• The Korean Journal of Cytopathology
• /
• v.16 no.1
• /
• pp.1-9
• /
• 2005

• Korean Journal of Head & Neck Oncology
• /
• v.16 no.2
• /
• pp.161-166
• /
• 2000

Objective: The nm23 gene has been identified as a potential metastasis suppressor gene in various human neoplasms. Both Bcl-2, which promotes cell survival, and Bax, which promotes cell death, have been considered as major factors in controlling the apoptotic pathway. This study was carried out to determine whether these markers are useful in distinguishing potential intrinsic differences in tumor virulence of papillary thyroid cancers. Material and Method: The expressions of nm23, Bcl-2 and Bax have been evaluated using immunohistochemical techniques in 100 pure papillary thyroid cancers and 20 metastatic lymphnodes. The intensity of immnunoreactivity was graded on arbitrary four point scale(grade 0 or 1 : negative reactivity, grade 2 or 3 positive reactivity). The immunoreactivities were analyzed in relation to TNM atage, AMES score, local recurrence and distant metastasis, and that of metastatic LNs was compared with the tumors. Results: The expression of Bcl-2 and bax did not show any statistical differences by TNM stage, AMES score, recurrence, distant metastasis and also between the tumor and metastatic LN. However, the nm23 showed higher expression of Ki67 in distant metastasis than in control group and in metastatic LNs than in the tumors(p<0.05). Conclusion: Although the expression of Bcl-2 and Bax protein showed no correlation with clinical parameters representing tumor virulence, the nm23 expression could be an useful prognostic factor, especially in predicting nodal or distant metastasis in papillary thyroid cancer.

• 대한세포병리학회:학술대회논문집
• /
• 1992.06a
• /
• pp.27.1-27.1
• /
• 1992

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

• The Korean Journal of Nuclear Medicine
• /
• v.32 no.1
• /
• pp.109-113
• /
• 1998

We report a 37 year-old-female patient with papillary thyroid cancer treated by surgery who demonstrated residual thyroid and bilateral breast uptake on a diagnostic I-131 whole body scan. She had an extrathyroidal extension needing I-131 ablative therapy. Her galactorrhea was investigated and treated with low doses of bromocriptine prior to I-131 therapy. Her galactorrhea was due to the decreased secretion of PIF induced by empty sella.

• The Korean Journal of Cytopathology
• /
• v.19 no.2
• /
• pp.144-151
• /
• 2008

Fine needle aspiration (FNA) cytology is the decisive test in the pre-operative diagnostics of thyroid nodules. Here we share our institutional experience about thyroid aspiration and give suggestions for suspicious cytology results. Three hundred twenty-two cases in 270 patients (mean age 47.4 years, 243 women and 27 men) who underwent thyroidectomy were reviewed. Among the 322 cases, the FNA diagnosis of "positive for malignancy" was 87 cases (27.0%), "suggestive of malignancy" 30 cases (9.3%), "suspicious for malignancy" 61 cases (18.9%), "negative for malignancy" 102 cases (31.7%), and "unsatisfactory smear" 42 cases (13.0%). Eighty seven cases (100%) out of "positive for malignancy", 29 cases (96.7%) out of "suggestive of malignancy", and 39 cases (64.0%) out of "suspicious for malignancy" were papillary carcinoma (148 cases, 95.5%), or follicular carcinoma (2 cases, 1.3%), or metastatic carcinoma (1 case, 0.6%). Seventeen patients who had only negative or unsatisfactory cytology underwent thyroidectomy and nine cases (52.9%) were papillary carcinoma. We suggest that: the cytology diagnosis of "suggestive of malignancy" could be regarded as "positive for malignancy", the cytology diagnosis of "suspicious of malignancy" should be carefully correlated with clinico-radiologic manifestation, and even a negative or unsatisfactory smear should be carefully followed up.

