• Title/Summary/Keyword: Thyroid goiter

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A Study of Usefulness of Fine Needle Aspiration Cytology of the Thyroid Lesions (갑상선 병변의 세침흡인 세포검사의 유용성에 관한 연구)

  • Kwon, Kye-Hyun;Jin, So-Young;Lee, Dong-Wha
    • The Korean Journal of Cytopathology
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    • v.7 no.2
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    • pp.111-121
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    • 1996
  • Fine needle aspiration cytology(FNAC) is preferred because of simplicity, safety, and reliability in the evaluation of patients with thyroid nodule or hyperplasia. However, there are a few limitations such as false-negative or false-positive cases and non-diagnostic material. To evaluate the usefulness of FNAC in thyroid lesions, we reviewed 704 FNAC cases of thyroid nodules from 1988 to 1994 at Soonchunhyang University Hospital. The results are as follows. 1. Among 704 FNAC cases of thyroid gland, 571(81.1%) cases were benign, 12(1.7%) were suspicious, 71(10.1%) were malignancy, and 50(7.1%) were material insufficiency. The cytologic diagnoses of the benign lesions included 168 cases of follicular neoplasm, 139 cases of adenomatous goiter, 162 cases of follicular lesion such as follicular neoplasm or adenomatous goiter, 61 cases of Hashimoto's thyroiditis, 13 cases of subacute thyroiditis, and 28 cases of colloidal nodule or benign nodule. The malignant lesions included 68 cases of papillary carcinona, two medullary carcinomas and a case of metastatic colon cancer. 2. The average number of cytologic smear slides was $4.12{\pm}1.81$ in material insufficiency and $5.63{\pm}1.79$ in diagnostic cases. This difference was statistically significant(p<0.00001). 3. Histological assessment of 150 cases revealed 2 false negative and 1 false positive cases. The false negative cases were a case of marked sclerosis in papillary carcinoma and an occult case of papillary carcinoma. The false positive case resulted from pseudo-ground glass nuclei due to marked dry artifact. 4. Comparison between the FNAC and the histologic diagnosis revealed that FNAC had a sensitivity of 93.5%, a specificity of 99.2%, a false negative rate of 6.6%, a false positive rate of 0.8%, and an overall diagnostic accuracy of 98.0%. Therefore, FNAC of thyroid gland is a very reliable diagnostic method with excellent accuracy rate.

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Fine Needle Aspiration Cytology of Mediastinal Goiter (종격동 갑상선종 1예의 세침흡인생검 소견)

  • Kim, Yee-Jeong;Lee, Kwang-Gil
    • The Korean Journal of Cytopathology
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    • v.2 no.2
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    • pp.148-152
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    • 1991
  • A mediastinal mass was aspirated by fluoroscope-guided fine needle aspiration biopsy in a 47 years old female patient. The first aspiration smears were not diagnostic, because of hemorrhagic background and cell paucity. On the second aspiration, the smears were composed of some clusters of benign epithelial cells in hemorrhagic back-ground. Cells were arranged in mostly solid sheets and tended to form glandular lumina in part. Their nuclei were round and vesicular. Nucleoli were not prominent. These findings were suggestive of benign glandular tissue, which was finally confirmed as mediastinal thyroid gland by open thoracotomy specimen.

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Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma in a Child: A Case Report (소아의 미만성 경화 변종 갑상선 유두암: 증례 보고)

  • Seung Hee Byun;Sun Kyoung You;Seong Su Kang;Kyung Sook Shin;Jeong Eun Lee
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1250-1254
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    • 2020
  • The diffuse sclerosing variant of papillary thyroid carcinoma (DSPTC) is uncommon. Herein, we report a rare case of DSPTC in a 9-year-old girl who initially presented with a painless diffuse goiter. Thyroid peroxidase antibody testing yielded positive results, and the initial clinical diagnosis was Hashimoto's thyroiditis. However, thyroid ultrasonography revealed characteristic findings of DSPTC, which was confirmed through the postoperative histopathological diagnosis. Although thyroid cancers are rare in the pediatric population, DSPTC should be included in the differential diagnosis of goiter in these patients. Moreover, ultrasonography may prevent a diagnostic delay and facilitate the detection of a concomitant malignancy.

A Case of Thyroid Hemiagenesis Associated with Hypothyroidism (갑상선 기능 저하증과 동반된 갑상선 반쪽 무형성증 1예)

  • Lee, Dong Won;Ji, Yong Bae;Song, Chang Myeon;Tae, Kyung
    • Korean Journal of Head & Neck Oncology
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    • v.29 no.1
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    • pp.26-28
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    • 2013
  • Thyroid hemiagenesis is rare congenital anomaly that one lobe of thyroid fails to develop. It is often asymptomatic and discovered incidentally with other thyroid disease such as hypothyroidism, hyperthyroidism, multinodular goiter, benign adenoma and cancer. Most cases reported are left thyroid lobe agenesis and occurred in female. Compensatory hypertrophy occurs in most cases. Many cases are asymptomatic and detected incidentally, so awareness of its existence can help its detection and proper treatment. Here, we report a case of thyroid hemiagenesis accompanying hypothyroidism with a review of literature.

