• Title/Summary/Keyword: Thyroid Ultrasonography

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Ultrasonographic Mass Screening for Thyroid Carcinoma (초음파를 이용한 갑상선암의 집단검진)

  • Chung Woong-Yoon;Chang Hang-Seok;Kim Eun-Kyung;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.2
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    • pp.177-181
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    • 1999
  • Objective: The clinical significance of mass screening for thyroid carcinoma remains unclear. This study was carried out to clarify the value of mass screening for thyroid carcinoma. Materials and Methods: From December 1997 through July 1998, a total of 1,401 subjects who were enrolled to receive breast screening or follow-up examination for breast cancer were included in this study. Thyroid glands were examined by 10 MHz ultrasonography by one experienced radiologist. The patients with thyroid nodules were classified into 2 groups according to their potential risk of malignancy by ultrasonographic findings(high-risk : hypoechogenicity, microcalcification, irregular margin, taller than wider shape). High-risk patients were advised to undergo fine-needle aspiration biopsy and thyroidectomy. The characteristics of the thyroid cancers detected by ultrasonographic mass screening were compared by those of clinical thyroid cancer excluding male patients during the same period. Results: Thyroid nodules were detected in 353(25.2%) of the subjects and 259(73.4%) were listed in the low-risk group and 94(26.6%) in high-risk group. Among 94 patients in the high-risk group, 43 underwent thyroidectomy and 37 turned out to have thyroid carcinomas. Thus, the detection rates for carcinoma were 2.6% of all subject, 10.5% of the detected nodules, 36.4% of the high risk women and 86.0% of the operated cases. The tumor size was significantly smaller in the mass-screening group than in the clinical cancer group(p<0.05). However, there was no statistical differences between two groups in the prevalences of neck node involvement and extracapsular invasion and the patients distributions by AMES score, MACIS score and TNM stage. Conclusion: Ultrasonogrpahic mass screening may be useful for the early detection of thyroid carcinoma in women who are scheduled to have breast examination.

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Hypopharyngeal Wall Exposure within the Surgical Field : The Role of Axial Rotation of the Thyroid Cartilage during Anterior Cervical Surgery

  • Choi, Byung-Kwan;Cho, Won-Ho;Choi, Chang-Hwa;Song, Geun-Sung;Kim, Choon-Grak;Kim, Hak-Jin
    • Journal of Korean Neurosurgical Society
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    • v.48 no.5
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    • pp.406-411
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    • 2010
  • Objective : Esophageal/hypopharyngeal injury can be a disastrous complication of anterior cervical surgery. The amount of hypopharyngeal wall exposure within the surgical field has not been studied. The objective of this study is to evaluate the chance of hypopharyngeal wall exposure by measuring the amount of axial rotation of the thyroid cartilage (ARTC) and posterior projection of the hypopharynx (PPH). Methods : The study was prospectively designed using intraoperative ultrasonography. We measured the amount of ARTC in 27 cases. The amount of posterior projection of the hypopharynx (PPH) also was measured on pre-operative CT and compared at three different levels; the superior border of the thyroid cartilage (SBTC), cricoarytenoid joint and tip of inferior horn of the thyroid cartilage (TIHTC). The presence of air density was also checked on the same levels. Results : The angle of ARTC ranged from $-6.9^{\circ}$ to $29.7^{\circ}$, with no statistical difference between the upper and lower cervical group. The amount of PPH was increased caudally. Air densities were observed in 26 cases at the SBTC, but none at the TIHTC. Conclusion : Within the confines of the thyroid cartilage, surgeons are required to pay more attention to the status of hypopharynx/esophagus near the inferior horn of the thyroid cartilage. The hypopharynx/esophagus at the TIHTC is more likely to be exposed than at the upper and middle part of the thyroid cartilage, which may increase the risk of injury by pressure. Surgeons should be aware of the fact that the visceral component at C6-T1 surgeries also rotates as much as when the thyroid cartilage is engaged with a retractor. The esophagus at lower cervical levels warrants more careful retraction because it is not protected by the thyroid cartilage.