• Korean Journal of Head & Neck Oncology
• /
• v.31 no.2
• /
• pp.11-15
• /
• 2015

Background and Objectives: This study aimed to analyze the features of patients with papillary thyroid carcinoma (PTC) recurred as distant metastases (DM). Materials and Method: We retrospectively reviewed and analyzed clinical records of 63 patients who were treated for PTC recurred as DM between 2000 and 2006. Univariate and multivariate analyses of various clinical factors were performed. Results: Male patients were 12, and female patients were 51. The 5- and 10-year survival rates for PTC recurred as DM were 85% and 73%, respectively. Size of tumor, multiplicity of tumor, lateral neck node metastasis, and RAI ablation therapy with other treatments such as surgery were associated with survival rate (p < 0.005) in univariate analysis. The lateral neck node metastasis[p =0.039, hazard ratio=2.2(95% CI. 1.18~3.24)] and multiple organ DM[p =0.041, hazard ratio=2.18(95% CI. 1.03~2.89)] were related to the survival in multivariate analysis. Conclusion: PTC recurred as DM is uncommon (2.2%). The size of tumor, the multiplicity of tumor, lateral neck node metastasis and RAI ablation therapy with other treatments for DM were revealed as associated factors for the survival. Evaluation of DM should be considered in patients with PTC during long-term follow-up.

• Journal of Yeungnam Medical Science
• /
• v.37 no.3
• /
• pp.202-209
• /
• 2020

Background: Prophylactic central neck dissection (CND) in clinically node-negative (cN0) papillary thyroid carcinoma (PTC) remains controversial. The purpose of this study was to evaluate the benefits of prophylactic ipsilateral CND compared with bilateral CND in total thyroidectomy for cN0 unilateral PTC. Methods: We retrospectively enrolled 174 patients who underwent total thyroidectomies with prophylactic CND for cN0 unilateral PTC between January 2009 and May 2010. The prophylactic CND patients were divided into group 1, the ipsilateral CND group (n=74), and group 2, the bilateral CND group (n=100). The incidence of central lymph node metastasis (CLNM) and postoperative complications, such as hypoparathyroidism, recurrent laryngeal nerve injury, and recurrence were assessed. Results: CLNM was found in 22 (29.8%) in group 1 and 69 (69%) in group 2. The incidence of postoperative severe hypocalcemia less than 7.0 was also significantly different (six patients [8.1%] in group 1 and 23 [23%] in group 2; p=0.009). Permanent hypoparathyroidism was significantly more frequent in group 2 (4.1% vs. 19%; p=0.005). However, the incidence of transient hypoparathyroidism, recurrence, and recurrent laryngeal nerve injury was not significantly different. Conclusion: Prophylactic ipsilateral CND has advantage not only to reduce incidence of some complications but also to have similar recurrence rate compared with bilateral CND. We suggest that prophylactic ipsilateral CND may be safe and effective for selected patients undergoing total thyroidectomy for cN0 unilateral PTC.

• Korean Journal of Head & Neck Oncology
• /
• v.37 no.1
• /
• pp.47-51
• /
• 2021

Papillary thyroid carcinoma (PTC) typically has a good prognosis, but it frequently metastasizes to the regional lymph nodes. Although survival impact of lymph node metastasis is not clear, complementary treatment is generally added after surgery when lymphatic metastasis exists. Several previous studies have reported that the multifocal PTC is associated with poor prognosis and requires selective neck dissection to prevent regional lymph node metastasis, but they are under controversy. In this study, we present a 24-year-old female patient, diagnosed as PTC with intrathyroidal spread and regional lymph node metastases. Intrathyroidal spread of PTC can only be observed microscopically and is believed to have the similar origin of unicentric multifocal PTC. As multifocal PTC is highly associated with regional lymph node metastasis and requires an additional treatment, PTC with intrathyroidal spread may follow a similar clinical course and treatment plan. Here we report the case with a brief literature review and expect its attribution to further academic interest of treatment choice.

• The Korean Journal of Cytopathology
• /
• v.2 no.2
• /
• pp.119-126
• /
• 1991

A 33-year-old woman who was diagnosed as medullary carcinoma by fine needle aspiration of thyroid mass is presented. The smear revealed dispersed pattern and small clusters of cells without follicular or papillary structures. The nuclei were round, oval or spindle shaped and eccentrically located. The cytoplasm was abundant and showed red-stained cytoplasmic granulation and tail-like projection with indistinct border. Clumps of amorphous, light-green material were intermingled with tumor cells.