• Korean Journal of Head & Neck Oncology
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• v.15 no.1
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• pp.3-8
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• 1999

Objective: The expression of Ki67, a proliferation marker, and p27, a cyclin dependent kinases(CDKs) inhibitor, has been studied in various human neoplasms. This study was carried out to determine whether these markers are useful in distinguishing benign from malignant lesions of the thyroid or predicting biologic behavior of malignant lesions. Material and Methods: Using immunohistochemical techniques with monoclonal antibodies to Ki67 and p27, we analyzed the expression of Ki67 and p27 in various thyroid disorders(25 follicular adenomas, 47 follicular carcinomas, 16 papillary carcinomas, 20 adenomatous goiters and 40 normal thyroid tissues). The labeling indices(LIs) were determined by counting cells expressing these markers in 1000 cells per immunostained slide. Results: Neoplastic thyroid diseases showed higher expression of Ki67 and lower expression of p27 than non-neoplastic diseases(p<0.05). The expression of p27 was significantly different between follicular adenomas($LI=55.4{\pm}5.7$) and follicular carcinomas($LI=23.2{\pm}10.2$). There was, however, no significant correlation between the degree of Ki67 and p27labeling indices and types of carcinoma or clinical aggressiveness of diseases. Conclusion: The degree of Ki67 and p27 expression was useful in distinguishing between benign from malignant thyroid lesions, particulary between follicular adenoma and follicular carcinoma, but was not directly proportional to the tumor aggressiveness.

• Archives of Craniofacial Surgery
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• v.23 no.2
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• pp.83-88
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• 2022

Nevus sebaceous of Jadassohn is a congenital cutaneous hamartoma with epidermal, sebaceous, follicular, and apocrine structures that usually appears at birth or in early childhood. It has the potential to generate a variety of secondary neoplasms of different lineages, and the risk increases with patient age. Although multiple neoplasms may occasionally arise within the same lesion, the coexistence of more than five secondary tumors is extremely rare. Here we report a case of seven secondary tumors including syringocystadenoma papilliferum, desmoplastic trichilemmoma, sebaceoma, trichoblastoma, pigmented trichoblastoma, sebaceous adenoma, and tumor of follicular infundibulum arising within a nevus sebaceous. The complete diagnosis relies on the histopathological analysis of multipoint biopsies and delicate pathological sections.

• Korean Journal of Head & Neck Oncology
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• v.17 no.1
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• pp.38-41
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• 2001

Background and Objectives: Thyroid nodules can be diagnosed by FNAB, neck sonography, CT scan, or frozen section with relative accuracy. But some cases, which show no malignancy with those methods, are proved differentiated carcinomas on permanent sections. These false negative results of those diagnostic methods pose difficulties in the surgeon's decision-making process. We analyzed completion thyroidectomies retrospectively in order to make a treatment guideline for thyroid nodules. Materials and Methods: During the last six years, we performed 243 thyroid lobectomies, no evidence of malignancy with preoperative or intraoperative diagnostic methods at the Department of Otolaryngology-Head and Neck Surgery, Ansan and Anam Korea University Hospital. Among these cases, 23 patients (male 6, female 17, mean age 33.4 year old) were proved differentiated thyroid carcinomas on permanent section and we performed completion thyroidectomies. Results: Preoperative FNAB showed seven cases of nodular hyperplasia, 11 cases of follicular adenoma, and five cases of inadequate specimen. Among total 15 cases on frozen section, five cases were nodular hyperplasias, and 10 cases were follicular adenomas. Pathologic results of the permanent section were six cases of papillary cell carcinoma and 17 cases of follicular cell carcinoma. Completion thyroidectomy was performed on all these cases. Conclusion: FNAB and frozen section cannot be sufficient to make the diagnosis of thyroid nodule, we consider that completion thyroidectomy should be performed at the moment with malignant evidence on permanent section.

• 대한두경부종양학회:학술대회논문집
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• 2001.11a
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• pp.272-272
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• 2001

• Korean Journal of Head & Neck Oncology
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• v.10 no.2
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• pp.200-205
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• 1994

