• Title/Summary/Keyword: Thyroid Biopsy

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The Study on the Thyroid Disease (갑상선질환(甲狀腺疾患)에 관(關)한 연구(硏究) -20여년간(餘年間)의 핵의학교실업적(核醫學敎室業績)을 중심(中心)으로-)

  • Lee, Mun-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.16 no.2
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    • pp.1-24
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    • 1982
  • Several recent advances in our knowledge of thyroid physiology have broad application to the diagnosis and management of thyroid disorders. For in the thyroid, more than other endocrine organs, pathophysiology can be translated directly into the diagnosis and management of thyroid disease. Graves' disease is a syndrome including goiter with hyperthyroidism, exophthalmos and dermopathy. The pathogenesis of Graves' disease is not yet clearly identified, but various autoantibodies to the thyroid gland and immunopathologic studies indicate that autoimmune processes are involved in the pathogenesis of the disease. The diagnosis and management of Graves' disease are largely dependent on radionuclide techniques as radioimmunoassay, radioactive iodine therapy and so on. Several laboratory tests are also developed to determine the remission of this disase including TRH stimulation test, $T_3$ suppression test and detection of thyroid stimulating immunoglobulins. Autoimmune thyroiditis is almost certainly a primary immunologic disease and the incidence tends to increase recently, mainly due to the application of biopsy technique in thyroid diseases. Thyroid nodules have been a great challenge to physicians because of the possibility of malignancy. But recently, cytologic examination of thyroid aspirate provides a very simple and also reliable diagnostic method in patients with thyroid nodules. In 163 patients with thyroid nodules, only 19.3% was revealed to be malignant. Therefore cytologic examination of thyroid aspirate and thyroid biopsy should be included in the diagnosis of nodular patients prior to surgical intervention. In this paper, a comprehensive review is presented on the pathogenesis, clinical features, laboratory findings and therapeutic modalities of various thyroid diseases on the basis of over 80 researches performed during the past 20 years at radioisotope clinic, Seoul National University Hospital.

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A Case of Intra-thyroidal Schwannoma Diagnosed by Preoperative Core Needle Biopsy (수술 전 중심부바늘생검을 통해 진단된 갑상선에 발생한 신경초종 1예)

  • Dong Gyu Choi;Young-Ok Kim;Min Jung Jung;Hyoung Shin Lee
    • Korean Journal of Head & Neck Oncology
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    • v.39 no.1
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    • pp.37-40
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    • 2023
  • Schwannoma is a slow growing benign tumor that can occur anywhere in our body. About 25~45% cases of schwannomas occur in the head and neck, but intra-thyroidal schwannomas are very rare, and mostly are diagnosed by post-thyroidectomy pathologic study. In this article, we present a case of intra-thyroidal schwannoma diagnosed preoperatively with core needle biopsy. The patient underwent enucleation of the thyroid tumor, and the pathology of the tumor was confirmed as schwannoma. Few cases of intra-thyroidal schwannomas have been reported in the literature, but none of them have been diagnosed through core needle biopsy preoperatively. Preoperative diagnosis of intra-thyroidal schwannoma can be helpful when determining appropriate surgical extent and avoid unnecessary thyroidectomy.

Fine Needle Aspiration Cytology of Papillary Carcinoma of the Thyroid with Numerous Multinucleated Giant Cells (다수의 다핵 거대세포를 동반한 갑상선 유두상 암종의 세침흡인 세포학적 소견)

  • Kim, Kyung-Mi;Lee, Kyo-Young;Kang, Chang-Suk;Shim, Sang-In;Kim, Sun-Moo
    • The Korean Journal of Cytopathology
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    • v.4 no.1
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    • pp.62-65
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    • 1993
  • An unusual case of papillary carcinoma of the thyroid revealing numerous multinucleated giant cells in the aspiration biopsy cytology is reported. Papillary carcinoma is the most common malignant neoplasm of the thyroid and is frequently diagnosed by aspiration biopsy cytology. Recently, we experienced a case of papillary carcinoma with many multinucleated giant cells in a 55-year-old woman. The cytologic features are described.

