinical management of patients with thyroid nodules. Thyroid FNA specimens containing follicular-patterned lesions are the most commonly encountered and include various forms of benign thyroid nodules, follicular carcinomas, and the follicular variant of papillary thyroid carcinoma. Based primarily upon the cytoarchitectural pattern, FNA is used as a screening test for follicular-patterned lesions to identify the majority of patients with benign nodules who can be managed without surgical intervention. The terminology and reporting of thyroid FNA results have been problematic due to significant variation between laboratories, but the recent multidisciplinary NCI Thyroid FNA State of the Science Conference has provided a seven-tiered diagnostic solution. A key element of this approach is the category "atypical cells of undetermined significance" (ACUS) which is used for those aspirates which cannot be easily classified as benign, suspicious, or malignant. Lesions in this category represent approximately 3-6% of thyroid FNAs and have a risk of malignancy intermediate between the "benign" category and the "suspicious for a follicular neoplasm" category. The recommended follow-up for an ACUS diagnosis is clinical correlation and in most cases, repeat FNA sampling.

  17. Late bone metastasis from an apparently benign oncocytic follicular thyroid tumor

    Boronat, Mauro; Cabrera, Juan J; Perera, Carmen; Isla, Concepción; Nóvoa, Francisco J

    2013-01-01

    A man underwent total thyroidectomy for goiter when he was 62 years old. The pathology report informed on a 5.5 cm oncocytic follicular adenoma and a 3.5 mm papillary microcarcinoma. Due to the papillary tumor, he was treated with ablative radioiodine therapy and suppressive doses of levothyroxine. After uneventful follow-up for 9 years, increased levels of serum thyroglobulin were detected. Further imaging studies including a whole body scan (WBS) after an empirical dose of 200 mCi 131I were negative. Two years later, a 99mTc SestaMIBI WBS and a 2-[18F]-fluoro-2-deoxy-d-glucose positron-emission tomography showed a well-delimited focal uptake in the right femur. A bone biopsy of the lesion demonstrated metastasis of follicular thyroid carcinoma. Retrospective histological reexamination of available material from the primary oncocytic thyroid tumor failed to reveal definitive traits of malignancy. Learning points Oncocytic follicular thyroid tumors are a relatively uncommon variant of follicular thyroid neoplasms mostly composed of distinctive large oxyphilic cells (Hürthle cells).Criteria for the distinction between benign and malignant oncocytic neoplasms are not different from those used in the diagnosis of ordinary follicular tumors.Some cases of apparently benign oncocytic neoplasms have been found to develop malignant behavior.Search to rule out vascular and capsular invasion should be particularly exhaustive in histological assessment of oncocytic thyroid tumors.Even so, long-term surveillance remains appropriate for patients with large apparently benign oncocytic tumors. PMID:24616777

  18. 盐城市2009年居民恶性肿瘤疾病负担分析%Disease burden of malignant neoplasm among residents of Yancheng city, 2009

    孙晓凯; 刘荣海; 李峰

    2011-01-01

    Objective To estimate the disease burden of malignant neoplasm among residents in Yancheng city for making intervention measures on malignant tumor and public health plan. Methods Data on malignant neoplasm morbidity and mortality among residents of Yancheng city in 2009 were collected and years of life lost(YLL) ,years lived with disability(YLLD) ,and disability-adjusted life year( DALY )were calculated with the tools provided by World Health Organization. Results The incidence and standardized incidence rate of malignant neoplasm among the residents were 282.60/100000 and 217.25/100000; the mortality and standardized mortality rate were 215.81/100 000 and 150. 02/100 000. The first five malignatnt tumors were stomach, esophageal, lung, liver, and colorectal cancer. The YLL,YLD,and DALY of malignant neoplasm was 27.41,2. 70,and 30. 11 years per 1 000 person years( 33.04,3.28,36. 32 for male and 21.52,2. 07,23.59 for female ), respectively. The cancers with top four DALYs were liver, stomach, lung, and esophagus cancer with the DALY of 5.77,5. 67,5. 54 ,and 5.44 years per 1 000 person years. Most of the DALYs happened among the residents above 45 years old. The malignant tumors with the highest DALY for the residents at the age of 0 - 29,30 -59,60 -79,and ≥80 years were leukemia,liver,stomach,and esophageal cancer. Conclusion The disease burden of malignant neoplasm is serious and liver, lung, stomach, and esophagus cancer are the major cancers among the residents in Yancheng city.%目的 分析江苏省盐城市居民2009年恶性肿瘤疾病负担情况,为制定肿瘤防治干预措施和公共卫生规划提供参考依据.方法 对盐城市居民2009年恶性肿瘤发病和死亡病例资料进行分析,通过计算恶性肿瘤的死亡损失生命年(YLL)、伤残损失年(YLD)和伤残调整寿命年(DALY)评价盐城市居民恶性肿瘤的疾病负担.结果 盐城市居民2009年恶性肿瘤发病率和标化发病率分别为282.60/10万和217.58/10

  19. Endoscopic ultrasound-guided fine-needle aspiration plus KRAS and GNAS mutation in malignant intraductal papillary mucinous neoplasm of the pancreas

    Bournet, Barbara; Vignolle-Vidoni, Alix; Grand, David; Roques, Céline; Breibach, Florence; Cros, Jérome; Muscari, Fabrice; Carrère, Nicolas; Selves, Janick; Cordelier, Pierre; Buscail, Louis

    2016-01-01

    Background: KRAS and GNAS mutations are common in intraductal papillary mucinous neoplasia of the pancreas (IPMN). The aims of this study were to assess the role of pre-therapeutic cytopathology combined with KRAS and GNAS mutation assays within cystic fluid sampled by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) to predict malignancy of IPMN. Patients and methods: We prospectively included 37 IPMN patients with clinical and/or imaging predictors of malignancy (men: 24; mean age: 69.5 years). Cytopathology (performed on cystic fluid and/or IPMN nodules), KRAS (Exon 2, codon 12) and GNAS (Exon 8, codon 201) mutations assays (using TaqMan® allelic discrimination) were performed on EUS-FNA material. The final diagnosis was obtained from IPMN resections (n = 18); surgical biopsies, EUS-FNA analyses, and follow-up (n = 19): 10 and 27 IPMN were benign and malignant, respectively. Results: Sensitivity, specificity, positive and negative predictive values, and accuracy of cytopathology alone to diagnose IPMN malignancy were 55 %, 100 %, 100 %, 45 %, and 66 %, respectively. When KRAS-mutation analysis was combined with cytopathology these values were 92 %, 50 %, 83 %, 71 %, and 81 %, respectively. GNAS assays did not improve the performances of cytopathology alone or those of cytopathology plus a KRAS assay. Conclusions: In patients with a likelihood of malignant IPMN at pre-therapeutic investigation, testing for KRAS mutations in cystic fluid sampling by EUS-FNA improved the results of cytopathology for the diagnosis of malignancy whereas GNAS mutation assay did not. PMID:27995180

  20. 7.NEOPLASMS

    1993-01-01

    930635 Intensive combination chemotherapy with au-tologous bone marrow transplantation in advanced sol-id tumor:A report of 9 cases.SHEN Baijunet al.Shandong Med Univ,Jinan,250000.Chin J ClinOncol 1993;20(8):587—590.Nine patients with advanced malignancies(3 malig-nant lymphomas,3 osteosarcoma,1 each of Wilm’s tu-mor,brain tumor and bone metastasis)were treated

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

    Selvaggi Federico

    2012-05-01

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

  2. Papillary thyroid microcarcinoma in a thyroid pyramidal lobe

    Ha, Tae Kwan; Kim, Dong Wook; Park, Ha Kyoung; Jung, Soo Jin [Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2014-12-15

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

  3. 桥本甲状腺炎合并甲状腺疑似恶性结节的临床病理特点%The Clinico-pathological Features of Suspected Malignant Nodules Associated with Hashimoto's Thyroiditis-Diagnosis

    华晨; 傅永清; 周剑

    2013-01-01

    [Objective]To analyze the clinical and biological characteristics of suspected malignant thyroid nodules associated with Hashimoto thyroiditis .To summarize different characteristics of benign and malignant nodules,diagnosis and treatment of suspected malignant nodules associated with Hashimoto's thy-roiditis. [Methods]Surgical y and pathological y confirmed, 58 cases of suspected malignant thyroid nodules associated with Hashimoto's thyroiditis were retro-spectively analyzed with clinical and pathological data. The differences of gender, age, number of nodules, calcification, and thyroid hormone and thyroid an-tibodies levels between malignant and benign nodules were compared from January 2009 to December 2011 .[Results] The average age of malignant thyroid nodules coexisting with HT group was significantly lower than that of benign nodules coexisting with HT group( P<0.05). The proportion of nodular calcifi-cation in malignant thyroid nodules coexisting with HT group was significantly higher than that in benign nodules coexisting with HT group( P<0.05). Pre-operative TSH and anti-TG levels in malignant thyroid nodules coexisting with HT group were significantly higher than that in benign nodules coexisting with HT group. Preoperative FT3, FT4, anti-TPO levels, sex ratio and number of lesions between the two groups were not statistical y significant. [Conclu-sions] The key point of preoperative diagnosis:patients of malignant thyroid nodules coexisting with HT are associated with youth, calcified nodules, elevated serum TSH and anti-TG levels.%[目的]研究桥本甲状腺炎(hashimoto's thyroiditis,HT)合并甲状腺疑似恶性结节的临床病理特点,总结良、恶性结节的不同特点,恶性结节的临床诊断要点及手术治疗经验。[方法]回顾性分析2009年1月至2011年12月我院收治的58例HT合并甲状腺疑似恶性结节的临床病理资料。比较恶性结节及良性结节在性别构成、年龄、结节数目、有无

  4. Radiofrequency ablation for postsurgical thyroid removal of differentiated thyroid carcinoma

    Xu, Dong; Wang, Lipin; Long, Bin; Ye, Xuemei; Ge, MingHua; Wang, Kejing; Guo, Liang; Li, Linfa

    2016-01-01

    Differentiated thyroid carcinoma (DTC) is the most common endocrine malignancy. Surgical removal with radioactive iodine therapy is recommended for recurrent thyroid carcinoma, and the postsurgical thyroid removal is critical. This study evaluated the clinical values of radiofrequency ablation (RFA) in the postsurgical thyroid removal for DTC. 35 DTC patients who had been treated by subtotal thyroidectomy received RFA for postsurgical thyroid removal. Before and two weeks after RFA, the thyro...

  5. The triage efficacy of fine needle aspiration biopsy for follicular variant of papillary thyroid carcinoma using the Bethesda reporting guidelines.

    Kurian, Elizabeth M; Dawlett, Marilyn; Wang, Jianping; Gong, Yun; Guo, Ming

    2012-05-01

    Diagnosis of follicular variant of papillary thyroid carcinoma (FVPTC) by ultrasound-guided fine-needle aspiration (FNA) is challenging. In this retrospective review, we evaluated triage efficacy (i.e., potential for triggering surgical intervention) in 44 archived FNA biopsies of surgically confirmed FVPTC obtained between December 2006 and December 2008. We compared the original FNA diagnoses with reclassified diagnoses based on 2007 National Cancer Institute (NCI)/Bethesda recommendations, and reviewed FNA cytologic features. Original FNA diagnoses included colloid nodule (7%, 3/44), atypical follicular cells (5%, 2/44), follicular lesion (11%, 5/44), follicular neoplasm (16%, 7/44), suspicious for malignancy/PTC (27%, 12/44), and papillary thyroid carcinoma (34%, 15/44). Reclassified diagnoses included indeterminate (5%, 2/44), colloid nodule (7%, 3/44), atypical cells of undetermined significance [ACUS] (7%, 3/44), Hurthle cell neoplasm (2%, 1/44), follicular neoplasm (7%, 3/44), suspicious for malignancy/PTC (25%, 11/44), and PTC (48%, 21/44). Triage efficacy was 77% (34/44) for original diagnoses versus 82% (36/44) for reclassified FNA diagnoses. We frequently observed cytologic features of PTC, such as nuclear grooves and fine chromatin; conversely, intranuclear inclusions, though present in 77% cases, were scant. Our review findings suggest that lack of characteristic cytologic features of PTC,coexistence with other thyroid lesions, and small tumor size arethe major obstacles to FNA diagnosis of FVPTC. Reclassification of thyroid FNA diagnoses does not significantly improve triage efficacy. Furthermore, FNA diagnoses of follicular neoplasm and suspicious for malignancy are valuable in patients with FVPTC because they trigger triage toward surgical intervention.

  6. The Role of Insulin-Like Growth Factor 1 in the Development of Benign and Malignant Thyroid Nodules

    Ayşe Karadayı

    2012-06-01

    Full Text Available Objective: This study aims to investigate the role of IGF-1 in the development of nodular thyroid disease. Material and Methods: A total number of 100 consecutive patients operated for nodular thyroid disease in our institution were included in this prospective study. In addition to classical pathological examinations, nodules and extranodular healthy tissues were sampled and immunochemically stained for IGF-1. The materials were independently evaluated using an Allred Scoring System ranging from 0 to 8. If the score was ≥1, the tissue was accepted as IGF-1 positive.Results: IGF-1 positivity was observed in 88% and 58% of the samples obtained from nodules and extranodular healthy tissues, respectively. Allred 8-unit scores were higher in benign nodules (n=89; 4.1±2.3 and papillary carcinomas (n=7; 6.7±1.3, than in extranodular healthy tissues in the same patients (2.3±2.3 and 3.3±1.9, respectively; and higher in papillary carcinomas than in benign nodules, when the scores were compared to each other (p<0.01 for all comparisons. Conclusions: Allred 8-unit scores for IGF-1 increase in the presence of benign thyroid nodules, papillary cancer. The results of our study support the findings of previous studies demonstrating the role of IGF-1 in the development of thyroidal nodules.

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

    Chiofalo Maria

    2012-02-01

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

  8. The Challenge of Cancer Genomics in Rare Nervous System Neoplasms: Malignant Peripheral Nerve Sheath Tumors as a Paradigm for Cross-Species Comparative Oncogenomics.

    Carroll, Steven L

    2016-03-01

    Comprehensive genomic analyses of common nervous system cancers provide new insights into their pathogenesis, diagnosis, and treatment. Although analogous studies of rare nervous system tumors are needed, there are major barriers to performing such studies. Cross-species comparative oncogenomics, identifying driver mutations in mouse cancer models and validating them in human tumors, is a promising alternative. Although still in its infancy, this approach is being applied to malignant peripheral nerve sheath tumors (MPNSTs), rare Schwann cell-derived malignancies that occur sporadically, after radiotherapy, and in neurofibromatosis type 1. Studies of human neurofibromatosis type 1-associated tumors suggest that NF1 tumor suppressor loss in Schwann cells triggers cell-autonomous and intercellular changes, resulting in development of benign neurofibromas; subsequent neurofibroma-MPNST progression is caused by aberrant growth factor signaling and mutations affecting the p16(INK4A)-cyclin D1-CDK4-Rb and p19(ARF)-Mdm2-p53 cell cycle pathways. Mice with Nf1, Trp53, and/or Cdkn2a mutations that overexpress the Schwann cell mitogen neuregulin-1 or overexpress the epidermal growth factor receptor validate observations in human tumors and, to various degrees, model human tumorigenesis. Genomic analyses of MPNSTs arising in neuregulin-1 and epidermal growth factor receptor-overexpressing mice and forward genetic screens with Sleeping Beauty transposons implicate additional signaling cascades in MPNST pathogenesis. These studies confirm the utility of mouse models for MPNST driver gene discovery and provide new insights into the complexity of MPNST pathogenesis.

  9. Primary Non-Hodgkin’s Lymphoma of the thyroid with lymphocytic thyroiditis

    Raviprakash, C. S.; Joseph, Cherian; Xavier, Saju; Raj, Girish

    2005-01-01

    Primary Lymphoma of the thyroid is one of the very rare entities accounting to less than 2% of thyroid malignancies. We present a case of primary Non-Hodgkin’s Lymphoma of the thyroid with lymphocytic thyroiditis in a 60 year old woman. The patient presented with a rapidly growing nodular mass in the thyroid. The histological and immune marker features of the tumour were consistent with Primary Non-Hodgkin’s Lymphoma of the thyroid with associated thyroiditis.

  10. Expression of Phosphatase and Tensin Homologue, phospho-Akt, and p53 in Acral Benign and Malignant Melanocytic Neoplasms (Benign Nevi, Dysplastic Nevi, and Acral Melanomas)

    Lyu, So Min; Wu, Ju Yeon; Byun, Ji Yeon; Choi, Hae Young; Park, Sang Hee

    2016-01-01

    Background The role of the phosphatidylinositol-3 kinase signaling pathway in the development of acral melanoma has recently gained evidence. Phosphatase and tensin homologue (PTEN), one of the key molecules in the pathway, acts as a tumor suppressor through either an Akt-dependent or Akt-independent pathway. Akt accelerates degradation of p53. Objective We assessed the expression of PTEN, phospho-Akt (p-Akt), and p53 by immunohistochemistry in benign acral nevi, acral dysplastic nevi, and acral melanomas in the radial growth phase and with a vertical growth component. Methods Ten specimens in each group were included. Paraffin-embedded specimens were immunostained with antibodies for PTEN, p-Akt, and p53. We scored both the staining intensity and the proportion of positive cells. The final score was calculated by multiplying the intensity score by the proportion score. Results All specimens of benign acral nevi except one showed some degree of PTEN-negative cells. The numbers of p-Akt and p53-positive cells were higher in acral dysplastic nevi and melanoma than in benign nevi. P-Akt scores were 1.7, 1.8, 2.6, and 4.4, and p53 scores were 2.0, 2.1, 3.8, and 4.1 in each group. PTEN and p-Akt scores in advanced acral melanoma were higher than in the other neoplasms. Conclusion The expression of PTEN was decreased and the expression of p-Akt was increased in acral melanoma, especially in advanced cases. The PTEN-induced pathway appears to affect the late stage of melanomagenesis. Altered expression of p-Akt is thought to be due to secondary changes following the loss of PTEN. PMID:27746632

  11. [Primary nontransitional neoplasms of the bladder].

    Varo Solís, C; Soto Delgado, M; Hens Pérez, A; Baez Perea, J M; Estudillo González, F; Juárez Soto, A; Bachiller Burgos, J; Beltrán Aguilar, V

    1999-01-01

    Revision of all primitive tumours of the bladder diagnosed in our Service between July 1990 and July 1998. Among a total of 703 neoplasms of the bladder only 14 were non-transitional primitive tumours, accounting for just 1.98%. Eleven were malignant neoplasms with a diagnosis of epidermoid carcinoma in nine cases, one adenocarcinoma and one bladder adenocarcinoma. The other three were benign tumours: one haemangioma and two leiomyomas. From a clinical perspective, the predominant symptom was haematuria, followed by irritative symptoms. The two leiomyomas were accidental findings during a gynaecological examination (ultrasound) and a diagnostic examination for a nephritic colic (urography). The diagnostic means used and the extension studies were the same as used for transitional neoplasms. In general, treatment of benign neoplasms was partial cystectomy or transurethral resection while it was radical surgery for the malignant tumours when the existing criteria were an indication for that type of surgery (cystoprostatectomy with bypass), since there are no definite criteria with regards to therapy due to the low incidence of these tumours. Only three of the 11 patients with malignant neoplasms are still alive. All the others died within one year of diagnosis, an evidence of the aggressiveness of these tumours. These cases were considered primitive bladder tumours once it was concluded that there was no relation with any previous or simultaneous transitional neoplasms and that there had been no primitive tumour in a different organ.

  12. The Experience Analysis of Parathyroid Gland Protection During the Benign Thyroid Neoplasms Surgery%良性甲状腺肿瘤手术中甲状旁腺保护的经验分析

    冯勇; 张金峰; 周连仲; 徐开旭

    2013-01-01

    Objective :To explore the protection mode of parathyroid glands during the benign thyroid neoplasms sur-gery .Methods :Retrospective analysis of clinical data of 500 cases of thyroid surgery .From Aug .2006 to Aug .2012 . Traditional group only preserved posterior capsule ,but not presented parathyroid glands during the operation .Howev-er ,improvement group were performed the liberation and preservation of parathyroid glands and its blood supply during the operation .Postoperative serum calcium level was monitored dynamicly .Results :Postoperative incidence of hypocal-cemia in patients exposing and preserving of parathyroid glands during the operation was significantly lower than that in patients with no special preserving of parathyroid glands (P<0 .05) .Conclusion:During the thyroidectomy procedure ,it can effectively decrease the damage of parathyroid to expose and protect the parathyroid in situ by fine membrane anat-omy .%目的:探讨良性甲状腺肿瘤手术中甲状旁腺的保护方式,减少术后低血钙的发生率。方法:回顾性分析2006年8月-2012年8月500例良性甲状腺手术的临床资料,随机分传统组和改进组,传统组保留甲状腺后被膜,未寻找甲状旁腺;改进组暴露并保护甲状旁腺,精细被膜解剖,尽量保存甲状旁腺的血供及完整性。术后动态观察监测血清钙变化情况。结果:在术中暴露并保护甲状旁腺组中,术后低钙血症的发生率较未寻找甲状旁腺组患者明显降低,两组比较有统计学意义(P<0.05)。结论:在良性甲状腺肿瘤手术中,采用精细被膜解剖,暴露并原位保护好甲状旁腺及血供,可有效降低甲状旁腺的损伤。

  13. Dignosis and Treatment of Primary Malignant Lymphoma of the Thyroid Gland%原发性恶性甲状腺淋巴瘤的诊断与治疗

    Peter Meusers; Britta Elo; Andrea Wittig; ZOU Ping

    2003-01-01

    原发性恶性甲状腺淋巴瘤是一种罕见病,约占甲状腺恶性疾病的1%~3%,甚至不到非何杰金氏淋巴瘤的1%.根据改良的Ann-Arbor分类法对原发性甲状腺淋巴瘤所下的定义,此类淋巴瘤或局限于甲状腺(IE期),或累及甲状腺与其邻近的膈上淋巴结(ⅡE期).原发性甲状腺淋巴瘤是一种异源性疾病,它包括许多淋巴瘤的特性.本文的重点在于原发性甲状腺淋巴瘤的诊断和治疗.%Primary malignant lymphoma of the thyroid gland is a rare disease comprising about 1%-3% of the thyroid malignancies,and this uncommon lymphoma represents less than 1% of all non-Hodgkinlymphomas(NHL).According to the modified Ann-Arbor-Classification primary thyroid lymphoma by definition is a lymphoma that is restricted to the thyroid gland(stage IE)or involves the thyroid gland and supradiaphragmatic predominantly adjacent thyroid lymph nodes(stage IIE).Primary thyroid lymphoma is a heterogenous disease encompassing a wide variety of lymphoma entities.The diagnosis and treatment of this lymphoma are emphasis of this article.

  14. 分析慢性淋巴细胞性甲状腺炎合并甲状腺恶性肿瘤的临床诊治%Clinical Analysis of the Diagnosis and Treatment of Chronic Lymphocytic Thyroiditis Associated With Thyroid Malignancy

    门炳玲

    2015-01-01

    目的:探讨慢性淋巴细胞性甲状腺炎合并甲状腺恶性肿瘤的诊断与治疗。方法分析我院20例慢性淋巴细胞性甲状腺炎合并甲状腺恶性肿瘤患者的诊断及治疗过程。结果所有患者经医学检测确诊,患者血清甲状腺抗体明显升高,采用外科手术切除治疗术后2年内,16人无复发转移,3人医治无效死亡,1人随访失联。结论术前医学检测可提高诊断率,行外科切除手术可有效治疗慢性淋巴细胞性甲状腺炎合并甲状腺恶性肿瘤。%Objective To investigate the diagnosis and treatment of chronic lymphocytic thyroiditis associated with thyroid malignancy. Methods 20 cases of patients with chronic lymphocytic thyroiditis associated with thyroid malignancy diagnosis and treatment process were chosen. Results All patients were diagnosed by medical examination, serum thyroid antibodies were elevated, received surgical resection after 2 years, 16 people without recurrence and metastasis, 3 people died of his wounds, 1 cases lost contact. Conclusion Preoperative medical examination can improve the diagnosis rate. Surgical resection can be is effective in the treatment of chronic lymphocytic thyroiditis associated with thyroid malignancy.

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

    Stjepanovic N

    2014-04-01

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

  16. ROLE OF ULTRASOUND IN THYROID DISORDERS

    Janani Parkkunam; Balasubramanian Thiagarajan

    2015-01-01

    Ultrasonography has established itself has a useful tool in evaluating and managing thyroid disorders. This article provides an overview of basic principles of ultrasound, how it is used in different thyroid disorders, different sonographic pattern of thyroid disorders, comparative features of malignant and benign nodule, ultrasound features of diffuse thyroid disorders and congenital thyroid disorders, ultrasound guided FNAC, advanced techniques of ultrasound in thyroid imaging.

  17. Clinical and Epidemiological Clinical and Epidemiological Characteristics of Colloid Goiter Patients Undergoing Reoperation for Recurrent Thyroid Disease

    Gladys Iglesias Díaz

    2015-11-01

    Full Text Available Background: thyroid disease is one of the most prevalent medical conditions and thyroid cancer is the most common endocrine neoplasm. Thyroid reoperations are more common than it might seem.Objective: to establish the clinical and epidemiological characteristics of patients operated on for colloid goiter undergoing reoperation for recurrent thyroid disease.Methods: a case-series study was conducted at the León Cuervo Rubio Clinical-Surgical Hospital in Pinar del Rio. The sample included all patients (n = 29 who underwent thyroid operation and were reoperated on for recurrent thyroid disease in 2010, 2011 and 2012. The information was obtained from medical records and the register of histopathological diagnoses.Results: most patients (27.6% were in the 40-49 age group and females (79.3% were most affected. Recurrence was observed 5 to 9 years after surgery. Mixed nodules (55.2% followed by cysts (17.2% were the most frequent ultrasound diagnoses. Recurrent thyroid disease was malignant in 9% of patients.Conclusions: patients reoperated on for thyroid disease were mostly females in the fourth and fifth decade of life. The disease recurred in a period of 10 years after the first surgery in a greater number of cases. Follicular-patterned lesions, colloid goiter and cancer were the most common histologic diagnosis.

  18. Diagnosis of bone metastasis from thyroid carcinoma

    Bechsgaard, Thor; Lelkaitis, Giedrius; Jensen, Karl E;

    2015-01-01

    (MRI), but histology revealed a metastasis from thyroid carcinoma, although the patient had no previous history of thyroid malignancy and resection of the thyroid gland was without malignancy. Ultrasound-guided biopsy was possible due to cortical destruction and the multidisciplinary approach with re...

  19. [Ultrasound of the Thyroid].

    Dietrich, C F; Bojunga, J

    2016-02-01

    Thyroid nodules and thyroid abnormalities are common findings in the general population. Ultrasonography is the most important imaging tool for diagnosing thyroid disease. In the majority of cases a correct diagnosis can already be made in synopsis of the sonographic together with clinical findings and basal thyroid hormone parameters and an appropriate therapy can be initiated thereafter. A differentiation of hormonally active vs. inactive nodes, and in particular benign vs. malignant nodules is sonographically, however, not reliably possible. In this context, radioscanning has its clinical significance predominantly in diagnosing hormonal activity of thyroid nodules. Efforts of the past years aimed to improve sonographic risk stratification to predict malignancy of thyroid nodules through standardized diagnostic assessment of evaluated risk factors in order to select patients, who need further diagnostic work up. According to the "Breast Imaging Reporting and Data System" (BI-RADS), "Thyroid Imaging Reporting and Data Systems" (TI-RADS) giving standardized categories with rates of malignancy were evaluated as a basis for further clinical management. Recent technological developments, such as elastography, also showpromising data and could gain entrance into clinical practice. The ultrasound-guided fineneedle aspiration is the key element in the diagnosis of sonographically suspicious thyroid nodules and significantly contributes to the diagnosis of malignancy versus benignity.

  20. The value of ultrasonography in diagnosing benign and malignant thyroid nodules%超声显像对良恶性甲状腺结节的诊断价值

    刘淑红

    2012-01-01

    目的 探讨超声显像对良、恶性甲状腺结节的诊断价值.方法 回顾性分析2008年1月~2011年12月本院收治甲状腺结节患者143例161个结节的超声表现,观察结节内部回声、微钙化、边界、形态和纵横比.结果 恶性甲状腺结节超声主要表现为低回声、微钙化、边界不清、形态不规则、纵横比≥1.良、恶性甲状腺结节超声差异具有统计学意义(P<0.01).上述超声特征对诊断恶性甲状腺结节的特异度为75%~92%,灵敏度为53%~74%.结论 良、恶性甲状腺结节超声显像具有特征性表现,超声检查对甲状腺良、恶性结节鉴别诊断具有重要意义.%Objective To investigate the value of ultrasonography in diagnosing benign and malignant thyroid nodules. Methods The ultrasonography data of 143 patients with 161 thyroid nodules from our hospital between January 2008 and December 2011 were retrospectively analyzed. Internal echoes, microcalcification, border, shape and anteroposterior to transverse diameter ratio ( A/T) were observed. Results The ultrasound findings of malignant thyroid nodules were hypoechogenicity, microcalcification, ill - defined edge, irregular shape and A/T≥1, which were statistically different between benign and malignant thyroid nodules ( P < 0.01). The sensitivity and specificity of above ultrasound findings were 75% - 92% and 53% - 74% respectively. Conclusion Ultrasonography of malignant thyroid nodules has its own characteristics. Ultrasonography plays an important role in diagnosing benign and malignant thyroid nodules.

  1. Aggressive malignant phyllodes tumor

    Nathan Roberts; Dianne M. Runk

    2015-01-01

    Introduction: Originally described in 1838 by Muller, phyllodes tumor is a rare fibroepithelial neoplasm which represents roughly 0.3–0.9% of all breast cancers. Phyllodes tumor are divided into benign, borderline and malignant histologic categories. Malignant phyllodes tumor represent anywhere from 10–30% of all phyllodes tumors. This group has both the potential to recur locally and metastasize, however not all malignant phyllodes behave this way. The challenge lays in predicting which tumo...

  2. The Diagnostic Performance of Thyroid US in Each Category of the Bethesda System for Reporting Thyroid Cytopathology.

    So Yoon Park

    Full Text Available We aimed to evaluate the diagnostic performance of thyroid ultrasonography (US in each category of the Bethesda system and analyze false positive/negative findings using US. This retrospective study included 622 thyroid nodules in 592 patients. The sensitivity, specificity, negative predictive value (NPV, positive predictive value (PPV and accuracy of US in each category of the Bethesda system were evaluated. False positive/negative cases of US were analyzed. Out of the 622 total thyroid FNAs, 179 (28.8% were malignant. The malignancy rates for the 6 categories were as follows: I (nondiagnostic: 9.7%, II (benign: 2.5%, III (atypia/follicular lesion of undetermined significance: 37.5%, IV (suspicious for follicular neoplasm: 5.7%, V (suspicious for malignancy: 100%, and VI (malignancy: 100%. The accuracies of US for the 6 categories were 92.5%, 95.6%, 70.8%, 94.3%, 95%, and 92.4% in category order. US showed the lowest sensitivity (50% in Category IV. Category III demonstrated relatively low sensitivity (66.7% and specificity (73.3% due to a high incidence of follicular variant of papillary thyroid carcinoma and a low number of category III nodules. The most optimal performance of US was revealed in Category I with 88.9% sensitivity and 92.9% specificity. In 22 US false positive cases, the most frequent finding was associated with marked hypoechogenicity and the least finding was noncircumscribed margin. The most common US features of 19 false negative cases were circumscribed iso or hypoechoic nodules. These results highlight the excellent diagnostic performance of US in category I of the Bethesda system and the lowest sensitivity of US in category IV. Awareness of US interpreters regarding these pitfalls can minimize false positive/negative diagnoses and prevent unnecessary interventions.

