• 대한두경부종양학회지
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• 제13권2호
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• pp.265-268
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• 1997

Malignant lymphoma is the tumor of immune system which is known as the most common nonepitheloid tumor of head and neck region. It is mainly found in the cervical, axillary and inguinal lymph node, but gastrointestinal tract, palatine tonsil, nasopharynx, oropharynx, nasal cavity and salivary glands may be involved. Primary lymphoma of the thyroid gland is an uncommon condition, comprising approximately 2% of all malignant lymphoma and 5% of all thyroid malignant neoplasms. Recently, we experienced a case of malignant lymphoma of the thyroid gland, which was histopathologically proven. So we report our findings in this patient with review of literatures.

• 대한핵의학회지
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• 제17권1호
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• pp.25-31
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• 1983

Serum thyroglobulin(Tg) was measured by radioimmunoassay in 81 patients with thyroid tumor who were treated in the department of Internal medicine of National Medical Center from January, 1981 to June, 1982. The results were as follows: 1) The mean serum thyroglobulin level in thyroid tumor was significantly higher than normal subjects (p<0.001). 2) The mean serum thyroglobulin level in benign tumor was lower than malignant tumor (p<0.05). 3) The thyroid carcinoma with metastasis had significant high level of serum thyroglobulin than without metastasis (p<0.001). 4) The mean postoperative serum thyroglobulin level was significantly lower than preoperative level (p<0.001). Data from our study show that serum thyroglobulin determination is useful for assessing the presence of malignant thyroid tumor, metastasis and the extent of residual or recurrent thyroid cancer after surgery.

• 대한두경부종양학회지
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• 제14권2호
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• pp.253-259
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• 1998

The increasing risk of subsequent malignancy after treatment of malignant lymphoma is well known, which is mainly due to longer survival of these patients. Radiotherapy at an early stage of Hodgkin's disease or non-Hodgkin's lymphoma is accepted to be associated with future occurrence of secondary thyroid cancer. Nevertheless, the synchronous presentation of these malignancies is extremely rare. Well differentiated thyroid cancer, a slow-growing tumor that responds to therapy with surgery and radioactive iodine, is associated with prolonged survival. therefore, it is important to make this diagnosis in patients who show evidence of malignant lymphoma. Furthermore, appropriate treatment must be considered for thyroid cancer to improve the prognosis of these patients. We herein reported 4 cases of synchronous thyroid cancer and malignant lymphoma in patients who had not previously recieved radiotherapy or chemotherapy.

• Korean Journal of Radiology
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• 제21권5호
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• pp.605-613
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• 2020

Objective: To determine the malignancy risk of isolated macrocalcifications (a calcified nodule with complete posterior acoustic shadowing) detected on ultrasonography (US) and to evaluate the postoperative American Thyroid Association (ATA) risk stratification of malignant tumors manifesting as isolated macrocalcifications. Materials and Methods: A total of 3852 thyroid nodules (≥ 1 cm) of 3061 consecutive patients who had undergone biopsy between January 2011 and June 2018 were included in this study. We assessed the prevalence, malignancy rate, and size distribution of isolated macrocalcifications and evaluated the histopathologic features and postoperative ATA risk stratification of malignant tumors manifesting as isolated macrocalcifications. Results: Isolated macrocalcifications were found in 38 (1.2%) of the 3061 patients. Final diagnosis was established in 30 (78.9%) nodules; seven malignant tumors were diagnosed as papillary thyroid carcinomas (PTCs). The malignancy rate of the isolated macrocalcifications was 23.3% in the 30 nodules with final diagnoses and 18.4% in all nodules. Among the six surgically-treated malignant tumors, five (83.3%) had an extrathyroidal extension (ETE) (minor ETE 1, gross ETE 4), and two (33.3%) had macroscopic lymph node metastasis. Four (66.7%) malignant tumors were categorized as high-risk tumors, one as an intermediate-risk tumor, and one as a low-risk tumor using the ATA risk stratification. Histopathologically, out of the six malignant tumors, ossifications were noted in four (66.7%) and predominant calcifications in two (33.3%). Conclusion: The US pattern of isolated macrocalcifications (≥ 1 cm) showed an intermediate malignancy risk (at least 18.4%). All malignant tumors were PTCs, and most showed an aggressive behavior and a high or intermediate postoperative ATA risk.