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Thyroid Radiology Practice: Diagnosis and Interventional Treatment of Patients with Thyroid Nodules (갑상선 영상의학 진료: 갑상선 결절 환자의 진단과 중재적 치료)

  • Jung Hwan Baek;Dong Gyu Na
    • Journal of the Korean Society of Radiology
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    • v.81 no.3
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    • pp.530-548
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    • 2020
  • Thyroid radiology practice is a medical practice in which thyroid diseases are diagnosed using imaging modality and treated by imaging-based interventional techniques, and the primary care target is thyroid nodular disease. Diagnosis of thyroid nodules is primarily done by ultrasound imaging and biopsy; thyroid nodules can be treated by non-surgical interventional treatment and thyroidectomy. Ethanol ablation is the first-line treatment for cystic benign nodules, and radiofrequency ablation is used for the treatment of benign solid nodules and recurrent thyroid cancers. Thyroid radiology practice has an essential clinical role in diagnosis and nonsurgical treatment of thyroid nodular diseases, and treatment should be performed based on standard care guidelines for proper patient care. In order to provide the best care to patients with thyroid nodular disease, it is desirable to treat patients in the radiology outpatient clinic. Thyroid radiology practice centered on outpatient clinic practice needs to be expanded.

The Clinical Analysis of Medullary Thyroid Carcinoma : 10 Cases (갑상선 수질암 10례의 임상적 분석)

  • Kim Sang-Hyun;No Ho-Sang;Moon Jun-Hwan;Kim Jung-Su;Hwang Dong-Jo;Seo Jeong-Min
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.2
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    • pp.222-225
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    • 1999
  • Background and Objectives: Medullary thyroid carcinoma(MTC) is a rare tumor derived from the parafollicular C cells of the thyroid gland accounting for 5-10% of all thyroid malignancies. In Korea, there has been a few case report of medullary thyroid carcinoma(MTC) but their clinical analysis were not exactly studied. So, we made clinical study of 10 patients diagnosed as medullary thyroid carcinoma. Materials and Methods: We reviewed clinical data of 10 patients who were diagnosed as medullary thyroid carcinoma(MTC) from April 1973 to August 1998 at National Medical Center. Results: The incidence of MTC was 2.3% of all thyroid cancer and their mean age were 44.2 years old. Preoperative thyroid scan showed cold nodule in all patients and thyroid function test(TFT) was within normal range. Of the 10 patents, only 4 patients had diagnosis of MTC in preoperative fine needle aspiration biopsy. All the patients underwent total thyroidectomy with central neck dissection. Two patients with cervical lymph node metastasis underwent total thyroidectomy, central neck dissection and modified neck dissection. Two patients (20%) showed recurrence at the site of neck, lung, mediastinum, bone and liver. Conclusion: Most MTC is sporadic form and have peak incidence in the fifth decade and female preponderance. Preoperative fine needle aspiration biopsy is considered to be a clinically useful diagnostic method, but its accuracy is not considered as much high as others. Total thyroidectomy with central neck dissection may be an useful surgical modality in treating medullary thyroid carcinoma.

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Study of Autoantibody Concentration Distribution by Thyroid Fine Needle Aspiration Biopsy (갑상선 조직 검사에 따른 자가 항체 농도 분포 연구)

  • Kim, Jean-Soo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.9
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    • pp.4320-4325
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    • 2013
  • This study was investigated the correlation between thyroid fine needle aspiration biopsy and serological test's concentrations. I examined fifty patients who were diagnosed with thyroid cancer from June 2012 to December 2012 in Pathology of a certain university hospital. Healthy fifty people were selected as a control group. Thyroid function tests were used as variables. In conclusion, The thyroglobulin and autoantibody was showed positive correlations in cancer groups. also Thyroglobulin Ab was showed a little correlation. If we examine this study items, we will get help in early diagnosis.

A Clinical Study of Surgically Managed Thyroid Nodule (외과적으로 처치한 갑상선 결절)

  • Hong Kwan-Uye;Lee Myung-Bok;Moon Chul;Kim Ik-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.2
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    • pp.91-101
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    • 1994
  • Nodular thyroid disease is a common clinical problem. The problem in clinical practice is to distinguish malignant or potentially malignant tumor from harmless nodules. The cases of thyroid nodule surgically managed at Department of General Surgery, Soon Chun Hyang Univ. Hospital during the period Jan. 1985 to July. 1992 were reviewed retrospectively. To assess method of distinguishing malignant from benign lesions of the thyroid gland, we reviewed 162 patients with thyroid nodule. There were 61(37.7%) malignant nodules and 101(62.3%) benign nodules. According to the review, distinguishing the benign from the malignant nodule with history, physical examination, clinical manifestation, and duration of illness was not suggested sufficiently. In ultrasonogram of 73 cases, 57.5% of nodules were solid, 20.6% were cystic, 21.9% were mixed solid and cystic. Of these, 28.5% of the operated solid lesions, 12.5% of the mixed lesions, and only 6.7% of the cystic lesions were malignant. Thyroid scanning of 82 cases revealed cold nodules in 60 patients(73.2%), of which 26 cases were malignant(36.6%) 137 patients underwent fine needle aspiration cytology(FNAC), and these results were as follow: sensitiviey was 70.6%, specificity was 93.0%, false-positive rate was 14.3%, and false-negative rate was 15.8%. 41 patients underwent frozen biopsy, and the results as follow: sensitivity was 80.0%, specificity was 89.7%. Neither scintigraphy nor ultrasonogram has sufficient specificity to distinguish benign from malignant nodule. But FNAC and frozen biopsy have sufficient accuracy to differentiate benign from malignant nodule. In the benign nodules, the most common type of operation was total lobectomy (60.4%). Of the malignant nodules, total thyroidectomy with or without modified radical neck dissection was performed in 30 cases(49.2%). We conclude that the single technique used to determine the differential diagnosis of a thyroid nodule are unrealiable. It is therefore essential to combine all avaiable clinical and laboratory information.