  3. The Diagnostic Performance of Thyroid US in Each Category of the Bethesda System for Reporting Thyroid Cytopathology

    Park, So Yoon; Hahn, Soo Yeon; Ko, Eun Young; Oh, Young Lyun

    2016-01-01

    We aimed to evaluate the diagnostic performance of thyroid ultrasonography (US) in each category of the Bethesda system and analyze false positive/negative findings using US. This retrospective study included 622 thyroid nodules in 592 patients. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and accuracy of US in each category of the Bethesda system were evaluated. False positive/negative cases of US were analyzed. Out of the 622 total thyroid FNAs, 179 (28.8%) were malignant. The malignancy rates for the 6 categories were as follows: I (nondiagnostic): 9.7%, II (benign): 2.5%, III (atypia/follicular lesion of undetermined significance): 37.5%, IV (suspicious for follicular neoplasm): 5.7%, V (suspicious for malignancy): 100%, and VI (malignancy): 100%. The accuracies of US for the 6 categories were 92.5%, 95.6%, 70.8%, 94.3%, 95%, and 92.4% in category order. US showed the lowest sensitivity (50%) in Category IV. Category III demonstrated relatively low sensitivity (66.7%) and specificity (73.3%) due to a high incidence of follicular variant of papillary thyroid carcinoma and a low number of category III nodules. The most optimal performance of US was revealed in Category I with 88.9% sensitivity and 92.9% specificity. In 22 US false positive cases, the most frequent finding was associated with marked hypoechogenicity and the least finding was noncircumscribed margin. The most common US features of 19 false negative cases were circumscribed iso or hypoechoic nodules. These results highlight the excellent diagnostic performance of US in category I of the Bethesda system and the lowest sensitivity of US in category IV. Awareness of US interpreters regarding these pitfalls can minimize false positive/negative diagnoses and prevent unnecessary interventions. PMID:27348515

  4. Thyroid and parathyroid ultrasound.

    Ghervan, Cristina

    2011-03-01

    Thyroid ultrasound is easy to perform due to the superficial location of the thyroid gland, but appropriate equipment is mandatory with a linear high frequency transducer (7.5 - 12) MHz. Some pathological aspects of the thyroid gland are easily diagnosed by ultrasound, like the enlargement of the thyroid volume (goiter) or the presence of nodules and cysts; while other aspects are more difficult and need more experience (diffuse changes in the structure, echogenicity and vascularization of the parenchyma, differential diagnosis of malignant nodules). Ultrasound has become the diagnostic procedure of choice in guidelines for the management of thyroid nodules; most structural abnormalities of the thyroid need evaluation and monitoring but not intervention. A good knowledge of the normal appearance of the thyroid gland is compulsory for an accurate ultrasound diagnosis.

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

    MA Gordón-Núñez

    2005-06-01

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

  6. Conventional radiological strategy of common gastrointestinal neoplasms

    Yi-Zhuo; Li; Pei-Hong; Wu

    2015-01-01

    This article summarizes the clinical characteristics and imaging features of common gastrointestinal(GI) neoplasms in terms of conventional radiological imaging methods. Barium studies are readily available for displaying primary malignancies and are minimallyor not at all invasive. A neoplasm may be manifested as various imaging findings, including mucosal disruption, soft mass, ulcer, submucosal invasion and lumen stenosis on barium studies. Benign tumors typically appear as smoothly marginated intramural masses. Malignant neoplasms most often appear as irregular infiltrative lesions on barium examination. Tumor extension to adjacent GI segments may be indistinct on barium images. Cross-sectional images such as computed tomography and magnetic resonance imaging may provide more accurate details of the adjacent organ invasion, omental or peritoneal spread.

  7. The new WHO nomenclature: lymphoid neoplasms.

    Leclair, Susan J; Rodak, Bernadette F

    2002-01-01

    The development of the WHO classification of lymphoid neoplasms is a remarkable example of cooperation and communication between pathologists and oncologists from around the world. Joint classification committees of the major hematopathology societies will periodically review and update this classification, facilitating further progress in the understanding and treatment of hematologic malignancies.

  8. Activation of tumor cell proliferation by thyroid hormone in a mouse model of follicular thyroid carcinoma

    2011-01-01

    Thyroid cancers are the most common malignancy of the endocrine system in humans. To understand the molecular genetic events underlying thyroid carcinogenesis, we have generated a mouse model that spontaneously develops follicular thyroid carcinoma similar to human thyroid cancer (ThrbPV/PV mouse). This mutant mouse harbors a dominantnegative mutated thyroid hormone receptor β (denoted PV). The PV mutation was identified in a patient with resistance to thyroid hormone (TH). ThrbPV/PV mice exh...

  9. The follicular variant of papillary thyroid carcinoma: Characteristics of preoperative ultrasonography and cytology

    Yoon, Jung Hyun; Kwon, Hyeong Ju; Kim, Eun Kyung; Moon, Hee Jung; Kwak, Jin Young [Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-01-15

    The goal of this study was to validate the ultrasonography (US) and cytopathological features that are used in the diagnosis of the follicular variant of papillary thyroid carcinoma (FVPTC) and to characterize the role of BRAFV600E mutation analysis in the diagnosis of FVPTC. From May 2012 to February 2014, 40 thyroid nodules from 40 patients (mean age, 56.2 years; range, 26 to 81 years) diagnosed with FVPTC were included in this study. The US features of the nodules were analyzed and the nodules were classified as probably benign or suspicious for malignancy. Twenty-three thyroid nodules (57.5%) underwent BRAFV600E mutation analysis. Clinical information and histopathologic results were obtained by reviewing the medical records of the patients. Thirty nodules (75.0%) were classified as suspicious for malignancy, while 10 (25.0%) were classified as probably benign. Seven of the eight nodules (87.5%) with atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) cytology showed suspicious US features, while one of the two nodules (50.0%) with follicular neoplasm cytology presented suspicious US features. Five of the 23 nodules (21.7%) that underwent BRAFV600E mutation analysis had positive results, all of which were diagnosed as suspicious for malignancy or malignant based on cytology. None of the nodules with benign, AUS/FLUS, or follicular neoplasm cytology were positive for the BRAFV600E mutation. US features allow nodules to be classified as suspicious for malignancy, and the presence of suspicious US features in nodules with ambiguous cytology may aid in the diagnosis of FVPTC. BRAFV600E mutation analysis is of limited value in the diagnosis of FVPTC.

  10. Mucins in the diagnosis and differential diagnosis of pancreatic cystic neoplasms: report of 40 cases

    JI Yuan; TAN Yun-shan; XU Jian-fang; QI Wei-dong; LI Xiao-ping; SU-JIE Ake-su; ZHU Xiong-zeng

    2006-01-01

    @@ Cystic neoplasms of the pancreas account for 10% to 15% of all cystic pancreatic lesions.The majority (85% to 90%) of cystic lesions of the pancreas are pseudocysts. Although cystic neoplasms of the pancreas are rare, they range from benign to malignant neoplasms. The clinical challenge is the differential diagnosis and management of the cystic neoplasms, which represent 10% to 25% of primary pancreatic neoplasms. Pancreatic neoplasms and tumour like lesions with cystic features have been recently reviewed. The incidence of pancreatic cystic neoplasms reported is variable. Because there is no large, systematic study on tne cases from China comparing the incidence and biology of cystic neoplasms of pancreas to that of Western series, we reviewed all the cases of cystic neoplasms from Zhongshan Hospital over 6 years. Most of the neoplasms in our series were classified according to the recent World Health Organization (WHO)classification.1,2

  11. Study on the Relationship between Microvessel Density in Benign and Malignant Thyroid Nodules%不同性质甲状腺结节与微血管密度关系的研究

    邹文远; 刘源源; 李胜; 石思李; 田林

    2012-01-01

    Objective: To investigate the relationship between microvessel density in benign and malignant thyroid nodules. Methods: Papillary thyroid carcinoma, thyroid adenoma, Nodular goiter and normal thyroid tissue were selected, the tissue were processed by HE and immunohistochemical SP staining. Five vascular shader intensive areas are counted under high power field (x 400), the average MVD value = (nl + n2 + n3, + n4, + n5.) / 5. Results: (1) The average MVD of papillary thyroid carcinoma, thyroid adenoma, nodular goiter and normal thyroid tissue were (65.54± 19.21)/HP, (54.54 ± 11.76)/HP,(47.85± 10.92 )/HP and (21.82 ± 7.43)/HP, the average MVD of thyroid papillary cancer was significantly higher than that of thyroid adenoma and normal thyroid tissue (P 40 and ≤ 40 years of papillary thyroid carcinoma patients. Conclusion: The mean MVD value of papillary thyroid cancer was significantly higher than thyroid adenoma, nodular goiter and normal thyroid tissue, and the average MVD of papillary thyroid carcinoma with lymph node metastasis was significantly higher than those without lymph node metastasis.%目的:探讨不同性质甲状腺结节与微血管密度关系,提高认识.方法:分别选取甲状腺乳头状癌、甲状腺腺瘤、结节性甲状腺肿及正常甲状腺组织,病理切片行常规HE染色及免疫组化SP染色.在高倍视野(×400)下选取5个血管着色密集区进行计数并取其平均数,MVD值=(n1 +n2+n3+n4+n5)/5.结果:(1)甲状腺乳头状癌、甲状腺腺瘤、结节性甲状腺肿及正常甲状腺组织平均MVD值分别为(65.54±19.21)个/HP、(54.54±11.76)个/HP、(47.85± 10.92)个/HP、(21.82±7.43)个/HP,甲状腺乳头状癌MVD值显著高于甲状腺腺瘤、结节性甲状腺肿及正常甲状腺组织(P<0.05).甲状腺腺瘤、结节性甲状腺肿MVD值显著高于正常甲状腺组织(P<0.05).(2)伴有淋巴结转移的甲状腺乳头状癌患者MVD值显著高于不伴有淋巴结转移者(P<0.05);男

  12. Thyroid lymphoma on a background of Hashimoto's thyroiditis: PET/CT appearances.

    Mane, Mayuresh; O'Neill, Ailbhe C; Tirumani, Sree Harsha; Shi, Min; Shinagare, Atul B; Fisher, David C

    2014-01-01

    Primary thyroid lymphoma is a rare thyroid tumor accounting for only 5% of all thyroid malignancies. It is more common in patients with a background history of chronic thyroiditis. PET/CT is helpful in the initial staging and for follow up to assess treatment response.

  13. Thyroid disease in the pediatric patient: emphasizing imaging with sonography

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

    2006-04-15

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

  14. Abdominal-Pelvic Actinomycosis Mimicking Malignant Neoplasm

    Teresa Pusiol

    2011-01-01

    Full Text Available Abdominal-pelvic actinomycosis is often mistaken for other conditions, presenting a preoperative diagnostic challenge. In a 46-year-old female, computed tomography showed an abdominal-pelvic retroperitoneal mass extending from the lower pole of the right kidney to the lower pelvis. The patient had a 3-year history of intrauterine device. The mass appeared to involve the ascending colon, cecum, distal ileum, right Fallopian tube and ovary, and ureter anteriorly and the psoas muscle posteriorly. The resection of retroperitoneal mass, distal ileum appendicectomy, right hemicolectomy, and right salpingo-oophorectomy was performed. The postoperative period was uneventful. Penicillin therapy was given for six months without any complication. The retroperitoneal mass measured 4.5 × 3.5 × 3 cm, surrounded adjacent organs and histologically showed inflammatory granulomatous tissue, agglomeration of filaments, and sulfur granules of Actinomyces, with positive reaction with periodic acid Schiff. Right tubo-ovarian abscess was present. Abdominalpelvic actinomycosis should always be considered in patients with a pelvic mass especially in ones using intrauterine device.

  15. Spontaneous proliferative and neoplastic lesions in thyroid and parathyroid glands of nondomestic felids.

    Pope, Jenny P; Steeil, James; Ramsay, Edward C; Reel, Danielle; Newman, Shelley J

    2017-01-01

    Based on microscopic and immunohistochemical characterization, we documented spontaneous proliferative and neoplastic lesions in the thyroid and parathyroid glands of nondomestic felids. Ten animals (4 leopards, 3 tigers, and 3 cougars), all with a previous diagnosis of thyroid neoplasia were identified from the University of Tennessee College of Veterinary Medicine database. The mean age of affected animals was 15.9 y. Twelve neoplasms were identified; 2 animals had 2 concurrent neoplasms. After immunohistochemical characterization using a panel of chromogranin A, thyroglobulin, and calcitonin, 7 of the former thyroid neoplasms were diagnosed as thyroid adenomas, 1 was diagnosed as a thyroid carcinoma, and 4 were diagnosed as parathyroid adenomas. No thyroid medullary neoplasms (C-cell tumors) were diagnosed in the current study. Most of the diagnosed neoplasms were benign (11 of 12), and metastasis was not documented in the single carcinoma. Only 2 animals were suspected to have functional neoplasms (1 thyroid adenoma and 1 parathyroid adenoma), based on associated tissue lesions or serum biochemistry. Other documented lesions in the thyroid and parathyroid glands included thyroid nodular hyperplasia ( n = 7), parathyroid hyperplasia associated with chronic renal disease ( n = 2), a thyroid abscess, and a branchial cyst. Parathyroid adenomas were more commonly diagnosed than expected in comparison with domestic cats. We demonstrated that an immunohistochemistry panel for thyroglobulin, calcitonin, and chromogranin A can be used to differentiate neoplasms of thyroid from parathyroid origin in nondomestic felids.

  16. Risk of thyroid cancer in euthyroid asymptomatic patients with thyroid nodules with an emphasis on family history of thyroid cancer

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

    2016-04-15

    To determine the factors associated with thyroid cancer, focusing on first-degree family history and ultrasonography (US) features, in euthyroid asymptomatic patients with thyroid nodules. This retrospective study included 1310 thyroid nodules of 1254 euthyroid asymptomatic patients who underwent US-guided fine-needle aspiration biopsy between November 2012 and August 2013. Nodule size and clinical risk factors- such as patient age, gender, first-degree family history of thyroid cancer, multiplicity on US and serum thyroid stimulating hormone (TSH) levels - were considered together with US features to compare benign and malignant nodules. Multiple logistic regression analysis was performed to assess the risk of thyroid malignancy according to clinical and US characteristics. Although all of the clinical factors and US findings were significantly different between patients with benign and malignant nodules, a solitary lesion on US (p = 0.041–0.043), US features and male gender (p < 0.001) were significant independent risk factors for thyroid malignancy in a multivariate analysis. Patient age, a first-degree family history of thyroid cancer and high normal serum TSH levels did not independently significantly increase the risk of thyroid cancer. However, multicollinearity existed between US assessment and patient age, first-degree family history of thyroid cancer and serum TSH values. Ultrasonography findings should be the primary criterion used to decide the management of euthyroid asymptomatic patients with thyroid nodules. The concept of first-degree family history as a risk factor for thyroid malignancy should be further studied in asymptomatic patients.

  17. Relation of benzodiazepine use to the risk of selected cancers: breast, large bowel, malignant melanoma, lung, endometrium, ovary, non-Hodgkin's lymphoma, testis, Hodgkin's disease, thyroid, and liver.

    Rosenberg, L; Palmer, J R; Zauber, A G; Warshauer, M E; Strom, B L; Harlap, S; Shapiro, S

    1995-06-15

    Some animal data have raised the possibility that benzodiazepines influence the risk of selected cancers. With data collected in 1977-1991 in a US hospital-based study, the authors assessed the relation of benzodiazepine use to the risk of 11 cancers: breast (6,056 patients), large bowel (2,203), malignant melanoma (1,457), lung (1,365), endometrium (812), ovary (767), non-Hodgkin's lymphoma (382), testis (314), Hodgkin's disease (299), thyroid (111), and liver (37). Cases were compared with cancer controls (3,777 patients with other cancers) and noncancer controls (1,919 patients admitted for acute nonmalignant disorders). Relative risks were estimated for benzodiazepine use at least 4 days a week for at least 1 month, initiated at least 2 years before admission (sustained use) by multiple logistic regression with control for confounding factors. Results derived with noncancer controls were similar to those derived with cancer controls. For sustained benzodiazepine use relative to no use, relative risk estimates for all 11 cancers were compatible with 1.0 at the 0.05 level of significance. Relative risk estimates for durations of at least 5 years were also compatible with 1.0, with the exceptions of an increased estimate, of borderline statistical significance, for endometrial cancer, and a decreased estimate for ovarian cancer. Relative risk estimates both for sustained use that continued into the 2-year period before admission and for sustained use that ended up to > or = 10 years previously were compatible with 1.0, suggesting a lack of tumor promotion and no increase in the risk after a latent interval. Results were also null for diazepam, chlordiazepoxide, and other benzodiazepines considered separately. The results suggest absence of association between benzodiazepine use and the cancers considered, with the evidence stronger for the cancers with larger numbers of subjects. The similarity of results derived with cancer and noncancer controls suggests that

  18. Molecular Testing for miRNA, mRNA, and DNA on Fine-Needle Aspiration Improves the Preoperative Diagnosis of Thyroid Nodules With Indeterminate Cytology

    Shifrin, Alexander; Busseniers, Anne E.; Lupo, Mark A.; Manganelli, Monique L.; Andruss, Bernard; Wylie, Dennis; Beaudenon-Huibregtse, Sylvie

    2015-01-01

    Context: Molecular testing for oncogenic mutations or gene expression in fine-needle aspirations (FNAs) from thyroid nodules with indeterminate cytology identifies a subset of benign or malignant lesions with high predictive value. Objective: This study aimed to evaluate a novel diagnostic algorithm combining mutation detection and miRNA expression to improve the diagnostic yield of molecular cytology. Setting: Surgical specimens and preoperative FNAs (n = 638) were tested for 17 validated gene alterations using the miRInform Thyroid test and with a 10-miRNA gene expression classifier generating positive (malignant) or negative (benign) results. Design: Cross-sectional sampling of thyroid nodules with atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) or follicular neoplasm/suspicious for a follicular neoplasm (FN/SFN) cytology (n = 109) was conducted at 12 endocrinology centers across the United States. Qualitative molecular results were compared with surgical histopathology to determine diagnostic performance and model clinical effect. Results: Mutations were detected in 69% of nodules with malignant outcome. Among mutation-negative specimens, miRNA testing correctly identified 64% of malignant cases and 98% of benign cases. The diagnostic sensitivity and specificity of the combined algorithm was 89% (95% confidence interval [CI], 73–97%) and 85% (95% CI, 75–92%), respectively. At 32% cancer prevalence, 61% of the molecular results were benign with a negative predictive value of 94% (95% CI, 85–98%). Independently of variations in cancer prevalence, the test increased the yield of true benign results by 65% relative to mRNA-based gene expression classification and decreased the rate of avoidable diagnostic surgeries by 69%. Conclusions: Multiplatform testing for DNA, mRNA, and miRNA can accurately classify benign and malignant thyroid nodules, increase the diagnostic yield of molecular cytology, and further improve

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

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

    2010-04-15

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

  20. Case presentation – thyroid lymphoma

    Belkisa Izić

    2011-11-01

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

  1. Positron emission tomography thyroid incidentaloma: Is it different in Indian subcontinent?

    R Vaish

    2016-01-01

    Full Text Available Background: Positron emission tomography (PET forms an integral part in work-up and follow-up of various malignancies. With the increased use of PET in oncology, finding of an incidental focal thyroid uptake (incidentaloma is not unusual and presents a diagnostic challenge. Aim: The aim of the following study is to evaluate the frequency and radio-pathologic correlation of focal 18-fluoro deoxyglucose uptake (FDG on PET within the thyroid from a large series. Materials and Methods: Retrospective review of 37,000 consecutive patients who underwent FDG-PET at tertiary cancer center in India. Radiological, pathological, PET scan and follow-up details were evaluated. Statistical analyzes were carried out using Mann Whitney test and Pearson correlation. Results: Abnormal thyroid uptake was seen in 78 (0.2% patients. Nearly 61 (0.16% scans had focal and 17 (0.04% had diffuse FDG uptake. A total of 57 patients with focal uptake were available for further evaluation. No further evaluation was done in 24 (42.1% patients who had advanced index malignancy. Of the remaining 33 patients 26 were benign and seven were a cause for concern (four primary thyroid cancers, one follicular neoplasm with hurthle cell change and two metastatic cancers. There was no significant correlation in Standardized uptake value (SUV max of benign and malignant lesion (P = 0.5 on Mann Whitney or size (r = 0.087 Pearson correlation co-efficient P= 0.667. Conclusion: Incidence of PET incidentaloma is low in this large cohort of Indian patients. Nearly 27% of focal incidentaloma were malignant. There was no correlation between the SUVmax, size and malignancy.

  2. Emerging therapies for thyroid carcinoma.

    Walsh, S

    2012-02-01

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

  3. French National Registry of Rare Peritoneal Surface Malignancies

    2016-07-12

    Rare Peritoneal Surface Malignancies; Pseudomyxoma Peritonei; Peritoneal Mesothelioma; Desmoplastic Small Round Cell Tumor; Psammocarcinoma; Primary Peritoneal Serous Carcinoma; Diffuse Peritoneal Leiomyomatosis; Appendiceal Mucinous Neoplasms

  4. Cutaneous Metastasis of Medullary Carcinoma Thyroid Masquerading as Subcutaneous Nodules Anterior Chest and Mandibular Region

    Rahul Mannan

    2014-01-01

    Full Text Available Cutaneous metastasis of underlying primary malignancies can present to dermatologist with chief complaints of cutaneous lesions. The underlying malignancy is generally diagnosed much later after a complete assessment of the concerned case. Medullary carcinoma thyroid (MCT is a relatively uncommon primary neoplasia of the thyroid. Very few cases presenting as cutaneous metastases of MCT have been reported in the literature. Most of the cases which have been reported are of the papillary and the follicular types. We here report a case of a patient who presented in the dermatology clinic with the primary complaint of multiple subcutaneous nodules in anterior chest wall and left side of body of mandible. By systematic application of clinical and diagnostic skills these nodules were diagnosed as cutaneous metastasis of MCT bringing to the forefront a history of previously operated thyroid neoplasm. So clinically, the investigation of a flesh coloured subcutaneous nodule, presenting with a short duration, particularly in scalp, jaw, or anterior chest wall should include possibility of metastastic deposits. A dermatologist should keep a possibility of an internal organ malignancy in patients while investigating a case of flesh coloured subcutaneous nodules, presenting with short duration. A systematic application of clinical and diagnostic skills will eventually lead to such a diagnosis even when not suspected clinically at its primary presentation. A prompt and an emphatic diagnosis and treatment will have its bearing on the eventual outcome in all these patients.

  5. Pitfalls in cytological diagnosis of autoimmune thyroiditis.

    Kumarasinghe, M P; De Silva, S

    1999-02-01

    The aims of this study are to document pitfalls in cytologic diagnosis of autoimmune thyroiditis (AT) and highlight possible ways to minimize them. One hundred consecutive thyroid aspirates with features diagnostic or suggestive of AT, performed and reported by the first author, were included in the study. Follow-up was traced and cytologic features responsible for indecisiveness were re-assessed in those reported as suggestive of AT. The features were then correlated with the results of serologic and thyroid function tests and clinical features, and an attempt was made to amend the final diagnosis using an integrated approach. Seventy eight were diagnostic and 22 were suggestive of AT. In the latter 22, features responsible for the indecisiveness were: cytologic atypia, in the form of nuclear enlargement, irregularity and grooves and altered chromatin texture, in 14 (64%); nucleoli with suspicion of a coexisting neoplasm in three (13.6%), two of which showed epithelial preponderance, crowding and discohesion; sparse inflammation in four (18%); a predominant lymphoid population without epithelial cells resembling a reactive lymph node in one (4.5%); co-existing toxic features in two (9%); and scanty smears in one (4.5%). Eighteen of the 22 suspected of AT had follow-up. Six had been assessed histologically; three with features suspicious of a neoplasm were diagnosed respectively as a papillary carcinoma (PC), Hurthle cell carcinoma (HCC) and a multinodular goitre (MNG) with degenerate changes. The other three were confirmed as AT; one with cytologic atypia, one with sparse inflammation and the third as cytologically resembling a reactive lymphnode. In ten of the remaining 12, the final diagnosis could be revised following an integrated approach with possible reduction of the indecisiveness. Potential pitfalls are: cytologic atypia occurring in AT; abundance or scarcity of background inflammation; low cell yield; and co-existing toxicity and malignancies. Epithelial

  6. Thyroid storm

    Thyrotoxic storm; Hyperthyroid storm; Accelerated hyperthyroidism; Thyroid crisis; Thyrotoxicosis - thyroid storm ... thyroid storm can be caused by treatment of hyperthyroidism with radioiodine therapy.

  7. Computed tomography in the evaluation of thyroid disease

    Silverman, P.M.; Newman, G.E.; Korobkin, M.; Workman, J.B.; Moore, A.V.; Coleman, R.E.

    1984-05-01

    Traditionally, thyroid imaging has been performed primarily using radionuclide scanning. High-resolution computed tomography (CT) was performed in 18 patients to evaluate the CT appearance of various thyroid abnormalities including diffuse toxic goiter, multinodular goiter, Hashimoto thyroiditis, thyroid adenoma, and malignant thyroid tumors. CT images of the thyroid were correlated with radionuclide scanning, surgical findings, and clinical and laboratory results. CT provided a complementary method for evaluation of the thyroid by defining the morphology of the thyroid gland and more precisely defining the anatomic extent of thyroid abnormalities in relation to the normal structures of the neck and mediastinum.

  8. Two Metachronous Neoplasms in the Radiotherapy Fields of a Young Man With Familial Adenomatous Polyposis

    Patrick A. Williams BS

    2013-04-01

    Full Text Available Background: It is recognized that various radiation-induced malignancies often follow childhood radiotherapy. Radiation-induced neoplasms have been shown to occur with increased frequency in syndromes due to mutated tumor suppressor genes. There exist no recommendations for the management of cancer patients with germline APC gene mutations. Preclinical data suggest that APC gene mutations cause enhanced radiosensitivity, but no clinical observations exist that show that patients with this mutation are at higher risk for radiation-induced malignancies. Results: We report the case of a 32-year-old man with a genetic diagnosis of familial adenomatous polyposis (FAP who initially presented at age 10 with a medulloblastoma treated with radiotherapy and surgery. Radiation-induced papillary thyroid carcinoma followed 13 years later. Finally, radiation-induced soft tissue osteosarcoma occurred with widespread metastasis 20 years thereafter. Conclusions: This is the first report of 2 malignancies in the prior radiotherapy fields of a patient with a genetic diagnosis of FAP. More important, this suggests that APC-defective cells are at an enhanced sensitivity to the carcinogenic effects of radiotherapy compared with APC-proficient cells. This could argue for genetic screening in affected members of these families and for creation of treatment recommendations to more seriously consider the risks of radiation therapy.

  9. RET oncogene in MEN2, MEN2B, MTC and other forms of thyroid cancer.

    Lodish, Maya B; Stratakis, Constantine A

    2008-04-01

    Hereditary medullary thyroid carcinoma (MTC) is caused by specific autosomal dominant gain-of-function mutations in the RET proto-oncogene. Genotype-phenotype correlations exist that help predict the presence of other associated endocrine neoplasms as well as the timing of thyroid cancer development. MTC represents a promising model for targeted cancer therapy, as the oncogenic event responsible for initiating malignancy has been well characterized. The RET proto-oncogene has become the target for molecularly designed drug therapy. Tyrosine kinase inhibitors targeting activated RET are currently in clinical trials for the treatment of patients with MTC. This review will provide a brief overview of MTC and the associated RET oncogenic mutations, and will summarize the therapies designed to strategically interfere with the pathologic activation of the RET oncogene.

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

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

    2013-03-01

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

  11. HABP2 G534E Mutation in Familial Nonmedullary Thyroid Cancer.

    Zhang, Tao; Xing, Mingzhao

    2016-06-01

    Papillary thyroid cancer (PTC) is a common endocrine malignancy, accounting for nearly 90% of all thyroid cancers. About 5% of PTC is hereditary familial nonmedullary thyroid cancer (FNMTC). No general susceptibility gene is known for FNMTC. An oncogenic HABP2 G534E mutation has been recently reported in one FNMTC kindred, suggesting that HABP2 is a susceptibility gene for FNMTC. Because of the limited kindred studied, how commonly this gene is responsible-and hence how important clinically it is-for FNMTC remains to be answered. By investigating a large number of FNMTC kindreds in the present study, we identified HABP2 G534E in several independent kindreds of FNMTC. The overall prevalence of HABP2 G534E was six per 43 (14.0%) PTC patients from the 29 kindreds and four per 29 (13.8%) kindreds. None of the subjects with benign thyroid neoplasm or the normal subjects from these kindreds had this mutation. These results are consistent with HABP2 G534E being a susceptibility gene in a subgroup of FNMTC, providing important diagnostic implications for this hereditary thyroid cancer.

  12. A case of papillary microcarcinoma of the thyroid with abundant colloid (masquerading as colloid goiter with papillary hyperplasia: Cytological evaluation with histopathological correlation

    Elancheran Muthalagan

    2015-01-01

    Full Text Available Papillary thyroid carcinoma (PTC is the most common malignant neoplasm of the thyroid. On fine-needle aspiration (FNA cytology smears of conventional PTC, the background usually shows scanty, bubble gum-like colloid. But the macrofollicular variant and papillary microcarcinoma reveals abundant thin colloid in the background. We report a case of papillary carcinoma of thyroid in a 37-year-old female with abundant thin colloid, obscuring the nuclear morphology in many clusters, along with the presence of typical nuclear features within occasional clusters in FNA cytology and hence, masquerading as colloid goiter with papillary hyperplasia. Histopathological examination of the total thyroidectomy specimen revealed papillary microcarcinomatous focus in a background of nodular hyperplasia. The differential diagnosis of PTC should be entertained even in colloid-rich FNA smears if the typical nuclear features are present. Hence, a meticulous search for any fragment with nuclear features of PTC is mandatory before labeling the smears as benign nodular hyperplasia.

  13. Carcinossarcoma tireoidiano em um cão Thyroid carcinosarcoma in a dog

    Aline Rodrigues

    2007-08-01

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

  14. SNP Array in Hematopoietic Neoplasms: A Review

    Jinming Song

    2015-12-01

    Full Text Available Cytogenetic analysis is essential for the diagnosis and prognosis of hematopoietic neoplasms in current clinical practice. Many hematopoietic malignancies are characterized by structural chromosomal abnormalities such as specific translocations, inversions, deletions and/or numerical abnormalities that can be identified by karyotype analysis or fluorescence in situ hybridization (FISH studies. Single nucleotide polymorphism (SNP arrays offer high-resolution identification of copy number variants (CNVs and acquired copy-neutral loss of heterozygosity (LOH/uniparental disomy (UPD that are usually not identifiable by conventional cytogenetic analysis and FISH studies. As a result, SNP arrays have been increasingly applied to hematopoietic neoplasms to search for clinically-significant genetic abnormalities. A large numbers of CNVs and UPDs have been identified in a variety of hematopoietic neoplasms. CNVs detected by SNP array in some hematopoietic neoplasms are of prognostic significance. A few specific genes in the affected regions have been implicated in the pathogenesis and may be the targets for specific therapeutic agents in the future. In this review, we summarize the current findings of application of SNP arrays in a variety of hematopoietic malignancies with an emphasis on the clinically significant genetic variants.

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

    Torkian Bahman

    2004-06-01

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

  16. Primary bone neoplasms in dogs: 90 cases

    Maria E. Trost

    2012-12-01

    Full Text Available A retrospective study of necropsy and biopsy cases of 90 primary bone tumors (89 malignant and one benign in dogs received over a period of 22 years at the Laboratório de Patologia Veterinária, Universidade Federal de Santa Maria, was performed. Osteosarcoma was the most prevalent bone tumor, accounting for 86.7% of all malignant primary bone neoplasms diagnosed. Most cases occurred in dogs of large and giant breeds with ages between 6 and 10-years-old. The neoplasms involved mainly the appendicular skeleton, and were 3.5 times more prevalent in the forelimbs than in the hindlimbs. Osteoblastic osteosarcoma was the predominant histological subtype. Epidemiological and pathological findings of osteosarcomas are reported and discussed.

  17. The significance of enlarged cervical lymph nodes in diagnosing thyroid cancer

    Hossam Eldin Mohamed

    2016-01-01

    Conclusion: ECLN are associated with an increased likelihood of thyroid malignancy in the patients undergoing evaluation of a suspicious nodule. The risk of malignancy in thyroid nodules increases with the presence of suspicious ultrasonographic features on cervical lymph nodes.

  18. Thyroid Tests

    ... calories and how fast your heart beats. Thyroid tests check how well your thyroid is working. They ... thyroid diseases such as hyperthyroidism and hypothyroidism. Thyroid tests include blood tests and imaging tests. Blood tests ...

