• Title/Summary/Keyword: thyroiditis

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Preoperative BRAF Mutation is Predictive of Occult Contralateral Carcinoma in Patients with Unilateral Papillary Thyroid Microcarcinoma

  • Zhou, Yi-Li;Zhang, Wei;Gao, Er-Li;Dai, Xuan-Xuan;Yang, Han;Zhang, Xiao-Hua;Wang, Ou-Chen
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1267-1272
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    • 2012
  • Background and Objective: The optimal resection extent for clinically unilateral papillary thyroid microcarcinoma (PTMC) remains controversial. The objective was to investigate risk factors associated with occult contralateral carcinoma, and put emphasis on the predictive value of preoperative BRAF mutation. Materials and Methods: 100 clinically unilateral PTMC patients all newly diagnosed, previously untreated were analyzed in a prospective cohort study. We assessed the T1799A BRAF mutation status in FNAB specimens obtained from all PTMC patients before undergoing total thyroidectomy (TT) and central lymph node dissection (CLND) for PTMC. Univariate and multivariate analyses were used to reveal the incidence of contralateral occult cancer, difference of risk factors and predictive value, with respect to the following variables: preoperative BRAF mutation status, age, gender, tumor size, multifocality of primary tumor, capsular invasion, presence of Hashimoto thyroiditis and central lymph node metastasis. Results: 20 of 100 patients (20%) had occult contralateral lobe carcinoma. On multi-variate analysis, preoperative BRAF mutation (p = 0.030, OR = 3.439) and multifocality of the primary tumor (p = 0.004, OR = 9.570) were independent predictive factors for occult contralateral PTMC presence. However, there were no significant differences between the presence of occult contralateral carcinomas and age, gender, tumor size, capsular invasion, Hashimoto thyroiditis and central lymph node metastasis. Conclusions: Total thyroidectomy, including the contralateral lobe, should be considered for the treatment of unilateral PTMC if preoperative BRAF mutation is positive and/or if the observed lesion presents as a multifocal tumor in the unilateral lobe.

Primary Thyroid Lymphoma: Multi-Slice Computed Tomography Findings

  • Li, Xu-Bin;Ye, Zhao-Xiang
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.1135-1138
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    • 2015
  • Background: The objective of this study was to investigate the MSCT characteristics of PTL in order to enhance the awareness of this uncommon entity among both clinicians and radiologists. Materials and Methods: The clinicopathological data and MSCT images of 27 patients with PTL were retrospectively reviewed. The MSCT appearances were classified into three types: type 1, solitary nodule surrounded by normal thyroid tissue; type 2, multiple nodules in the thyroid, and type 3, enlarged thyroid glands with a reduced attenuation with or without peripheral thin hyperattenuating thyroid tissue. Results: The patients were enrolled in the study with a mean age of 68 years (range, 51-86years) and compression symptoms or enlarged cervical lymph nodes at diagnosis. Hashimoto's thyroiditis was in 20 patients. All patients had non-Hodgkin lymphoma of B-cell in origin, including 22 cases of diffuse large B-cell lymphoma (DLBCL) and 5 of low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT). For MSCT appearance, type 1 pattern was observed in 2 patients, type 2 in 8, and seventeen type 3 in 17. The lesions occurred in more than one lobe with a mean maximal transverse diameter of 6.9 cm and an ill-defined margin. Most tumors showed a homogeneous attenuation equal to that of surrounding muscles before contrast and obvious enhancement after contrast. Cervical lymph node involvement and invasion of the trahea and (or) esophagus were mainly observed in patients with DLBCL. Conclusions: PTL should be clinically considered in elder patients presenting with a history of Hashimoto's thyroiditis and cervical lymphadenopathy. The MSCT characteristics of PTL includes a mass diffusely affecting more than one thyroid lobe, isointense to muscle and obvious enhancement before and after contrast. DLBCL, the most common histological subtype of PTL, is associated with a higher invasive tendency.

Assessment of Thyroid Status by T4, TSH and Thyroglobulin Autoantibody in Dogs (개에서 T4, TSH, 갑상샘글로불린 자가항체 값에 의한 갑상샘의 상태 평가)

  • Choi Eun-Wha;Bae Bo-Kyoung;Shin Il-Seob;Bhang Dong-Ha;Hwang Cheol-Yong;Lee Chang-Woo;Youn Hwa-Young
    • Journal of Veterinary Clinics
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    • v.23 no.2
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    • pp.149-152
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    • 2006
  • The canine thyroglobulin autoantibody assay is to be used for the diagnosis of autoimmune thyroid disease in dogs. Antithyroglobulin antibodies are present in about 50 percent of hypothyroid dogs. In this report, the sera of the five canine patients ($P1{\sim}P5$) referred to the Veterinary Medical Teaching Hospital in Seoul National University were assessed by T4, TSH and thyroglobulin autoantibody (TgAA). P1 was diagnosed as severe hypothyroidism since he showed very high TSH levels with low T4 values. P2 and P3 born with a genetic predisposition were assessed as normal in thyroid function. P4 was normal, but needed follow-up examination for TgAA assay. P5 showed the positive result in TgAA assay, so it was diagnosed as autoimmune thyroiditis. As the cases above show, not only T4 and TSH, but also TgAA assay to be considered for more accurate assessment of the status of the thyroid.