Intrathyroidal branchial cleft-like cyst in neonate (신생아에서 발견된 갑상샘의 아가미틈새양 낭종)

  • Kang, Joonwon;Oh, Sangmin;Sul, Jiyoung;Lee, Choongsik;Chang, Meayoung
    • Clinical and Experimental Pediatrics
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    • v.49 no.9
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    • pp.1005-1009
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    • 2006
  • A rare case is described of an intrathyroidal branchial cleft-like cyst in neonate. The patient was a newborn girl with a mass in the left lateral neck. The ultrasonography and computed tomography revealed a cystic lesion in the left thyroid. The lesion was enucleated surgically from the thyroid. Histologically, the cyst was lined by squamous or columnar epithelium and contained inflammatory cell infiltraion, thyroid and parathyroid tissue. The patient has been doing well without any evidence of thyroid dysfunction for 15 months.

High-grade mucoepidermoid carcinoma in the thyroid gland with poor prognosis

  • Shin, Hyeong Chan
    • Journal of Yeungnam Medical Science
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    • v.38 no.2
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    • pp.169-174
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    • 2021
  • Mucoepidermoid carcinoma (MEC) is the most common malignant neoplasm of the salivary gland, but primary thyroid MEC has rarely been reported and usually has a good prognosis. Herein, I report a case of thyroidal MEC with a poor prognosis in an 82-year-old woman with an anterior neck mass. Ultrasonography and computed tomography revealed a thyroid mass. The patient initially underwent fine-needle aspiration, was diagnosed with malignancy, and underwent a right lobectomy. On gross examination, a 4.0×3.6×2.6 cm-sized ill-defined, unencapsulated, and infiltrative tan to whitish mass with necrosis was identified. Microscopically, epidermoid tumor cell nests or solid sheets were identified. Mucous cells that were positive for periodic acid-Schiff and mucicarmine stains were also identified within epidermoid cell nests. Frequent mitosis and necrosis were observed. Immunohistochemical staining for p40 and p63 was positive, and that for thyroid transcription factor-1 and paired box gene 8 was focally positive. According to the Armed Forces Institute of Pathology grading system for salivary gland MEC, the current case was classified as high-grade MEC. After surgery, the patient suffered from dyspnea due to a remnant neck mass that compressed and obstructed the trachea; therefore, the patient refused further treatment. Thyroidal MECs are considered low-grade with a favorable prognosis, but there are several reported cases of thyroidal MEC with poor prognosis. The current case is a rare presentation of high-grade thyroidal MEC with a poor prognosis.

Diagnostic Value of Preoperative Ultrasonographic Evaluation on Thyroid Cancer (갑상선 암의 판정에 대한 술전 초음파의 의의)

  • Yoon Kil-Hoon;Ryou Kie-Sun;Jung Jin-Young;Jo Jae-Hyun;Kim Myung-Wook;So Euy-Young
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.1
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    • pp.66-69
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    • 1999
  • Background and Objectives: It is critical to distinguish benign from malignant thyroid nodule and to select a patient for surgery. Even though the U/S study dose not make great contribution to diagnose a malignant thyroid nodule, it is widely used in the evaluation of anatomic feature of thyroid. The authors tried to estimate the efficacy of the U/S study in preoperative diagnosis of malignant thyroid nodule. Materials and Method: At the department of General Surgery of Ajou University, 75 patients who were operated after diagnosis with thyroid nodule by U/S study between July 1996 to June 1997 were retrospectively analyzed. By comparing the U/S impression that implies malignant thyroid nodule to FNAC and post-operative pathologic results ware as follows. Results: 1) Absence of cystic change, presence of internal hypoechogenicity, lobulation, calcification, thick and irregular halo, and nodule more than 4cm in diameter on U/S were considered significant statistically for the diagnosis of malignancy(Chi-square test, p<0.05) 2) Presence of internal hypoechogenicity or thick and irregular halo has the validity in Logistic regression analysis. 3) FNAC was done in 65 case. 19 case were malignant, 11 case were suspicious and 46 patients were benign (sensitivity 52.6%, specificity 87%). 4) The findings of U/S which are hypoechogenic and thick and irregular halo show 82% sensitivity and 97% specificity. In combination with the findings of FNAC that imply benign or suspicious lesions, the sensitivity was 100% and the specificity was 97%. Conclusion: This study suggest that the hypoechogenicity and thick and irregular halo on U/S are important information for the diagnosis of thyroid malignancy which were considered benign or suspicious after FNAC.