  19. A molecular computational model improves the preoperative diagnosis of thyroid nodules

    Tomei Sara

    2012-09-01

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

  20. Risk of thyroid nodular disease and thyroid cancer in patients with acromegaly--meta-analysis and systematic review.

    Kosma Wolinski

    Full Text Available INTRODUCTION: Acromegaly is a quite rare chronic disease caused by the increased secretion of growth hormone (GH and subsequently insulin - like growth factor 1. Although cardiovascular diseases remains the most common cause of mortality among acromegalic patients, increased prevalence of malignant and benign neoplasms remains a matter of debate. The aim of this study is to evaluate the risk of thyroid nodular disease (TND and thyroid cancer in patients with acromegaly. MATERIALS AND METHODS: PubMed, Cochrane Library, Scopus, Cinahl, Academic Search Complete, Web of Knowledge, PubMed Central, PubMed Central Canada and Clinical Key databases were searched to identify studies containing. Random-effects model was used to calculate pooled odds ratios and risk ratios of TND in acromegaly. Studies which not included control groups were systematically reviewed. RESULTS: TND was more frequent in acromegaly than in control groups (OR = 6.9, RR = 2.1. The pooled prevalence of TND was 59.2%. Also thyroid cancer (TC proved to be more common in acromegalic patients (OR = 7.5, RR = 7.2, prevalence was 4.3%. The pooled rate of malignancy (calculated per patient was equal to 8.7%. CONCLUSIONS: This study confirms that both TND and TC occur significantly more often in acromegalic patients than in general population. These results indicate that periodic thyroid ultrasound examination and careful evaluation of eventual lesions should be an important part of follow-up of patients with acromegaly.

  1. Plurihormonal Cosecretion by a Case of Adrenocortical Oncocytic Neoplasm

    J. J. Corrales

    2016-01-01

    Full Text Available Adrenocortical oncocytic neoplasms (oncocytomas are extremely rare; only approximately 159 cases have been described so far. The majority are nonfunctional and benign. We describe an unusual case of a functional oncocytoma secreting an excess of glucocorticoids (cortisol and androgens (androstenedione and DHEAS, a pattern of plurihormonal cosecretion previously not reported in men, presenting with endocrine manifestations of Cushing’s syndrome. The neoplasm was considered to be of uncertain malignant potential (borderline according to the Lin-Weiss-Bisceglia criteria.

  2. Malignant neoplasms of the uterus following radiation therapy for cervical carcinoma:a clinical study of 47 cases%子宫颈癌放疗后子宫体恶性肿瘤47例临床分析

    Shaokang Ma; Lingying Wu

    2009-01-01

    Objective: To study the characteristics and clinical features of uterine neoplasms developed after radiation ther-apy for cervical carcinoma. Methods: Clinical data of 47 cases of uterine neoplasms occurred following radiation therapy for cervical carcinoma were retrospectively reviewed. Results: The median age at uterine neoplasms diagnosis was 62 years (range: 38-77 years), and the median latency period from initial therapy to development of uterine neoplasms was 14 years (range: 5-35 years). Thirty of 47 cases were endometrial carcinoma, of which 3 were uterine papillary serous carcinoma (UPSC). Seventeen of 47 patients were uterine sarcoma, all of those were carcinosarcoma. The distribution by stage, grade, and histology of 30 cases of endometrial carcinoma was as follows: stage Ib, 1 case; stage Ic, 2 cases; stage Ⅱ, 6; stage Ilia, 4; stage Ⅲb, 2; stage Ⅲc, 11; stage Ⅳ, 4 cases; grade 1, two cases; grade 2, nine; grade 3 (include 3 UPSC patients), seventeen; unknown grade, two; endometried, 27; UPSC, 3 cases; 7 of 30 cases of endometrial carcinoma had recurrences (23.3%), at median time to recurrence was 24 months, and their median survival time was 26 months. The overall 3- and 5-year survival rates were 60% and 38%, respectively. Of the 17 cases of uterine sarcoma, the median survival was 10 months, 6 patients oc-curred recurrence (35.9%), at a median time to recurrence was 9 months, and their median survival was 6 months. The overall 3- and 5-year survival rates were 12% and 0, respectively. Conclusion: The main uterine neoplasms development after radiation therapy for cervical carcinoma is endomethal carcinomas, of which there is a preponderance of high-risk histological subtypes and a poor prognosis. Most of the uterine sarcomas occurred following radiation therapy for cervical carcinoma are carcinosarcomas and the prognosis is very poor.

  3. Selection and validation of miRNAs as normalizers for profiling expression of microRNAs isolated from thyroid fine needle aspiration smears

    Titov, Sergei E.; Demenkov, Pavel S.; Ivanov, Mikhail K.; Malakhina, Ekaterina S.; Poloz, Tatiana L.; Tsivlikova, Elena V.; Ganzha, Maria S.; Shevchenko, Sergei P.; Gulyaeva, Lyudmila F.; Kolesnikov, Nikolay N.

    2016-01-01

    Fine needle aspiration cytology (FNAC) is currently the method of choice for malignancy prediction in thyroid nodules. Nevertheless, in some cases the interpretation of FNAC results may be problematic due to limitations of the method. The expression level of some microRNAs changes with the development of thyroid tumors, and its quantitation can be used to refine the FNAC results. For this quantitation to be reliable, the obtained data must be adequately normalized. Currently, no reference genes are universally recognized for quantitative assessments of microRNAs in thyroid nodules. The aim of the present study was the selection and validation of such reference genes. Expression of 800 microRNAs in 5 paired samples of thyroid surgical material corresponding to different histotypes of tumors was analyzed using NanoString technology and four of these (hsa-miR-151a-3p, -197-3p, -99a-5p and -214-3p) with the relatively low variation coefficient were selected. The possibility of use of the selected microRNAs and their combination as references was estimated by RT-qPCR on a sampling of cytological smears: benign (n=226), atypia of undetermined significance (n=9), suspicious for follicular neoplasm (n=61), suspicious for malignancy (n=19), medullary thyroid carcinoma (MTC) (n=32), papillary thyroid carcinoma (PTC) (n=54) and non-diagnostic material (ND) (n=34). In order to assess the expression stability of the references, geNorm algorithm was used. The maximum stability was observed for the normalization factor obtained by the combination of all 4 microRNAs. Further validation of the complex normalizer and individual selected microRNAs was performed using 5 different classification methods on 3 groups of FNAC smears from the analyzed batch: benign neoplasms, MTC and PTC. In all cases, the use of the complex classifier resulted in the reduced number of errors. On using the complex microRNA normalizer, the decision-tree method C4.5 makes it possible to distinguish between

  4. Surgical and Pathological Changes after Radiofrequency Ablation of Thyroid Nodules

    Dobrinja, Chiara; Bernardi, Stella; Fabris, Bruno; Eramo, Rita; Makovac, Petra; Bazzocchi, Gabriele; Piscopello, Lanfranco; Barro, Enrica; de Manzini, Nicolò; Bonazza, Deborah; Pinamonti, Maurizio; Zanconati, Fabrizio; Stacul, Fulvio

    2015-01-01

    Background. Radiofrequency ablation (RFA) has been recently advocated as an effective technique for the treatment of symptomatic benign thyroid nodules. It is not known to what extent it may affect any subsequent thyroid surgery and/or histological diagnosis. Materials and Methods. RFA was performed on 64 symptomatic Thy2 nodules (benign nodules) and 6 symptomatic Thy3 nodules (follicular lesions/follicular neoplasms). Two Thy3 nodules regrew after the procedure, and these patients accepted to undergo a total thyroidectomy. Here we present how RFA has affected the operation and the final pathological features of the surgically removed nodules. Results and Conclusions. RFA is effective for the treatment of Thy2 nodules, but it should not be recommended as first-line therapy for the treatment of Thy3 nodules (irrespective of their mutational status), as it delays surgery in case of malignancy. Moreover, it is unknown whether RFA might promote residual tumor progression or neoplastic progression of Thy3 lesions. Nevertheless, here we show for the first time that one session of RFA does not affect subsequent thyroid surgery and/or histological diagnosis. PMID:26265914

  5. Surgical and Pathological Changes after Radiofrequency Ablation of Thyroid Nodules

    Chiara Dobrinja

    2015-01-01

    Full Text Available Background. Radiofrequency ablation (RFA has been recently advocated as an effective technique for the treatment of symptomatic benign thyroid nodules. It is not known to what extent it may affect any subsequent thyroid surgery and/or histological diagnosis. Materials and Methods. RFA was performed on 64 symptomatic Thy2 nodules (benign nodules and 6 symptomatic Thy3 nodules (follicular lesions/follicular neoplasms. Two Thy3 nodules regrew after the procedure, and these patients accepted to undergo a total thyroidectomy. Here we present how RFA has affected the operation and the final pathological features of the surgically removed nodules. Results and Conclusions. RFA is effective for the treatment of Thy2 nodules, but it should not be recommended as first-line therapy for the treatment of Thy3 nodules (irrespective of their mutational status, as it delays surgery in case of malignancy. Moreover, it is unknown whether RFA might promote residual tumor progression or neoplastic progression of Thy3 lesions. Nevertheless, here we show for the first time that one session of RFA does not affect subsequent thyroid surgery and/or histological diagnosis.

  6. Surgical and Pathological Changes after Radiofrequency Ablation of Thyroid Nodules.

    Dobrinja, Chiara; Bernardi, Stella; Fabris, Bruno; Eramo, Rita; Makovac, Petra; Bazzocchi, Gabriele; Piscopello, Lanfranco; Barro, Enrica; de Manzini, Nicolò; Bonazza, Deborah; Pinamonti, Maurizio; Zanconati, Fabrizio; Stacul, Fulvio

    2015-01-01

    Background. Radiofrequency ablation (RFA) has been recently advocated as an effective technique for the treatment of symptomatic benign thyroid nodules. It is not known to what extent it may affect any subsequent thyroid surgery and/or histological diagnosis. Materials and Methods. RFA was performed on 64 symptomatic Thy2 nodules (benign nodules) and 6 symptomatic Thy3 nodules (follicular lesions/follicular neoplasms). Two Thy3 nodules regrew after the procedure, and these patients accepted to undergo a total thyroidectomy. Here we present how RFA has affected the operation and the final pathological features of the surgically removed nodules. Results and Conclusions. RFA is effective for the treatment of Thy2 nodules, but it should not be recommended as first-line therapy for the treatment of Thy3 nodules (irrespective of their mutational status), as it delays surgery in case of malignancy. Moreover, it is unknown whether RFA might promote residual tumor progression or neoplastic progression of Thy3 lesions. Nevertheless, here we show for the first time that one session of RFA does not affect subsequent thyroid surgery and/or histological diagnosis.

  7. Malignant salivary gland tumours

    Thompson, S.H. (University of the Witwatersrand, Johannesburg (South Africa). Dept. of Oral Pathology)

    1982-08-01

    The most frequent malignant salivary gland tumours are the mucoepidermoid tumour, adenoid cystic carcinoma and adenocarcinoma. The major salivary glands and the minor glands of the mouth and upper respiratory tract may potentially develop any of these malignant lesions. Malignant lesions most frequently present as a palpable mass and tend to enlarge more rapidly than benign neoplasms. Pain, paresthesia, muscle paralysis and fixation to surrounding tissue are all ominous signs and symptoms. The only reliable means of differential diagnosis of these lesions is biopsy and histologic analysis. Therapy involves surgery or a combination of surgery and radiation therapy. The ultimate prognosis is governed by the intrinsic biologic behaviour of the neoplasms, the extent of disease and adequate clinical therapy.

  8. A rare case of thyroid metastasis from pancreatic adenocarcinoma.

    Kelly, Michael E

    2012-02-01

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

  9. {sup 131}I treatment for thyroid cancer and the risk of developing salivary and lacrimal gland dysfunction and a second primary malignancy: a nationwide population-based cohort study

    Ko, Kuan-Yin [National Taiwan University Hospital, Department of Nuclear Medicine, Taipei (China); Kao, Chia-Hung [China Medical University, Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, Taichung (China); China Medical University Hospital, Department of Nuclear Medicine and PET Center, Taichung (China); Lin, Cheng-Li [China Medical University Hospital, Management Office for Health Data, Taichung (China); China Medical University, College of Medicine, Taichung (China); Huang, Wen-Sheng [Changhua Christian Hospital, Department of Nuclear Medicine, Changhua (China); Yen, Ruoh-Fang [National Taiwan University Hospital, Department of Nuclear Medicine, Taipei (China); National Taiwan University College of Medicine, Department of Radiology, Taipei (China)

    2015-07-15

    The aim of this study was to determine the prevalence of salivary and lacrimal gland dysfunction and a second primary malignancy in patients from Taiwan with thyroid cancer after radioiodine therapy. This nationwide population-based cohort study was based on data obtained from the Taiwan National Health Insurance Database from 2000 to 2011. A total of 1,834 thyroid cancer patients treated with {sup 131}I therapy and 1,834 controls (thyroid cancer without {sup 131}I therapy) selected by 1:1 matching on a propensity score were enrolled. The cumulative {sup 131}I dose in each patient was calculated. A Cox proportional hazards model was applied to estimate the effect of radiation from the {sup 131}I therapy on the risk of salivary and lacrimal gland impairment as well as second primary malignancies in terms of hazard ratios (HRs) and 95 % confidence intervals (CIs). In patients treated with {sup 131}I therapy and in controls, the incidence rates of salivary gland dysfunction were 6.76 and 1.01 per 10,000 person-years, respectively (HR 6.81, 95 % CI 0.74 - 55.3), the incidence rates of keratoconjunctivitis sicca (KCS) were 13.6 and 16.3 per 10,000 person-years, respectively (HR 0.84, 95 % CI 0.41 - 1.73), and the incidence rates of second primary malignancy were 76.7 and 62.4 per 10,000 person-years, respectively (HR 1.23, 95 % CI 0.88 - 1.72). The risk of salivary secretion impairment significantly increased with increasing administered doses (HR 14.3, 95 % CI 1.73 - 119.0). However, there was no increase in the incidence of KCS or secondary cancer in patients treated with higher doses. {sup 131}I therapy insignificantly increased the risk of salivary gland dysfunction and second primary malignancy. In patients with higher cumulative doses, an increase in the incidence of salivary gland dysfunction was observed. By contrast, we did not find an association between {sup 131}I treatment and KCS development. (orig.)

  10. Incidence of malignant hemopathies and thyroid carcinomas in infants less than 15 years old around the nuclear site of Marcoule; Incidence des hemopathies malignes et des cancers thyroidiens chez les enfants de moins de 15 ans autour du site nucleaire de Marcoule

    Bouges, S.; Daures, J.P. [Montpellier Institut Universitaire de Recherche Clinique, 34 - Montpellier (France); Arthus, J.C. [Centre Hospitallier Universitaire de Nimes, 30 - Nimes (France); Vidonne Sartre, O. [Medecin Inspecteur Chef, 83 - Gard (France)

    1997-03-01

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

  11. Chronic Myeloproliferative Neoplasms Treatment

    ... way to treat some chronic myeloproliferative neoplasms. Platelet apheresis Platelet apheresis is a treatment that uses a special machine ... using interferon alfa or pegylated interferon alpha . Platelet apheresis . A clinical trial of a new treatment. Check ...

  12. Activating mutations of the GNAQ gene : a frequent event in primary melanocytic neoplasms of the central nervous system

    Kusters-Vandevelde, Heidi V. N.; Klaasen, Annelies; Kusters, Benno; Groenen, Patricia J. T. A.; van Engen-van Grunsven, Ilse A. C. H.; van Dijk, Marcory R. C. F.; Reifenberger, Guido; Wesseling, Pieter; Blokx, Willeke A. M.

    2010-01-01

    Primary melanocytic neoplasms of the central nervous system (CNS) are uncommon neoplasms derived from melanocytes that normally can be found in the leptomeninges. They cover a spectrum of malignancy grades ranging from low-grade melanocytomas to lesions of intermediate malignancy and overtly maligna

  13. Chronic thyroiditis (Hashimoto disease)

    Hashimoto thyroiditis; Chronic lymphocytic thyroiditis; Autoimmune thyroiditis; Chronic autoimmune thyroiditis; Lymphadenoid goiter - Hashimoto; Hypothyroidism - Hashimoto; Type 2 polyglandular autoimmune ...

  14. Radiofrequency ablation for postsurgical thyroid removal of differentiated thyroid carcinoma.

    Xu, Dong; Wang, Lipin; Long, Bin; Ye, Xuemei; Ge, Minghua; Wang, Kejing; Guo, Liang; Li, Linfa

    2016-01-01

    Differentiated thyroid carcinoma (DTC) is the most common endocrine malignancy. Surgical removal with radioactive iodine therapy is recommended for recurrent thyroid carcinoma, and the postsurgical thyroid removal is critical. This study evaluated the clinical values of radiofrequency ablation (RFA) in the postsurgical thyroid removal for DTC. 35 DTC patients who had been treated by subtotal thyroidectomy received RFA for postsurgical thyroid removal. Before and two weeks after RFA, the thyroid was examined by ultrasonography and (99m)TcO4 (-) thyroid imaging, and the serum levels of free triiodothyronine (FT3), free thyroxin (FT4), thyroid stimulating hormone (TSH) and thyroglobulin (Tg) were detected. The efficacy and complications of RFA were evaluated. Results showed that, the postsurgical thyroid removal by RFA was successfully performed in 35 patients, with no significant complication. After RFA, the average largest diameter and volume were significantly decreased in 35 patients (P > 0.05), and no obvious contrast media was observed in ablation area in the majority of patients. After RFA, the serum FT3, FT4 and Tg levels were markedly decreased (P RFA, radioiodine concentration in the ablation area was significantly reduced in the majority of patients. The reduction rate of thyroid update was 0.69±0.20%. DTC staging and interval between surgery and RFA had negative correlation (Pearson coefficient = -0.543; P = 0.001), with no obvious correlation among others influential factors. RFA is an effective and safe method for postsurgical thyroid removal of DTC.

  15. Maltoma of Thyroid: A Rare Thyroid Tumour

    Navisha Latheef

    2013-01-01

    Full Text Available Introduction. Primary thyroid lymphomas constitute up to 5% of all thyroid malignancies and can be divided into non-Hodgkin’s lymphomas (NHLs of B- and T-cell types, as well as Hodgkin’s lymphomas. Mucosa-associated lymphoid tissue (MALT lymphomas are a relatively recently recognized subset of B-cell NHLs, and they are listed as extranodal marginal zone lymphomas according to the revised European-American lymphoma classification. Case Report. We report an uncommon case of a 44-year-old man, who noted a painless, growing mass on right side of his neck of the three-month duration. Thyroid profile was within normal limits. FNAC showed lymphocytic thyroiditis. The patient underwent a right hemithyroidectomy. The histologic examination and the immunohistochemistry showed an extra nodal marginal B-cell type maltoma (malt lymphoma. CHOP chemotherapy with rituximab was given. The clinical course has been favourable in the first year of followup, with no evidence of local or systemic recurrence of the disease. Discussion. Marginal zone lymphoma encompasses a heterogeneous group of B-cell tumours that variously arise within the lymph nodes, spleen, or extranodal tissues. A case of maltoma of thyroid is presented for its rarity and diagnostic dilemmas. Conclusion. Maltomas are slow-growing lymphomas. The optimal treatment and followup of patients with thyroid maltomas remain controversial at present.

  16. Predictive value of sonographic features in preoperative evaluation of malignant thyroid nodules%超声影像特点对甲状腺结节性质的诊断价值

    吕朝晖; 朱海清; 窦京涛; 罗渝昆; 孔庆龙; 杨国庆; 巴建明; 母义明; 陆菊明

    2010-01-01

    Objective To retrospectively evaluate the diagnostic accuracy of ultrasonographic (US)features for the pre-operative differentiation of benign and malignant thyroid nodules by using pathological diagnosis as the reference standard. Methods A total of 1501 patients with 2123 thyroid nodules ( 1864 malignant, 259 benign ) diagnosed intra-operatively and undergoing pre-operative ultrasonography at our hospital were recruited. The following characteristics of US images were evaluated: nodule size, shape,margin, echotexture, echogenicity, presence and type of calcification, blood flow inside or around nodules and the presence of ipsilateral cervical lymphadenectasis. Results ( 1 )The risk of malignancy was higher in a solitary nodule than in a non-solitary nodule [16.7% (109/653) vs 10.2% (150/1470), P = 0.000].The mean diameter of benign nodules was larger than that of malignant nodules [( 2.4 ± 1.4 ) vs ( 2.1 ±1.9) cm, P = 0.009]. (2) Microcalcification, irregular shape, ill-defined border, solid and hypoechogenicity were more common in malignant nodules. Irregular shape had the highest sensitivity and positive predictive value while microcalcification had the highest diagnostic accuracy. (3) Nodules with a rich blood flow inside tended to have a higher risk of malignancy. The distribution pattern of blood flow around the nodules was not associated with the differentiation of benign and malignant thyroid nodules.Nodules with the presence of ipsilateral cervical lymphadenectasis had a higher risk of malignancy than those without lymphadenectasis [28.3% ( 80/283 ) vs 9.6% (92/963), P < 0.01]. (4) If microcalcification,irregular shape, ill-defined border, solid, hypoechogenicity and the presence of ipsilateral cervical lymphadenectasis were treated as the characteristics of malignancy, a higher frequency of these characteristics was correlated with a higher risk of malignancy. Conclusion Despite a lack of specific US imaging characteristics in malignant thyroid

  17. Application value of contrast-enhanced ultrasound combined with time-intensity curve to identify benign and malignant orbital neoplasms%超声造影时间-强度曲线在眼眶良恶性肿瘤鉴别诊断中的应用价值

    柏刚; 陈文卫; 孙彬; 陈辽; 康莹; 陈继

    2013-01-01

    目的 探讨超声造影在眼眶肿瘤良恶性病变鉴别诊断中的应用价值.方法 对47例眼眶肿瘤患者47个病灶(良性组35例,恶性组12例)进行术前常规超声和超声造影检查,观察肿瘤超声造影的特征,应用SonoLiver分析软件进行后处理得到肿瘤造影时间-强度曲线(TIC),获取造影剂达到时间(AT)、上升时间(RT)、达峰时间(TTP)、平均渡越时间(mTT)、曲线下面积(AUC)、峰值强度(IMAX)、造影灌注指数(PI)进行定量分析.结果 良恶性肿瘤的血流灌注特点不同.时间-强度曲线参数中上升支斜率、半降斜率的绝对值、IMAX、PI、mTT、半洗出时间、RT良恶性间差异有统计学意义(P<0.05),AT、AUC、TTP差异无统计学意义(P>0.05).结论 超声造影在眼眶良恶性肿瘤的鉴别诊断中有一定的临床应用价值.%Objective To explore the value of ultrasound-enhanced ultrasound (CEUS) in the differential diagnosis of orbital neoplasms by observing the perfusion characteristics of orbital benign and malignant neoplasms for the application of ultrasound contrast microbubbles.Methods Preoperative ultrasound imaging of 47 patients with orbital neoplasms(benign group 35 cases,malignant group 12 cases)were observed for the tumor characteristics of CEUS.The parameters of tumor imaging obtained time intensity curve (TIC) were obtained by quantitative analysis of SonoLiver analysis software,which were contrast agent arrive time (AT),rise time (RT),time to peak (TTP),mean transit time (mTT),area under the curve (AUC),maximum intensity(IMAX) and perfusion index (PI).Results Different characteristics of perfusion were shown between benign and malignant groups.Time parameters of TIC:rising slope,semidescending slope,IMAX,PI,mTT,semi-washed out time and RT were significantly different between the two groups (P < 0.05) while there was no significant difference of parameters as AT,TTP,AUC.Conclusions There is certain clinical value of the CEUS

  18. Postpartum Thyroiditis

    ... to be an autoimmune disease very similar to Hashimoto’s thyroiditis. In fact, these two disorders cannot be ... from one another on pathology specimens. As in Hashimoto’s thyroiditis, postpartum thyroiditis is associated with the development ...

  19. Thyroid Antibodies

    ... e.g., at regular intervals after thyroid cancer treatment) Thyroid stimulating hormone receptor antibody, Thyroid Stimulating Immunoglobulin TRAb, TSHR Ab, TSI Graves disease When a person has symptoms of hyperthyroidism If a pregnant woman has a known autoimmune ...

  20. Panorama of neoplasms of upper GI tract: a 5 year research study

    T.C.S. Suman Kumar

    2015-06-01

    Results: we have received 120 specimens regarding the upper gastrointestinal system. Among these 120 specimens, 71 specimens were endoscopic biopsies and 49 specimens were surgically resected specimens. Out of 71 Endoscopic biopsies 28 biopsies were malignant among which 2 was esophagus and 26 were stomach. Out of 49 surgically resected specimens 1 was benign and 32 were malignant tumors. Out of 59 neoplasms of stomach there were single cases each of Sub mucosal Lipoma, Malignant lymphoma, GIST and 56 cases of Adenocarcinoma and its variants were noted. Conclusion: Most of the neoplasms are of stomach (97%. All the neoplasms are malignant except one benign lesion sub mucous lipoma of stomach. Most of the neoplasms of stomach were Adenocarcinoma (96.5%. Both tumors of esophagus were squamous cell carcinoma occurred after 50 years of age. [Int J Res Med Sci 2015; 3(6.000: 1313-1320

  1. [Thyroid nodules and differentiated thyroid cancer: Brazilian consensus].

    Maia, Ana Luiza; Ward, Laura S; Carvalho, Gisah A; Graf, Hans; Maciel, Rui M B; Maciel, Léa M Zanini; Rosário, Pedro W; Vaisman, Mario

    2007-07-01

    Thyroid nodules are a common manifestation of thyroid diseases. It is estimated that approximately 10% of adults have palpable thyroid nodules with the frequency increasing throughout life. The major concern on nodule evaluation is the risk of malignancy (5-10%). Differentiated thyroid carcinoma accounts for 90% of all thyroid malignant neoplasias. Although most patients with cancer have a favorable outcome, some individuals present an aggressive form of the disease and poor prognostic despite recent advances in diagnosis and treatment. Here, a set of clinical guidelines for the evaluation and management of patients with thyroid nodules or differentiated thyroid cancer was developed through consensus by 8 member of the Department of Thyroid, Sociedade Brasileira de Endocrinologia e Metabologia. The participants are from different reference medical centers within Brazil, to reflect different practice patterns. Each committee participant was initially assigned to write a section of the document and to submit it to the chairperson, who revised and assembled the sections into a complete draft document, which was then circulated among all committee members for further revision. All committee members further revised and refined the document. The guidelines were developed based on the expert opinion of the committee participants, as well as on previously published information.

  2. The Diffuse Sclerosing Variant of Papillary Thyroid Cancer Presenting as Innumerable Diffuse Microcalcifications in Underlying Adolescent Hashimoto's Thyroiditis: A Case Report.

    Jeong, Sun Hye; Hong, Hyun Sook; Lee, Eun Hye; Kwak, Jeong Ja

    2016-03-01

    Hashimoto's thyroiditis is the most common diffuse thyroid disease and is characterized by diffuse lymphocytic infiltration. However, the ultrasonographic findings of papillary thyroid carcinomas that arise from Hashimoto's thyroiditis in the pediatric and adolescent population are not well known.We report a rare ultrasonographic finding in a 22-year-old woman diagnosed with the diffuse sclerosing variant of papillary thyroid carcinoma that arose from underlying Hashimoto's thyroiditis: innumerable diffuse microcalcifications instead of a typical malignant-appearing nodule.

  3. 良恶性甲状腺结节的临床与影像学特征分析%Clinical and Imaging Features of Benign and Malignant Thyroid Lesions

    于亚静; 杨彩哲; 王良宸; 陈莹; 王敏; 王璐宁

    2015-01-01

    目的:探讨良恶性甲状腺结节的临床与影像学特征,为临床治疗提供依据。方法采用单中心回顾性研究方法分析2001年1月—2014年2月中国人民解放军空军总医院住院及门诊900例甲状腺结节术后患者的资料,依据病理结果分为甲状腺癌组198例(22.0%),甲状腺良性结节组702例(78.0%)。比较两组患者一般临床资料、甲状腺超声、甲状腺功能七项〔甲状腺球蛋白抗体( TgAb )、甲状腺过氧化物酶抗体( TPO -Ab )、促甲状腺激素( TSH)、游离三碘甲状腺原氨酸( FT3)、游离甲状腺素( FT4)、三碘甲状腺原氨酸( TT3)、甲状腺素( TT4)〕等方面的特征。结果两组患者年龄、进行性增大症状发生率比较,差异有统计学意义( P<0.05)。两组边界欠清晰、形态欠规则、结节性质、回声、结节直径比较,差异有统计学意义( P<0.05)。甲状腺癌组实性结节比例、低回声结节比例、结节直径≤1 cm 比例高于甲状腺良性结节组(χ2=279.606、93.215、57.189, P <0.05)。两组 TgAb、TPO-Ab阳性率及TSH、 TT4水平比较,差异有统计学意义( P<0.05);两组FT3、 FT4、 TT3水平比较,差异无统计学意义(P>0.05)。结论甲状腺超声提示边界欠清晰、形态欠规则、实性结节、低回声,甲状腺功能提示TSH水平、 TgAb阳性率、 TPO-Ab阳性率较高的甲状腺结节恶性可能性大,应高度关注。%Objective To explore the clinical and imaging features of benign and malignant thyroid lesions, to provide the basis for clinical work.Methods A total of 900 outpatients and inpatients who received thyroid nodule surgical treatment in Air Force General Hospital, PLA from January 2001 to February 2014, were selected as study subjects, the data of them were analyzed using single center retrospective analysis method.The cases were divided into thyroid carcinoma

  4. Mucin profile of the pancreatic mucinous cystic neoplasms

    JI Yuan; XU Jian-fang; KUANG Tian-tao; ZHOU Yan-nan; LU Shao-hua; TAN Yun-shan

    2006-01-01

    @@ Mucinous cystic neoplasms (MCNs) of the pancreas are a distinct entity, account for 1% of pancreatic exocrine tumors. MCNs can be classified histologically as adenomas, borderline tumors, or carcinomas. Because several evidences showing that mucinous cystadenomas are poten- tially malignant and may transform into cystadeno- carcinomas, particularly if treated by drainage, these tumors should be identified accurately.1

  5. Peroxiredoxins in colorectal neoplasms

    Wu, X.Y.; Fu, X.Z.; Wang, X. H.

    2010-01-01

    Peroxiredoxins (Prxs) are novel group proteins with efficient antioxidant capacity, and some of them also have effects on cell proliferation, differentiation, apoptosis, and chemotherapy and radiotherapy resistance. Altogether six distinct Prxs expressions were investigated in histological samples of colorectal neoplasm and the distant normal tissues and investigated associatedly with parameters such as clinical stage and lymphnodes metastasis. Normal colorectal tis...

  6. Cribriform-Morular Variant of Papillary Thyroid Carcinoma

    Bahar AKKAYA

    2009-09-01

    Full Text Available Cribriform-morular variant of papillary thyroid carcinoma is a rare histological subtype of papillary thyroid carcinoma. This subtype is commonly reported in patients with familial adenomatous polyposis. However, cases not associated with polyposis have also been reported. The differential diagnosis of this entity from other aggressive thyroid neoplasms is important. A 29-year old man presented with a solitary mass in the left thyroid lobe underwent total thyroidectomy. Pathologic examination of the specimen revealed cribriform-morular variant of papillary thyroid carcinoma. After diagnosis, colonoscopy revealed a normal colon without polyposis. Herein, we report a case not associated with polyposis and discuss with the literature.

  7. Hematologic malignancies during preg

    Hossam K. Mahmoud

    2016-07-01

    Full Text Available Malignancy is the second most common cause of mortality in the reproductive period and it complicates up to one out of every 1000 pregnancies. When cancer is diagnosed during pregnancy, the management approach must take into consideration both the mother and her fetus. Hematologic cancers diagnosed in pregnancy are not common, resulting in paucity of randomized controlled trials. Diagnosis of such malignancies may be missed or delayed, as their symptoms are similar to those encountered during normal pregnancy. Also, many imaging studies may be hazardous during pregnancy. Management of these malignancies during pregnancy induces many treatment-related risks for mother and baby and should consider patient’s preferences for pregnancy continuation. In this article, hematologic malignancies diagnosed in pregnant patients including acute leukemias, chronic myeloid leukemia, lymphomas, multiple myeloma and myeloproliferative neoplasms, will be reviewed, including diagnostic and management strategies and their impact on the pregnant patient and the developing fetus.

  8. Papillary thyroid carcinoma in children and adolescents.

    Chung, Bo Mi; Park, Sung Hee; Kim, Soo Jin; Seo, Jae Seung; Kim, Yang Soo; Shim, Hyung Jin; Lee, Jong Beum

    2014-09-01

    Differentiated thyroid carcinoma is uncommon in children and constitutes 0.5% to 3% of all pediatric malignancies. Few studies have reported imaging findings of childhood papillary thyroid carcinomas. We report 3 cases of papillary thyroid carcinomas in children. Among the 3 patients, the youngest was a 7-year-old girl. In the current report, we describe 2 cases of classic papillary thyroid carcinoma and 1 case of pediatric diffuse sclerosing variant of papillary thyroid carcinoma. The ultrasonographic features and diagnostic procedures in these pediatric patients are similar to those in adults.

