• 대한두경부종양학회지
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• 제21권2호
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• pp.178-182
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• 2005

Insular carcinoma(poorly differentiated thyroid cancer) is defined as a aggressive, follicular-derived thyroid carcinoma with behavior intermediate between follicular/papillary and anaplastic carcinomas. It was described by Carcangiu in 1984, but its prognosis, classification and the origin is not yet clear. And preoperative fine needle aspiration cytology of insular carcinoma has not been satisfactory. We experienced a case of advanced thyroid insular carcinoma with invasion of the sternum. So we intend to present the case with a review of the related literatures.

• 대한두경부종양학회지
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• 제13권1호
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• pp.74-80
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• 1997

We have experienced 5 cases of unusual well differentiated thyroid carcinoma with insular component during the past 5 years. 4 cases were presented with cervical masses but I case (patient 2.) was initiallty with lung and brain metastasis. The tumors from 4 cases showed invasive growths but that of 1 cases(patient 1.) showed intrathyroidal. Total thyroidectomy and cervical lymphnode dissection(CCND or RND) was performed in 4 cases but only RND was performed in spite of mediastinal metastasis of the tumor in patient 5 under the patient's choice. During the follow-up period, we also performed radical nephrectomy and metastatectomy for the kidney and iliac bone metastasis respectively, in patint 2. Microcsopically, the tumors showed the insular growth patterns, focally(less than 50%) in 3 cases and predominantly(more than 75%) in 2 cases. And the insular componentas were combined with papillary carcinoma in 2 cases and follicular carcinoma in 3 cases. Cervical lymphnode metastases were confirmed in 4 cases. Patient 2 died of disease with metastases to lung, brain, bone and kidney, 52 months after initial therapy. Patient 1, 3 and 4 are alive and have no recurrence and distant metastasis. Patient 5 is also alive with the mediastinal metastasis. In our experience, the well differentiated thyroid carcinomas with insular component showed characteristic histologic features, aggressive behavior in initial presentation and unfavorable prognosis regardless of the percentage of the insular component.

• 대한세포병리학회지
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• 제14권1호
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• pp.17-21
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• 2003

Insular carcinoma of the thyroid(ICT) is an uncommon thyroglobulin-producing neoplasm, intermediate between well differentiated and anaplastic carcinoma. Only a few publications have addressed the fine needle aspiration cytologic(FNAC) findings from ICT. We experienced a case histologically diagnosed as ICT and with preoperative FNAC in a 52 - year - old woman. The FNAC displayed scanty colloid and abundant monomorphic follicular cells presented singly, in small loose aggregates, and in cohesive trabecular or acinar clusters. Intact insulae of tumor cells were also identified. Necrosis and mitosis were rare. Tumor cells showed round and monomorphic nuclei, finely granular chromatin, and inconspicuous nucleoli. When insular structure is identified in thyroid FNAC specimen, ICT should be included in the differential diagnosis. Herein we discuss and review the cytologic criteria for separation of ICT from other thyroid neoplasms.

• 대한세포병리학회지
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• 제5권1호
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• pp.35-40
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• 1994

저자들은 접할 기회가 흔치 않은 갑상선의 저분화암종인 일명 "도암종"의 세침흡인 세포검사 1예를 경험하고 조직학적으로 확인하였기에 문헌검색과 함께 보고하는 바이다. 흡인 도말된 세포들은 비교적 깨끗한 도말배경에 중등도 이상의 높은 세포밀도를 보였으며, 세포들은 개개로 흩어지는 양상과 판상의 군집을 이루는 양상이 어우러져 관찰되었다. 때로 세포들이 소포배열을 이루는 곳도 관찰되었다. 대부분의 종양세포들은 비교적 비슷한 크기와 모양을 나타내었으나 일부의 세포들은 현저한 다형성을 보였다. 일부의 세포에서 핵에 주름을 보였으나 소수에 불과하여 이는 어떤 갑상선병변에서나 관찰할 수 있는 비특이적 변화로 간주되었다. 세포의 겹침이 별로 없이 높은 세포밀도를 보이는 점, 세포가 개개로 흩어지는 양상과 소수 다형성이 현저한 세포의 혼재 등은 본 종양을 진단하는데 도움이 되는 소견으로 생각되며, 이러한 소견을 염두에 둠으로써 수술전 진단에 도움을 줄 수 있으리라 생각된다.

• 대한세포병리학회지
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• 제9권1호
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• pp.117-121
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• 1998

Cytologic features of a poorly differentiated "insular" carcinoma of the thyroid are presented. In fine needle aspiration cytology, the aspirates were highly cellular and tumor cells were arranged in loose cluster or singly dispersed on focally necrotic background. Occasional microfollicles were evident. The tumor cells had poorly defined, scanty cytoplasm and most of the nuclei were fairly uniform with coarse chromatin pattern. A few large pleomorphic cells were also noted. The cytologic findings of the present case were correlated well with the histologic findings, which showed typical insular pattern and the presence of uniform cells with occasional pleomorphism.