Effect of Sulfamonomethoxine on Thyroid Function of Rabbits (Sulfamonomethoxine (SMM) 투여(投與)가 가토(家兎)의 갑상선기능(甲狀線機能)에 미치는 영향(影響))

  • Lee, Dong-Myoung
    • Journal of radiological science and technology
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    • v.8 no.2
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    • pp.65-69
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    • 1985
  • In order to investigate the effects of sulfamonomethoxine (SMM) on thyroid glands in short term administration as medical dose, a total of twenty albino rabbits (mean body weight 1,750g) were selected at random and allotted to control and experimental group. Rabbits in experiment were administered SMM of 50 mg/kg/day for 30 days, and histopathological changes of thyroid glands and the blood levels for T4 and T3 were observed every 5 days. The Results obtained were summarized as follows: 1. The thyroid follicles were decreased or obliterated by highly hypertrophic and hyperplastic epithelial cells and the newly formed small follicles contained scanty colloidal materials. These changes revealed increasing tendency in accordance with the experimental days. 2. The blood levels for T4 and T3 of experimental group manifested significantly decreased values than those of control through the experimental term consistently. Finally, above observations suggest that administration of SMM to animals leads thyroid glands to typical hypofunctional hyperplastic goiter.

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Purine Nucleoside Phosphorylase (PNP) Activity of Lymphocytes and T Cell Subsets in Peripheral Blood in Thyroid Tumors (갑상선 종양에 있어서 말초형 림프구의 Purine Nucleoside Phosphorylase (PNP) 활성과 T 세포 아형에 관한 연구)

  • Kim, Dong-Soo
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.1
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    • pp.1-7
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    • 1992
  • To elucidate alteration of purine nucleoside phosphorylase (PNP) activity of peripheral lymphocytes and helper/inducer and suppressor/cytototxic T cells in patients with thyroid tumors, the author examined PNP activity, and $CD4^+\;and\;CD8^+$ cells of peripheral blood in 20 cases of simple goiter, 9 cases of thyroid adenoma and 20 cases of thyroid cancer as well as 11 cases of adult healthy subjects as control. Diagnoses were established on the basis of commonly accepted clinical and biochemical criteria in simple goiter and were confirmed histopathologically in thyroid adenoma and cancer. All blood was obtained from veins of the patients and control subjects in Pusan National University Hospital during the period of January to August, 1991. The results obtained were summarized as follows: 1) The PNP activity was significantly decreased or tended to be decreased in thyroid adenomas and cancers as compared with control subjects and simple goiters. 2) The percentage of CD8 cells was significantly decreased or tended to be decreased in thyroid cancers as compared with simple goiters, thyroid adenomas and control subjects. 3) The CD4/CD8 ratio was significantly increased or tended to be increased in thyroid cancer as compared with simple goiters, thyroid adenomas and control subjects. On the basis of the results, it can be suggested that the immunodysfunction in thyroid cancer may be due to decreased suppressor/cytotoxic T cells, and the estimation of PNP activity of peripheral lymphocyte is a helpful test in detecting the immune status in thyroid tumors.

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Concurrent Thyroid Carcinoma and Benign Thyroid Disease (양성 갑상선질환과 함께 나타나는 갑상선암)

  • Chung So-Hwan;Yoon Jung-Han;JaeGal Young-Jong
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.1
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    • pp.88-93
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    • 1998
  • In order to review the clinicopathologic characteristics of the thyroid cancer associated with benign thyroid disease, we evaluated 47 patients treated between January, 1993 and September, 1997 at the Chonnam National University Hospital. In those period, we had operated a total of 690 thyroidectomy of which 320 were diagnosed as thyroid cancer. Forty three(91.4%)occurred in women and four(8.5%)occurred in men. The mean age at operation was 46.7years(range, 15 to 76 years). Forty three of the 47 cancers(91.4%) were papillary carcinomas while 4(8.5%)were follicular. Twenty four of the 47 patients (51%) were occult thyroid carcinomas measured less than 1 cm in diameter. The concurrent benign disease were nodular goiter(n=17), Hashimoto's thyroiditis(n=16), follicular adenoma(n=10), Graves' disease(n=2) and diffuse hyperplasia(n=2). Thirty one patients were diagnosed by preoperative FNAC and they underwent total thyroidectomy. Three were diagnosed by frozen section examination at the time of operation. Among them, one underwent total thyroidectomy and two underwent subtotal thyroidectomy. Eight cases revealed lymph node metastases and 2 cases extended to surrounding muscles. In conclusion, concurrent thyroid cancers and benign thyroid disease are not uncommon and a regular ultrasonic follow-up with selective aspiration cytologic examination is recommaned to enhance their diagnostic accuracy.