  9. Burkitts primary thyroid lymphoma coexistence with Hashimoto's thyroiditis; Linfoma Burkitt primario tiroideo. Coexistencia con tiroiditis de Hashimoto

    Higuera, A. [Hospital Alto Guadalquivir. Andujar Jaen (Spain); Vicente, J.; Lazaro, J. C. [Hospital Universitario Reina Sofia. Cordoba (Spain)

    2000-07-01

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

  10. Phase II Study of Intraventricular Methotrexate in Children With Recurrent or Progressive Malignant Brain Tumors

    2016-06-30

    Recurrent Childhood Medulloblastoma; Recurrent Childhood Ependymoma; Childhood Atypical Teratoid/Rhabdoid Tumor; Embryonal Tumor With Abundant Neuropil and True Rosettes; Metastatic Malignant Neoplasm to the Leptomeninges

  11. Treatment Options for Myelodysplastic/Myeloproliferative Neoplasms

    ... Treatment Myelodysplastic/ Myeloproliferative Neoplasms Treatment Myelodysplastic/ Myeloproliferative Neoplasms Treatment (PDQ®)–Patient Version General Information About Myelodysplastic/ Myeloproliferative ...

  12. Preservation of parathyroid gland during the resection of thyroid neoplasms: anatomy and operative procedure%甲状腺肿瘤手术中暴露并保护甲状旁腺的解剖与手术操作要点

    洪浩波; 黄英凯; 林仁渠; 黄汉民

    2011-01-01

    Objective To explore operational points for preserving parathyroid glands during the thyroid neoplasms surgery. Methods From Jan. 2004 to Dec. 2010, 145 cases of thyroid diffuse nodules and thyroid cancer underwent surgical therapy. Among them, 65 cases only preserved posterior capsule, but not presented parathyroid glands during the operation. However, another 80 cases were performed the liberation and preservation of parathyroid glands and its blood supply during the operation. Postoperative serum calcium level was monitored dynamicly, for evaluating the function of parathyroid glands. Results Postoperative incidence of hypoparathyroidism in patients exposing and preserving of parathyroid glands during the operation was significantly lower than that in patients with no special preserving of parathyroid glands (P<0.05). Conclusions During the thyroidectomy procedure, exposing and protecting the parathyroid gland can effectively decrease the incidence of postoperative hypoparathyroidism.%目的 探讨甲状腺肿瘤手术中暴露并保护甲状旁腺的要点。方法对2004年1月至2010年12月145例甲状腺弥漫性结节和甲状腺癌患者进行手术,分前、后3年两组,前3年组65例患者保留甲状腺后被膜,未寻找甲状旁腺;后3年组80例患者暴露并保护甲状旁腺,精细解剖观察被膜,尽量保存甲状旁腺的血供及完整性。术后进行动态监测血清钙变化,观察甲状旁腺的功能情况。结果在术中暴露并保护甲状旁腺后3年组中,术后甲状旁腺功能低下的机率较未寻找甲状旁腺前3年组患者明显降低,两组比较有统计学意义(P<0.05)。结论在甲状腺肿瘤手术中,暴露并保护好甲状旁腺,可有效降低术后甲状旁腺功能低下的发生率。

  13. Current perspectives on pancreatic serous cystic neoplasms: Diagnosis, management and beyond

    Xiao-Peng Zhang; Zhong-Xun Yu; Yu-Pei Zhao; Meng-Hua Dai

    2016-01-01

    Pancreatic cystic neoplasms have been increasingly recognized recently. Comprising about 16% of all resected pancreatic cystic neoplasms, serous cystic neoplasms are uncommon benign lesions that are usually asymptomatic and found incidentally. Despite overall low risk of malignancy, these pancreatic cysts still generate anxiety, leading to intensive medical investigations with considerable financial cost to health care systems. This review discusses the general background of serous cystic neoplasms, including epidemiology and clinical characteristics, and provides an updated overview of diagnostic approaches based on clinical features, relevant imaging studies and new findings that are being discovered pertaining to diagnostic evaluation. We also concisely discuss and propose management strategies for better quality of life.

  14. Thyroid Tests

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

  15. Primary Ovarian Malignant PEComa: A Case Report.

    Westaby, Joseph D; Magdy, Nesreen; Fisher, Cyril; El-Bahrawy, Mona

    2016-09-28

    Perivascular epithelioid cell tumor (PEComa) is a rare mesenchymal neoplasm characterized by expression of both melanocytic and smooth muscle markers. PEComas are rarely encountered in the female genital tract. We here report a case of malignant primary PEComa of the ovary, and discuss the differential diagnosis. This represents the first case of primary typical malignant PEComa of the ovary.

  16. PATTERN OF OVARIAN NEOPLASM IN RURAL POPULATION: A FIVE YEAR STUDY FROM TERTIARY CARE HOSPITAL

    Umesh

    2014-02-01

    Full Text Available OBJECTIVE : The aim of the study was to know the morphological pattern of benign and malignant ovarian neoplasms and their distribution in different age groups in rural population of India. MATERIAL AND METHODS : A retrospective study of all cases of ovarian neoplasms diagnosed at department of pathology, Maharaja Medical College, Agroha during period of five year (Aug, 07 — Oct.12 was done. The tumors were classified according to WHO classification after thorough examination of slides and their distribution in different age groups was also noted. RESULTS : There were total fifty three cases of ovarian tumors noted during this period. Benign tumors comprised 81.13% and malignant tumors were 18.86%. Surface epithelial tumor emerged as the commonest variety accounting for 60.37%, followed by germ cell tumor (32.07% and sex cord stromal tumors were least common comprising 7.54 % of all ovarian neoplasm. No metastatic tumor or tumors with borderline malignancy were seen. Serous cystadenoma was the commonest tumor (43.39% followed by mature cystic teratoma (30.23%.Among the malignant tumor, malignant germ cell tumor were the commonest type (40%, followed by 30 %of each surface epithelial tumor and sex cord stromal tumor. CONCLUSION : Benign ovarian tumors are seen more common than malignant tumor. Malignant epithelial tumors are seen after the age of 30 years and malignant germ cell tumor are seen below the age of 30 years. Bilaterality is more commonly seen in malignant o varian neoplasm

  17. Thyroid functional status in aged patients with malignant tumors and relationship with chemo-therapy%老年恶性肿瘤患者甲状腺功能状态及化学药物疗法对其的影响

    邹春华; 黄涛金; 谢勇久; 林争; 王绎; 明华

    2014-01-01

    目的:探讨老年恶性肿瘤患者的甲状腺功能状态及化学药物疗法(简称化疗)对其甲状腺功能的影响。方法选取2010-01至2014-02确诊的老年恶性肿瘤患者398例,并选择400例体检老年人群作为健康对照组,进行甲状腺激素(thyroid hormone,TH)和促甲状腺激素(thyroid stimulating hormone,TSH)水平测定。将激素水平正常,KPS (Karnofsky)评分>60的老年恶性肿瘤患者分为:肿瘤治疗组132例,肿瘤对照组129例。两组年龄、KPS评分无统计学差异。肿瘤治疗组患者进行相应化疗,观察治疗前及治疗后6个月的TH和TSH水平,肿瘤对照组仅给予对症治疗,同期比较两组TH和TSH水平,分析化疗对老年恶性肿瘤患者甲状腺功能的影响。结果398例老年恶性肿瘤患者的TH、TSH与健康对照组相比差异无统计学意义(P>0.05)。肿瘤治疗组患者的TH、TSH与肿瘤对照组相比,TSH的差异存统计学意义(P<0.05)。肿瘤治疗组中甲状腺功能减退(甲减)的比例为7.58%,亚临床型甲减的比例为23.48%。肿瘤对照组中甲减的比例为5.65%,亚临床甲减的比例为5.65%。两组比较,亚临床型甲减的发生率存在统计学差异( P<0.05)。结论老年恶性肿瘤患者的甲状腺功能异常发生率与健康群体比较无统计学差异,化疗对老年恶性肿瘤患者的甲状腺功能有一定的影响。%Objective To study thyroid functional status of the aged patients with malignant tumors and the relationship be-tween thyroid function with chemotherapy.Methods 398 aged patients with malignant tumors were recruited as the pathological group.At the same time, 400 aged healthg subjects served as the control group.The thyroid hormones (thyroid hormone, TH), and thyrotropin ( thyroid stimulating hormone, TSH) levels were measured.The thyroid function in the groups was analyzed and compared. When KPS

  18. Preoperative predictors of malignancy and invasive carcinoma in intraductal papillary mucinous neoplasms%胰管内乳头状黏液性肿瘤的术前良、恶性与浸润性预测因子

    王雷; 金刚; 王莉; 郑建明; 金震东; 邹多武; 张华高; 蔡全才; 李兆申

    2010-01-01

    目的 分析术前预测胰管内乳头状黏液性肿瘤(IPMN)良、恶性与浸润性的因子,及不同病理类型IPMN的手术后生存率.方法 回顾性分析长海医院1993年1月至2009年9月间手术切除的78例IPMN病例资料,采用单因素与多因素分析的方法分析病史、临床表现、肝功能、CEA、CA19-9、影像学征象等在术前判断IPMN良、恶性与浸润性的价值,分析患者术后生存率.结果 单因素分析结果显示,黄疸、急性胰腺炎、血CA19-9>37 U/ml、AKP、肿块边界不清为恶性及浸润性预测因子;主胰管扩张、分支胰管直径>30 mm、出现壁节结等为恶性预测因子;CEA>6 ng/ml为浸润性预测因子.多因素分析显示,肿块边界不清为恶性及浸润性预测因子;急性胰腺炎为浸润性预测因子.良性IPMN患者的5年生存率为100%;恶性IPMN的2年生存率为78.9%、5年生存率为68.5%,其中浸润性IPMN的2年生存率为64.6%、5年生存率为43.1%.结论 肿块边界不清为IPMN恶性预测因子,急性胰腺炎、肿块边界不清是IPMN的浸润性预测因子.%Objective To investigate the predictive factors for malignancy and invasive carcinoma of IPMN, and the survival rates of different pathological type of IPMN were compared. Methods Seventy-eight patients with IPMN admitted to Changhai Hospital from January 1993 to September 2009, who underwent surgery with histological evidence were retrospectively analyzed. The univariate and multivariate analysis of potential predictive factors, including medical history, clinical presentations, liver function, CEA, CA19-9,and imaging findings was conducted to identify the predictive factors for malignancy and invasive carcinoma of IPMN. Results Univariate analysis identified jaundice, acute pancreatitis history, CA19-9 Level > 37U/ml,AKP, unclear border of tumour as independent predictive factors for malignancy and invesiveness, main pancreatic duct dilation, branch pancreatic duct diameter > 30

  19. Misdiagnosed ectopic thyroid carcinoma:report of two cases

    凌玲; 周水洪; 汪审清; 王丽君

    2004-01-01

    Ectopic thyroid tissue is a congenital disease caused by abnormal migration of thyroid in the embryonic stage. Malignant ectopic thyroid tissue is often misdiagnosed as a cyst of the thyroglossal duct. We treated 2 patients with papillary carcinoma in the anterior midline of the neck from May 1985 to Detober 2002.

  20. ANTI-THYROID PEROXIDASE ANTIBODY LEVEL IN THYROID NODULES: WITH SPECIAL REFERENCE TO THYROID NEOPLASIA

    Bera Swati

    2013-06-01

    Full Text Available Anti-TPO antibody level was evaluated in 86 patients, along with 25 healthy controls to detect its change in various forms of thyroid nodules particularly in thyroid malignancy when compared with healthy controls. The study revealed that Anti-TPO antibody level was increased in Benign & toxic form of Multi nodular goiter and papillary carcinoma but there is no elevation of Anti- TPO antibody level in follicular adenoma or follicular carcinoma.

  1. ANTI-THYROID PEROXIDASE ANTIBODY LEVEL IN THYROID NODULES: WITH SPECIAL REFERENCE TO THYROID NEOPLASIA

    Bera Swati; Gupta Soma; Dutta Sumanta K; Chowdhury Kanika M; Bhattacharyya Swati; Saha (Das) Mita

    2013-01-01

    Anti-TPO antibody level was evaluated in 86 patients, along with 25 healthy controls to detect its change in various forms of thyroid nodules particularly in thyroid malignancy when compared with healthy controls. The study revealed that Anti-TPO antibody level was increased in Benign & toxic form of Multi nodular goiter and papillary carcinoma but there is no elevation of Anti- TPO antibody level in follicular adenoma or follicular carcinoma.

  2. 胰腺导管内乳头状黏液性肿瘤形态学特征与疾病良恶性的相关分析%Correlative characteristics of morphological features of benign/malignancy in pancreatic intraductal papillary mucinous neoplasms: a pooled analysis

    张栋; 陈大志; 樊华; 金中奎; 李先亮; 冯艳; 郎韧

    2013-01-01

    Objective To study the clinical characteristics which are related to malignancy in pancreatic intraductal papillary mucinous neoplasm (IPMN) with an aim to provide evidence for clinical practice.Methods Using PubMed,all pancreatic IPMN related articles with positive pathologic results before July 30th,2011 were studied.A pooled analysis was carried out on the morphological features of the disease.The analysis included gender,diameter of main pancreatic duct,diameter of cystic lesion,mural nodules and histological types (benign/malignant) of the neoplasm.Results 98 articles (including 1902 cases) were collected and analyzed.1025 cases were benign (53.89%) and 877 cases (46.11 %) were malignant.Morphologically,there were a correlation between main pancreatic duct dilatation (≥5 mm),cystic lesion of large size (≥30 mm),presence of mural nodules and malignancy.The OR (95% CI) were 5.591 (3.657-8.548),3.633 (2.626-5.027) and 4.983 (3.872-6.412) respectively.Conclusions A main pancreatic duct dilatation (≥5 mm),cystic lesions of large size (≥30 mm) and presence of mural nodules prompt the tumor to be malignant.In clinical work,the management of pancreatic IPMN should be made prudently based on comprehensive analysis of clinical features and the patient's status and intent.%目的 寻找与胰腺导管内乳头状黏液性肿瘤(IPMN)良恶性相关的形态学特征以供临床实践参考.方法 研究尝试运用汇集分析的方法,通过对PubMed数据库中2011年6月30日以前所发表文献中经病理学证实的胰腺IPMN的形态学特征进行分析.主要分析数据为:性别特征、主胰管直径、囊性病变直径、壁结节情况、肿瘤的病理学类型(良、恶性).结果 共汇集文献98篇,胰腺IPMN病例1902例,其中良性1025例(53.89%),恶性877例(46.11%).胰腺IPMN形态学特征中,主胰管扩张(≥5 mm)、囊性病变尺寸较大(≥30 mm)及壁结节的存在与肿瘤的良恶

  3. Primary papillary thyroid carcinoma previously treated incompletely with radiofrequency ablation.

    Kim, Hoon Yub; Ryu, Woo Sang; Woo, Sang Uk; Son, Gil Soo; Lee, Eun Sook; Lee, Jae Bok; Bae, Jeoung Won

    2010-01-01

    Radiofrequency ablation (RFA) recently has been applied to benign thyroid nodules, mainly for the cosmetic reasons, and limited cases of local recurrences or focal distant metastases of well-differentiated thyroid cancer, in the high-risk reoperative condition or for the palliative purpose. But no report has been made on the RFA for primary thyroid cancer to date. We report on a patient with primary papillary carcinoma of thyroid gland who had undergone RFA before the cytological diagnosis of malignancy, later referred and treated with robotic surgery successfully. We can learn the following lessons from our case; (1) the RFA for operable primary thyroid malignancy should be avoided, because of the possibility of remnant viable cancer and undetectable nodal metastasis, and (2) robotic or endoscopic thyroid surgery may be a feasible operative method for benign or malignant thyroid nodules previously treated with RFA.

  4. Primary papillary thyroid carcinoma previously treated incompletely with radiofrequency ablation

    Kim Hoon

    2010-01-01

    Full Text Available Radiofrequency ablation (RFA recently has been applied to benign thyroid nodules, mainly for the cosmetic reasons, and limited cases of local recurrences or focal distant metastases of well-differentiated thyroid cancer, in the high-risk reoperative condition or for the palliative purpose. But no report has been made on the RFA for primary thyroid cancer to date. We report on a patient with primary papillary carcinoma of thyroid gland who had undergone RFA before the cytological diagnosis of malignancy, later referred and treated with robotic surgery successfully. We can learn the following lessons from our case; (1 the RFA for operable primary thyroid malignancy should be avoided, because of the possibility of remnant viable cancer and undetectable nodal metastasis, and (2 robotic or endoscopic thyroid surgery may be a feasible operative method for benign or malignant thyroid nodules previously treated with RFA.

  5. 恶性分子标记物的检测与甲状腺结节的诊断%Detection of malignant molecular markers and diagnosis of thyroid nodules

    雷海燕; 王坚

    2010-01-01

    研究发现,许多蛋白分子可以作为甲状腺结节的恶性分子标记物.如半乳糖凝集素-3(galectin-3)、端粒酶(telomerase)、Fra-1蛋白、细胞外基质蛋白1(ECM1)、跨膜丝氨酸蛋白酶4(TMPRSS4)等,以及几种新型生物分子标记物如膜整合蛋白1(ITM1)、1号染色体开放阅读框24(Clorf24)、DNA损伤诱导转录因子3(DDIT3)、精氨酸酶Ⅱ(ARG2).现将甲状腺结节恶性分子标记物的研究进展及其对甲状腺结节的鉴别诊断意义作一综述.%Many protein molecules observed by studies may act as molecular markers of malignant thyroid nodules,such as galectin-3, telomerase, Fra-1 protein, extracellular matrix protein 1 (ECMI), trans-membrane serine protease(TMPRSS4) ,and some new biological molecules, such as integral membrane pro-teinl (ITM1), Chromosome 1 open reading frame 24 (Clorf24), DNA darnage-inducible transcript 3 (DDIT3), arginase Ⅱ (ARG2). In this paper, the progression in the researches of the molecular markers in i-dentification of thyroid nodules are reviewed.

  6. The results of combined therapy malignant neoplasms of maxillary sinus at Oncology Center in Poznan; Ocena wynikow leczenia skojarzonego chorych na nowotwory zlosliwe zatoki szczekowej w materiale Wielkopolskiego Centrum Onkologii

    Adamiak, E.; Cerkaska-Gluszak, B.; Gorny, A. [Wielkopolskie Centrum Onkologii im. M. Sklodowskiej-Curie, Poznan, (Poland)

    1994-12-31

    Between 1985-1989 22 patients with malignant neoplasma maxillary sinus have been treated. At the first stage the surgical resection of maxilla was performed. Most of the patients (77%) had histopathological diagnosis of carcinoma planoepitheliale, 13% carcinoma solidum and 4% carcinoma adenoides cysticum. All patients had adjuvant therapy by Co-60 irradiation. Single fraction dose of 2 Gy/T 5 times a week up to total dose of 60-70 Gy/T has been applied. In the follow-up period of minimum 36 months the free-symptoms survival rate of 18%. (author) 5 refs, 3 tabs, 1 fig

  7. 18F-FDG PET/CT诊断小肠恶性肿瘤的价值%18F-FDG PET/CT in Diagnosis of Small Intestinal Malignant Neoplasm

    丁重阳; 李天女

    2015-01-01

    目的:分析小肠肿瘤的18F-FDG PET/CT特征,探讨18F-FDG PET/CT诊断小肠恶性肿瘤的价值。资料与方法回顾性分析临床高度怀疑小肠肿瘤并行18F-FDG PET/CT检查的47例患者,将PET/CT检查结果与手术或活检病理结果进行对比,测量小肠病灶的最大标准化摄取值(SUVmax)和最大肠壁厚度(IWTmax),并分析SUVmax与IWTmax的相关性。结果47例小肠肿瘤中,良性6例;恶性41例,其中恶性淋巴瘤19例,腺癌17例。18F-FDG PET/CT诊断小肠恶性肿瘤的灵敏度、特异度、准确度、阳性预测值及阴性预测值分别为92.7%、83.3%、91.5%、97.4%、62.5%。与小肠良性肿瘤比较,小肠恶性肿瘤的SUVmax和IWTmax明显增大(t=5.596、2.376,P0.05)。小肠恶性淋巴瘤的SUVmax与IWTmax无相关性(r=0.293,P>0.05),小肠腺癌的SUVmax与IWTmax呈正相关(r=0.542,P0.05). The SUVmax and IWTmax of small intestinal malignant lymphoma had no correlation (r=0.293, P>0.05), whilst there was significant correlation between the IWTmax and SUVmax in small intestinal adenocarcinoma (r=0.542, P<0.05). Conclusion The SUVmax and IWTmax of malignant intestinal tumors are higher than those of benign intestinal tumors; 18F-FDG PET/CT imaging is rather reliable in differentiating small intestinal malignant tumors from benign ones. Intestinal malignant lymphoma shows a higher uptake of 18F-FDG than intestinal adencarcinoma, but the intestinal wall thickness of the two kinds shows no difference.

  8. Update on epidemiology classification, and management of thyroid cancer

    Heitham Gheriani

    2006-06-01

    Full Text Available Thyroid cancer represents approximately 0.5–1% of all human malignancy1. In the UK the incidence of thyroid cancer is 2-3 per 100,000 populations 2. In geographical areas of low iodine intake and in areas exposed to nuclear disasters the incidence of thyroid cancer is higher. Benign thyroid conditions are much more common. In the UK approximately 8 % of the population have nodular thyroid disease2. Nodular thyroid disease increases with age and is also more common in females and in geographical areas of low iodine intake. Primary thyroid malignancy can be broadly divided into 2 groups. The first group, which generally have much better prognosis, are the well-differentiated thyroid carcinoma, which includes papillary carcinoma, follicular carcinoma and Hürthle cell tumours. The second group includes the poorly differentiated thyroid carcinoma like medullary thyroid carcinoma and the anaplastic thyroid carcinoma. Other rare tumours such as sarcomas, lymphomas and the extremely rare primary squamous cell carcinoma of the thyroid should be included in the second group. Secondary or metastatic thyroid cancer can be from breast, lung, colon and kidney malignancies.

  9. Disseminated encephalomyelitis-like central nervous system neoplasm in childhood.

    Zhao, Jianhui; Bao, Xinhua; Fu, Na; Ye, Jintang; Li, Ting; Yuan, Yun; Zhang, Chunyu; Zhang, Yao; Zhang, Yuehua; Qin, Jiong; Wu, Xiru

    2014-08-01

    A malignant neoplasm in the central nervous system with diffuse white matter changes on magnetic resonance imaging (MRI) is rare in children. It could be misdiagnosed as acute disseminated encephalomyelitis. This report presents our experience based on 4 patients (3 male, 1 female; aged 7-13 years) whose MRI showed diffuse lesions in white matter and who were initially diagnosed with acute disseminated encephalomyelitis. All of the patients received corticosteroid therapy. After brain biopsy, the patients were diagnosed with gliomatosis cerebri, primitive neuroectodermal tumor and central nervous system lymphoma. We also provide literature reviews and discuss the differentiation of central nervous system neoplasm from acute disseminated encephalomyelitis.

  10. CD4~+CD56~+ hematodermic neoplasm in a child

    GUO Xia; LI Qiang; ZHOU Chen-yan

    2010-01-01

    @@ CD4~+CD56~+ hematodermic neoplasm (HN) is a rare, highly aggressive systemic neoplasm, which had been described under various names including lymphoblastic lymphoma of natural killer (NK) phenotype, blastic NK cell lymphoma (BNK), leukemic lymphoma of immature NK lineage and CD4~+CD56~+ HN. This malignancy is mainly involved in elderly people and usually a rapidly fatal disease, since consistently effective treatments have not yet been developed. It is relatively rare in children.~(1-6) Herein we report a boy with CD4~+CD56~+ HN.

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

    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.)

  12. High-resolution ultrasonographic findings in thyroid nodules

    Choi, Sun Seob; Lee, Kwan Seh; Kim, Kun Sang; Park, Soo Soung [College of Medicine, Chung-Ang University, Seoul (Korea, Republic of)

    1985-08-15

    Ultrasonography, it's excellent ability of differentiating cystic from solid lesion and depicting detailed architecture, proved itself useful in the diagnosis of thyroid pathologies. Advanced high resolution equipment made hidden small lesion detected and finer structure clearly seen. They seemed to throw light on the histological diagnosis of thyroid diseases, especially differentiation of benignancy and malignancy. Author reviewed pictures of high-resolution ultrasonography of thyroid disease (24 cases) and correlated them with proven pathological findings. The results were as follows: 1. Multiplicity of lesion favors benignancy (4 cases). 2. Well defined margin favors benignancy (14/17), while ill defined margin favors malignancy (3/4), and lesion of no margin favors thyroiditis (3/3). 3. Surrounding halo favors benignancy (7 cases). 4. Hypoechogenicity were found in most of malignancy and thyroiditis. Cystic components in solid nodule were common findings in benign and malignant lesions. Calcification was not found in malignancy.

  13. Application of CD56, P63 and CK19 immunohistochemistry in the diagnosis of papillary carcinoma of the thyroid

    Alowami Salem

    2008-02-01

    in PTC cases, in contrast to other non PTC lesions/tumors. P63 expression was in 70% of cases of PTC and was consistently absent in all the non PTC cases. E-Cadherin showed consistent non discriminatory expression in all cases included in the study. We concluded that a panel consisted of CD56, CK19 and P63 is of value in distinction of PTC from other thyroid follicular lesion. P63 is a specific but less sensitive marker for PTC than CK19. CD56 is more specific and sensitive marker than CK19, however it is a negative rather than a positive marker for PTC. E-Cadherin is of no value in the diagnosis of thyroid follicular lesions/tumors. We recommend application of a panel composed of CK19, P63 and CD56 by a group of expert thyroid pathologists on a large series of follicular malignant thyroid neoplasms of uncertain malignant.

  14. COEXISTENCE OF CARCINOMAS OF THYROID WITH MULTINODULAR GOITRES OF THYROID – A TWO-YEAR STUDY

    Kiran Kumar Epari

    2016-08-01

    Full Text Available BACKGROUND Multinodular goitre or nodular hyperplasia or adenomatoid goitre is the most common thyroid disease, which occurs due to deficient iodine intake. Initial hyperthyroid states, followed by follicular atrophy and secondary changes like haemorrhage, calcification and cystic degeneration occurs in most of the cases. Longstanding cases of nodular goitre can be associated with carcinomas, usually follicular carcinomas, and rarely papillary carcinomas.[1] This study was done to know the incidence of coexisting malignancies, follicular and papillary carcinomas of thyroid, in longstanding nodular goitres of thyroid. METHODS All the cases of nodular goitres examined in the last two years were studied, including the thyroidectomy specimens and FNAC slides whichever was done. Extensive grossing of the thyroidectomy specimens was done to detect the possibility of malignancy in longstanding cases of nodular goitre of thyroid. Review of FNAC slides was done in cases where cytodiagnosis of coexisting malignancy was missed and detected in histopathological examination. RESULTS In the present study, conducted over a two-year period, out of 50 cases of thyroidectomy specimens of multinodular goitres studied, six cases were diagnosed to be having coexisting malignancy of thyroid, of which four were follicular carcinomas of thyroid and two were papillary carcinomas of thyroid. FNAC diagnosis of coexisting malignancy was initially missed in FNAC in two cases, i.e. one case each of follicular carcinoma and papillary carcinoma. These FNAC slides were reviewed and the foci of malignancies detected. CONCLUSION There is a possibility of malignancy of thyroid coexisting with longstanding multinodular goitre of thyroid, which should be kept in mind, while performing the needle biopsy and thorough examination of FNAC slides is needed to avoid missing the possible detection of the coexisting malignant lesion. Thyroidectomy specimens should be extensively grossed to

  15. Technetium-99m scintimammography in the diagnosis of malignant breast tumors

    Jauković Ljiljana

    2004-01-01

    Full Text Available Background. Technetium-99m (99mTc tetrofosmin scintigraphy is a new imaging method for the diagnosis of various malignancies, such as lung, thyroid, and most frequently breast neoplasms. The aim of this study was to evaluate the diagnostic reliability of 99mTc-Tetrofosmin breast scintigraphy in the detection of malignant breast disease. Methods. 99mTc -Tetrofosmin scintimammography (SMM was performed in 28 patients with 30 breast lesions suspicious for malignancy. Standard mammography (MM was also done. After surgery, the results of SMM and MM were compared to definitive histopathological findings as the "gold standard". After intravenous injection of radiotracer, SMM was performed in prone and supine views of the thorax, using large field-of-view Gamma camera. Results. The results of SMM were interpreted visually and semiquantitatively, and evaluated as positive or negative. Sensitivity, specificity and accuracy, positive (PPV and negative predictive value (NPV were obtained in relation to histopathology. After comparing the results of SMM and MM, SMM was proved more sensitive (95% for SMM vs. 80% for MM, while the specificity of both methods was similar. Conclusion. The results of this study indicate that the contribution of SMM as a nuclear medicine procedure has its place in the diagnostic protocol for patients suspected of malignant breast cancer.

  16. Malignant Struma Ovarii in a Postmenopausal Asymptomatic Woman: A Case Report

    Behiye Pınar Çilesiz Göksedef

    2011-09-01

    Full Text Available Introduction: Struma ovarii is an ovarian tumor that consists predominantly thyroid tissue and accounts for only 2% of all mature teratomas. It is usually a benign condition - malignant transformation has been reported to occur in about 5% of all struma ovarii cases. Case: A 58-year-old postmenopausal woman attended our outpatient clinic for her annual gynecologic exam, on which a palpable ovary was incidentally found. Ultrasound and magnetic resonance imaging work-up showed two-centimeter solid mass on the right ovary. Laparoscopic salpingo-oophorectomy was performed; the histology report revealed a focus of thyroid papillary carcinoma in a struma ovarii. The patient underwent surgical staging procedure according to the ovarian cancer guideline. The tumor was in stage 1A, thus, no further treatment was indicated apart from follow-up. Conclusion: Malignant struma ovarii is a rare neoplasm of the ovary. Surgical staging should be included in the treatment, like in the other germ cell ovarian tumors. (The Medical Bulletin of Haseki 2011;49: 117-9

  17. Thermal Ablation for Benign Thyroid Nodules: Radiofrequency and Laser

    Baek, Jung Hwan; Lee, Jeong Hyun [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Valcavi, Roberto [Endocrinology Division and Thyroid Disease Center, Arcispedale Santa Maria Nuova, Reggio Emilia (Italy); Pacella, Claudio M. [Diagnostic Imaging and Interventional Radiology Department, Ospedale Regina Apostolorum, Albano Laziale-Rome (IT); Rhim, Hyun Chul [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Na, Dong Kyu [Human Medical Imaging and Intervention Center, Seoul (Korea, Republic of)

    2011-10-15

    Although ethanol ablation has been successfully used to treat cystic thyroid nodules, this procedure is less effective when the thyroid nodules are solid. Radiofrequency (RF) ablation, a newer procedure used to treat malignant liver tumors, has been valuable in the treatment of benign thyroid nodules regardless of the extent of the solid component. This article reviews the basic physics, techniques, applications, results, and complications of thyroid RF ablation, in comparison to laser ablation.

  18. Thyroid Nodules

    ... very accurate for identifying cancerous or “suspicious” nodules. Thyroid ultrasound is used to get an exact picture of ... up may involve a physical exam or a thyroid ultrasound or both. If the nodule gets larger, you ...

  19. Thyroid Cancer

    ... 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 ...

  20. Thyroid ultrasound

    Vikas Chaudhary; Shahina Bano

    2013-01-01

    Thyroid ultrasonography has established itself as a popular and useful tool in the evaluation and management of thyroid disorders. Advanced ultrasound techniques in thyroid imaging have not only fascinated the radiologists but also attracted the surgeons and endocrinologists who are using these techniques in their daily clinical and operative practice. This review provides an overview of indications for ultrasound in various thyroid diseases, describes characteristic ultrasound findings in th...

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

    D. Askitis

    2013-01-01

    Full Text Available Objective. Currently, total thyroidectomy (TT is widely used to treat benign thyroid diseases and thyroid carcinoma. The differential diagnosis between benign and malignant thyroid disorders and the potential identification of thyroid microcarcinomas with biochemical markers remain controversial. This retrospective study aimed to estimate the prognostic validity of thyroid autoantibodies, thyroglobulin (Tg, and the thyroid disease type in diagnostic approaches regarding the co-existence of incidental thyroid carcinoma (ITC with benign thyroid diseases. Methods. A cohort of 228 patients was treated with TT for benign thyroid disorders between 2005 and 2010. Thyroid autoantibodies and Tg were preoperatively estimated. Patients were classified according to the preoperative and histologically established diagnoses, and the median values of the biochemical markers were compared between the groups. Results. ITC was detected in 33/228 patients and almost exclusively in the presence of nontoxic thyroid disorders (. There were no statistically significant differences in the median values of the biochemical markers between the benign and malignant groups. There was also no significant association between ITC and chronic lymphocytic thyroiditis. Conclusions. The co-existence of ITC with benign and especially nontoxic thyroid diseases is significant, and treatment of these disorders with TT when indicated can lead to the identification and definitive cure of microcarcinomas. Further studies are required to establish precise markers with prognostic validity for TC diagnosis.