• Molecules and Cells
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• 제42권2호
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• pp.113-122
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• 2019

Communications at the interface between the apical membrane of follicular cells and the follicular lumen are critical for the homeostasis of thyroid gland. Primary cilia at the apical membrane of thyroid follicular cells may sense follicular luminal environment and regulate follicular homeostasis, although their role in vivo remains to be determined. Here, mice devoid of primary cilia were generated by thyroid follicular epithelial cell-specific deletion of the gene encoding intraflagellar transport protein 88 (Ift88). Thyroid follicular cellspecific Ift88-deficient mice showed normal folliculogenesis and hormonogenesis; however, those older than 7 weeks showed irregularly dilated and destroyed follicles in the thyroid gland. With increasing age, follicular cells with malignant properties showing the characteristic nuclear features of human thyroid carcinomas formed papillary and solid proliferative nodules from degenerated thyroid follicles. Furthermore, malignant tumor cells manifested as tumor emboli in thyroid vessels. These findings suggest that loss-of-function of Ift88/primary cilia results in malignant transformation from degenerated thyroid follicles.

• 대한두경부종양학회지
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• 제10권2호
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• pp.91-101
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• 1994

Nodular thyroid disease is a common clinical problem. The problem in clinical practice is to distinguish malignant or potentially malignant tumor from harmless nodules. The cases of thyroid nodule surgically managed at Department of General Surgery, Soon Chun Hyang Univ. Hospital during the period Jan. 1985 to July. 1992 were reviewed retrospectively. To assess method of distinguishing malignant from benign lesions of the thyroid gland, we reviewed 162 patients with thyroid nodule. There were 61(37.7%) malignant nodules and 101(62.3%) benign nodules. According to the review, distinguishing the benign from the malignant nodule with history, physical examination, clinical manifestation, and duration of illness was not suggested sufficiently. In ultrasonogram of 73 cases, 57.5% of nodules were solid, 20.6% were cystic, 21.9% were mixed solid and cystic. Of these, 28.5% of the operated solid lesions, 12.5% of the mixed lesions, and only 6.7% of the cystic lesions were malignant. Thyroid scanning of 82 cases revealed cold nodules in 60 patients(73.2%), of which 26 cases were malignant(36.6%) 137 patients underwent fine needle aspiration cytology(FNAC), and these results were as follow: sensitiviey was 70.6%, specificity was 93.0%, false-positive rate was 14.3%, and false-negative rate was 15.8%. 41 patients underwent frozen biopsy, and the results as follow: sensitivity was 80.0%, specificity was 89.7%. Neither scintigraphy nor ultrasonogram has sufficient specificity to distinguish benign from malignant nodule. But FNAC and frozen biopsy have sufficient accuracy to differentiate benign from malignant nodule. In the benign nodules, the most common type of operation was total lobectomy (60.4%). Of the malignant nodules, total thyroidectomy with or without modified radical neck dissection was performed in 30 cases(49.2%). We conclude that the single technique used to determine the differential diagnosis of a thyroid nodule are unrealiable. It is therefore essential to combine all avaiable clinical and laboratory information.

• 대한두경부종양학회지
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• 제15권2호
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• pp.156-161
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• 1999

Objectives: The epidermal growth factor receptor(EGFR) family has been increasingly recognized as an important component in the control of normal cell proliferation and the pathogenesis of cancer. To confirm the usefulness of epidermal growth factor receptor as a tumor marker, we initiated this study. Materials and Methods: EGFR was measured by immunohistochemical staining using EGFR antibody. It was performed on section from paraffin blocks of 65 thyroid tissue including 33 paillary carcinoma, 11 follicular carcinoma, 11 nodular hyperplasia, 5 follicular adenoma and 5 normal thyroid tissue. We evaluated morphologic characteristic of various thyroid neoplasms, and the relationship between EGFR and other prognostic factors in papillary thyroid carcinomas. Results: The expression of EGFR was commonly found in neoplasms of thyroid, with trend for stronger staining in the more malignant tumor(p=0.000). Also the expression of EGFR in papillary thyroid cancer related to tumor characters including tumor size(p=0.042), extent(p=0.024) and prognostic features including AMES scores(p=0.019). The strong EGFR staining in papillary carcinoma was significantly associated with tumor recurrence(p=0.003). Conclusions: EGFR may have a role in the regulation of normal and neoplastic thyroid cell growth. EGFR status may help predict the clinical course of patients with malignant thyroid neoplasms. However, the study of more cases will be needed for significance of the information about the EGFR as an independent prognostic factor.