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The Prevalence of Thyroid Nodules and the Morphological Analysis of Malignant Nodules on Ultrasonography (갑상선 결절 유병률과 초음파 영상에서 악성소견 결절의 형태학적 분석)

  • An, Hyun;Ji, Tae-jeong;Lee, Hyo-young;Im, In-chul
    • Journal of radiological science and technology
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    • v.42 no.3
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    • pp.201-207
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    • 2019
  • The purpose of this study was to evaluate the prevalence of thyroid nodules and malignant findings of thyroid nodules in 1,954 patients (654 males and 1,300 females) aged 20 years or older who underwent thyroid ultrasound from January 2018 to December 2018. Examination of the thyroid gland was performed, and fine needle aspiration cytology was performed on the thyroid nodule. As a result, 108 (16.5%) out of 654 males and 368 (28.3%) out of 1,300 females showed higher prevalence than males. The prevalence of single nodules and multiple nodules in gender and age groups was significantly higher for women and for ages (male p=.001, female p=.001). There was a significant difference in males in the nodule size (p=.001) and no significant difference in females (p=.069). Fine - needle aspiration cytology of 476 patients with nodules was diagnosed as malignant in 46 patients (9.6%). Based on pathologic results, 383 benign and 93 malignant groups were analyzed. Ultrasonographic findings were as follows single nodule (p=.000), solid(p=.004), hypoechoic (p=.000), ill-defined peripheral boundary (p=.000), and calcification (p=.000), respectively. In the diagnosis of thyroid nodule, primary ultrasonographic findings through morphological classification of the nodules may reduce indiscriminate fine needle aspiration cytology in benign and malignant nodules.

Ultrasonography Of Jugular Vein, Carotid Artery and Thyroid Glands in Native Korean Cattle (한우에서 경정맥, 경동맥 및 갑상선의 초음파상)

  • 김명철;변홍섭
    • Journal of Veterinary Clinics
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    • v.17 no.1
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    • pp.205-208
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    • 2000
  • 소에서 경정맥, 경동맥 및 갑상선의 초으파상에 관한 기초자료를 확립하기 위하여 본 연구를 실시하였다. 한우 9두에서 6개월경으로부터 12개월령에 도달할 때까지 1개월 간격으로 성장에 따른 경정맥, 경동맥 및 갑상선의 초음파상을 측정하였다. 경정맥, 경도맥 및 갑상선은 경부의 양측에서 관찰하였다. 경정맥의 내경은 6, 7, 8, 9, 10, 11, 12 및 13개월령에서, 각각 8.5, 8.7, 8.8, 9.5, 10.0, 10.5, 11.5 및 12.2mm를 나타내었다. 경동맥의 내경은, 6, 7, 8, 9, 10, 11, 12 및 13개월령에서, 각각 7.4, 7.5, 8.6, 9.1, 9.4, 9.7, 10.1 및 10.3mm 이었다. 갑상선엽의 길이는 6, 7, 8, 9, 10, 11, 12 및 13개월령에서, 각각 28.0, 32.1, 36.4, 42.2, 51.7, 53.2, 55.1 and 58.8mm이었다. 갑상선엽의 높이는 6, 7, 8, 9. 10, 11, 12 및 13개월령에서, 각각 13.6, 15.3, 16.1, 20.7, 22.9, 25.6, 28.9 and 29.4mm를 나타내었다. 본 연구에서는 초음파측정 결과는 한우에서의 경정맥, 경동맥 및 갑상선에서의 형태학적 변화의 진단을 위한 참고자료가 될 수 있을 것으로 사료된다.

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2021 Korean Thyroid Imaging Reporting and Data System and Imaging-Based Management of Thyroid Nodules: Korean Society of Thyroid Radiology Consensus Statement and Recommendations

  • Eun Ju Ha;Sae Rom Chung;Dong Gyu Na;Hye Shin Ahn;Jin Chung;Ji Ye Lee;Jeong Seon Park;Roh-Eul Yoo;Jung Hwan Baek;Sun Mi Baek;Seong Whi Cho;Yoon Jung Choi;Soo Yeon Hahn;So Lyung Jung;Ji-hoon Kim;Seul Kee Kim;Soo Jin Kim;Chang Yoon Lee;Ho Kyu Lee;Jeong Hyun Lee;Young Hen Lee;Hyun Kyung Lim;Jung Hee Shin;Jung Suk Sim;Jin Young Sung;Jung Hyun Yoon;Miyoung Choi
    • Korean Journal of Radiology
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    • v.22 no.12
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    • pp.2094-2123
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    • 2021
  • Incidental thyroid nodules are commonly detected on ultrasonography (US). This has contributed to the rapidly rising incidence of low-risk papillary thyroid carcinoma over the last 20 years. The appropriate diagnosis and management of these patients is based on the risk factors related to the patients as well as the thyroid nodules. The Korean Society of Thyroid Radiology (KSThR) published consensus recommendations for US-based management of thyroid nodules in 2011 and revised them in 2016. These guidelines have been used as the standard guidelines in Korea. However, recent advances in the diagnosis and management of thyroid nodules have necessitated the revision of the original recommendations. The task force of the KSThR has revised the Korean Thyroid Imaging Reporting and Data System and recommendations for US lexicon, biopsy criteria, US criteria of extrathyroidal extension, optimal thyroid computed tomography protocol, and US follow-up of thyroid nodules before and after biopsy. The biopsy criteria were revised to reduce unnecessary biopsies for benign nodules while maintaining an appropriate sensitivity for the detection of malignant tumors in small (1-2 cm) thyroid nodules. The goal of these recommendations is to provide the optimal scientific evidence and expert opinion consensus regarding US-based diagnosis and management of thyroid nodules.