  2. Pathology of thyroid in acquired immunodeficiency syndrome

    Dhaneshwar Namdeorao Lanjewar

    2016-01-01

    Full Text Available Background: The course of human immunodeficiency virus infection and the acquired immunodeficiency syndrome can be complicated by a variety of endocrine abnormalities, including abnormalities of thyroid gland. Materials and Methods: This study was designed to understand the spectrum of pathology of thyroid in Indian patients with AIDS. The present study describes the findings of retrospective autopsy findings of 158 patients with AIDS which revealed infectious diseases from a time period before the use of highly active antiretroviral regimen. Results: A wide range of bacterial, fungal, and viral infections were observed. Tuberculosis was recorded in 14 (09% patients, Cryptococcus neoformans in 11 (7% patients and cytomegalovirus in 3 (2% patients. Hashimoto's thyroiditis and lymphocytic thyroiditis were seen in 02 (01% patients each. One patient had dual infection comprising of tuberculosis and cytomegalovirus infection. The other microscopic findings observed were goiter (2 patients, interstitial fibrosis in thyroid (7 patients, and calcification in thyroid (8 patients. Conclusions: Abnormalities of thyroid are uncommon findings in patients with HIV infection however several case reports of thyroid involvement by infectious agents and neoplasm are described in these patients; hence patients with HIV infection should be closely followed up for development of goiter or abnormalities of thyroid functions.

  3. Is there loss or qualitative changes in the expression of thyroid peroxidase protein in thyroid epithelial cancer?

    Czarnocka, B.; Pastuszko, D; Janota-Bzowski, M; Weetman, A P; Watson, P F; Kemp, E H; McIntosh, R S; Asghar, M S; Jarzab, B.; Gubala, E; J. Wloch; Lange, D.

    2001-01-01

    There is disagreement concerning the expression of thyroid peroxidase (TPO) in thyroid cancer, some studies finding qualitative as well as quantitative differences compared to normal tissue. To investigate TPO protein expression and its antigenic properties, TPO was captured from a solubilizate of thyroid microsomes by a panel of murine anti-TPO monoclonal antibodies and detected with a panel of anti-human TPO IgGκ Fab. TPO protein expression in 30 samples of malignant thyroid tissue was comp...

  4. Logistic 回归模型在超声评价甲状腺结节良恶性及淋巴转移的应用研究%Logistic regression mo delf or ultrason ic evaluation fo thyroid nodule benign an d malignancy and lym-pha tic metastasis

    冯卓颖; 鹿瑶; 苏雁欣; 都杨

    2015-01-01

    Objective To explore the ultrasonic imaging features of malignant thyroid nodules risk fac-tors by logistic regression.Methods Two hundreds and forty patients with thyroid nodules by ultrasonic examina-tion and surgical treatment for patients with definited pathological diagnosis were included in this study.The pre-operative sonographic features of the nodules were put into the logistic regression model to explore the risk factors of ultrasonic imaging features of malignant thyroid nodules.Results By logistic regression model analysis,hypoe-cho,taller than wide≥1 and micro calcification were found to be significantly statistical variables for thyroid car-cinoma.Micro calcification could predict thyroid cancer for lymph node metastases.Conclusoin During clinical diagnosis,hypoecho,taller than wide more than 1 and micro calcification could be used as indicators by ultrasound doctors to judge malignant thyroid nodules and lymph node metastases.Prospective larger similar research is still very necessary to explore the indicator for thyroid carcinoma in the future.%目的 应用Logistic回归模型 ,筛选出甲状腺恶性结节的超声影像学特征危险因素. 方法 240例甲状腺结节患者经超声检查,并手术治疗有明确病理诊断的患者纳入本研究,将术前结节的超声特征引入Logistic回归模型, 筛选甲状腺恶性结节的超声影像学特征危险因素. 结果 经过Logistic逐步回归模型分析,筛选出纵横比≥1、微钙化、低回声是甲状腺癌患病的影响因素. 本次研究同时发现微钙化可做为预测甲状腺癌淋巴转移的危险因素. 结论 超声医生可以在临床诊断中,参考本研究筛选出的危险因素作为诊断甲状腺恶性结节及转移的辅助指标. 在未来,前瞻性的更大规模的同类研究仍有必要.

  5. Anti-thyroid peroxidase antibodies: Its effect on thyroid gland and breast tissue

    Sabitha Kandi

    2012-01-01

    Full Text Available Thyroid peroxidase (TPO is a key enzyme in the synthesis of thyroid hormone. TPO is involved in thyroid hormone synthesis (organification and coupling reactions. TPO is a major antigen corresponding to thyroid-microsomal autoantibodies. Anti-TPO auto antibodies are very important to diagnose autoimmune thyroid diseases and also in estimating its clinical course. Autoimmune thyroid disease is detected mostly by measuring circulating antibodies to thyroglobulin which is uncommon measurement of antibodies to TPO that gives reliable information about autoimmune thyroid disease. Eighty percent of Grave′s disease patients have high levels of antiTPO antibodies. About 4% of subclinical hypothyroid patients with positive TPO antibodies develop clinical hypothyroidism. There is always a controversy on the relationship between breast cancer and thyroid disorders. As these tissues, i.e., breast and thyroid, originate embryologically from the same type of cells, hypothyroid/hyperthyroid females are more prone to develop benign or malignant breast tumors. The studies on breast cancer patients indicate increased thyroid disorders in breast cancer patients, most commonly Hashimoto′s thyroiditis accounts to increased thyroid disorders in these patients. This is independent of hormonal receptor status of the patient. These findings suggest the usefulness of screening for thyroid disease in any patient with breast cancer.

  6. Cervical Paraganglioma Mimicking Thyroid Nodule: A Rare Clinical Case

    Berna İmge Aydoğan

    2016-01-01

    Full Text Available Objective. Paraganglioma is a rare neuroendocrine tumor. When it is located in the neck, it is commonly misdiagnosed as other thyroid neoplasms. Case Report. We report a case of cervical paraganglioma in a 55-year-old female. Patient was admitted to our clinic with goiter and neck pain. Thyroid ultrasonography revealed a 20 mm solitary, heterogeneous nodule located in the upper pole of left thyroid lobe. Fine needle aspiration cytology was nondiagnostic. She underwent left lobectomy and histopathology showed paraganglioma. Discussion. Cervical paragangliomas should be considered in the differential diagnosis of thyroid nodules.

  7. Warthin-like papillary thyroid carcinoma: A rare tumor of the thyroid

    Nuray Can

    2011-12-01

    Full Text Available Warthin-like papillary thyroid carcinoma is a rare variant of papillary thyroid carcinoma with favorable prognosis. The tumor is named “Warthin-like papillary thyroid carcinoma” because of bearing a striking morphological resemblance to Warthin’s tumor occurring in the salivary glands. Thyroid ultrasonography of 65 years old female patient with a history of bilateral subtotal thyroidectomy 30 years ago in another center with unknown histopathological diagnosis revealed a 20 mm isoechoic solid nodule in the left lobe and this nodule was hypoactive in thyroid scintigraphy. Grossly, a grey-tan colored, solid nodule with 1 cm diameter was seen in the left lobe. Histologically, the tumor was composed of papillary structures surrounded by marked lymphocytic stroma and oncocytic cells with papillary carcinoma’s nuclear features were lining the papillae. Hashimoto’s thyroiditis was present throughout the thyroid. Immunohistochemically, tumor cells exhibited cytokeratin 19, Thyroid transcription factor-1 (TTF-1, Galectin-3, HBME-1(Mesothelioma antibody and thyroglobulin positivity, proliferative index with Ki-67 was low. Warthin-like papillary thyroid carcinoma is a rare variant of papillary thyroid carcinoma and other oncocytic cell lesions especially Hurthle cell carcinoma should be kept in mind in the differential diagnosis of this neoplasm.

  8. Carbimazole induced atypia in the thyroid gland

    Sunil Y Swami

    2016-01-01

    Full Text Available Thyroid nuclear atypia associated with carbimazole is well-known. However, there are rare cases described in literature. We report here a case of thyroid fine needle aspiration cytology (FNAC of a follicular lesion of undetermined significance or nuclear atypia of undetermined significance (FLUS/AUS observed in a 56-year-old female presenting with Hashimoto's thyroiditis on treatment by carbimazole. In conclusion, thyroid nuclear atypia in the form of anisonucleosis, prominent nucleoli, and hyperchromasia associated with carbimazole treatment should be interpreted with caution in differentiating from malignancy.

  9. Cystic neoplasms of the pancreas: A diagnostic challenge

    Grant F Hutchins; Peter V Draganov

    2009-01-01

    Cystic neoplasms of the pancreas are increasingly recognized due to the expanding use and improved sensitivity of cross-sectional abdominal imaging. Major advances in the last decade have led to an improved understanding of the various types of cystic lesions and their biologic behavior. Despite significant improvements in imaging technology and the advent of endoscopic-ultrasound (EUS)-guided fineneedle aspiration, the diagnosis and management of pancreatic cystic lesions remains a significant clinical challenge. The first diagnostic step is to differentiate between pancreatic pseudocyst and cystic neoplasm.If a pseudocyst has been effectively excluded, the cornerstone issue is then to determine the malignant potential of the pancreatic cystic neoplasm. In the majority of cases, the correct diagnosis and successful management is based not on a single test but on incorporating data from various sources including patient history, radiologic studies, endoscopic evaluation, and cyst fluid analysis. This review will focus on describing the various types of cystic neoplasms of the pancreas, their malignant potential, and will provide the clinician with a comprehensive diagnostic approach.

  10. MALIGNANCY IN LARGE COLORECTAL LESIONS

    Carlos Eduardo Oliveira dos SANTOS

    2014-09-01

    Full Text Available Context The size of colorectal lesions, besides a risk factor for malignancy, is a predictor for deeper invasion Objectives To evaluate the malignancy of colorectal lesions ≥20 mm. Methods Between 2007 and 2011, 76 neoplasms ≥20 mm in 70 patients were analyzed Results The mean age of the patients was 67.4 years, and 41 were women. Mean lesion size was 24.7 mm ± 6.2 mm (range: 20 to 50 mm. Half of the neoplasms were polypoid and the other half were non-polypoid. Forty-two (55.3% lesions were located in the left colon, and 34 in the right colon. There was a high prevalence of III L (39.5% and IV (53.9% pit patterns. There were 72 adenomas and 4 adenocarcinomas. Malignancy was observed in 5.3% of the lesions. Thirty-three lesions presented advanced histology (adenomas with high-grade dysplasia or early adenocarcinoma, with no difference in morphology and site. Only one lesion (1.3% invaded the submucosa. Lesions larger than 30 mm had advanced histology (P = 0.001. The primary treatment was endoscopic resection, and invasive carcinoma was referred to surgery. Recurrence rate was 10.6%. Conclusions Large colorectal neoplasms showed a low rate of malignancy. Endoscopic treatment is an effective therapy for these lesions.

  11. Obesity and gastrointestinal neoplasms

    Izabela Binkowska-Borgosz

    2014-10-01

    Full Text Available Being overweight or obese is a significant public health problem in the 21st century due to its scale, common existence and its cause-effect association with multiple diseases. Excessive accumulation of adipose tissue in humans is regarded as a major risk factor for development of cardiovascular and skeletal diseases. However, data from recent years have revealed that obesity is also strongly associated with increased risk of the majority of cancers in humans, including those originating from the gastrointestinal tract. During the last few year this association has been thoroughly proven and supported by several epidemiological analyses. The authors present i the current state of knowledge regarding key (pathomechanisms that link metabolism of human adipose tissue to development/progression of neoplasms (especially in the gastrointestinal tract, as well as ii the results of selected clinical studies in which the influence of obesity on risk of gastrointestinal cancer development has been addressed.

  12. Bioequivalence & Food Effect Study in Patients With Solid Tumor or Hematologic Malignancies

    2016-10-24

    Hematological Neoplasms; Non-Hodgkin's Lymphoma; Hodgkin's Lymphoma; Lymphoma; Multiple Myeloma; Acute Myeloid Leukemia; Leukemia; Myelodysplastic Syndromes; Neoplasms; Melanoma; Breast Cancer; Metastatic Breast Cancer; Non-Small Cell Lung Cancer; Small Cell Lung Cancer; Renal Cell Carcinoma; Glioblastoma Multiforme; Osteosarcoma; Sarcoma; Thyroid Cancer; Genitourinary

  13. Hyalinizing trabecular tumor and papillary carcinoma of the thyroid

    ZHU Hong; QI Ji-ping; WANG Ying-wei; SONG Yue-jia; ZHANG Zhi-yi

    2010-01-01

    Background Hyalinizing trabecular tumor (HTT) is a rare thyroid neoplasm, which shares some histologic features with thyroid papillary carcinoma (TPC). Clinically, it is frequently misdiagnosed as papillary carcinoma, even for some experienced pathologists. The aim of this study was to investigate whether HTT is variant of TPC or HTT is an independent entity of thyroid neoplasm.Methods The expression of CK19, galectin-3, HBME-1 and MIB-1 was detected by immunohistochemical staining in 12 cases of hyalinizing trabecular tumor and 20 cases of thyroid papillary carcinoma.Results Two of the 12 HTT samples were positive or focally positive for CK19. Four of the 12 samples of HTT presented positive to galectin-3; 3 were stained strongly and the other one was focally positive. None of the 12 samples of HTT was positive for HBME-1. Five in 12 HTT samples were stained in nucleus for MIB-1. Almost all the 20 cases of thyroid papillary carcinoma were intensely stained for CK19, galectin-3 and HBME-1. Fifteen in 20 cases of thyroid papillary carcinoma showed nuclear staining for MIB-1.Conclusions HTT is an independent thyroid neoplasm, not a variant of TPC. This study could help in the differential diagnosis of HTT from TPC. CK19, galectin-3 and HBME-1 are adequate to identify HTT and TPC, but MIB-1 does not play an important role in discrimination between HTT and TPC.

  14. Molecular biology of Philadelphia-negative myeloproliferative neoplasms

    Paulo Vidal Campregher

    2012-01-01

    Full Text Available Myeloproliferative neoplasms are clonal diseases of hematopoietic stem cells characterized by myeloid hyperplasia and increased risk of developing acute myeloid leukemia. Myeloproliferative neoplasms are caused, as any other malignancy, by genetic defects that culminate in the neoplastic phenotype. In the past six years, since the identification of JAK2V617F, we have experienced a substantial increase in our knowledge about the genetic mechanisms involved in the genesis of myeloproliferative neoplasms. Mutations described in several genes have revealed a considerable degree of molecular homogeneity between different subtypes of myeloproliferative neoplasms. At the same time, the molecular differences between each subtype have become clearer. While mutations in several genes, such as JAK2, myeloproliferative leukemia (MPL and LNK have been validated in functional assays or animal models as causative mutations, the roles of other recurring mutations in the development of disease, such as TET2 and ASXL1 remain to be elucidated. In this review we will examine the most prevalent recurring gene mutations found in myeloproliferative neoplasms and their molecular consequences.

  15. An unusual case of Hashimoto′s thyroiditis with four lobed thyroid gland

    Rayees Ahmad Dar

    2012-01-01

    Full Text Available Hashimoto′s thyroiditis (HT, an autoimmune disorder, is the most prevalent cause of subclinical or overt hypothyroidism in areas with sufficient iodine intake. The gland is often diffusely enlarged, and the parenchyma is coarsened, hypoechoic, and often hypervascular on ultrasonograpy. Histopathologic appearance of HT includes lymphocyte aggregates with germinal centers, small thyroid follicles, presence of Hurthle cells, and variable fibrosis. We present a case of a 40-year-old female with suspected follicular neoplasm on fine-needle aspiration cytology of neck swelling. Intraoperatively, thyroid gland was found having four lobes separated from each other. Total thyroidectomy was done and histopathology from all four lobes revealed HT. At present, there is no literature to support the fact that such distorted thyroid anatomy may be due to the underlying disease. If we consider it as thyroid gland anomaly, no such anomaly has been mentioned in the literature till date.

  16. Ultrasound sonoelastography in the evaluation of thyroiditis and autoimmune thyroid disease.

    Ruchała, Marek; Szmyt, Krzysztof; Sławek, Sylwia; Zybek, Ariadna; Szczepanek-Parulska, Ewelina

    2014-01-01

    Sonoelastography (USE) is a constantly evolving imaging technique used for the noninvasive and objective estimation of tissue stiffness. Several USE methods have been developed, including Quasi-Static or Strain Elastography and Shear Wave Elastography. The utility of USE has been demonstrated in differentiating between malignant and benign thyroid lesions. Recently, USE has been applied in the evaluation of thyroiditis and autoimmune thyroid disease (AITD).Thyroid inflammatory illnesses constitute a diverse group of diseases and may manifest various symptoms. These conditions may share some parallel clinical, biochemical, and ultrasonographic features, which can lead to diagnostic difficulties. USE may be an additional tool, supporting other methods in the diagnosis and treatment monitoring of thyroid diseases, other than thyroid nodular disease.The aim of this article was to analyse and summarise the available literature on the applicability of different elastographic techniques in the diagnosis, differentiation and monitoring of various types of thyroiditis and AITD. Advantages and limitations of this technique are also discussed.

  17. Papillary thyroid carcinoma presenting as an asymptomatic pelvic bone metastases

    Siddiq S

    2010-05-01

    Full Text Available Thyroid carcinoma is rare comprising 1% of all malignancies and commonly presents as a neck lump. Papillary thyroid carcinoma unlike follicular thyroid carcinoma tends not to metastasise to distant sites.We present a case of papillary thyroid carcinoma presenting as a solitary asymptomatic pelvic bone metastases and highlight current management of bone metastases. A 59-year old female was found on abdominal computerised tomography to have an incidental finding of a 4.5 cm soft tissue mass in the right iliac bone. Biopsy of the lesion confirmed metastatic thyroid carcinoma. There was no history of a neck lump, head and neck examination was normal. Further imaging confirmed focal activity in the right lobe of the thyroid. A total thyroidectomy and level VI neck dissection was performed and histology confirmed follicular variant of papillary carcinoma.Early detection of bone metastases have been shown to improve prognosis and thyroid carcinoma should be considered as a potential primary malignancy.

  18. Thyroid Cancer Risk Factors

    ... Prevented? Thyroid Cancer Causes, Risk Factors, and Prevention Thyroid Cancer Risk Factors A risk factor is anything that ... Cancer? Can Thyroid Cancer Be Prevented? More In Thyroid Cancer About Thyroid Cancer Causes, Risk Factors, and Prevention ...

  19. What Is Thyroid Cancer?

    ... Treatment? Thyroid Cancer About Thyroid Cancer What Is Thyroid Cancer? Cancer starts when cells in the body begin ... cell) Medullary Anaplastic (an aggressive undifferentiated tumor) Differentiated thyroid cancers Most thyroid cancers are differentiated cancers. The cells ...

  20. Thyroid Disorders Overview

    ... and Symptoms Hypothyroidism Thyroid Nodules Lifestyle and Prevention Thyroid Disorders The thyroid gland is located at the ... lives, and must be closely monitored by physicians. Thyroid Nodules Thyroid disorders can also occur because of ...

  1. Thyroid Disease (for Parents)

    ... Old Feeding Your 1- to 2-Year-Old Thyroid Disease KidsHealth > For Parents > Thyroid Disease A A ... many other parts of the body. What Is Thyroid Disease? Thyroid disease is when the thyroid gland ...

  2. Thyroid Disease and Teens

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Thyroid Disease KidsHealth > For Teens > Thyroid Disease A A ... other parts of your body. continue What Is Thyroid Disease? Thyroid disease occurs when the thyroid gland ...

  3. Thyroid Disorders (For Kids)

    ... Emergency Room? What Happens in the Operating Room? Thyroid Disorders KidsHealth > For Kids > Thyroid Disorders A A ... the world is a thyroid? What Is the Thyroid? The thyroid (say: THYE-royd) is a gland, ...

  4. Thyroid Diseases Tests

    ... Thyroid antibodies – to help differentiate different types of thyroiditis and identify autoimmune thyroid conditions Thyroid peroxidase (TPO) ... can be detected in Graves disease or Hashimoto thyroiditis . It may be especially helpful in early Hashimoto ...

  5. Thyroid Scan and Uptake

    ... Physician Resources Professions Site Index A-Z Thyroid Scan and Uptake Thyroid scan and uptake uses small ... Thyroid Scan and Uptake? What is a Thyroid Scan and Uptake? A thyroid scan is a type ...

  6. Particulate cytoplasmic structures with high concentration of ubiquitin-proteasome accumulate in myeloid neoplasms

    2015-01-01

    Background Increased plasma levels of proteasome have been associated with various neoplasms, especially myeloid malignancies. Little is known of the cellular origin and release mechanisms of such proteasome. We recently identified and characterized a novel particulate cytoplasmic structure (PaCS) showing selective accumulation of ubiquitin-proteasome system (UPS) components. PaCSs have been reported in some epithelial neoplasms and in two genetic disorders characterized by hematopoietic cell...

  7. Intraductal Papillary Mucinous Neoplasm (IPMN) and Chronic Pancreatitis: Overlapping Pathological Entities? Two Case Reports

    Athanasios Petrou; Alexandros Papalambros; Nicholas Brennan; Evangelos Prassas; Thoedora Margariti; Konstadinos Bramis; Theofilos Rozemberg; Efstathios Papalambros

    2011-01-01

    Context Intraductal papillary mucinous neoplasms (IPMNs) are a recently classified pancreatic neoplasm with an increasing incidence. IPMN is often misdiagnosed as chronic pancreatitis because of symptoms of relapsing abdominal pain, pancreatitis, and steatorrhea and imaging findings of a dilated pancreatic duct of cystic lesions that are frequently confused with pseudocysts. Early recognition of IPMN allows for prompt surgical resection before malignant transformation. Case reports We report ...

  8. MALIGNANT MELANOMA OF THE ORAL CAVITY

    Vishnu Prasad

    2016-02-01

    Full Text Available Oral malignant melanoma is a rare aggressive neoplasm commonly affects males and is more frequently seen at the level of the hard palate and gingiva. In many cases, melanoma has evolved from the pre-existing pigmented lesions. These neoplasms are biologically aggressive, but they often go unnoticed since they usually present merely as a hyperpigmented patch on the gingival surface. Performing biopsies of doubtful pigmented lesions helps in early treatment and better prognosis. The surgical excision combined with the chemotherapy is the treatment of choice. Here, we report a rare case of an elderly male patient with oral malignant melanoma with metastasis to vertebral column.

  9. Co-occurrence of papillary thyroid carcinoma and mucosa-associated lymphoid tissue lymphoma in a patient with long-standing hashimoto thyroiditis.

    Nam, Yoon Jeong; Kim, Bo Hyun; Lee, Seong Keun; Jeon, Yun Kyung; Kim, Sang Soo; Jung, Woo Jin; Kahng, Dong Hwahn; Kim, In Ju

    2013-12-01

    Papillary thyroid carcinoma (PTC) is a common affliction of the thyroid gland, accounting for 70% to 80% of all thyroid cancers, whereas mucosa-associated lymphoid tissue (MALT) lymphoma of the thyroid gland is uncommon. The simultaneous occurrence of both malignancies is extremely rare. We report the case of a patient with both PTC and MALT lymphoma in the setting of Hashimoto thyroiditis. An 81-year-old female patient was first admitted with goiter and hoarseness, which was attributed to an ultrasonographic thyroid nodule. Subsequent fine-needle aspirate, interpreted as suspicious of papillary thyroid cancer, prompted total thyroidectomy. MALT lymphoma was an incidental postsurgical finding, coexisting with PTC in the setting of Hashimoto thyroiditis. Although the development of MALT lymphoma is very rare, patients with longstanding Hashimoto thyroiditis should undergo careful surveillance for both malignancies.

  10. 超声弹性应变率比值在桥本甲状腺炎合并甲状腺良恶性结节鉴别诊断中的应用%Real-time Elastosonography in Diagnosis of Benign and Malignant Nodules with Hashimoto Thyroiditis

    王建红; 刘韶平; 李萍; 丁兆艳; 马喆; 房世保

    2012-01-01

    Objective To evaluate the clinical value of strain ratio using real-time elastosonography in differential diagnosis of benign and malignant thyroid nodules with Hashimoto thyroiditis. Methods Elasticity imaging was used to examine 36 Hashimoto thyroiditis patients with 50 nodules. The stain ratio was obtained through sternocleidomas-toid and lesion. The cut off point of stain ratio was determined as 5. 03, which is used to differential diagnosis of benign and malignant nodules. Results There were 12 malignant nodules and 38 benign ones in 36 Hashimoto thyroiditis with thyroid nodules. The mean of elastics stain ratio of benign and malignant was 2. 89 ?1. 50 and 7. 83 ?4. 95 (P< 0.05). The cut off point of stain ratio was determined as 5. 03, and the sensitivity,specificity, veracity was 75.0%, 92. 1% and 84. 0% respectively in differential diagnosis of benign and malignant nodules with Hashimoto thyroiditis. Conclusions The stain ratio has high value in the differential diagnosis of malignant and benign nodules with Hashimoto thyroiditis.%目的 探讨超声弹性应变率比值在桥本甲状腺炎合并甲状腺良恶性结节鉴别诊断中的应用价值.方法 分析36例50个经穿刺活检或手术后病理证实的桥本甲状腺炎(HT)合并甲状腺结节的超声弹性图像,计算病灶同侧胸锁乳突肌与病灶的应变率比值(strain rate),以5.03为界点判断结节的良恶性.结果 50个HT合并甲状腺结节中,恶性12个,良性38个,恶性结节应变率比的均值为7.83±4.95,良性结节应变率比的均值为2.89±1.50,两者的差别有统计学意义(P<0.05).以5.03为诊断的最佳界点,则弹性成像应变率比值判断桥本甲状腺炎合并结节良恶性的敏感性、特异性和准确性分别为75.0%、92.1%和84.0%.结论 超声弹性应变率比值在HT合并甲状腺良恶性结节的鉴别诊断中有较高的诊断价值.

  11. Topical treatment options for conjunctival neoplasms

    Jonathan W Kim

    2008-10-01

    Full Text Available Jonathan W Kim, David H AbramsonOphthalmic Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USAAbstract: Topical therapies offer a nonsurgical method for treating conjunctival tumors by delivering high drug concentrations to the ocular surface. Over the past ten years, topical agents have been used by investigators to treat various premalignant and malignant lesions of the conjunctiva, such as primary acquired melanosis with atypia, conjunctival melanoma, squamous intraepithelial neoplasia and squamous cell carcinoma of the conjunctiva, and pagetoid spread of the conjunctiva arising from sebaceous cell carcinoma. Despite the enthusiasm generated by the success of these agents, there are unanswered questions regarding the clinical efficacy of this new nonsurgical approach, and whether a single topical agent can achieve cure rates comparable with traditional therapies. Furthermore, the long-term consequences of prolonged courses of topical chemotherapeutic drugs on the ocular surface are unknown, and the ideal regimen for each of these agents is still being refined. In this review, we present specific guidelines for treating both melanocytic and squamous neoplasms of the conjunctiva, utilizing the available data in the literature as well as our own clinical experience at the Memorial Sloan-Kettering Cancer Center.Keywords: topical therapies, conjunctival neoplasms melanosis, Mitomycin-C, 5-Fluorouracil

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

    A. Capote Moreno

    2005-10-01

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

  13. Diagnostic value of CD-10 marker in differentiating of papillary thyroid carcinoma from benign thyroid lesions

    Mojgan Mokhtari

    2014-01-01

    Full Text Available Background: Using of CD10 in accordance with clinical and histological features of thyroid lesions could be used as both diagnostic and prognostic tool, which consequently influence the management and their prognosis for survival of patients with thyroid neoplasms especially papillary thyroid carcinoma (PTC. The aim of this study was to determine its expression in PTC and different benign thyroid lesions. Materials and Methods: In this descriptive-analytic, cross-sectional study, paraffin-embedded tissues of patients with definitive pathologic diagnosis of different benign thyroid lesions and PTC were retrieved. Immunostained sections of each slides was performed using immunohistochemistry methods and expression of CD10 was compared in two groups of benign thyroid lesions and PTC. Results: From selected cases 134 sections studied in two groups of PTC (n = 67 and benign thyroid lesions (n = 67. CD10 were immunohistochemically positive in 29.9% of PTC cases, but in none of the thyroid benign lesions (0% (P 0.05. Conclusion: The results of the current study indicate that due to the higher expression of CD10 in PTC than benign thyroid lesions it might be used for differentiating mentioned lesions. But for using it as a diagnostic tool further studies with larger sample size and determination of its sensitivity, specificity and cut-off point is necessary.

  14. Lack of BRAF mutations in hyalinizing trabecular neoplasm

    Brose Marcia

    2006-01-01

    Full Text Available Abstract The hyalinizing trabecular neoplasm (HTN of the thyroid is an unusual and controversial lesion. Some consider it a peculiar type of papillary thyroid carcinoma (PTC because of its nuclear features and presence of psammoma bodies. Others consider it an adenoma. Molecular studies have found RET/PTC translocations in some examples, supporting HTN as a PTC; however mutations in BRAF (another marker for PTC have not been found. We report two cases of classic HTN and a case of trabecular PTC and show BRAF mutations in the latter and not in HTN. Trabecular growth pattern is insufficient for a diagnosis of HTN and lesions with such a pattern and nuclear features of PTC are cancers. Morphologically classic HTN are not associated with metastatic potential and should be considered adenomas.

  15. MIBI-SPECT in hypofunctioning thyroid nodules for detection of thyroid carcinoma; MIBI-SPECT bei kalten Knoten zur Schilddruesenkarzinomdetektion

    Schmidt, M.; Schicha, H. [Universitaetsklinikum Koeln (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2010-12-15

    The clinical usefulness of Tc-99m-MIBI in hypofunctioning thyroid nodules for detection of thyroid carcinoma is presented. Tc-99m-MIBI is a lipophilic cation and a non-specific radiopharmaceutical for tumour imaging. It has become an important imaging technique for the assessment of hypofunctioning thyroid nodules because of its high negative predictive value excluding malignant thyroid tumours. After injection of Tc-99m-MIBI either a single-phase protocol with late planar and SPECT images about 1-2 h post injection or a double-phase protocol with early (about 15-30 min p.i.) and late images (about 2 h p.i.) were reported. Findings include a reduced, an isointense or an increased Tc-99m-MIBI accumulation in the thyroid nodule in comparison to the paranodular thyroid tissue and in comparison to pertechnetate thyroid scintigraphy. A 'Match' between pertechnetate and Tc-99m-MIBI scintigraphy is a concordantly decreased uptake in the thyroid nodule in comparison to the normal thyroid gland. This finding has a negative predictive value of >97% to exclude differentiated thyroid cancer. A definite 'Mismatch' means a cold thyroid nodule on pertechnetate scintigraphy and an increased uptake of Tc-99m-MIBI in comparison to the MIBI-uptake of the paranodular thyroid tissue. The positive predictive value of this finding for malignancy varies between studies and is in the range of <10-65% (Cologne data: 19%) depending on the prevalence of malignant thyroid tumours in the patient population studied. An isointense uptake was not associated with thyroid malignancy according to 'Cologne' data. Further studies are desirable for better characterization of the method. (orig.)

  16. Immunohistochemical staining for thyroid peroxidase (TPO) of needle core biopsies in the diagnosis of scintigraphically cold thyroid nodules

    Yousaf, U.; Christensen, Lars Høj; Rasmussen, A.K.;

    2008-01-01

    patients with a cold thyroid nodule were evaluated by ultrasound-guided NCB, which had been routinely stained for TPO in an automated immunostainer. Sensitivity and specificity and predictive values of the TPO immunostaining were estimated, based on the final diagnosis obtained from surgical resection......BACKGROUND: Cold thyroid nodules are common, in particular in iodine-deficient areas, but only a minority of them are malignant requiring surgery. Thyroid peroxidase (TPO) immunostaining of fine-needle aspiration cytology (FNAC) material has proven helpful in diagnosing cells from malignant lesions...... of cold thyroid nodules of the nonoxyphilic type Udgivelsesdato: 2008/6...