Proliferating cell nuclear antgen(PCNA) plays an important role in DNA synthesis in nucleoli and is highly conserved non-histone nuclear protein composed of 261 amino acid. and is considered to correlated with the cells proliferative state, because it is synthesized particulary during the proliferative period of late Gland S-phase. Therefore, PCNA index meaningfully increases in the active or proliferative kinetic cells. By the use of recently developed monoclonal antibodies against PCNA, the immunohistochemical staining methods can make possible. These staining methods are the useful and productive one for ascertaining the cell's proliferating abillity. Moreover, immunohistochemical staining method with a antiPCNA antibody has particulrar advantages as follows. By means of these methods, we can stain the tissue that was already fixed in formalin or paraffin wax. We can see with naked eye that which cell is, where is differentiated through a microscope. Lastly, it maintains the whole tissue architecture and makes a search for the correlation. As we have seen above, the immunohistochemical staining methods for PCNA have been studied as an impotant factor that can find the cell proliferative kinetics in malignancy and biologic behavior of tumors. To investigate of the proliferative activity in thyroid nodule, Authors evaluated cell proliferative activity by immunostaing for PNCA in 45 pathologically confirmed solitary thyroid nodule. The results were as follows. 1) The benign nodules were 25 cases(Adenomatous Goiter: 20 cases, Follicular adenoma: 5 cases) and malignant nodules were 20 cases(Papillary Ca : 14 cases, Follicular Ca : 4 cases, Anaplastic Ca : 2 cases). 2) The Most prevalent age groups were 4th decade(11 cases), and the next group was 5th decade. 3) The average PCNA labelling indices were as follows. Adenomatous goiter(I6.9%), Follicular adenoma(37.6%), papillary Ca(26.3%), Follicular Ca(8.8%) and Anaplastic Ca(86.7%). There were no significant differences in benign(20.4) and malignant nodules (28.8%) except anaplastic Ca(p=0.3226). 4) When the average tumor size 2cm in papillary Ca, the PCNA indices were 26.0% (below 2cm) : 26.6% (above 2cm) (p=0.9642). The PCNA incidies were 23.9% (with lymphatic spread) : 28.7% (without lymphatic spread) (p=0.7056). There were no signlficant differences in the above cases. In conclusion, there were no significant differences in cell proliferative activity by staining for PCNA between benign and malignat nodules except anaplastic Ca.

• Korean Journal of Head & Neck Oncology
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• v.14 no.1
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• pp.94-98
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• 1998

Background: Completion thyroidectomy can most accurately be described as reexploration of the neck to remove the contralateral thyroid lobe. This procedure has commonly been performed when the histopatholoic condition of the ipsilateral thyroid lobe reveals papillary or follicular carcinoma of the thyroid. Because of a definitely increased risk of complications with completion thyroidectomy, avoiding its routine use is important. But this operation is safe procedure with minimal morbidity by coinsidering interval, surgical approach, surgeon's experience. The purpose of this review is to define the indication, and the safety of completion thyroidectomy. Materials & Methods: Recent 2 years(1995. 1 to 1996. 12), we have performed 161 thyroid operations. Fourteen of these patients were treated by completion thyroidectomy. The patients ranged in age from 21 to 66 years. We have routinely used ultrasound guided needle biopsy and intraoperative frozen section. Result: The completion thyroidectomized specimen contained papillary carcinoma in 12 (86%), follicular carcinoma in 1(7%) and follicular adenoma(no residual tumor) in 1(7%). The complication of completion thyroicetomy was absent, although case number was a few. The indication of completion thyroidectomy in our study was defined recurrence in 9 and staging in 5. The site of recurrence consists of residual thyroid in 7 and residual thyroid added cervical lymph node in 2. The staging consists of incomplete thyroidectomy 3, questionable frozen biopsy 1, and huge follicular carcinoma. Conclusion: The incidence of completion thyroidectomy appear to be increasing by application of ultrasonogram in follow-up of thyroidectomized patients, especially, for the improving of well differentiated thyroid carcinoma. Experience suggests that the morbidity of completion thyroidectomy is low, so we recommend completion thyroidectomy as an efficient and safe method of surgical treatment.

• Korean Journal of Head & Neck Oncology
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• v.14 no.1
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• pp.70-75
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• 1998

Tumor growth and metastasis depends on angiogenesis. Vascular endothelial growth factor (VEGF) is a potent mitogen for vascular endothelial cells in vitro and promotes neoangiogenesis in vivo. Objective: Follicular thyroid cancers(FTC) are a vascular tumor and traditionally metastasize via blood vessels. Likely other cancers, angiogenesis may playa important role in FTC. We, therefore, investigated the expression of VEGF and microvascular density by immunohistochemistry in FTC and follicular adenoma(FA). Materials and Methods: Findings of immunohistochemical stainings for VEGF and CD31 were measured by grading scale from +1 to 4+(strongest) and by counting the stained microvessels in 14 FTCs and 14 FAs. Results: 1) Expression of VEGF. a) FTCs have stronger expression than FAs in areas of tumor adjacent to capsule($mean{\pm}SD\:\;3.2{\pm}0.9\;vs\;2.0{\pm}0.9$, p<0.01) and in central area($2.3{\pm}0.7\;vs\;1.3{\pm}0.6$, p<0.01). b) The VEGF expression of capsular area in FTCs are higher than that of central area(p<0.05). 2) Microvascular density by CD31. a) FTCs have more microvessels than FAs in areas of adjacent to capsule($78.9{\pm}27.3\;vs\;38.7{\pm}15.6$, p<0.01) and in central area($75.5{\pm}23.3\;vs\;27.8{\pm}10.7$, p<0.01). b) In FTCs, the number of microvessels of capsular area are more than that of central tumor area, but not significant statistically(p>0.05). Conclusion: The higher expression of VEGF and microvascular density in FTC suggests angiogenesis plays an important role in progression of FTC.