Immunohistochemical Expression of Galectin-3, Cytokeratin 19 and HBME-1 in Papillary Microcarcinoma of the Thyroid Gland (갑상선 미세 유두암종에서 Galectin-3, Cytokeratin 19와 HBME-1의 발현)

  • Kim, Jin-Hwan;Lee, Sang-Sook
    • Korean Journal of Head & Neck Oncology
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    • v.23 no.2
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    • pp.133-137
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    • 2007
  • With the wide use of ultrasonography and fine needle aspiration of the thyroid gland, the incidence of papillary microcarcinoma of the thyroid gland is rapidly increasing nowadays. To improve the diagnostic accuracy of histopathologic findings of papillary thyroid carcinoma, various molecular markers have been used recently. We analysed the expression of galectin-3, cytokeratin 19 and HBME-1, using immunohistochemical technique in 37 cases of papillary microcarcinoma of the thyroid gland to evaluate the diagnostic value of these molecular markers. Immunohistochemically, galectin-3 expression was found in 37 cases of papillary microcarcinoma. Its localization was mostly cytoplasmic. Cytokeratin 19 expression was found in 36 cases. It was mostly localized to the cytoplasm and membrane. HBME-1 expression was found in all cases. Its localization was plasma membrane. The expression of these three molecular markers was negative in the adjacent normal thyroid tissue and accompanying benign lesions, although there are scattered foci of incomplete positive staining in cases of Hashimoto's thyroiditis. Our findings suggest that the immunohistochemical staining using antibodies for galectin-3, cytokeratin 19 and HBME-1 is an useful adjunctive method for the histopathological diagnosis of a papillary microcarcinoma of the thyroid gland.

Shorter Distance Between the Nodule and Capsule has Greater Risk of Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma

  • Wang, Qiu-Cheng;Cheng, Wen;Wen, Xin;Li, Jie-Bing;Jing, Hui;Nie, Chun-Lei
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.855-860
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    • 2014
  • Background: The purpose of this study was to assess the relationship between different sonographic features of papillary thyroid carcinoma (PTC) on high-frequency ultrasound and cervical lymph node metastasis (CLNM). Materials and Methods: We enrolled 548 patients who underwent initial surgery for PTC between May 2011 and December 2012 in our hospital at diagnosis. The sonographic features of 513 PTC nodules in 513 eligible patients, who had single PTC nodules in their thyroid glands, were retrospectively investigated. All patients with a suspect malignant nodule (d<0.5cm) among multiple nodules were initially diagnosed by fine-needle aspiration biopsy (FNAB) to ascertain if the suspect nodule was PTC. The final diagnosis of all the thyroid nodules and existence of CLNM were based on postoperative pathology. Patients were divided into two groups: a positive group with CLNM (224 nodules) and a negative group without CLNM (289 nodules). The following factors were investigated: gender, age, echogenicity, echotexture, size, shape, location, margin, contour, calcification morphology, distance between the nodule and pre- or post-border of the thyroid capsule, vascularity and the differences between the two groups. Results: Correlation analysis showed that shorter distances between the nodule and pre- or postborder of thyroid capsule resulted in greater risk of CLNM (Spearman correlation coefficient=-0.22, p<0.0001). The significant factors in multivariate analysis were age<45yrs, larger size (d>1cm), "wider than tall" shape, extrathyroid extension and mixed flow (internal and peripheral) (p<0.05, OR=0.406, 2.093, 0.461, 1.610, 1.322). Conclusions: Significant sonographic features of PTC nodules in preoperative high-frequency ultrasound are crucial for predicting CLNM.