  17. 江西省第3次死因回顾恶性肿瘤调查结果分析%Analysis of Malignant Neoplasm in the Third Death Cause Retrospective Review in Jiangxi Province

    朱丽萍; 李艾; 赵军; 张伟; 颜玮; 吉路; 陈轶英; 余平; 刘杰

    2012-01-01

    Objective To analyze the mortality distribution characteristics and epidemiological trend of cancer from the 3rd National Death Retrospective Sampling Survey areas in Jiangxi province. Methods All death records of cancer from 2 city and 6 counties in Jiangxi province were extracted from the 3rd National Death Retrospective Sampling Survey database. Crude rate, the constitute proportion to all cancer deaths, age—specific proportion, age—standardized mortality rate by Chinese population and by world standard population and rank of cancer-specific mortality were calculated by different gender and area groups. Results Thers were 7 842 deaths caused by cancer with death rate of 115.37 per 100 000, age-standardized mortality rate by Chinese population of 83.41 per 100 000 and 110.34 per 100 000 by world standard population in Jiangxi province in 2004-2005. The total death rates were 144.59 per 100 000 in male and 83.77 per 100 000 in female. Mortality rate was higher in male than that in female and higher in urban than that in rural areas. The top five malignant tumors causing death were lung, liver, stomach, colorectal and esophageal cancer. The top three leading causes of deaths from cancer in urban areas were lung, liver and stomach cancers, and in rural areas were liver, stomach and lung cancers. Conclusion The mortality of cancers is lower from the 3rd National Death Retrospective Sampling Survey areas in Jiangxi province than that in the whole country and higher than western region in 2004-2005. Lung, liver, and stomach cancers remain the most common causes of cancer deaths in Jiangxi province.%目的 分析江西省第3次死因回顾调查地区恶性肿瘤死亡分布特点和流行趋势,为制定恶性肿瘤干预措施提供依据.方法 抽取2004-2005年全国第3次死因回顾调查江西省2个市6个县恶性肿瘤死亡资料,按性别和地区分别计算恶性肿瘤死亡专率、恶性肿瘤死因构成比、年龄别恶性肿瘤死因构成比

  18. Pitfalls in the biopsy diagnosis of intraoral minor salivary gland neoplasms: diagnostic considerations and recommended approach.

    Turk, Andrew T; Wenig, Bruce M

    2014-01-01

    Among the more common types of intraoral minor salivary gland neoplasms are pleomorphic adenoma, basal cell adenoma, polymorphous low-grade adenocarcinoma, and adenoid cystic carcinoma. These minor salivary gland neoplasms share similar morphologic features and to a large extent immunohistochemical findings. Differentiation between these benign and malignant neoplasms is often predicated on the presence or absence of invasion. As such, in the presence of limited tissue sampling that typifies the initial testing modalities, including fine needle aspiration biopsy and/or incisional biopsy, it often is not possible to differentiate a benign from malignant minor salivary gland neoplasm. The diagnostic difficulties arise from the absence in needle or incisional biopsy of the tumor's periphery to determine whether infiltrative growth is or is not present. In this manuscript we discuss limitations and considerations associated with evaluation of incisional biopsies of intraoral minor salivary gland tumors. We offer a diagnostic approach to evaluating these biopsies, and suggest diagnostic terminology for biopsy specimens in which distinction between benignancy and malignancy is not feasible. The pathologist's approach to this distinction is critical, as treatment of benign neoplasms is generally conservative, whereas malignant lesions may warrant more aggressive management.

  19. Thyroid Hormones, Autoantibodies, Ultrasonography, and Clinical Parameters for Predicting Thyroid Cancer

    He, Lin-zheng; Zeng, Tian-shu; Pu, Lin; Pan, Shi-xiu; Xia, Wen-fang; Chen, Lu-lu

    2016-01-01

    Our objective was to evaluate thyroid nodule malignancy prediction using thyroid function tests, autoantibodies, ultrasonographic imaging, and clinical data. We conducted a retrospective cohort study in 1400 patients with nodular thyroid disease (NTD). The thyroid stimulating hormone (TSH) concentration was significantly higher in patients with differentiated thyroid cancer (DTC) versus benign thyroid nodular disease (BTND) (p = 0.004). The receiver operating characteristic curve of TSH showed an AUC of 0.58 (95% CI 0.53–0.62, p = 0.001), sensitivity of 74%, and specificity of 57% at a cut-off of 1.59 mIU/L. There was an incremental increase in TSH concentration along with the increasing tumor size (p < 0.001). Thyroglobulin antibody (TgAb) concentration was associated with an increased risk of malignancy (p = 0.029), but this association was lost when the effect of TSH was taken into account (p = 0.11). Thyroid ultrasonographic characteristics, including fewer than three nodules, hypoechoic appearance, solid component, poorly defined margin, intranodular or peripheral-intranodular flow, and punctate calcification, can be used to predict the risk of thyroid cancer. In conclusion, our study suggests that preoperative serum TSH concentration, age, and ultrasonographic features can be used to predict the risk of malignancy in patients with NTD. PMID:27313612

  20. Surgical and Pathological Changes after Radiofrequency Ablation of Thyroid Nodules

    Chiara Dobrinja; Stella Bernardi; Bruno Fabris; Rita Eramo; Petra Makovac; Gabriele Bazzocchi; Lanfranco Piscopello; Enrica Barro; Nicolò de Manzini; Deborah Bonazza; Maurizio Pinamonti; Fabrizio Zanconati; Fulvio Stacul

    2015-01-01

    Background. Radiofrequency ablation (RFA) has been recently advocated as an effective technique for the treatment of symptomatic benign thyroid nodules. It is not known to what extent it may affect any subsequent thyroid surgery and/or histological diagnosis. Materials and Methods. RFA was performed on 64 symptomatic Thy2 nodules (benign nodules) and 6 symptomatic Thy3 nodules (follicular lesions/follicular neoplasms). Two Thy3 nodules regrew after the procedure, and these patients accepted t...

  1. ROLE OF ULTRASONOGRAPHY & COLOR DOPPLER IN THE EVALUATION OF THYROID NODULES WIT H HISTOPATHOLOGICAL CORRELATION

    Raghu Teja

    2015-02-01

    Full Text Available PURPOSE OF THE STUDY: 1. To identify morphologic patterns on sonography , those are predictive of benign thyroid nodules and malignant thyroid nodules. 2. To evaluate the efficacy of sonography in differentiating benign and malignant thyroid nodules in comparison with histopathology. MATERIALS AND METHODS: HRS of thyroid was performed in 60 patients with clinically palpable STN , referred to Department of Radiodiagnosis , R. L. Jssalappa Hospital and Research Centre , Tamaka , Kolar , Karnataka over a period of 24months , using SIEMENS ACCUSON X 300 and SIEMENS G 50 with 5 - 10 MHz transducers . Thyroid sonographic findings relevant to benign or malignant thyroid nodules were recorded and these findings w ere compared with histopathology reports. RESULTS: Out of 60 cases of solitary thyroid nodules evaluated at sonography , 41 were diagnosed to be benign thyroid nodules. 19 were malignant thyroid nodules. After histopathological evaluation , 43 cases were fou nd to be benign thyroid nodules and 17 were malignant thyroid nodules. Among benign thyroid nodules , follicular adenoma 55.8% (24 caseswas most common followed by nodular hyperplasia 27.9% (12 casesand colloid nodule 16.3%(7 cases. Among malignant nodul es , papillary carcinoma 88.2% (15 cases was most common followed by follicular carcinoma 11.8% (2 cases. CONCLUSION: Thyroid nodules were more common in the females of age group 31 – 45 years. Sonography is a safe , fairly accurate investigation to differentiate benign from malignant thyroid nodules with sensitivity of 82.3 % and specificity of 88.3 %. KEY WORDS: solitary thyroid nodu le; high resolution sonography; histopathology.

  2. EVALUATION OF THYROID NODULES: AN ULTRASONOGRAPHIC STUDY

    Vijai

    2013-10-01

    Full Text Available ABSTRACT : Thyroid nodules are common in adults, with a reported prevalence of up to 50%. (1 – 5. Furthermore, 9% to 15% of nodules identified during clinical examinations are diagnosed as malignant (6 – 8. It is gen erally accepted that sonography and sonographically guided fine - needle aspiration cytologic examination are the modalities of choice for differentiating benign and malignant thyroid nodules (1 , 9 . Thyroid ultrasonography (USG is the major diagnostic moda lity for evaluating thyroid nodules. Using USG, a thyroid nodule appears as a nodular lesion within the thyroid gland that is distinguishable from the adjacent parenchyma. Several USG features, such as marked hypoechogenicity, irregular margin, micro calci fications, and a taller - than - wide shape have been introduced as potential predictors for the presence of thyroid malignancies. AIMS & OBJECTIVE : The aim of this study was to assess the accuracy of USG diagnosis for thyroid nodules. MATERIALS & METHODS: Th e present study was conducted in the Department of Radiodiagnosis, TMMC & RC, TMU, Moradabad. Patients under the study were referred from department of Surgery, Paediatrics, Medicine, ENT, Gynaecology and Obstetrics. Patients for the study were evaluated b y Clinical & Radiological examination. The total number of patients were 120. RESULT: On clinical examination, multiple nodules were found only in 17% of cases, whereas on USG, multiple nodules were found in 58%. 50% of clinically solitary nodules were d emonstrated to be multiple on USG. CONCLUSION: In conclusion, similar to the recent literature reviewed so far, for a large majority of patients, diagnosis changed after ultrasonography, so the results necessitate the use of ultrasonography, which is a non invasive method, as a complementary method to physical examination in the diagnosis of thyroid diseases, especially thyroid nodules.

  3. Bethesda categorization of thyroid nodule cytology and prediction of thyroid cancer type and prognosis

    X. Liu (Xiaoyun); M. Medici (Marco); N. Kwong (Norra); T.E. Angell (Trevor E.); E. Marqusee (Ellen); M.I. Kim (Matthew I.); P.R. Larsen (P. Reed); N.L. Cho (Nancy L.); M.A. Nehs (Matthew A.); D.T. Ruan (Daniel T.); A. Gawande (Atul); F. Moore (Francis); J. Barletta (Justine); J.F. Krane (Jeffrey F.); E.S. Cibas (Edmund S.); T. Yang (Tao); E.K. Alexander (Erik K.)

    2016-01-01

    textabstractBackground: Since its inception, the Bethesda System for Reporting Thyroid Cytopathology (TBS) has been widely adopted. Each category conveys a risk of malignancy and recommended next steps, though it is unclear if each category also predicts the type and extent of malignancy. If so, thi

  4. Possible association between hepatitis C virus and malignancies different from hepatocellular carcinoma: A systematic review

    Fiorino, Sirio; Bacchi-Reggiani, Letizia; de Biase, Dario; Fornelli, Adele; Masetti, Michele; Tura, Andrea; Grizzi, Fabio; Zanello, Matteo; Mastrangelo, Laura; Lombardi, Raffaele; Acquaviva, Giorgia; di Tommaso, Luca; Bondi, Arrigo; Visani, Michela; Sabbatani, Sergio; Pontoriero, Laura; Fabbri, Carlo; Cuppini, Andrea; Pession, Annalisa; Jovine, Elio

    2015-01-01

    AIM: To summarize the current knowledge about the potential relationship between hepatitis C virus (HCV) infection and the risk of several extra-liver cancers. METHODS: We performed a systematic review of the literature, according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) Statement. We extracted the pertinent articles, published in MEDLINE and the Cochrane Library, using the following search terms: neoplasm/cancer/malignancy/tumor/carcinoma/adeno-carcinoma and non-Hodgkin lymphomas, kidney/renal-, cholangio-, pancreatic-, thyroid-, breast-,oral-, skin-, prostate-, lung-, colon-, stomach-, haematologic. Case series, case-series with control-group, case-control, cohort-studies as well as meta-analyses, written in English were collected. Some of the main characteristics of retrieved trials, which were designed to investigate the prevalence of HCV infection in each type of the above-mentioned human malignancies were summarised. A main table was defined and included a short description in the text for each of these tumours, whether at least five studies about a specific neoplasm, meeting inclusion criteria, were available in literature. According to these criteria, we created the following sections and the corresponding tables and we indicated the number of included or excluded articles, as well as of meta-analyses and reviews: (1) HCV and haematopoietic malignancies; (2) HCV and cholangiocarcinoma; (3) HCV and pancreatic cancer; (4) HCV and breast cancer; (5) HCV and kidney cancer; (6) HCV and skin or oral cancer; and (7) HCV and thyroid cancer. RESULTS: According to available data, a clear correlation between regions of HCV prevalence and risk of extra-liver cancers has emerged only for a very small group of types and histological subtypes of malignancies. In particular, HCV infection has been associated with: (1) a higher incidence of some B-cell Non-Hodgkin-Lymphoma types, in countries, where an elevated prevalence of this

  5. Analysis the Clinical Significance of the Ultrasonic Diagnosis of the Benign or the Malignant About the Nodules With Diffuse Hashimoto's Thyroiditis%浅谈弥漫型桥本氏甲状腺炎合并结节的良恶性超声诊断的临床意义

    申琳

    2015-01-01

    ObjectiveTo explore the significance of the ultrasound diagnostic signiifcance of the nodules with diffuse hashimoto's thyroiditis. MethodsSelected 47 cases of patients suffered diffuse hashimoto’s thyroiditis complicated with thyroid nodules in our hospital, and contrasted ultrasound diagnoses with pathologic results.Results 20 cases were papillary carcinoma, 5 cases were follicular carcinoma, 1 case were malignant lymphoma, 16 cases were nodular goiter, 3 cases were adenocarcinoma, 2 cases were inflammatory nodules, and the degrees of sensitivity, speciifcity and accuracy were respectively 84.3%, 75.8%, 81.5%with ultrasonic diagnoses.ConclusionUltrasound is extremely valuable to diagnosis of the Benign or the Malignant about the Nodules with diffuse hashimoto's thyroiditis.%目的:探讨弥漫型桥本氏甲状腺炎合并结节超声诊断意义。方法选取我院收治的弥漫型桥本甲状腺合并结节患者47例,将超声诊断与病理结果对比。结果20例为乳头状癌,5例为滤泡性癌,1例为恶性淋巴癌,16例为结节性甲状腺肿,3例为腺癌,2例为炎性结节,超声诊断敏感度为84.3%,特异度为75.8%,准确性为81.5%。结论超声诊断弥漫型桥本氏甲状腺炎合并结节的良恶性价值高。

  6. Qualitative elastography can replace thyroid nodule fine-needle aspiration in patients with soft thyroid nodules. A systematic review and meta-analysis

    Nell, Sjoerd; Kist, Jakob W.; Debray, Thomas P A; de Keizer, Bart; Van Oostenbrugge, Timotheus J.; Borel Rinkes, Inne H.M.; Valk, Gerlof D.; Vriens, Menno R.

    2015-01-01

    Context: Only a minority of thyroid nodules is malignant; nevertheless, many invasive diagnostic procedures are performed to distinguish between benign and malignant nodules. Qualitative ultrasound elastography is a non-invasive technique to evaluate thyroid nodules. Objective: To investigate the di

  7. Second malignancies after Hodgkin's disease: the Munich experience.

    Munker, R; Grützner, S; Hiller, E; Aydemir, U; Enne, W; Dietzfelbinger, H; Busch, M; Haas, R; Emmerich, B; Schmidt, M; Dühmke, E; Hölzel, D; Wilmanns, W

    1999-12-01

    The occurrence of second malignancies (SM) is an important late event following the treatment of Hodgkin's disease (HD). We sought to determine the incidence, the risk factors, and the prognosis of SM in our population of patients with HD. A total of 1120 patients diagnosed with HD were registered at six participating institutions in Munich (calendar period 1974-1994). The mean follow-up for the development of SM was 9.1 years. A cumulative treatment score was calculated for both radio- and chemotherapy. The relative and absolute risks of SM were established. All SM were investigated for response to treatment and outcome. We observed 85 SM [eight leukemias, 22 non-Hodgkin's lymphomas (NHL), two plasma cell neoplasias, and 53 solid tumors]. Five patients developed third malignancies. The relative risk of developing a second neoplasm was compared with that within the normal population and was 3.1-fold. The risk varied according to the category of SM. Higher relative risks (20.5 and 25.9-fold), but lower absolute risks were observed for leukemias and non-Hodgkin's lymphomas. Solid tumors had lower relative risks (1.8-fold). Splenectomy increased the risk of SM (relative risk 4.4-fold versus 2.7-fold). The risk of SM did not correlate with the initial treatment (radio- or chemotherapy) and did not decrease with prolonged follow-up. The cumulative intensity of radiotherapy, chemotherapy, or the two modalities combined correlated with the risk of SM. Since some cases occurred early after diagnosis, not all second neoplasms can be considered treatment-associated. After 15 years, an actuarial risk of 11.7% was calculated for all SM, of 1.0% for leukemias, of 3.0% for NHL, and of 7.7% for solid tumors. The prognosis of SM varied between good (thyroid cancer, melanoma: median survival 5+ years), average (breast cancer, NHL), and poor (acute myeloid leukemias, lung cancers: median survival 9 months). With the exception of NHL, second cancers often occurred in topographic

  8. MED-C Registry: Advanced Malignancy or Myelodysplasia, Tested by Standard Sequencing and Treated by Physician Choice

    2016-09-08

    Neoplasms; Lung Neoplasms; Colon Neoplasms; Breast Neoplasms; Pancreatic Neoplasms; Prostate Neoplasms; Kidney Neoplasms; Liver Neoplasms; Rectal Neoplasms; Hematologic Neoplasms; Multiple Myeloma; Myelodysplastic Syndromes; Ovarian Neoplasms; Bladder Neoplasms; Testicular Neoplasms; Endometrial Neoplasms; Brain Neoplasms; Biliary Tract Neoplasms; Head and Neck Neoplasms; Uterine Cervical Neoplasms; Skin Neoplasms; Melanoma; Gastric Neoplasms; Anal Neoplasms; Sarcoma

  9. Intraductal papillary mucinous neoplasm of pancreas

    Norman Oneil Machado

    2015-01-01

    Full Text Available Intraductal papillary mucinous neoplasms (IPMNs of the pancreas are neoplasms that are characterized by ductal dilation, intraductal papillary growth, and thick mucus secretion. This relatively recently defined pathology is evolving in terms of its etiopathogenesis, clinical features, diagnosis, management, and treatment guidelines. A PubMed database search was performed. All the relevant abstracts in English language were reviewed and the articles in which cases of IPMN could be identified were further scrutinized. Information of IPMN was derived, and duplication of information in several articles and those with areas of persisting uncertainties were excluded. The recent consensus guidelines were examined. The reported incidence of malignancy varies from 57% to 92% in the main duct-IPMN (MD-IPMN and from 6% to 46% in the branch duct-IPMN (BD-IPMN. The features of high-risk malignant lesions that raise concern include obstructive jaundice in a patient with a cystic lesion in the pancreatic head, the findings on radiological imaging of a mass lesion of >30 mm, enhanced solid component, and the main pancreatic duct (MPD of size ≥10 mm; while duct size 5-9 mm and cyst size <3 mm are considered as "worrisome features." Magnetic resonance imaging (MRI and endoscopic ultrasound (EUS are primary investigations in diagnosing and following up on these patients. The role of pancreatoscopy and the analysis of aspirated cystic fluid for cytology and DNA analysis is still to be established. In general, resection is recommended for most MD-IPMN, mixed variant, and symptomatic BD-IPMN. The 5-year survival of patients after surgical resection for noninvasive IPMN is reported to be at 77-100%, while for those with invasive carcinoma, it is significantly lower at 27-60%. The follow-up of these patients could vary from 6 months to 1 year and would depend on the risk stratification for invasive malignancy and the pathology of the resected specimen. The

  10. Cytology of Pericardial Effusion due to Malignancy

    Kalogeraki Alexandra

    2016-09-01

    Full Text Available Background. Malignant pericardial effusion occurs in one tenth of all cancers. It is a very serious disorder that is mainly a secondary process due to metastasis because primary neoplasms of the pericardium such as mesotheliomas, sarcomas being exceedingly rare.

  11. TFF3 and C1orf24 Assist in the Identification of Benign and Malignant Thyroid Follicular Tumor%TFF3和C1orf24协助鉴别甲状腺滤泡型肿瘤良恶性

    张福彬; 王坚

    2014-01-01

    Objective Using RT-PCR technique in the nucleic acid level to detected the gene expression of TFF3, C1orf24 in thyroid tumor tissues,that was extracted from patients by fine-needle aspiration biopsy.To assess whether it can be used clinical y in the identification of benign and malignant thyroid fol icular type tumor. Methods 279 cases of fine-needle aspiration tissue samples were col ected from patients with thyroid nodules between April 2013 and April 2011 in Jinling hospital.Then using RT-PCR technique in nucleic acid level to detected TFF3, C1orf24 gene expression level in each tissue sample.Contrast the cytology and postoperative pathology examination results,To learn the gene expression level of TFF3 and C1orf24 whether there are dif erences between thyroid fol icular tumor and malignant thyroid fol icular tumor. Results The gene expression level of TFF3 was higher in Fol icular thyroid carcinoma group compared to Thyroid fol icular adenoma group ( <0.05). Conclusion Two kinds of molecular biomarkers can help clinical identification of thyroid fol icular type of benign and malignant tumors.%目的:运用RT-PCR技术在核酸水平上检测甲状腺细针穿刺提取的甲状腺肿瘤组织中的TFF3、C1orf24基因的表达,评估其是否可用于临床上甲状腺滤泡型肿瘤良恶性的鉴别。方法选取我院2013年4月~2011年4月的细针穿刺甲状腺结节组织标本279例。然后运用RT-PCR技术在核酸水平上分别检测各样本组织中目的TFF3、C1orf24的表达水平。对照细胞学和术后病理学检查结果,了解TFF3、C1orf24在良性甲状腺滤泡型肿瘤和恶性甲状腺滤泡型肿瘤中是否存在差异。结果 TFF3在滤泡状癌中的表达高于滤泡状腺瘤(P<0.05)。 C1orf24在滤泡状癌中的表达高于滤泡状腺瘤(P<0.05)。结论两种分子标记物能较好的帮助临床鉴别甲状腺滤泡型肿瘤的良恶性。

  12. A Modified Thyroid Imaging Reporting and Data System (mTI-RADS) For Thyroid Nodules in Coexisting Hashimoto's Thyroiditis.

    Zhou, Hang; Yue, Wen-Wen; Du, Lin-Yao; Xu, Jun-Mei; Liu, Bo-Ji; Li, Xiao-Long; Wang, Dan; Zhou, Xian-Li; Xu, Hui-Xiong

    2016-05-19

    To develop a conventional ultrasound (US) modified Thyroid Imaging Reporting and Data System (mTI-RADS) to stratify the malignancy risk of thyroid nodule in coexisting Hashimoto's thyroiditis (HT). The study included 138 malignant and 292 benign thyroid nodules confirmed by cytological or histopathological results. The risk score (RS) for each significant US feature was estimated by multiplying corresponding regression coefficient and the total score for each nodule was defined as the sum of these individual scores. The mTI-RADS was established according to the total RS and divided into category 3, 4a, 4b, 4c and 5. Marked hypoechogenicity, taller-than-wide shape, poorly-defined margin, microcalcification or macrocalcification and halo sign absence were statistically significant US features in prediction of thyroid malignancy (all p hypoechogenicity) + 1.2× (if taller-than-wide shape) + 1.7× (if no halo sign) + 0.6× (if poorly-defined margin) + 1.2× (if microcalcification or macrocalcification). The malignancy rates in mTI-RADS category 3, 4a, 4b, 4c and 5 nodules were 3.7%, 19.3%, 38.1%, 62.7% and 94.1%, respectively, with significant differences among different categories (P < 0.001). The mTI-RADS category may facilitate subsequent treatment management in HT patients.

  13. 原发性小肠恶性肿瘤18F-FDG PET/CT显像与病理特征探讨%Relationship between the 18F-FDG PET/CT imaging characteristics and pathologic features of primary small intestine malignant neoplasms

    谢昌辉; 尹吉林; 李向东; 王欣璐; 李兴耀

    2012-01-01

    目的 探讨原发性小肠恶性肿瘤不同病理条件下的18F-双脱氧葡萄糖(FDG)PET/CT全身显像征象.方法 回顾分析44例原发性小肠疾病患者(恶性25例,良性19例)的18 F-FDGPET/CT显像资料,结果 经组织学、诊断性治疗和/或临床随访证实;采用目测法、定量方法(测病变肠壁的厚度)及半定量方法测量病灶的最大标准摄取值(SUVmax)及肠壁厚度,总结分析不同病理条件下的PET/CT的影像特点.结果(1)原发性小肠良、恶性病变局部肿块形成分别为31.6%、84.0%(x2=10.4,P<0.01);肠壁厚度分别为(0.75±0.32)cm、(1.42±0.20)cm(t =2.66,P<0.01);SUVmax分别为(5.17±3.04)、(9.65±5.48)(t =2.88,P<0.01);灶周淋巴结肿大的发生率分别为52.6%、72.0%(x2=1.01,P>0.05),SUVmax分别为(4.80±1.91)、(7.00±5.61)(t=1.11,P>0.05).(2)原发性小肠恶性肿瘤的其他脏器转移发生率为44.0%(11/25),以肝(28.0%)、远处淋巴结(20.0%)和骨转移(16.0%)最为多见;最多病理类型为恶性淋巴瘤(44.0%),其次为腺癌(32.0%),两者的肠壁厚度分别为(1.41±0.59)cm、(1.36±0.62)cm(t =0.18,P>0.05);SUVmax分别为(12.49±7.00)、(7.93±2.82)(t =7.55,P<0.01);转移发生率分别为9.1%、62.5%(x2 =3.89,P<0.05).(3)以小肠局部肿块形成、SUVmax=4.20、局部肠壁增厚和/或转移为依据,18F-FDGPET/CT显像诊断小肠原发恶性肿瘤的灵敏度、特异性和准确度分别为96.0%、94.7%和95.4%;假阳性主要为肠结核,假阴性为印戒细胞癌.结论 18F-FDGPET/CT显像对原发性小肠恶性肿瘤具有较高的鉴别诊断价值,灶周淋巴结大小及其SUVmax值不能提示其良恶性,原发性小肠淋巴瘤的18F-FDG摄取明显高于腺癌,两者的肠壁厚度无显著差异.%Objective To study the relationship between the 18F-FDG PET/CT whole body imaging characteristics and pathologic features of small intestine primary malignant neoplasms.Methods A

  14. [Adenoid cystic carcinoma of the larynx, trachea and thyroid].

    Gryczyński, M; Piotrowski, S

    1995-01-01

    The aim of this article was to describe rarely occurred carcinoma adenoides cysticum located in the larynx, trachea and thyroid. Epidemiology, clinical course and medical therapy was demonstrated. In reported case concerning 65-year old woman early bilateral paresis of vocal folds was observed as results of the perineural infiltration. That caused sudden laryngeal dyspnea. It is important to pay attention on local extensiveness of neoplasm. Besides changes in larynx, neoplastic infiltration was found in trachea, preesophageal tissues and right lobe of thyroid. For above reasons there is no possible to exclude thyroid as a primary tumor of carcinoma adenoides cysticum.

  15. Metastatic thyroid carcinoma presenting as distal spinal cord compression.

    Goldstein, S I; Kaufman, D; Abati, A D

    1988-01-01

    The prognosis of metastatic thyroid carcinoma is dependent on the age of the patient, the histologic characteristics of the neoplasm, and the site of metastasis. A more favorable prognosis is found in patients less than 40 years old with follicular carcinoma and without any bony metastases. Metastatic thyroid carcinoma presenting as distal spinal cord compression is extremely rare. We report one such case and review the literature. As reported in the literature, the combination of decompressive laminectomy followed by total thyroidectomy and radioactive iodine therapy has proved to be effective in the treatment of patients with thyroid carcinoma metastatic to the distal vertebral bodies.

  16. Mucin-hypersecreting bile duct neoplasm characterized by clinicopathological resemblance to intraductal papillary mucinous neoplasm (IPMN of the pancreas

    Harimoto Norifumi

    2007-08-01

    Full Text Available Abstract Background Although intraductal papillary mucinous neoplasm (IPMN of the pancreas is acceptable as a distinct disease entity, the concept of mucin-secreting biliary tumors has not been fully established. Case presentation We describe herein a case of mucin secreting biliary neoplasm. Imaging revealed a cystic lesion 2 cm in diameter at the left lateral segment of the liver. Duodenal endoscopy revealed mucin secretion through an enlarged papilla of Vater. On the cholangiogram, the cystic lesion communicated with bile duct, and large filling defects caused by mucin were observed in the dilated common bile duct. This lesion was diagnosed as a mucin-secreting bile duct tumor. Left and caudate lobectomy of the liver with extrahepatic bile duct resection and reconstruction was performed according to the possibility of the tumor's malignant behavior. Histological examination of the specimen revealed biliary cystic wall was covered by micropapillary neoplastic epithelium with mucin secretion lacking stromal invasion nor ovarian-like stroma. The patient has remained well with no evidence of recurrence for 38 months since her operation. Conclusion It is only recently that the term "intraductal papillary mucinous neoplasm (IPMN," which is accepted as a distinct disease entity of the pancreas, has begun to be used for mucin-secreting bile duct tumor. This case also seemed to be intraductal papillary neoplasm with prominent cystic dilatation of the bile duct.

  17. Primary Thyroid Sarcoma: A Systematic Review.

    Surov, Alexey; Gottschling, Sebastian; Wienke, Andreas; Meyer, Hans Jonas; Spielmann, Rolf Peter; Dralle, Henning

    2015-10-01

    Different types of malignant tumors can occur within the thyroid. Primary cancer is the most common type of thyroid malignancy. Non-epithelial malignancies can also arise within the thyroid. The aim of the present study was to analyze clinical and radiological characteristics of reported primary thyroid sarcomas (PTS), based on a large sample of cases. The PubMed database was screened for articles from between 1990 and 2014. Overall, 86 articles with 142 patients were identified. Ultrasound evaluation was reported for 36 patients. Data regarding computed tomography of the neck were available for 29 cases. Magnetic resonance imaging was performed for eight patients. The following data were retrieved for the identified sarcomas: localization, size, homogeneity, internal texture, and margin characteristics. In most cases, PTS occurred in patients over 40 years of age, with a peak incidence for the group aged 60-79 years. Angiosarcoma was diagnosed in 29 cases (20.4%), followed by malignant hemangioendothelioma (n=23, 16.3%), malignant fibrous histiocytoma (n=20, 14.1%), leiomyosarcoma (n=16, 11.3%), and fibrosarcoma (n=13, 9.2%). In most patients (n=113, 79.6%), PTS manifested clinically as a painless goiter. On ultrasound, PTS were predominantly mixed hypo-to-hyperechoic in comparison to the normal thyroid tissue. On non-contrast computed tomography, most sarcomas were inhomogeneous hypo-to-hyperdense. On post-contrast magnetic resonance images, most sarcomas showed marked non-homogenous enhancement. In 26.8%, infiltration of the adjacent organs was seen. The trachea or esophagus was affected more frequently in patients with malignant histiocytoma and liposarcoma. Different strategies were used in the treatment of PTS. Our analysis provides clinical and radiological characteristics of PTS. The described features should be taken into consideration in the differential diagnosis of thyroid tumors.

  18. Thyroid metastasis as initial presentation of clear cell renal carcinoma

    César Pablo Ramírez-Plaza

    2015-01-01

    Conclusion: The possibility of finding of an incidental metastatic tumor in the thyroid gland from a previous unknown and non-diganosed primary (as CCRC in our case was is rare and account only for less than 1% of malignancies. Nonetheless, the thyroid gland is a frequent site of metastasis and the presence of “de novo” thyroid nodules in oncologic patients must be always considered and studied.

  19. An analysis of salivary gland neoplasms: a 12-year, single-institution experience in Turkey.

    Etit, Demet; Ekinci, Nese; Tan, Ayca; Altinel, Deniz; Dag, Filiz

    2012-03-01

    The epidemiology of salivary gland tumors worldwide is not very well defined. Although many studies on this subject have been undertaken, the data are generally focused on specific topics such as parotid gland neoplasms or tumors of the major salivary glands. We conducted a study to establish the prevalence and distribution of benign and malignant neoplasms of both the major and minor salivary glands at a single institution. We reviewed 244,204 cases that had come through our pathology department from January 1994 through December 2005 and found 235 cases of a salivary gland neoplasm (0.09%). The female-to-male ratio was 1.04:1, and the mean age of the patients was 47 years. Of the 235 neoplasms, 159 (67.66%) were located in the parotid gland, 34 (14.47%) in the submandibular gland, and 42 (17.87%) in the minor salivary glands. A total of 146 tumors (62.13%) were benign and 89 (37.87%) were malignant. Pleomorphic adenoma was the most common neoplasm, occurring in 98 cases (41.70%). The most common malignancy was mucoepidermoid carcinoma, with 27 cases (11.49%). Our data demonstrate that the characteristics of salivary gland tumors in a Turkish population at a single institution are similar to those reported in the literature worldwide.