The Clinical Study on 39 Cases of Subclinical Hypothyroidism (전현성 갑상선 기능저하증의 임상적 고찰)

  • Yu, Cheol-Jae;Ahn, Weon-Jeon;Lee, Houn-Young;Ro, Heung-Kyu
    • The Korean Journal of Nuclear Medicine
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    • v.20 no.1
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    • pp.67-73
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    • 1986
  • Subclinical hypothyroidism can be defined as an asymptomatic state in which a reduction in thyroid activity has been compensated by an increased TSH output to maintain a euthyroid state. We analysed clinical features, laboratory data, and pathologic findings in 3g cases of subclinical hypothyroidism who were diagnosed at the Dept. of Internal Medicine, Chungnam National University Hospital from Aug. 1984 to June, 1985. 1) The age distribution was from sixteen to sixty-nine and mean a9e was 34.8. Peak incidence was in the 4th decade and 3rd, 5th, 6th decade in order. 2) The sex distribution showed female preponderance with a ratio of 18.5 to 1. 3) The major presenting manifestations were nonspecific ones such as fatigue, indigestion, and anorexia. 4) Physical examination revealed diffuse goiter in 47.6%. Major abnormalities were no gross abnormality (30.9%), nodular goiter and facial edema. 5) There was no significant difference of the basal serum $T_3\;and\;T_4$ concentrations between subclinical hypothyroidism and normal controls (p>0.05). 6) The basal serum TSH concentration of subclinical hypothyroidism $(32.61{\pm}14.95{\mu}U/ml)$ was significantly higher than that of normal controls $(3.92{\pm}1.05{\mu}U/ml)$ (p<0.005). 7) Microsomal antibody was detected in 80.6% and thyroglobulin antibody was detected in 30%. 8) The pathologic findings in 26 cases revealed Hashimoto's thyroiditis in 76.9% (lymphocytic type, 34.6%; oxyphilic type, 26.9%; fibrotic type, 15.4%). The others were adenomatous goiter(15.4%), adenomatous carcinoma (3.8%) and subacute thyroiditis(3.8%).

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Clinical Evaluation of TBG Concentration Measured with Radioimmunoassay Kit (방사면역측정법에 의한 혈청 thyroxine결합글로부린 (TBG)의 임상적 의의)

  • Hong, Seong-Woon;Kang, Tae-Woong;Lee, Jhin-Oh
    • The Korean Journal of Nuclear Medicine
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    • v.16 no.1
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    • pp.23-30
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    • 1982
  • Serum thyroxine binding globulin (TBG) was measured with a radioimmunoassay (RIA) kit (GammaDab TBG). The TBG concentration in 23 adult normals was $23.7{\pm}1.9{\mu}g/ml(mean{\pm}SD)$. The serum TBG levels of $21.6{\pm}3.5{\mu}g/ml$) in hyperthyroidism, $24.7{\pm}4.9{\mu}g/ml$ in subacute thyroiditis, $20.7{\pm}7.0{\mu}g/ml$ in liver cirrhosis and $22.6{\pm}3.7{\mu}g/ml$ in sick patient were not significantly different from normals. The levels of $31.8{\pm}5.9{\mu}g/ml$ in hypothyroidism, $36.2{\pm}5.1{\mu}g/ml$ in pregnancy (p<0.01, p<0.001) and $29.3{\pm}6.1{\mu}g/ml$ in molar pregnancy (p<0.01) were significanty higher that in normals. In various cases without thyroid dieases (euthroid group), the TBG concentration correlated with the value for Amerlex $T_3$ (r=0.816) though there was curvilinear relationship. This relationship was altered in hyperthyroidism, subacute thyroiditis and molar pregnancy in which sera were overloaded with thyroxine $(T_4)$ so that concentration of unoccupied binding sites on TBG (free TBG concentration) were more decreased than expected from normal TBG concentrations. Hypothyroidism was also separated from the curvilinear relationship in euthyroid group indicating that free TBG concentrations were more increased relative to slightly increased TBG concentrations. Measurement of the TBG concentration was considered useful in the diagnosis of TBG defiency, in differentiating molar pregnancy from hyperthyroidism and for correct understanding the hormone binding in liver dieases and other nonthyroidal illness.