• Korean Journal of Head & Neck Oncology
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• v.21 no.1
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• pp.15-20
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• 2005

Objectives: The hepatocyte growth factor(HGF)/c-Met pathway may play various roles in the carcinogenesis of various organs. Although HGF/c-Met signalling pathway has been shown to demonstrate various cellular responses including mitogenic, proliferative, morphogenic and angiogenic activities, the study on their expression related to clinicopathological parameters in thyroid tumor is relatively rare. So we want to find out the clinical significance of the c-Met in thyroid tumor. Materials and Methods: We assess the mRNA and protein expression of the c-Met genes by means of RT-PCR method and the immunohistochemical stain in 100 cases of thyroid tumors(50 papillary carcinomas, 10 follicular carcinomas, 20 follicular adenomas, 20 nodular hyperplasia). Results: By RT-PCR, c-Met mRNA was detected in 43(86%) in papillary carcinoma, 4(40%) in follicular carcinoma, 4(20%) in follicular adenoma and 2(10%) in nodular hyperplasia cases. By immunohistochemistry, c-Met protein expression was detected in 44(88%), 2(20%), 3(15%) and 1(5%). Expression of the c-Met mRNA and protein expression was significantly highly recognized in papillary carcinoma. The c-Met protein overexpression was significantly correlated with the grade of the differentiation. Conclusion: These results suggest that c-Met expression may be associated with thyroid papillary cancer progression. The differential expression of c-Met protein and mRNA suggests that these molecules may be a reliable diagnostic marker in thyroid papillary cancer.

• Korean Journal of Head & Neck Oncology
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• v.13 no.1
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• pp.16-23
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• 1997

Although normal thyroid epithelial cells do not constitutively express HLA-DR antigen, their expression in wide spread within thyroid glands obtained from the human with autoimmune thyroid disease and with many neoplastic thyroids. We have, therefore, studied immunohistochemically with regard to the expression of HLA-DR antigen of thyroidectomy specimens from 50 patients of various thyroid diseases with use of paraffin-embedded tissue. One or two sections from each case were stained with commercially available mouse monoclonal antibody for class II HLA-DR antigen(HLA-DR/Alpha, DAKO) and examined by semiquantitative counting system for thyrocytes, neoplastic thyrocytes and other cells expressing HLA-DR antigen. All patients with lymphocytic thyroiditis(2/2) and diffuse hyperplasia(Graves' disease)(5/5), most patients with Hashimoto's disease(9/ll) expressed HLA-DR antigens in thyrocyte with abundant HLA-DR expressing lymphocytic infiltrates with lymph follicle formation in its vicinity or adjacent to the lesion. Most patients with papillary carcinoma(9/1l) had HLA-DR antigen detected in malignant thyrocytes ; while follicular carcinoma(0/3) and follicular adenoma(0/5) did not have detactable HLA-DR immunoreactivity. Adenomatous goiter(3/7) had HLA-DR antigen detected focally in lesser than half cases. Conversely, in four papillary carcinomas and three adenomatous goiters, HLA-DR expression of thyrocytes was found in the absence of HLA-DR expressing lymphoid infiltrates. In such cases therefore other factors more than thyroid autoimmunity must be causative for HLA-DR immunoreactivity. The results of this study indicate as follows. 1) The expression of HLA-DR on thyrocytes involved in autoimmune reactions appeared to be secondary to cytokine release from associated lymphocytic infiltrates. 2) Thyrocytes in thyroid lesions with equal degrees of lymphocytic infiltration without HLA­DR expression exhibited no HLA-DR immunoreactivity. 3) In neoplastic thyrocytes, most papillary carcinoma(9/11) exhibited detactable HLA-DR expression, while follicular carcinoma/adenoma(0/3/0/5) exhibited no detactable HLA-DR immunoreactivity which suggest the existence of divergent mechanisms inducing and modulating HLA-DR expression of different types of neoplastic thyrocytes.

• The Korean Journal of Cytopathology
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• v.6 no.2
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• pp.193-198
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• 1995

The increased use of thyroid fine needle aspiration(FNA) has re-focused on $H\"{u}rthle$ cell lesions. The cytologic diagnosis of $H\"{u}rthle$ cell tumor is a challenge due to the presence of $H\"{u}rthle$ cells in non-neoplastic lesions and the inability to differentiate between benign and malignant $H\"{u}rthle$ cell tumor. We report a case of $H\"{u}rthle$ cell adenoma(HCA) un a 68-year old woman, with review of the cytopathologic findings. FNA revealed loosely cohesive or sheets of large oval to polygonal $H\"{u}rthle$ cells containing abundant granular cytoplasm. The hustopathologic examination confirmed the diagnosis of HCA with follicular growth pattern. Ultrastructurally, the cytoplasm was packed with variable sized mitochondria.