  20. Pediatric Thyroid Cancer

    ... Marketplace Find an ENT Doctor Near You Pediatric Thyroid Cancer Pediatric Thyroid Cancer Patient Health Information News media ... and neck issues, should be consulted. Types of thyroid cancer in children: Papillary : This form of thyroid cancer ...

  1. Thyroid cancer - medullary carcinoma

    Thyroid - medullary carcinoma; Cancer - thyroid (medullary carcinoma); MTC; Thyroid nodule - medullary ... in children and adults. Unlike other types of thyroid cancer, MTC is less likely to be caused by ...

  2. Anaplastic thyroid cancer

    ... page: //medlineplus.gov/ency/article/000352.htm Anaplastic thyroid cancer To use the sharing features on this page, ... of cancer of the thyroid gland. Causes Anaplastic thyroid cancer is an invasive type of thyroid cancer that ...

  3. Hyperthyroidism (Overactive Thyroid)

    ... toxic adenoma, Plummer's disease (toxic multinodular goiter) and thyroiditis, can cause hyperthyroidism. Your thyroid is a butterfly- ... causes some to begin producing too much hormone. Thyroiditis. Sometimes your thyroid gland can become inflamed for ...

  4. Thyroid and Weight

    ... weight) weight loss. As in the treatment with hyperthyroidism, treatment of the abnormal state of hypothyroidism with thyroid ... Goiter Graves’ Disease Graves’ Eye Disease Hashimoto’s Thyroiditis Hyperthyroidism ... & Weight Thyroiditis Thyroid ...

  5. Thyroid disorders in mild iodine deficiency

    Laurberg, P; Nøhr, S B; Pedersen, K M

    2000-01-01

    endangered but the consequences of severe iodine deficiency for brain development are grave and a considerable safety margin is advisable. Moreover, a shift toward less malignant types of thyroid cancer and a lower radiation dose to the thyroid in case of nuclear fallout support that mild-to-moderate iodine...... in elderly subjects, especially women, with risk of cardiac arrhythmias, osteoporosis, and muscle wasting. The hyperthyroidism is caused by autonomous nodular growth and function of the thyroid gland and it is accompanied by a high frequency of goiter. Pregnant women and small children are not immediately...

  6. [Possibilities of ultrasonic investigations in differentiation of a small-foci impairment of thyroid gland].

    Reyti, A O; Vityuk, N V; Medvedev, V E; Starushok, I O

    2015-03-01

    The results of ultrasound investigation of microcarcinomas and nontumoral foci of thyroid gland up to 10 mm in diameter and malignant foci over 10 mm are presented. Ultrasound signs are depicted, in accordance to which a potentially malignant thyroid gland foci are delineated, what demands a morphological (cytological) verification conduction.

  7. Parapharyngeal ectopic thyroid: the possible persistence of the lateral thyroid anlage. Clinical case report.

    Soscia, A; Guerra, G; Cinelli, M-P; Testa, D; Galli, V; Macchi, V; De Caro, R

    2004-08-01

    The accessory midline thyroids are ascribed to an arrest of migration of the median thyroid anlage, while the lateral ectopic thyroids have induced a hypothesis of the presence of lateral thyroid anlage. We report the case of a 67-year-old man who presented with dyspnea and dysphagia of 1 year's duration. The clinical examination and radiological investigations (CT and MRI) showed a solid heterogeneous mass in the right parapharyngeal space. The fine needle aspiration biopsy was inconsistent. The mass (3x2.5x3.5 cm) was excised via a transoral approach. It was capsulated with an elastic consistency and showed a nodular appearance on the cut surface. Histological examination revealed thyroid tissue with the characteristics of colloid goiter. The postoperative (99m)Tc-pertechnetate scan showed the normal thyroid gland located in the usual pretracheal site. The absence of malignancy, at histology and immunohistochemistry, allows a metastatic nature of the mass to be ruled out, and accounts for a supernumerary thyroid. The occurrence of a parapharyngeal thyroid, although extremely rare, is worth bearing in mind as a possible ectopic location. This case also supports the hypothesized role of the lateral thyroid anlage in man deriving from the ultimo-branchial body in the morphogenesis of the lateral lobe of the thyroid gland.

  8. Elastography of the Thyroid Glands

    Kwak, Jin Young [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2011-06-15

    Although the current resolution of ultrasound (US) has markedly improved the ability to detect nodules and it can be used to differentiate malignant thyroid nodules from benign thyroid nodules, gray scale US alone is not perfectly capable of making this differentiation. US elastography is a relatively novel dynamic technique that evaluates the degree of distortion of a tissue under the application of an external force and it is based on the principle that the softer parts of tissues deform more easily than do the harder parts under compression, thus allowing an objective determination of tissue consistency. This review provides the basic concepts of US elastography and the potential clinical applications and limitations for diagnosing thyroid nodules

  9. Thyroid gland removal

    Total thyroidectomy; Partial thyroidectomy; Thyroidectomy; Subtotal thyroidectomy; Thyroid cancer - thyroidectomy; Papillary cancer - thyroidectomy; Goiter - thyroidectomy; Thyroid nodules - thyroidectomy

  10. Thyroid fine-needle aspiration biopsy and thyroid cancer diagnosis: a nationwide population-based study.

    Li-Ying Huang

    Full Text Available Thyroid cancer is the most common endocrine gland malignancy and fine-needle aspiration biopsy is widely used for thyroid nodule evaluation. Repeated aspiration biopsies are needed due to plausible false-negative results. This study aimed to investigate the overall relationship between aspiration biopsy and thyroid cancer diagnosis, and to explore factors related to shorter diagnostic time.This nationwide retrospective cohort study retrieved data from the Longitudinal Health Insurance Database in Taiwan. Subjects without known thyroid malignancies and who received the first thyroid aspiration biopsy after 2004 were followed-up from 2004 to 2009 (n = 7700. Chi-square test, Kaplan-Meier survival analysis, and Cox proportional hazards model were used for data analysis.Of 7700 newly-aspirated patients, 276 eventually developed thyroid cancer (malignancy rate 3.6%. Among the 276 patients with thyroid cancer, 61.6% underwent only one aspiration biopsy and 81.2% were found within the first year after the initial aspiration. Cox proportional hazards model revealed that aspiration frequency (HR 1.07, 95% CI 1.06-1.08, ultrasound frequency (HR 1.02, 95% CI 1.01-1.03, older age, male sex, and aspiration biopsies arranged by surgery, endocrinology or otolaryngology subspecialties were all associated with shorter time to thyroid cancer diagnosis.About 17.4% of thyroid cancer cases received more than two aspiration biopsies and 18.8% were diagnosed one year after the first biopsy. Regular follow-up with repeated aspiration or ultrasound may be required for patients with clinically significant thyroid nodules.

  11. Follicular adenomas exhibit a unique metabolic profile. ¹H NMR studies of thyroid lesions.

    Stanisław Deja

    Full Text Available Thyroid cancer is the most common endocrine malignancy. However, more than 90% of thyroid nodules are benign. It remains unclear whether thyroid carcinoma arises from preexisting benign nodules. Metabolomics can provide valuable and comprehensive information about low molecular weight compounds present in living systems and further our understanding of the biology regulating pathological processes. Herein, we applied ¹H NMR-based metabolic profiling to identify the metabolites present in aqueous tissue extracts of healthy thyroid tissue (H, non-neoplastic nodules (NN, follicular adenomas (FA and malignant thyroid cancer (TC as an alternative way of investigating cancer lesions. Multivariate statistical methods provided clear discrimination not only between healthy thyroid tissue and pathological thyroid tissue but also between different types of thyroid lesions. Potential biomarkers common to all thyroid lesions were identified, namely, alanine, methionine, acetone, glutamate, glycine, lactate, tyrosine, phenylalanine and hypoxanthine. Metabolic changes in thyroid cancer were mainly related to osmotic regulators (taurine and scyllo- and myo-inositol, citrate, and amino acids supplying the TCA cycle. Thyroid follicular adenomas were found to display metabolic features of benign non-neoplastic nodules and simultaneously displayed a partial metabolic profile associated with malignancy. This finding allows the discrimination of follicular adenomas from benign non-neoplastic nodules and thyroid cancer with similar accuracy. Moreover, the presented data indicate that follicular adenoma could be an individual stage of thyroid cancer development.

  12. Can Thyroid Cancer Be Prevented?

    ... Thyroid Cancer Causes, Risk Factors, and Prevention Can Thyroid Cancer Be Prevented? Most people with thyroid cancer have ... Cancer? Can Thyroid Cancer Be Prevented? More In Thyroid Cancer About Thyroid Cancer Causes, Risk Factors, and Prevention ...

  13. Thyroid inferno.

    Bhargava, Amit; Kaur, Manmeet

    2014-01-01

    The key to uncovering the etiology of hyperthyroidism lies in a careful history and physical examination. Autoimmune markers provide additive information, but should not solely be used to make a diagnosis. Concern has been raised that the overzealous use of thyroid ultrasound, following abnormal thyroid function tests, diverts attention from the workup of the biochemical abnormality to the workup of an incidentally found thyroid nodule. If further imaging is needed, the use ofathyroidscanhas been suggestedbythe Endocrine Society and the American Association of Clinical Endocrinologists. However, in certain scenarios, this may be contraindicated. We present the case of a 28-year-old female with hyperthyroidism, as aplatform to discuss an important clinical sign present on Doppler ultrasound of the thyroid. By recognizing the clinical information gained from a Doppler ultrasound, physicians can avoid additional invasive workup and apply the use of ultrasound where most appropriate.

  14. Thyroid Cancer

    ... you may be eligible to receive a medication (potassium iodide) that blocks the effects of radiation on the ... occur, you and your family could take the potassium iodide tablets to help prevent thyroid cancer. Contact your ...

  15. Invasive carcinoma derived from branch duct-type IPMN may be a more aggressive neoplasm than that derived from main duct-type IPMN

    OKABAYASHI, TAKEHIRO; Shima, Yasuo; KOSAKI, TAKUHIRO; SUMIYOSHI, TATSUAKI; KOZUKI, AKIHITO; IIYAMA, TASTUO; Takezaki, Yuka; Kobayashi, Michiya; Nishimori, Isao; Ogawa, Yasuhiro; Hanazaki, Kazuhiro

    2013-01-01

    The present study aimed to evaluate the long-term follow-up results of patients with intraductal papillary mucinous neoplasm (IPMN) and to estimate the degree of IPMN malignancy based on pathological and molecular features of resected specimens. The detection rate of IPMN has increased over the last decade; however, the management of this neoplasm remains controversial. This is particularly so for branch duct-type IPMN, which carries a high potential for malignancy and risk of recurrence. We ...

  16. Synchronous occurrence of gastrointestinal stromal tumors and other primary gastrointestinal neoplasms

    Marek Wronski; Bogna Ziarkiewicz-Wroblewska; Barbara Gornicka; Wlodzimierz Cebulski; Maciej Slodkowski; Aleksander Wasiutynski; Ireneusz W Krasnodebski

    2006-01-01

    AIM: To review clinical and pathologic features of Gastrointestinal stromal tumors (GISTs) occurring synchronously with other primary gastrointestinal neoplasms.METHODS: 28 patients with primary GIST were treated at our institution between 1989 and 2005. Clinical and pathologic records were reviewed.RESULTS: The gastrointestinal stromal tumor occurred simultaneously with other primary GI malignancies in 14% of all patients with GIST. The synchronous stromal tumors were located in the stomach and were incidentally found during the operation. The coexistent neoplasms were colon adenocarcinoma, gastric cancer (2 cases) and gastric lymphoma.CONCLUSION: The synchronous occurrence of GISTs and other gastrointestinal malignancies is more common than it has been considered. The development of gastrointestinal stromal tumors and other neoplasms may involvethe same carcinogenic agents.

  17. Intraductal Papillary Mucinous Neoplasms of the Pancreas (IPMNs: Epidemiology, Diagnosis and Future Aspects

    Froso Konstantinou

    2013-03-01

    Full Text Available Intraductal papillary mucinous neoplasms of the pancreas (IPMNs are potentially malignant intraductal epithelial neoplasms which consist of columnar, mucin-containing cells and arise from the epithelium of the main pancreatic duct or its branches. IPMNs as well as pancreatic intraepithelial neoplasias (PanINs and mucinous cystic neoplasms represent noninvasive precursors of invasive ductal adenocarcinoma of the pancreas. The diagnosis of IPMNs includes radiographic (CT scanning, MRI, MRCP and endoscopic evaluation (ERCP, EUS, PET, as well as serum tumor markers and molecular markers. The Sendai Consensus Guidelines help guide surgical resection for patients with IPMN. The follow-up of these patients, as well as of those who do not undergo surgical resection, is of great importance, since patients with IPMN appear to be at risk for other malignancies. Herein, the authors summarize the data presented at the 2013 ASCO Gastrointestinal Cancers Symposium regarding incidence and clinicopathological characteristics of IPMN (Abstracts #324, #187 and #179.

  18. Blastic plasmacytoid dendritic cell neoplasm with absolute monocytosis at presentation

    Jaworski JM

    2015-02-01

    Full Text Available Joseph M Jaworski,1,2 Vanlila K Swami,1 Rebecca C Heintzelman,1 Carrie A Cusack,3 Christina L Chung,3 Jeremy Peck,3 Matthew Fanelli,3 Micheal Styler,4 Sanaa Rizk,4 J Steve Hou1 1Department of Pathology and Laboratory Medicine, Hahnemann University Hospital/Drexel University College of Medicine, Philadelphia, PA, USA; 2Department of Pathology, Mercy Fitzgerald Hospital, Darby, PA, USA; 3Department of Dermatology, Hahnemann University Hospital/Drexel University College of Medicine, Philadelphia, PA, USA; 4Department of Hematology/Oncology, Hahnemann University Hospital/Drexel University College of Medicine, Philadelphia, PA, USA Abstract: Blastic plasmacytoid dendritic cell neoplasm is an uncommon malignancy derived from precursors of plasmacytoid dendritic cells. Nearly all patients present initially with cutaneous manifestations, with many having extracutaneous disease additionally. While response to chemotherapy initially is effective, relapse occurs in most, with a leukemic phase ultimately developing. The prognosis is dismal. While most of the clinical and pathologic features are well described, the association and possible prognostic significance between peripheral blood absolute monocytosis (>1.0 K/µL and blastic plasmacytoid dendritic cell neoplasm have not been reported. We report a case of a 68-year-old man who presented with a rash for 4–5 months. On physical examination, there were multiple, dull-pink, indurated plaques on the trunk and extremities. Complete blood count revealed thrombocytopenia, absolute monocytosis of 1.7 K/µL, and a negative flow cytometry study. Biopsy of an abdominal lesion revealed typical features of blastic plasmacytoid dendritic cell neoplasm. Patients having both hematologic and nonhematologic malignancies have an increased incidence of absolute monocytosis. Recent studies examining Hodgkin and non-Hodgkin lymphoma patients have suggested that this is a negative prognostic factor. The association between

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

    Sjoberg, R.J.; Blue, P.W.; Kidd, G.S.

    1989-01-01

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

  20. The diagnostic evaluation of fine needle aspiration cytology of thyroid and its clinical application

    Jiayu Zhang; Jian Wang

    2012-01-01

    Objective: The aim of the study was to investigate the diagnostic value of fine needle aspiration cytology (FNAC) and its clinical application. Methods: From April 2009 to February 2011, thyroid FNAC were performed in a total of 186 patients with thyroid nodule or mass in our hospital and 78 of those 186 patients subsequently underwent thyroidectomy. The FNAC findings were compared with the results of the corresponding histological diagnosis. Results: The results of thyroid FNAC for 186 patients showed that, (1) 166 cases of benign lesions, the detection rate was 89.24% (166/186), including 96 cases of nodular colloid goiter (51.61 %), 28 cases of simple colloid goiter (15.05%), 38 cases of Hashimoto's thyroiditis (HT) (20.43%) and 4 cases of thyroid adenoma (2.15%); (2) 4 cases of suspicious malignant lesion, the detection rate was 2.15% (4/186); (3) 16 cases of malignant tumor, the detection rate was 8.60% (16/186). Seventy eight patients including malignant (16), suspicious malignant (4), HT (20) and nodular colloid goiters (38) cases diagnosed by FNAC were performed operation with thyroidectomy and the postoperative histopathologic results showed that there were 2 cases HT combined thyroid papillary carcinoma in HT 20 cases by FNAC, 15 cases of thyroid papillary carcinoma and 1 case of follicular carcinoma in 16 cases of malignant tumor by FNAC and 4 case of thyroid papillary carcinoma in 4 cases of suspicious malignant by FNAC. Conclusion: Thyroid FNAC is a valuable and reliable method for the diagnosis of the thyroid nodules or mass or even most diffuse thyroid diseases. Diagnosis of HT and thyroid papillary carcinoma can be made by thyroid FNAC. There was larger hint value for nodular colloid goiter and simple colloid goiter according to thyroid FNAC.

  1. Differentiated thyroid tumors: surgical indications.

    Lucchini, R; Monacelli, M; Santoprete, S; Triola, R; Conti, C; Pecoriello, R; Favoriti, P; Di Patrizi, M S; Barillaro, I; Boccolini, A; Avenia, S; D'Ajello, M; Sanguinetti, A; Avenia, N

    2013-01-01

    Thyroid gland tumors represent 1% of malignant tumors. In Italy their incidence is in constant growth. The aggressiveness depends on the histological type. The relative non-aggressive grade of different forms of tumors is the basis for discussing the treatment of choice: total thyroidectomy vs lobectomy with or without lymphadenectomy of the sixth level in the absence of metastasis. Authors report about their experience, and they advocate, given the high percentage of multicentric forms, total thyroidectomy as treatment of choice.

  2. Malignant transformation of intracranial meningeal melanocytoma. Case report and review of the literature.

    Wang, Fulin; Qiao, Guangyu; Lou, Xin; Song, Xin; Chen, Wei

    2011-08-01

    Meningeal melanocytoma is an uncommon pigmented neoplasm that affects the CNS and develops in the cranial and spinal leptomeninges. Here we report on a case of malignant transformation of intracranial supratentorial meningeal melanocytoma which recurred after 3 years as malignant melanoma. This case demonstrates that the biological behavior of melanocytoma is uncertain and that these lesions may recur as malignant melanoma.

  3. Thyroid lesions diagnosis by Fourier transformed infrared absorption spectroscopy (FTIR); Diagnostico de lesoes da tireoide pela espectroscopia de absorcao no infravermelho por transformada de Fourier - FTIR

    Albero, Felipe Guimaraes

    2009-07-01

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

  4. The impact of ruxolitinib treatment on inflammation-mediated comorbidities in myelofibrosis and related neoplasms

    Bjørn, Mads Emil; Hasselbalch, Hans Carl

    2015-01-01

    The inflammation-mediated comorbidities in myelofibrosis (MF) and related neoplasms (MPNs) likely reflect the concurrent immune deregulation and systemic inflammatory nature of the MPNs, emphasizing the link between chronic systemic inflammation, immune deregulation, and the malignant clone. JAK1......-2 inhibitors in MF-patients reduce constitutional symptoms and splenomegaly, but also taget autoimmune and inflammation-mediated comorbidities....

  5. [The use of the Surgitron radiowave scalpel for the surgical treatment of external ear neoplasms].

    Popadyuk, V I; Chernolev, A I; Antoniv, V F; Korshunova, I A

    2016-01-01

    The objective of the present study was to elucidate etiology and clinical picture of the tumours of the external ear as well as to evaluate the effectiveness of their radiowave surgery. We sought to optimize the surgical strategy for the treatment of tumour-like masses, benign and malignant neoplasms of the external ear with the use of the Surgitron radiowave scalpel.

  6. 胰腺导管内乳头状黏液性肿瘤合并胰腺外恶性肿瘤特征荟萃分析%Pancreatic intraductal papillary mucinous neoplasm coexisting with extrapancreatic malignancy: an analysis of pooled published data

    张栋; 郎韧; 陈大志; 樊华; 金中奎; 李先亮; 冯艳

    2012-01-01

    Objective To analyse the clinical characteristics of pancreatic intraductal papillary mucinous neoplasm (IPMN) which coexists with extrapancreatic malignancy (EPM),with an aim to provide strategies for clinical diagnosis and treatment.Methods The PubMed was used to search for the pancreatic IPMN related articles with positive pathologic results.A pooled analysis was then performed.The ratio ofpancreatic IPMNs coexisting with EPMs and the locations (or the type) of EPMs were analyzed.Results After a strict process of screening,18 articles met the pre-determined standardsand were accepted.Of the 1327 patients,363 had coexisting EPMs (27.35%).There were 392 EPMs in these 363 patients.The EPMs occurred in almost all the systems of the body,especially in the digestive tract and its related organs,which accounted for 63.06% of the EPMs. Conclusions There is a tendency for patients with pancreatic IPMN to have coexisting EPM. More than half of these EPMs are malignant tumors in the digestive system. When pancreatic IPMN is diagnosed,the clinician should be aware of the possible coexistence of an EPM and should look for the possibility of a new EPM developing in a patient after treatment of pancreatic IPMN.%目的 探讨胰腺导管内乳头状黏液性肿瘤(IPMN)合并胰腺外恶性肿瘤(EPM)的部分临床特点,为临床诊治胰腺IPMN提供帮助.方法 以PubMed为检索数据库,对已发表的关于胰腺IPMN文献中经病理学证实的临床病例进行荟萃分析,尝试阐明胰腺IPMN病例并存EPM的发生率和EPM的发生部位(类型)及其比例.结果 共筛选出符合纳入排除标准的文献18篇,共汇集病例1327例,其中并存EPM病例363例,占 27.35%.该363例病例中,共统计到392处EPM.EPM几乎可发生于全身各个系统,以消化道及其相关来源恶性肿瘤最为多见,占总EPM数量的63.06%.结论 胰腺IPMN患者常合并EPM,以消化系统恶性肿瘤居多,提示在该疾病的诊治过程中不应忽视EPM

  7. Gastrointestinal lipoma and malignancies.

    Siegal, A; Witz, M

    1991-07-01

    Twenty gastrointestinal lipomata in 18 patients are reviewed: 15 located in the colon, 3 in the distal ileum, one in the duodenum, and one in the stomach. They were found most frequently in European-born, elderly women and presented with variable abdominal symptomatology. Four lipomata were removed during endoscopy, the remainder at laparotomy, partial colectomy being performed in 10 cases. All, except 2 subserosal types, were located in the submucosa, and their average size was 2.7 cm diameter. Microscopically, none showed true encapsulation, and all were composed of mature fat cells without cellular atypia. In spite of nonspecific changes at endoscopy, one-half of the cases showed, on microscopic examination, atrophy of the overlying glands and a prominent eosinophilic and/or lymphoplasmocytic infiltration of the lamina propria. Two large subserosal lipomata were associated with Crohn's disease. In addition, in 39% of cases, malignant tumours, either single or double, were present in the gastrointestinal tract or elsewhere. Gastrointestinal "lipomata" are located in the sites of normal fatty infiltration in the elderly; these growths could be a local aging or reactive process of the intestinal wall rather than true neoplasms without any potential malignancy. However, coexistent malignancies should be carefully searched for in elderly patients with colonic lipoma.

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

    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.

  9. Drugs Approved for Myeloproliferative Neoplasms

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for myeloproliferative neoplasms. The list includes generic names, brand names, and common drug combinations, which are shown in capital letters. The drug names link to NCI's Cancer Drug Information summaries.

  10. Anaplastic Thyroid Carcinoma: Computed Tomographic Differentiation from Other Thyroid Masses

    Lee, Jun Won; Yoon, Dae Young; Choi, Chul Soon; Chang, Suk Ki; Yun, Eun Joo; Seo, Young Lan; Rho, Young-Soo; Jin Cho, Sung; Kim, Keon Ha (Depts. of Radiology, Otorhinolaryngology, and Pathology, Kangdong Seong-Sim Hospital, Hallym Univ. College of Medicine, Seoul (KR))

    2008-04-15

    Background: Anaplastic thyroid carcinoma is rare but is one of the most aggressive malignancies. Therefore, accurate diagnosis is important in order to provide appropriate therapy. Purpose: To establish useful computed tomographic (CT) criteria for differentiating anaplastic carcinoma from other thyroid masses. Material and Methods: The CT scans of nine patients with anaplastic carcinomas were retrospectively reviewed and compared with those of 32 patients with papillary carcinomas (n = 12) or benign lesions (n = 20) exceeding a maximum diameter of 2.0 cm. Image analysis was performed according to the following CT parameters: size, margin (well defined or ill defined), composition (cystic, mixed, or solid), mean attenuation value, ratio of attenuation of the mass to that of the adjacent muscle (M/m attenuation ratio), necrosis (present or absent), and calcification (stippled, nodular, or absent) of the thyroid mass; and tumor-spreading patterns including the presence of surrounding normal thyroid tissue in the involved lobe, involvement of the contralateral thyroid lobe, extension into the adjacent structures, and cervical lymphadenopathy. Results: Anaplastic carcinomas appeared as large (average 4.6 cm), solid (100%), and ill-defined (88.9%) masses accompanied by necrosis (100%), nodular calcification (44.4%), direct invasion into the adjacent organs (55.6%), and cervical lymph node involvement (77.8%). Tumor necrosis was the most valuable parameter in differentiating anaplastic carcinomas from other thyroid masses. Patient age (>70 years) and low attenuation value on postcontrast scan (attenuation value <100 HU, or M/m attenuation ratio <1.3) are also helpful predictors for anaplastic carcinoma. Conclusion: If a patient is older than 70 years of age and has a large necrotic thyroid mass of low attenuation, anaplastic carcinoma should be included in the differential diagnosis

  11. Thyroid-Like Follicular Carcinoma of the Kidney in a Patient with Skull and Meningeal Metastasis: A Unique Case Report and Review of the Literature.

    Dong, Liang; Huang, Jiayu; Huang, Luke; Shi, Oumin; Liu, Qiang; Chen, Haige; Xue, Wei; Huang, Yiran

    2016-04-01

    Thyroid-like follicular carcinoma of the kidney (TLFCK) is an extremely rare subtype of renal cell carcinoma with close resemblance to the well-differentiated thyroid follicular neoplasms. TLFCK has not been included in the 2004 World Health Organization (WHO) classification due to the limited data available. Only 27 cases have been reported in the literature to date. Herein, we report a unique case of TLFCK that presented as a striking skull and meningeal metastasis 5 years after the initial diagnosis; this is the first case of TLFCK with such a novel metastasis pattern. A 68-year-old woman was found to have a right renal lesion using computed tomography (CT) during her regular clinical follow-up visit for bladder cancer, but she exhibited no obvious clinical symptoms. The CT scan showed a 4.4-cm diameter, slightly lobulated soft tissue mass in the right lower kidney, the pathological findings of which showed a TLFCK. Five years later, the patient had progressed to skull and meningeal metastasis. Both the renal tumor and the metastasis lesion were composed almost entirely of follicles with a dense, colloid-like material that resembled thyroid follicular carcinoma. However, no lesion was found in the thyroid gland. The neoplastic epithelial cells were strongly immunoreactive for cytokeratin 7 (and vimentin but negative for thyroid transcription factor-1 and thyroglobulin. This is the first reported case of TLFCK to consist of widespread metastases to the skull and meninges and provides evidence that this rare variant of renal cell carcinoma has uncertain malignant potential and can be more clinically aggressive than previously believed.

  12. Cytologic aspects of an interesting case of medullary thyroid carcinoma coexisting with Hashimoto′s thyroiditis

    Bidish K Patel

    2016-01-01

    Full Text Available Among primary thyroid neoplasms, papillary thyroid carcinoma (PTC and primary thyroid lymphoma (PTL are known to coexist and are pathogenetically linked with Hashimoto′s thyroiditis (HT. However, HT occurring in association with medullary thyroid carcinoma (MTC is rarely documented. We report here an interesting case. A 34-year-old female with a solitary thyroid nodule underwent fine needle aspiration cytology (FNAC that was interpreted as "MTC with admixed reactive lymphoid cells, derived possibly from a pretracheal lymph node." Total thyroidectomy specimen showed "MTC with coexisting HT." At a later stage, a follow-up FNAC from the recurrent thyroid swelling showed features consistent with HT. As an academic exercise, the initial smears on which a diagnosis of MTC was offered were reviewed to look for evidence of coexisting HT that showed scanty and patchy aggregates of reactive lymphoid cells without Hόrthle cells. Our case highlights an unusual instance of MTC in concurrence with HT that can create a tricky situation for cytopathologists.

  13. Cytological findings in scintigraphically nonfunctioning thyroid nodules

    Radović Branislava

    2010-01-01

    Full Text Available Background/Aim. The major one among the procedures for evaluating changes in the thyroid nodules is fine needle aspiration biopsy (FNAB. Thyroid scintigraphy is commonly used in diagnostic algoritham of nodules. Less than 5% of examined nodules show to be malignant. Scintigraphically, nodules could be classified as functional and nonfunctional. It is estimated that the risk of malignacy in nonfunctional nodules ranges from 8% to 25% and more. Aspiration punction provides 100% specific and positive predictive value. The aim of the study was to establish the distribution of cytological findings in nonfunctioning thyroid nodules. Methods. The prospective study enrolled 112 patients, 104 women and 8 men, submitted to thyroid scintigraphy for known thyroid nodule disorder. Scintigraphy was performed about half an hour after iv administration of 74 MBq of sodium-pertehnetate. A pin hole collimator was used. Scintigrams were visually evaluated, and absence of radiopharmaceutic in a nodule was estimated as nonfunctional one. Such nodules were afterwards subjected to FNAB and material obtained was cytologically analyzed. Results. In our patients nonfunctioning nodules comprised tissue of colloid struma, thyroid cyst, regular thyroid tissue, follicular lesion, oxiphillic lesion, papillary carcinoma tissue and tissue of lymphocytic thyroiditis. The most frequent cytological finding were colloid cysts (52%. A total of 70% were female nodules. Five citological findings were histopathologically analyzed. Conclusion. Cytological finding of nonfunctional nodules determines of the decision on radical therapy, and our preliminary results imply the need of FNAB routine use in nuclear medicine practice.

  14. Post treatment thyroid dysfunction and obesity in children with acute lymphoblastic leukemia and non-Hodgkin’s lymphoma: a brief report

    Ali Ghasemi

    2014-04-01

    Conclusion: Regarding to effects of thyroid dysfunction on short stature and obesity in adolescent with ALL and NHL, we suggest to have more attention about growth, thy-roid test to avoid late side effect of malignancy treatment.

  15. Histologic and Immunohistochemical classification of 41 bovine adrenal gland neoplasms

    Grossi, Anette Blak; Leifsson, Páll S.; Jensen, Henrik Elvang;

    2013-01-01

    Tumors of the adrenal glands are among the most frequent tumors in cattle; however, few studies have been conducted to describe their characteristics. The aim of this study was to classify 41 bovine adrenal neoplasms from 40 animals based on macroscopic and histologic examination, including....... An immunohistochemistry panel consisting of antibodies against melan A, synaptophysin, and CNPase was considered most useful to classify bovine adrenal tumors. However, the distinction between benign and malignant adrenocortical tumors was based on histologic features as in human medicine....

  16. Cellular schwannoma: a benign neoplasm sometimes overdiagnosed as sarcoma

    Alberghini, M. [Dept. of Surgical Pathology, Rizzoli Institute, Bologna (Italy); Anatomia Patologica, Istituto Rizzoli, Bologna (Italy); Zanella, L.; Bacchini, P.; Bertoni, F. [Dept. of Surgical Pathology, Rizzoli Institute, Bologna (Italy)

    2001-06-01

    A case of cellular schwannoma originating in the left lumbar paraspinal region is described. The diagnosis was originally made on needle biopsy material. The histological examination is usually not sufficient to correctly diagnose this benign neoplasm. Bone erosion, neurological symptoms, caused by compression of the spinal roots, together with hypercellularity, pleomorphism and an occasional increase in mitotic activity, may lead to an erroneous diagnosis of malignancy. Immunohistochemistry and ultrastructural analysis are helpful in confirming the diagnosis. The recognition of this entity avoids unnecessary overtreatment of these patients. (orig.)

  17. [Intraductal papillary mucinous neoplasm of the pancreas, IPMN].

    Sirén, Jukka

    2013-01-01

    With the development and increasing use of imaging techniques, intraductal papillary mucinous neoplasm (IPMN) is being detected with increasing frequency. Two forms of the disease are distinguished, the rare main duct form and the common accessory pancreatic duct form. The former often progresses to malignancy, the latter only seldom. The mixed form of IPMN exhibits features of both forms. In main duct IPMN, mucin production obstructs the pancreatic duct causing its dilatation and often symptoms typical of chronic pancreatitis. Main duct IPMN is always an indication for surgery, whereas monitoring is often sufficient for side duct IPMN.