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Diagnostic Efficacy of Fine Needle Aspiration Cytology, Frozen section Biopsy and Ultrasonography for a Palpable Thyroid Mass (갑상선 촉지 종괴에서 시행한 세침흡인세포검사법, 동결절편검사법 및 초음파검사법의 진단적 유용성)

  • Lee Byoung-Kil;Jung Sung-Hoo
    • Korean Journal of Head & Neck Oncology
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    • v.18 no.2
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    • pp.168-172
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    • 2002
  • Objectives: This study was done to determine the diagnostic efficacy of fine needle aspiration cytology (FNA), frozen section biopsy (FSx) and ultrasonography in a palpable thyroid mass. Materials and Methods: During the period from July 1999 to March 2002, the medical records of 98 patients who underwent a thyroidectomy for thyroid mass, at the Department of Surgery, Chonbuk National University Hospital, were reviewed retrospectively. Ninety eight cases were classified according to whether the FNA cytological diagnosis inadequate, benign, suspicious, or malignant and the FSx diagnosis benign or malignant and the ultrasonographic examination was benign, suspicious, or malignant. The diagnostic correlations of ultrasonography, FNA cytology, frozen section, and both FNA cytology and frozen section with definite histologic diagnosis were evaluated. Results: According to the FNA cytological interpretation, 76 cases were diagnosed as benign, 6 cases suspicious, 13 cases malignant, and 3 cases inadequate. The sensitivity and specificity for FNA were 86.3% and 95.9% and for FSx 95.5% and 100% respectively. The diagnostic accuracy of FNA and FSx were 93.5% and 98.9% respectively. Based on a definite histologic diagnosis, the ultrasonographic examination had a sensitivity and a specificity of 77.2% and 78.9%. Conclusion: The results confirm that FNA cytology is a reliable and useful tool in the initial evaluation of a palpable thyroid mass compared to the ultrasonographic examination. Intraoperative FSx is a valuable diagnostic procedure to confirm the cytological diagnosis with undetermined or unsatisfactory cytological diagnosis.

Comparison of Pre-Operation Diagnosis of Thyroid Cancer with Fine Needle Aspiration and Core-needle Biopsy: a Meta-analysis

  • Li, Lei;Chen, Bao-Ding;Zhu, Hai-Feng;Wu, Shu;Wei, Da;Zhang, Jian-Quan;Yu, Li
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7187-7193
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    • 2014
  • Background: The aim of this meta-analysis was to compare sensitivities and specificities of fine needle aspiration (FNA) and core needle biopsy (CNB) in the diagnosis of thyroid cancer. Materials and Methods: Articles were screened in Medline, the Cochrane Library, EMBASE and Google Scholar, and subsequently included and excluded based on the patient/problem-intervention-comparison-outcome (PICO) principle. Primary outcome was defined in terms of diagnostic values (sensitivity and specificity) of FNA and CNB for thyroid cancer. Secondary outcome was defined as the accuracy of diagnosis. Compiled FNA and CNB results from the final studies selected as appropriate for meta-analysis were compared with cases for which final pathology diagnoses were available. Statistical analyses were performed for FNA and CNB for all of the selected studies together, and for individual studies using the leave-one-out approach. Results: Article selection and screening yielded five studies for meta-analysis, two of which were prospective and the other three retrospective, for a total of 1,264 patients. Pooled diagnostic sensitivities of FNA and CNB methods were 0.68 and 0.83, respectively, with specificities of 0.93 and 0.94. The areas under the summary ROC curves were 0.905 (${\pm}0.030$) for FNA and 0.745 (${\pm}0.095$) for CNB, with no significant difference between the two. No one study had greater influence than any other on the pooled estimates for diagnostic sensitivity and specificity. Conclusions: FNA and CNB do not differ significantly in sensitivity and specificity for diagnosis of thyroid cancer.