A Clinical Review of 1547 Cases of Thyroid Nodule - Excluding Diffuse Hyperplasia-

갑상선 결절 1547 예에 대한 임상적고찰

A pathologic review was made of 1547 cases of thyroid nodule during the 20 years from 1970 to 1989 at the department of Head and Neck surgery of Presbyterian Medical Center in Chonju. 1547 cases were analysed in regard to cancer incidence of thyroid nodule, correlation of preoperative diagnosis with pathology and of frozen section diagnosis with final pathology, surgical procedures employed in managing thyroid itself, location of metastatic nodes, further definite procedure in cnacer cases, effectiveness of prophylactic neck dissection with lymph node pathology. The results are summarized as follows: 1) The cancer incidence of thyroid nodule was 21.7%. 2) The incidence of thyroid cnacer in total neoplasms increased from 1.6% to 2.9%. 3) The thyroid cancer was prevalent in female(5.9:1) and in fifth, fourth and sixth decade of life. 4) The incidence of solitary cold nodule in thyroid cancer was 72.7% (210/289). S) The incidence of thyroid cancer in solitary cold nodule was 28.7% (210/782). 6) The false negative of frozen section (1240 cases) was 19.8%. 7) Histologically, well differentiated carcinoma comprises about 94% of all cases and papillary carcinoma was 78.5% of all cases 8) The most frequent lymphatic metastasis was pre- & paratrachel nodes(63.3%), followed by Level III(50%) and Level II(47.7%). 9) 47.7% among 130 cases of papillary adenocarcinoma and 12.5% among 16 cases of follicular adenocarcinoma, each group treated with prophylactic neck dissection, were confirmed to be occult cervical node metastasis.