  18. Stemness is derived from thyroid cancer cells

    Risheng eMa

    2014-07-01

    Full Text Available Background: One hypothesis for thyroid cancer development is its derivation from thyroid cancer stem cells (CSCs. Such cells could arise via different paths including from mutated resident stem cells within the thyroid gland or via epithelial to mesenchymal transition (EMT from malignant cells since EMT is known to confer stem-like characteristics. Methods: To examine the status of stemness in thyroid papillary cancer we employed a murine model of thyroid papillary carcinoma and examined the expression of stemness and EMT using qPCR and histochemistry in mice with a thyroid-specific knock-in of oncogenic Braf (LSL-Braf(V600E/TPO-Cre. This construct is only activated at the time of thyroid peroxidase (TPO expression in differentiating thyroid cells and cannot be activated by undifferentiated stem cells which do not express TPO.Results: There was decreased expression of thyroid specific genes such as Tg and NIS and increased expression of stemness markers such as Oct4, Rex1, CD15 and Sox2 in the thyroid carcinoma tissue from 6 week old BRAFV600E mice. The decreased expression of the epithelial marker E-cadherin and increased EMT regulators including Snail, Slug, and TGF-β1 and TGF-β3, and the mesenchymal marker vimentin demonstrated the simultaneous progression of EMT and the CSC-like phenotype. Stemness was also found in a derived cancer thyroid cell line in which overexpression of Snail caused up-regulation of vimentin expression and up regulation of stemness markers Oct4, Rex1, CD15 with enhanced migration ability of the cells. Conclusions: Our findings support our earlier hypothesis that stemness in thyroid cancer is derived via EMT rather than from resident thyroid stem cells. In mice with a thyroid-specific knock-in of oncogenic Braf (LSL-Braf(V600E/TPO-Cre the neoplastic changes were dependent on thyroid cell differentiation and the onset of stemness must have been derived from differentiated thyroid epithelial cells.

  19. The thyroid gland and the process of aging; what is new?

    Gesing Adam

    2012-11-01

    Full Text Available Abstract The endocrine system and particular endocrine organs, including the thyroid, undergo important functional changes during aging. The prevalence of thyroid disorders increases with age and numerous morphological and physiological changes of the thyroid gland during the process of aging are well-known. It is to be stressed that the clinical course of thyroid diseases in the elderly differs essentially from that observed in younger individuals, because symptoms are more subtle and are often attributed to normal aging. Subclinical hypo- and hyperthyroidism, as well as thyroid neoplasms, require special attention in elderly subjects. Intriguingly, decreased thyroid function, as well as thyrotropin (TSH levels – progressively shifting to higher values with age – may contribute to the increased lifespan. This short review focuses on recent findings concerning the alterations in thyroid function during aging, including these which may potentially lead to extended longevity, both in humans and animals.

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

    Chen, Chien-Chin; Chen, Wen-Chung; Peng, Shu-Ling; Huang, Shih-Ming

    2013-06-01

    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.

  1. Immunotherapy and gene therapy of thyroid cancer.

    Schott, M; Scherbaum, W A

    2004-12-01

    Most forms of thyroid cancer have a good prognosis. Some tumours, however, dedifferentiate and may finally develop into highly malignant anaplastic thyroid carcinomas with a low survival time. Due to their dedifferentiation these tumours are inaccessible to classical therapeutic options as radioiodide treatment or thyrotropin-suppression. Radical surgical revision of the tumour masses is the therapy of choice of patients with limited disease stages including patients with medullary thyroid carcinomas. Despite progress in radiation and chemotherapy regimes, many metastatic forms remain, however, incurable by conventional therapies. During the past few years new developments in immunology have revealed increasing information about the molecular basis of tumour-host interactions. The multitude of information resulting from basic science in cellular immunology, together with the availability of biologic reagents in pharmacological amounts, has opened new venues for the development of immunotherapy approaches for patients with different kind of cancers including thyroid malignancies. This review describes some most important developments in cellular immunotherapies e.g. dendritic cells-based protocols and gene therapy. It also provides a brief overview on the role of cytokines and antibodies in the treatment of advanced thyroid malignancies.

  2. DNA Cytometry and Nuclear Morphometry in Ovarian Benign, Borderline and Malignant Tumors

    Amina A. Gamal el Din

    2015-10-01

    CONCLUSION: We suggest that DNA ploidy and nuclear area combined, may be adjuncts to histopathology; in ovarian serous and mucinous benign, borderline and malignant neoplasms; identifying the aggressive borderline tumours.

  3. Malignant thymona with symptoms of myasthenia gravis; Grasiczak zlosliwy z objawami nuzliwosci miesni

    Miarzynska, M.; Szlezak, L.; Fibak, J.; Wolski, M.; Lis-Podrzycka, E.; Miarzynski, K. [Szpital im. F. Raszei, Poznan (Poland)

    1994-12-31

    The rare case of malignant tumor of thymus - Thymoma malignum was described. The initial diagnosis was difficult, because of the irregular symptoms of myasthenia gravis. The diagnostic difficulties, treatment and clinical features of this neoplasm were also discussed. (author)

  4. A Glance at the Bethesda System for Reporting Thyroid Cytopathology

    Moon, Hee Jung; Kwak, Jin Young; Kim, Eun Kyung [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2011-03-15

    Fine needle aspiration biopsy (FNAB) is an accurate and cost effective diagnostic tool for differentiating malignant and benign thyroid nodules. Despite the efforts of the Papanicolaou group to standardize thyroid cytopathology reporting, no universal standard reporting system exists to date. Pathologists believe that clinicians sufficiently understand FNAB cytological reports. However, this is not necessarily the case. There is often a significant gap between pathologists' beliefs and the clinicians' understanding. As a result, we propose 'The Bethesda System for Reporting Thyroid Cytopathology' by the National Cancer Institute. In this editorial, we briefly introduce the Bethesda System for Reporting Thyroid Cytopathology

  5. Image reporting and characterization system for ultrasound features of thyroid nodules: Multicentric Korean retrospective study

    Kwak, Jin Young [Dept. of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of); Jung, In Kyung [Dept. of Biostatistics, Yonsei University College of Medicine, Seoul (Korea, Republic of); Beak, Jung Hwan [Dept. of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seou (Korea, Republic of); and others

    2013-01-15

    The objective of this retrospective study was to develop and validate a simple diagnostic prediction model by using ultrasound (US) features of thyroid nodules obtained from multicenter retrospective data. Patient data were collected from 20 different institutions and the data included 2000 thyroid nodules from 1796 patients. For developing a diagnostic prediction model to estimate the malignant risk of thyroid nodules using suspicious malignant US features, we developed a training model in a subset of 1402 nodules from 1260 patients. Several suspicious malignant US features were evaluated to create the prediction model using a scoring tool. The scores for such US features were estimated by calculating odds ratios, and the risk score of malignancy for each thyroid nodule was defined as the sum of these individual scores. Later, we verified the usefulness of developed scoring system by applying into the remaining 598 nodules from 536 patients. Among 2000 tumors, 1268 were benign and 732 were malignant. In our multiple regression analysis models, the following US features were statistically significant for malignant nodules when using the training data set: hypoechogenicity, marked hypoechogenicity, non-parallel orientation, microlobulated or spiculated margin, ill-defined margins, and microcalcifications. The malignancy rate was 7.3% in thyroid nodules that did not have suspicious-malignant features on US. Area under the receiver operating characteristic (ROC) curve was 0.867, which shows that the US risk score help predict thyroid malignancy well. In the test data set, the malignancy rates were 6.2% in thyroid nodules without malignant features on US. Area under the ROC curve of the test set was 0.872 when using the prediction model. The predictor model using suspicious malignant US features may be helpful in risk stratification of thyroid nodules.

  6. microRNAs in the Malignant Transformation Process.

    Sarver, Anne E; Li, Lihua; Kartha, Reena V; Subramanian, Subbaya

    2015-01-01

    Many cancers originate as benign neoplasms that transform into malignant cancerous tumors in a multistep progression that is regulated, in part, by microRNAs. Benign neoplasms, by definition, lack the ability to invade adjacent tissues or spread to distant sites through metastasis. The benign to malignant transition is a critical intervention stage as tumors diagnosed in subsequent nonlocalized and malignant stages are exponentially more difficult to treat successfully. This chapter explores the critical roles that microRNAs play in the transformation from benign to malignant in four representative cancers: colorectal cancer, pancreatic cancer, malignant peripheral nerve sheath tumor, and prostate cancer. Understanding how these microRNAs control this progression and transformation will lead to new therapeutic targets and diagnostic biomarkers, resulting in improved treatments and patient outcomes.

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

    "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

  8. Increased 18F-FDG uptake mimicking thyroid cancer in a patient with Hashimoto's thyroiditis

    Schmid, Daniel T.; Kneifel, Stefan; Merrill, Griff; Goerres, Gerhard W. [Division of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Stoeckli, Sandro J. [Clinic of Otolaryngology, Head and Neck Surgery, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Padberg, Barbara-C. [Department of Pathology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland)

    2003-09-01

    We report the case of a 68-year-old patient with a known paravertebral malignant schwannoma, sent to us for postoperative staging. A combined whole-body PET/CT scan showed only poor {sup 18}F-fluorodeoxyglucose uptake in the region of the primary tumor but distinct increased fluorodeoxyglucose uptake in the left and right thyroid gland. Thyroid sonography showed two hypoechogenic nodules. Ultrasound-guided fine-needle aspiration biopsy of one nodule showed oxyphil transformed cells, compatible with malignancy. Based on these findings, the patient underwent a subtotal thyroidectomy. Histopathology of the specimen revealed a chronic follicular Hashimoto's thyroiditis. This case demonstrates that Hashimoto's thyroiditis can mimic thyroid cancer in PET but also in sonography and fine-needle aspiration biopsy. (orig.)

  9. MR angiography in abdominal neoplasms

    Squillaci, E. [Dept. of Radiology, Rome-2 Univ., Hospital S. Eugenio, Rome (Italy); Crecco, M. [Dept. of Radiology, Cancer Research Inst. (Regina Elena), Rome (Italy); Grandinetti, M.L. [Dept. of Radiology, Cancer Research Inst. (Regina Elena), Rome (Italy); Maspes, F. [Dept. of Radiology, Rome-2 Univ., Hospital S. Eugenio, Rome (Italy); Lo Presti, G. [Dept. of Radiology, Rome-2 Univ., Hospital S. Eugenio, Rome (Italy); Squillaci, S. [Dept. of Radiology, Cancer Research Inst. (Regina Elena), Rome (Italy); Simonetti, G. [Dept. of Radiology, Rome-2 Univ., Hospital S. Eugenio, Rome (Italy)

    1994-10-01

    The role of magnetic resonance angiography (MRA) in the evaluation of vascular involvement was studied in 55 patients with abdominal neoplasms. A 2-D time-of-flight (TOF) technique was used in all patients. All patients underwent CT and MR examinations before MRA. Also, MR angiograms were compared with digital subtraction angiography in 22 cases, with Doppler US in 13 cases, and with surgical findings in 20 cases. In all patients with liver neoplasms (n=29) MRA demonstrated the absence of flow in the infiltrated segments. Pericapsular neovascularization was observed in 12 patients. Portal vein involvement was correctly detected in 27 patients. In all cases MRA demonstrated in relationship between the tumor and venous structures. Portosystemic shunts were visualized in 20 of 21 patients with portal hypertension. Vena cava thrombosis (3 cases), compression (5 cases), and displacement (2 cases) were correctly demonstrated. In renal (n=6) and adrenal gland (n=3) tumors renal vein compression was correctly detected in 2 cases, displacement in 1 case, and thrombosis in 3 cases, with only 1 false-positive finding. In 7 patients with pancreatic tumors MRA demonstrated splenic vein thrombosis in 2 cases and compression in 2 cases, with one false-positive finding. Our results indicate that MRA provides precise information regarding venous vascular involvement in abdominal neoplasms, but preoperative arterial mapping is still problematic. (orig.)

  10. [Non-autoimmune thyroiditis].

    Rizzo, Leonardo F L; Mana, Daniela L; Bruno, Oscar D

    2014-01-01

    The term thyroiditis comprises a group of thyroid diseases characterized by the presence of inflammation, including autoimmune and non-autoimmune entities. It may manifest as an acute illness with severe thyroid pain (subacute thyroiditis and infectious thyroiditis), and conditions in which the inflammation is not clinically evident evolving without pain and presenting primarily thyroid dysfunction and/or goiter (drug-induced thyroiditis and Riedel thyroiditis). The aim of this review is to provide an updated approach on non-autoimmune thyroiditis and its clinical, diagnostic and therapeutic aspects.

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

    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

  12. Thyroid function in pregnancy☆

    Leung, Angela M.

    2012-01-01

    Iodine is required for the production of thyroid hormones. Normal thyroid function during pregnancy is important for both the mother and developing fetus. This review discusses the changes in thyroid physiology that occur during pregnancy, the significance of thyroid function tests and thyroid antibody titers assessed during pregnancy, and the potential obstetric complications associated with maternal hypothyroidism.

  13. 恶性肿瘤染色体端粒行为异常与癌变发生的关系研究%Study on the Relationship between the Behavioral Abnormality of Chromosomal Telomeres in Malignant Neoplasm's and the Carcinogenesis

    周宏远; 肖林; 严军; 陈蔚蔚; 刘永惠; 周清华

    2001-01-01

    目的 探讨恶性肿瘤染色体端粒行为异常与癌变发生的关系。方法 粒端联合采用微量全血培养法制备淋巴细胞染色体;端粒长度用Southern杂交法;端粒酶活性用TRAP-PCR法。结果 食管癌、鼻咽癌、肺癌染色体端粒联合率分别为14.38%、35.07%、24.40%,均高于对照组9.83%、20.27%、15.60%(P<0.01);鼻咽癌、肺癌端粒长度变化分别为伸长16.67%、16.67%,缩短76.67%、69.04%,长度无变化6.66%、14.29%;端粒酶活性阳性率为鼻咽癌82.14%,肺癌(非小细胞肺癌NSCLC78.3%,小细胞肺癌SCLC100%)。结论 端粒联合率的增高、端粒长度的缩短及端粒酶活性表达与细胞癌变密切相关。%Objective Exploration of the relationship between the behavioralabnormality of chromosomal telomeres in malignant neoplasm's and the carcinogenesis.Methods The telomeric association was used by peripheral blood lymphocyte cultures,the telomere length was used by means of southern hybridization,the telomerase activity was used by means of TRAP(telomeric Repeat Amplification protocol)on PCR.Results The telomeric association rate of esophageal carcinoma (14.38%),Nasopharyngeal Carcinoma NPC (35.07%),Lung Carcinoma(24.40%) were found to be higher than that of controls (9.83%、20.27% and14.29%)P<0.01,the telomere length of in NPC and lung carcinoma 16.67% and 16.67% have telomere elongation,76.67% and 69.04%have telomere reduction,6.67% and 14.29% exhibited equal lengths as compared with the controls.The positive rates of telomerase activity were 82.14% in NPC,78.3% in NSCLC、100% in SCLC.Condusion Increase of the telomeric association retes,the reduction of telomere length and the positive rates of telomerase activity were more closely related to cell carcinogenesis.

  14. Spectrum of Intestinal Neoplasms: A study of 400 cases

    Aminder Singh

    2015-02-01

    Full Text Available Objective: The present study is a five-year analysis of all the tumors of small and large intestine received in the Pathology Department of Dayanand Medical College and Hospital, Ludhiana. Methods: All the cases were grossly and microscopically examined and were staged according to Astler Coller Staging and classified and subtyped according to WHO classification. The important differences between the small and large intestine tumors were also analyzed. Results: There were 400 cases out of which 356 were in large intestine while 44 were in the small intestine. There were only 56 benign neoplasms while 344 were malignant tumors. Adenomas were the most common benign tumors while majority of malignant tumors were adenocarcinomas. Lymphomas, mesenchymal tumors, and carcinoid tumors were much more common in a small intestine as compared to large intestine. Majority of adenocarcinomas were located in the large intestine with most of them being moderately differentiated having Astler Coller Stage B II. Mucinous carcinomas had the worst prognosis as compared to adenocarcinomas. Anal canal had mainly squamous cell carcinomas. Conclusions: Tumors of large intestine were much commoner than of small intestine. There was a higher incidence of tumor in males with M:F ratio of 2.2:1. Mean age of presentation of benign tumor was younger, i.e., 32.6 years when compared to 54.5 years for malignant tumors. Tubular adenoma was the most common benign tumor and adenocarcinoma the commonest malignant neoplasm. [J Interdiscipl Histopathol 2015; 3(1.000: 19-23

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

    Raquel Garza-Guajardo

    2005-09-01

    Full Text Available Abstract Metastases to the breast are unusual lesions that make up approximately 2% of all malignant mammary neoplasms and may mimic both benign and malignant primary neoplasms from a clinical point of view, as well as in imaging studies. Arriving at a correct diagnosis is therefore essential in order to establish appropriate management. We present three cases of metastatic neoplasms diagnosed through fine needle aspiration biopsy and immunocytochemistry. The cytological diagnoses were: medulloblastoma in an 18-year-old woman, melanoma in a 26-year-old man, and an exceptional case of ovarian sarcoma originating from a granulosa cell tumor with metastases to both breasts. A metastatic disease should be considered in the differential diagnosis of a palpable mass in the breast, especially if there is a history of an extramammary malignant neoplasm. Fine needle aspiration biopsy is the method of choice for the management of these cases. Whenever possible the exam of the material obtained should be compared to the previous biopsy, which is usually enough to arrive at a correct diagnosis, thus preventing unnecessary surgical procedures.

  16. Focal thyroid incidentalomas identified with whole-body FDG-PET warrant further investigation.

    Prichard, R S

    2012-02-01

    Fluorodeoxyglucose (FDG) whole body positron emission computed tomography (PET-CT) detects clinically occult malignancy. The aim of this study was to assess the prevalence and significance of focal thyroid 18F - fluorodeoxyglucose uptake. A retrospective review of all patients who had FDG PET-CT examinations, in a single tertiary referral centre was performed. PET scan findings and the final pathological diagnosis were collated. 2105 scans were reviewed. Focal uptake was identified in 35 (1.66%) patients. Final surgical histology was available on eight patients, which confirmed papillary carcinoma in four (20%) patients and lymphoma and metastatic disease in two patients respectively. This gave an overall malignancy rate in focal thyroid uptake of at least 33%. Thyroid incidentalomas occurred with a frequency of 2.13%, with an associated malignancy rate of at least 33% in focal thyroid uptake. The high malignancy rate associated with focal thyroid uptake mandates further investigation in medically fit patients.

  17. Magnetic resonance imaging of less common pancreatic malignancies and pancreatic tumors with malignant potential

    D. Franz

    2014-01-01

    Full Text Available Pancreatic tumors are an increasingly common finding in abdominal imaging. Various kinds of pathologies of the pancreas are well known, but it often remains difficult to classify the lesions radiologically in respect of type and grade of malignancy. Magnetic resonance imaging (MRI is the method of choice for the evaluation of pancreatic pathologies due to its superior soft tissue contrast. In this article we present a selection of less common malignant and potentially malignant pancreatic neoplasms with their characteristic appearance on established MRI sequences with and without contrast enhancement.

  18. Magnetic resonance imaging of less common pancreatic malignancies and pancreatic tumors with malignant potential

    Franz, D.; Esposito, I.; Kapp, A.-C.; Gaa, J.; Rummeny, E.J.

    2014-01-01

    Pancreatic tumors are an increasingly common finding in abdominal imaging. Various kinds of pathologies of the pancreas are well known, but it often remains difficult to classify the lesions radiologically in respect of type and grade of malignancy. Magnetic resonance imaging (MRI) is the method of choice for the evaluation of pancreatic pathologies due to its superior soft tissue contrast. In this article we present a selection of less common malignant and potentially malignant pancreatic neoplasms with their characteristic appearance on established MRI sequences with and without contrast enhancement. PMID:26937427

  19. Use of the gamma probe and of 99mTc-DMSA (V) in the identification of the neck recurrence of medullary carcinoma thyroid; Uso do gama probe e do 99mTc-DMSA (V) na identificacao de recorrencias cervicais de carcinoma medular de tireoide

    Melo, Rosana Leite de; Kowalski, Luiz P.; Ubrich, Fabio F. [Hospital do Cancer A.C. Camargo, Sao Paulo, SP (Brazil). Centro de Tratamento e Pesquisa. Dept. de Cirurgia de Cabeca e Pescoco e Otorrinolaringologia; Lima, Eduardo N. Pereira; Torres, Ivone C.G. [Hospital do Cancer A.C. Camargo, Sao Paulo, SP (Brazil). Centro de Tratamento e Pesquisa. Dept. de Medicina Nuclear

    2003-03-01

    Medullary carcinoma of the thyroid, a malignant neoplasm of para follicular C cells, represent about 5-10% of thyroid tumors. The symptoms are related to local invasion and hormonal secretion. The clinical course is variable, from indolent cases to extremely aggressive. Many radionuclide imaging have been described to locate metastasis of medullary cancer. Tl-201 and Tc-99m (V)DMS A showed to be useful in the evaluation o persistent elevated serum calcitonin levels. On the other hand, the use of the 131 I-Mibg, that is the isotope more used, has not been demonstrating efficiency in identifying metastasis. Our objective is to report a case of a patient with medullary thyroid carcinoma in which the follow-up use DMS A(V) demonstrated a recurrence no identified for other methods. A 34-year-old man had a diagnosis of medullary thyroid carcinoma and has submitted a total thyroidectomy and neck lymph node dissection. He presented elevated serum calcitonin levels and DMS A(V) scintigraphy demonstrated focal area of pathologic uptake at the medline of the neck, but the surgical exploration was negative. He persisted with high calcitonin levels and it was used a new DMS A(V). On this occasion he was submitted to the radio-guided surgery that located the recurrence and it was confirmed with anatomo-pathologic exam. This case allowed to demonstrate that the use of radionuclide associated to the gamma-probe is promising, allowing a precise surgical approach. (author)

  20. Molecular photoacoustic imaging of follicular thyroid carcinoma

    Levi, Jelena; Kothapalli, Sri-Rajashekar; Bohndiek, Sarah

    2013-01-01

    Purpose To evaluate the potential of targeted photoacoustic imaging as a non-invasive method for detection of follicular thyroid carcinoma. Experimental Design We determined the presence and activity of two members of matrix metalloproteinase family (MMP), MMP-2 and MMP-9, suggested as biomarkers...... for malignant thyroid lesions, in FTC133 thyroid tumors subcutaneously implanted in nude mice. The imaging agent used to visualize tumors was MMP activatable photoacoustic probe, Alexa750-CXeeeeXPLGLAGrrrrrXK-BHQ3. Cleavage of the MMP activatable agent was imaged after intratumoral and intravenous injections...... With the combination of high spatial resolution and signal specificity, targeted photoacoustic imaging holds great promise as a noninvasive method for early diagnosis of follicular thyroid carcinomas....

  1. An open access thyroid ultrasound image database

    Pedraza, Lina; Vargas, Carlos; Narváez, Fabián.; Durán, Oscar; Muñoz, Emma; Romero, Eduardo

    2015-01-01

    Computer aided diagnosis systems (CAD) have been developed to assist radiologists in the detection and diagnosis of abnormalities and a large number of pattern recognition techniques have been proposed to obtain a second opinion. Most of these strategies have been evaluated using different datasets making their performance incomparable. In this work, an open access database of thyroid ultrasound images is presented. The dataset consists of a set of B-mode Ultrasound images, including a complete annotation and diagnostic description of suspicious thyroid lesions by expert radiologists. Several types of lesions as thyroiditis, cystic nodules, adenomas and thyroid cancers were included while an accurate lesion delineation is provided in XML format. The diagnostic description of malignant lesions was confirmed by biopsy. The proposed new database is expected to be a resource for the community to assess different CAD systems.

  2. Pleural malignancies.

    Friedberg, Joseph S; Cengel, Keith A

    2010-07-01

    Pleural malignancies, primary or metastatic, portend a grim prognosis. In addition to the serious oncologic implications of a pleural malignancy, these tumors can be highly symptomatic. A malignant pleural effusion can cause dyspnea, secondary to lung compression, or even tension physiology from a hydrothorax under pressure. The need to palliate these effusions is a seemingly straightforward clinical scenario, but with nuances that can result in disastrous complications for the patient if not attended to appropriately. Solid pleural malignancies can cause great pain from chest wall invasion or can cause a myriad of morbid symptoms because of the invasion of thoracic structures, such as the heart, lungs, or esophagus. This article reviews pleural malignancies, the purely palliative treatments, and the treatments that are performed with definitive (curative) intent.

  3. Thyroid emergencies.

    Klubo-Gwiezdzinska, Joanna; Wartofsky, Leonard

    2012-03-01

    This review presents current knowledge about the thyroid emergencies known as myxedema coma and thyrotoxic storm. Understanding the pathogenesis of these conditions, appropriate recognition of the clinical signs and symptoms, and their prompt and accurate diagnosis and treatment are crucial in optimizing survival.

  4. Thyroid swellings

    Rebecca Hatton; Madhukar Patel; Devasenan Devendra

    2009-01-01

    @@ A 48 year old post-menopausal woman presents with a smooth midline sweHing in her neck,which has been present for more than 10 years.On examination.you find that it is consistent with an enlarged thyroid gland.

  5. Thyroid dysfunction and neoplasia in children receiving neck irradiation for cancer

    Fleming, I.D.; Black, T.L.; Thompson, E.I.; Pratt, C.; Rao, B.; Hustu, O.

    1985-03-15

    The reported relationship of radiation exposure and thyroid carcinoma stimulated this retrospective study of 298 patients treated at St. Jude Children's Hospital with radiation therapy to the neck for childhood cancer to identify patients who developed subsequent thyroid abnormalities. This series includes 153 patients with Hodgkin's disease, 95 with acute lymphocytic leukemia, 28 with lymphoepithelioma, and 22 with miscellaneous tumors. Inclusion in the study required 5 years of disease-free survival following therapy for their original tumor, which included thyroid irradiation. Follow-up has been 100%. Most patients also received chemotherapy. Seventeen patients were found to have decreased thyroid reserve with normal levels of free triiodothyroxine (T3) or free thyroxin, (T4) and an elevated level of thyroid-stimulating hormone (TSH). In nine patients hypothyroidism developed, with decreased T3 or T4 levels and an elevated level of TSH. One hyperthyroid patient was identified. Two patients had thyroiditis, and seven had thyroid neoplasms: (carcinoma in two, adenoma in two, colloid nodule in one, and undiagnosed nodules in two). This survey has demonstrated an increased incidence of thyroid dysfunction and thyroid neoplasia when compared to the general population. The importance of long-term follow-up for thyroid disease is emphasized in patients who have received thyroid irradiation. The possible role of subclinical hypothyroidism with TSH elevation coupled with radiation damage to the thyroid gland as a model for the development of neoplastic disease is discussed.

  6. Intraductal papillary mucinous neoplasms of the pancreas: reporting clinically relevant features.

    Del Chiaro, Marco; Verbeke, Caroline

    2016-11-22

    Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas can exhibit a wide spectrum of macroscopic and microscopic appearances. This not only causes occasional difficulties for the reporting pathologist in distinguishing these tumours from other lesions, but is also relevant clinically. As evidence accumulates, it becomes clear that multiple macroscopic and histological features of these neoplasms are relevant to the risk for malignant transformation and, consequently, of prime importance for clinical patient management. The need for detailed reporting is therefore increasing. This review discusses the panoply of gross and microscopic features of IPMN as well as the recommendations from recent consensus meetings regarding the pathology reporting on this tumour entity.

  7. How Is Thyroid Cancer Diagnosed?

    ... Cancer Early Detection, Diagnosis, and Staging Tests for Thyroid Cancer Thyroid cancer may be diagnosed after a person ... Health Care Team About Thyroid Cancer? More In Thyroid Cancer About Thyroid Cancer Causes, Risk Factors, and Prevention ...

  8. Key Statistics for Thyroid Cancer

    ... and Treatment? Thyroid Cancer About Thyroid Cancer Key Statistics for Thyroid Cancer How common is thyroid cancer? ... remains very low compared with most other cancers. Statistics on survival rates for thyroid cancer are discussed ...

  9. Interactions between thyroid disorders and kidney disease

    Gopal Basu

    2012-01-01

    Full Text Available There are several interactions between thyroid and kidney functions in each other organ′s disease states. Thyroid hormones affect renal development and physiology. Thyroid hormones have pre-renal and intrinsic renal effects by which they increase the renal blood flow and the glomerular filtration rate (GFR. Hypothyroidism is associated with reduced GFR and hyperthyroidism results in increased GFR as well as increased renin - angiotensin - aldosterone activation. Chronic kidney disease (CKD is characterized by a low T3 syndrome which is now considered a part of an atypical nonthyroidal illness. CKD patients also have increased incidence of primary hypothyroidism and subclinical hypothyroidism. The physiological benefits of a hypothyroid state in CKD, and the risk of CKD progression with hyperthyroidism emphasize on a conservative approach in the treatment of thyroid hormone abnormalities in CKD. Thyroid dysfunction is also associated with glomerulonephritis often by a common autoimmune etiology. Several drugs could affect both thyroid and kidney functions. There are few described interactions between thyroid and renal malignancies. A detailed knowledge of all these interactions is important for both the nephrologists and endocrinologists for optimal management of the patient.

  10. Papillary thyroid microcarcinoma presenting as skull base metastasis

    YAN Bo; LIU Dian-gang; L(U) Hai-li; ZHANG Qiu-hang

    2010-01-01

    @@ Papillary thyroid carcinoma (PTC) is the most common type of well-differentiated thyroid cancer and is considered to be a relatively indolent tumor in which distant metastasis and death are rare.1 The metastasis of PTC is usually to regional lymph nodes, especially the cervical and mediastinal nodes. Metastases to the brain are rare, and constitute 0.1%-5.0% of distant metastases of papillary carcinoma.2 Skull metastasis is uncommon,and is found in 2.5%-5.8% of cases of thyroid cancer.3 Skull base metastasis of PTC is extremely rare, with only eight reported cases in the literature involving the clivus,cavernous sinus, sella turcica, and the petrous apex and ridge.4 A metastatic lesion can arise from histologically benign and silent thyroid neoplasms,5 and differential diagnosis between ectopic and metastatic thyroid cancer can be difficult,6 therefore, the management of thyroid cancer is controversial after removal of metastatic disease.Here we reported a case of papillary thyroid microcarcinoma (PTMC) that was manifested as a solitary clivus metastasis and discussed the diagnostic and therapeutic management strategies. The 73-year-old patient presented with visual impairment in the right eye,and epistaxis. The patient subsequently underwent complete total thyroidectomy after a diagnosis of papillary microcarcinoma. This finding emphasizes that clinically significant metastases can arise from thyroid papillary microcarcinoma. Total thyroidectomy and careful review of the histology are necessary to prevent delay in proper diagnosis.

  11. Nodular Lymphocyte Predominant Hodgkin Lymphoma of the Thyroid

    Cassis, João; Simões, Helder; Sequeira Duarte, João

    2016-01-01

    Thyroid lymphomas are rare clinical entities that may result from either the primary intrathyroid de novo or secondary thyroid gland involvement of a lymphoma. Among these, the Hodgkin's subtype is quite uncommon, accounting for 0.6–5% of all thyroid malignancies. The authors report on a 76-year-old female presenting with a thyroid nodule that, upon surgical excision, was found to be a nodular lymphocyte predominant Hodgkin lymphoma of the thyroid. So far, thyroid involvement by this variant has never been reported. Upon reporting on this clinical case, the authors emphasize the difficulties usually found in establishing the diagnosis and in defining the best management strategy. A thorough review of the available literature is done. PMID:28044111

  12. Cystic change in thyroid nodules: A confounding factor for real-time qualitative thyroid ultrasound elastography

    Bhatia, K.S.S.; Rasalkar, D.P.; Lee, Y.P.; Wong, K.T.; King, A.D.; Yuen, H.Y. [Department of Imaging and Interventional Radiology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin N.T, Hong Kong (Hong Kong); Ahuja, A.T., E-mail: aniltahuja@cuhk.edu.hk [Department of Imaging and Interventional Radiology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin N.T, Hong Kong (Hong Kong)

    2011-09-15

    Objective: To evaluate real-time qualitative ultrasound elastography for focal thyroid masses undergoing fine-needle aspiration in a routine thyroid ultrasound clinic. Materials and methods: Ninety-four thyroid nodules scheduled for fine-needle aspiration cytology in a thyroid ultrasound clinic also underwent real-time freehand elastography. Colour-scaled elastograms were graded visually on the stiffness of the solid component of nodules relative to thyr