• 대한세포병리학회지
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• 제5권1호
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• pp.46-51
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• 1994

갑상선 미분화 "도암종"은 예후가 나쁘고 희귀한 종양으로 이 종양의 세침흡인 세포학적 소견에 관한 보고는 1990년 Pietribiasi에 의해 처음 기술된 이후 현재까지 8례가 있을 따름이다. 최근 저자들은 23세 여자의 좌측 경부의 갑상선 종괴로 부터 세침흡인 세포 검사를 시행하여 진단된 갑상선 도암종을 경험하여 그 세침흡인 세포학적 소견을 기술하는 바이다. 환자는 10년전부터 좌측 경부에 서서히 자라는 종괴를 호소하였으며 본 종괴에서 세침흡인 세포학적 검사를 시행하였다. 종괴의 세침흡인 도말은 세포밀도가 높았고 일정한 모양의 작고 둥근 세포들이 "도"구조 혹은 "지주" 구조를 보이며 간혹 개개로 산재되어 있는 세포 및 소포형태도 보였다. "도" 구조 및 "지주" 구조 내에는 미세한 소포형태가 관찰되었고 종양세포들의 핵은 자주 중첩되어 있었다. 갑상선 여포상 선종에서 보이는 성글게 배열된 소포구조도 드물게 관찰 되었다. 세포간의 크기나 모양은 거의 일정하였고 유사분열은 거의 관찰되지 않았다. 핵은 둥글고 뚜렷한 핵막과 미세하게 뭉친 염색질을 가지며 핵소체는 뚜렷하지 않았으며 드물게 젖빛 유리모양의 핵과 핵구가 관찰되었으나 유두상 구조는 관찰되지 않았다. 세포질의 경계는 불명확하였고 간혹 세포질내에 공포가 관찰되었다. 이상의 도암종의 세포학적 소견은 여포상 종양이나 유두상 종양들과는 구분되는 특징적인 소견이라 생각되며 세포학적 소견으로도 도암종의 진단이 가능하다고 생각된다.

• Journal of Korean Neurosurgical Society
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• 제29권10호
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• pp.1372-1376
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• 2000

The authors present two cases of lytic skull metastasis from thyroid carcinoma. The first case is a 62-year-old female who was diagnosed as thyroid cancer one year ago. She complained a mass over the right parietal area but showed no neurological abnormalities. The mass didn't invade the dura, and was completely removed. Histopathological examination revealed the insular thyroid carcinoma, composed of undifferenciated cells that were responded to thyroglobulin in immunohistochemical staining. The second case is a 75-year-old female who complained a mass over the right parietal and neck area without any neurological abnormality. The mass was confined to the epidural region which was associated with osteolytic change of skull. It was also completely removed. Histopathological examination of mass revealed the follicular thyroid carcinoma.

• Advances in pediatric surgery
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• 제6권2호
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• pp.95-99
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• 2000

Thyroid carcinoma is relatively rare in children. Eight cases of thyroid carcinoma were among 18 patients operated upon for thyroid tumors at Pediatric Surgery, Asan Medical Center in 11 years' period between 1989 and 2000. Five patients were boys and three were girls. The age distribution ranged from 10 to 14 years with a median age of 11.6 years. We studied clinical presentations, diagnostic workup, pathology, treatment, and follow-up (recurrence, mortality, and survival). All patients presented with anterior neck mass but one with multiple cervical lymph nodes enlargement. Familial history of thyroid cancer was seen in one case. All patients had a cold nodule by 1-131 thyroid scan. Fine needle aspiration (FNA) biopsy was performed in all patients. The right lobe was involved in four patients and the left lobe in two. Two had both lobes involvement. Pathologically, six cases were papillary carcinoma, one was follicular carcinoma, and one insular carcinoma. Four patients underwent unilateral lobectomy and isthmectomy. Total thyroidectomy was performed in three patients. The insular carcinoma case was preoperatively diagnosed as follicular neoplasm by FNA. After confirmation of the pathology by initial right thyroid lobectomy, total thyroidectomy was subsequently done. Cervical lymph node metastases were presented in three cases (37.5%), and lung metastasis in two cases (25%). Three patients received postoperative I-131 ablation. After a median follow-up of 53 months, all patients were alive without evidence of recurrence. In conclusion, thyroid carcinoma in children is frequently associated with lymph nodes involvement and distant metastasis, however, the prognosis is relatively good.