• 대한두경부종양학회지
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• 제33권2호
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• pp.59-62
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• 2017

Solitary fibrous tumor (SFT) is an uncommon spindle cell neoplasm that is usually presented as a pleural origin localized tumor. There are few cases, found in thyroid. Twenty six cases found in thyroid have been reported since 1993, and two of these were malignant. We report another malignant case in this study; a 55 years old man visited out-patient clinic due to palpable mass of anterior neck, and pathologically diagnosed as malignant SFT of thyroid after surgical resection. In this study, we focus on the clinical features of this uncommon disease along with other literature reviews.

• 대한두경부종양학회지
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• 제14권2호
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• pp.199-205
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• 1998

Objective: Telomerase, a specialized ribonucleoprotein polymerase associated with cellular immortality, is expressed by most malignant cells and is inactive in most normal somatic cells. The assays of telomerase activity in various tumors have provided both diagnostic and prognostic information. This study was carried out to determine whether telomerase activity could be useful in distinguishing benign and malignant thyroid diseasees. Materials & Methods: Telomerase activity was determined using Oncor $TRAP_{EZE}^{TM}ELISA$ Telomerase Detection Kit for performing PCR-based telomeric repeat amplification protocol (TRAP) assay followed by ELISA detection in both normal and tumor tissues of 23 adenomatous hyperplasias, 12 follicular adenomas, 4 follicular carcinomas, 16 papillary carcinomas, 4 Hashimoto's thyroiditises and 3 malignant lymphomas. We also examined all cases microscopically to review the status of lymphoid infiltrate. Results: Of the 62 cases, extensive lymphoid infiltrates were contained in 20 tumor tissues(4 Hashimoto's thyroiditises, 3 malignant lymphomas, 6 adenomatous hyperplasias and 7 papillary carcinomas), all of which showed positive telomerase activity. All the normal tissues without lymphoid infiltrates(n=43) did not express telomerase activity. Of 42 tumor tissues without lymphoid infiltrates, 37(88.0%) showed positive telomerase activity: 13 of 17 adenomatous hyperplasias(76.5%), 11 of 12 follicular adenomas(91.7%), 4 of 4 follicular carcinomas(100.0%) and 9 of 9 papillary carcinomas(100.0%). Conclusions: Our methods showed high sensitivity in the detection of telomerase activity and the exclusion of lymphoid infiltrates may be important in telomerase assay. In our work, the measurement of telomerase activity was not useful in distinguishing benign and malignant thyroid diseases.

• 대한세포병리학회지
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• 제9권2호
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• pp.169-180
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• 1998

Fine needle aspiration cytology(FNAC) has been used effectively as the initial modality in evaluating various thyroid lesions. We correlated cytologic and histopathologic features to investigate the diagnostic pitfalls of FNAC of the thyroid. A total of 1,593 FNACs of the thyroid were diagnosed at the Department of Pathology, Hanyang University Hospital, from January 1993 to December 1997 There were 963 cytologically benign cases(60.5%), 97 suspicious cases(6.1%), and 75 malignant cases(4.71%). The remaining 458 cases(28.8%) were unsatisfactory. Subsequent surgical resection was done in 192 cases. Seventy-two cases(37.5%) were cytologically diagnosed as benign, 45 cases(23.4%) suspicious, 56 cases(29.2%) malignant, and 19 cases(9.9%) unsatisfactory. Histopathologically, 101 cases were benign(11 thyroidites, 52 adenomatous hyperplasias, 34 follicular adenomas, and four Hurthle cell adenomas), and 91 cases malignant(72 papillary carcinomas, 16 follicular carcinomas, one medullary carcinoma, one anaplastic carcinoma, and one granular cell tumor). After excluding 19 unsatisfactory cases, 63 were misdiagnosed. They included 17 benign(three thyroidites and 14 adenomatous hyperplasias), 27 suspicious(10 follicular adenomas, four Hurthle cell adenomas, and seven follicular carcinomas), and 19 malignant(16 papillary carcinoma, one medullary carcinoma, one anaplastic carcinoma. and one granular cell tumor) lesions. The accuracy rates in the benign, suspicious, and malignant categories were 54.9%, 49.8%, & 92.8%, respectively. The cytological pitfalls were as follows: (1) background, (2) crowded follicular cell clusters indistinguishable between follicular neoplasia and adenomatous hyperplasia, (3) papillary structure, irregular nuclear membrane and pleomorphism mimicking those of papillary carcinoma, (4) indistinct eosinophilia in follicular epithelial cells, (5) unusual cellular components not commonly seen in FNACS of the thyroid.