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The Changes of Thyroid Function after Subtotal Thyroidectomy in Diffuse Toxic Goiter(Graves' Disease) (미만성 갑상선중독증(그레이브씨병)의 갑상선 아전절제술 후 갑상선 기능의 변화에 대한 연구)

  • Song Eun-Young;Kim Sung-Bae;Kim Sang-Hyo
    • Korean Journal of Head & Neck Oncology
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    • v.18 no.1
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    • pp.60-64
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    • 2002
  • Objectives: Three classic treatment modalities have been used to treat Graves' disease: antithyroid medication, radioiodine ablation, and subtotal thyroidectomy. Postoperative thyroid functions were studied in patients with Graves' disease treated by subtotal thyroidectomy to evaluate the superiority of surgical treatment. Materials and Methods: One hundred fourty patients of Graves' disease were analysed retrospectively in follow-up for more than three years following subtotal thyroidectomy. Postoperative serum levels of $T_3,\;T_4, TSH, TSH-R Ab, free $T_4$, were evaluated to watch hypo- or hyperthyroidsm. Results: In the evaluation of preop- and postoperative thyroid function after three years of subtotal thyroidectomy, $T_3$ was changed from $464.10{\pm}196.16ng/dl$ to $140.41{\pm}76.56ng/dl$ in mean value, $T_4$ was changed from $20.76{\pm}7.98{\mu}g/dl$ to $9.54{\pm}4.02{\mu}g/dl$, $TSHT_3$ was changed from $0.55{\pm}4.42{\mu}u/ml$ to $4.96{\pm}7.20{\mu}u/ml$, TSH-R Ab was changed from $41.6{\pm}28.27%$ to $28.7{\pm}28.79%$ and free $T_4$ was changed from $4.45{\pm}2.33ng/dl$ to $1.44{\pm}0.69ng/dl$ in mean value. Euthyroidism was noted in 118 patients(84.3%), overt hyperthyroidism in 6 patiens(4.3%), latent hyperthyroidism in 8 patients(5.7%), overt hypothyroidism in 2 patint(1.4%), and latent hypothyroidism in 6 patients(4.3%). Of surgical complications, permanant hypoparathyroidism was found in one patient, recurrent laryngeal nerve injury in two patients, postoprative bleeding with reoperation in two patients, and death in one patient. Conclusion: The thyroid function after subtotal thyroidectomy in diffuse toxic goiter is normal level (euthyroidism) in 84.3% and low recurrence rate of hyperthyroidism is showed with rare surgical complication. Therefore, subtotal thyroidectomy in diffuse toxic goiter is more effective and safe than RI or longterm ATD treatment, if the operation is performed by skillful surgeon.

Three Cases of Thyroid Hemiagenesis (갑상선 일측 무형성증 3예)

  • Kim, Ki-Hyun;Chung, Hyun-Pil;Kim, Jae-Wook;Koh, Yoon-Woo
    • Korean Journal of Head & Neck Oncology
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    • v.22 no.2
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    • pp.183-187
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    • 2006
  • Thyroid hemiagenesis is a very rare congenital anomaly in which one thyroid lobe fails to develop. The cause of thyroid hemiagenesis is still unknown. The true prevalence of thyroid hemiagenesis is not known, but it is estimated to be from 0.05% to 0.2% in normal children. Thyroid hemiagenesis is common in female with the left lobe being absent. The common disease in the remaining lobe is hyperthyroidism, benign adenoma, a toxic multinodular goiter, chronic thyroiditis, primary myxedema, and rarely carcinoma. Tc-99m pertechnate scintigraphy, ultrasonography and computerized tomography can be used to confirm this anomaly. Here we report three cases with left lobe agenesis. Two of them were euthyroid state while the other hypothyroid patient had a ectopic lingual thyroid.

Comparison of $Na^+/I^-$ Symporter Expression Rate in Malignant and Benign Thyroid Diseases: Immunohistochemical Study (악성 및 양성 갑상선 질환의 조직에서 면역조직학적 검사법에 의한 $Na^+/I^-$ symporter의 발현율 비교)

  • Kang, Do-Young;Jeong, Young-Jin;Lee, Kyung-Eun;Park, Heon-Soo;Yoo, Young-Hyun;Roh, Mee-Sook
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.1
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    • pp.9-15
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    • 2006
  • Purpose: 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 thyroid disease. Materials and Methods: Total patients were 119 cases (Men 15, $48{\pm}13$ 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 stored 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. Results: 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 malignant thyroid diseases 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 of NIS expression, which was not correlated with that of primary lesion. Conclusion: In papillary thyroid carcinoma, distribution of NIS expression was heterogeneous and increased, and not different compared with that of benign thyroid disease.