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Associations between Hashimoto Thyroiditis and Clinical Outcomes of Papillary Thyroid Cancer: A Meta-Analysis of Observational Studies

  • Moon, Shinje;Chung, Hye Soo;Yu, Jae Myung;Yoo, Hyung Joon;Park, Jung Hwan;Kim, Dong Sun;Park, Young Joo
    • Endocrinology and Metabolism
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    • v.33 no.4
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    • pp.473-484
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    • 2018
  • Background: Epidemiological studies have suggested an association between Hashimoto thyroiditis (HT) and papillary thyroid cancer (PTC) development. Other studies, however, have reported a protective role of HT against PTC progression. Through this updated meta-analysis, we aimed to clarify the effects of HT on the progression of PTC. Methods: We searched citation databases, including PubMed and Embase, for relevant studies from inception to September 2017. From these studies, we calculated the pooled odds ratios (ORs) of clinicopathologic features and the relative risk (RR) of PTC recurrence with 95% confidence intervals (CIs) using the Mantel-Haenszel method. Additionally, the Higgins $I^2$ statistic was used to test for heterogeneity. Results: The meta-analysis included 71 published studies with 44,034 participants, among whom 11,132 had HT. We observed negative associations between PTC with comorbid HT and extrathyroidal extension (OR, 0.74; 95% CI, 0.68 to 0.81), lymph node metastasis (OR, 0.82; 95% CI, 0.72 to 0.94), distant metastasis (OR, 0.49; 95% CI, 0.32 to 0.76), and recurrence (RR, 0.50; 95% CI, 0.41 to 0.61). Conclusion: In this meta-analysis, PTC patients with HT appeared to exhibit more favorable clinicopathologic characteristics and a better prognosis than those without HT.

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.

An Evaluation on the Thyroid Function Tests of the Patients with Autoimmune Thyroiditis (자가면역성 갑상선염환자의 갑상선기능 검사소견)

  • Lim, Jae-Yang;Lee, Jae-Tae;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.343-349
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    • 1994
  • The study was taken to analyze the laboratory findings of the 161 patients with autoimmune thyroiditis treated at Kyungpook University Hospital from January 1992 to July 1993. They were all female and mean age was 33 years ranging from 10 to 73 years. Mean radioactive iodine uptake(RAIU) of the thyroid was $30.90{\pm}21.80(mean{\pm}SD)%$ at 6 hours and $37.97{\pm}23.25%$ at 24 hours. Mean serum levels of thyroid hormones were $1.41{\pm}0.48$(ng/ml) of T3, $7.26{\pm}3.23$(ug/dl) of T4, and $1.11{\pm}0.66$(ng/dl) of free T4, while mean serum level of TSH was $17.99{\pm}30.72$(uIU/ml). Mean levels of serum autoantibodies were 24. $43{\pm}31.91$(U/ml) of antithyroglobulin antibody and $55.32{\pm}41.97$(U/ml) of antimicrosomal antibody. The correlation between RAIU and serum thyroid hormone levels was significantly negative, but the positive correlation between RAIU and serum TSH was noted. The correlation between thyroid hormones and TSH was significantly negative, but the positive correlation between RAIU and serum TSH was noted. The correlation between thyroid hormones and TSH was significantly negative, while antimicrosomal antibody titer revealed significantly positive correlation with TSH. The RAIU and free T4 showed negatively correlated with the increasing age. The Initial clinical findings of the patients with autoimmune thyroiditis revealed euthyroidism in 83.2%, hypothyroidism in 14.9%, and hyperthyroidism in 1.9%. The incidence of abnormally increased serum thyroglobulin, antithyroglobulin antibody, and antimicrosomal antibody were 21.3%, 97.5%, and 87.6%, respectively and these abnormalities were more frequent in the patients with documented clinical thyroid functional disturbances.

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Production and characterization of anti-thyrog1obulin monoclonal antibodies (Thyroglobulin에 대한 단일클론항체의 제작 및 특성)

  • 남경수;손윤희;백태선;김철호;임종국;황철원
    • Journal of Life Science
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    • v.12 no.4
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    • pp.460-463
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    • 2002
  • Twelve clones of monoclonal antibodies (mAbs) against thyroglobulin were produced and characterized. Among them, three mAbs (TN-1, TN-2 and TN-3) showed high binding affinity to thyroglobulin. from ELISA inhibition assay, TN-2 showed considerable reactivity with soluble thyroglobulin. TN-2 also reacted with phosphatidylserine which has a negative charge in aqueous condition. These results suggest that TN-2 has characteristics of autoantibody concerned with thyroiditis.

Natural killer T cell and pathophysiology of asthma

  • Jang, Gwang Cheon
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.136-145
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    • 2010
  • Natural killer T (NKT) cell is a special type of T lymphocytes that has both receptor of natural killer (NK) cell (NK1.1, CD161c) and T cell (TCR) and express a conserved or invariant T cell receptor called $V{\alpha}14J{\alpha}18$ in mice or Va24 in humans. Invariant NKT (iNKT) cell recognizes lipid antigen presented by CD1d molecules. Marine-sponge-derived glycolipid, ${\alpha}-galactosylceremide$ (${\alpha}-GalCer$), binds CD1d at the cell surface of antigen-presenting cells and is presented to iNKT cells. Within hours, iNKT cells become activated and start to secrete Interleukin-4 and $interferon-{\gamma}$. NKT cell prevents autoimmune diseases, such as type 1 diabetes, experimental allergic encephalomyelitis, systemic lupus erythematous, inflammatory colitis, and Graves' thyroiditis, by activation with ${\alpha}-GalCer$. In addition, NKT cell is associated with infectious diseases by mycobacteria, leshmania, and virus. Moreover NKT cell is associated with asthma, especially CD4+ iNKT cells. In this review, I will discuss the characteristics of NKT cell and the association with inflammatory diseases, especially asthma.