• Korean Journal of Head & Neck Oncology
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• v.14 no.2
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• pp.244-252
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• 1998

The thyroid nodules are the most common endocrine disease requiring surgical management. We perfomed a clinical study of 298 cases with thyroid nodules, who were admitted to and operated at the Department of Surgery, College of Medicine, Gyeong sang National University from January 1987 to April 1997 and the results were summarized as follows: 1) Patients were composed of 214 cases(71.8%) of benign nodule and 84 cases(28.2%) of malignant nodule. Benign and malignant nodules were prevalent in fifth decade. 2) The sex distribution showed a preponderance of females with ratio of 5.88:1 in benign nodule and 11:1 in malignant nodule. 3) The nodules were located in the right lobe(134 cases, 44.9%), the left lobe(121 cases, 40.6%), both lobes(34 cases, 11.4%), and isthmus(8 cases, 2.7%). The possibility of malignancy was higher in the solid rather than cystic lesions. 4) Radioactive iodine scintiscans were perfomed in 273 cases and revealed cold nodules in 237 cases(86.8%), 58 of these cases(24.4%) were malignant. 5) According to the histopathologic classification, benign nodules included follicular adenomas 136 cases(63.5%), adenomatous goiters 67 cases(31.3%), Hurthle cell adenomas 4 cases(1.9%), cysts 3 cases(1.4%) and thyroiditis 4 cases(1.4%). In malignant nodules, papillary carcinomas 72 cases(85.7%), follicular carcinoma 8 cases(9.5%), undifferentiated carcinoma 2 cases(2.4%), medullary carcinoma 1 case(1.2%) and malignant lymphoma 1 case(1.2%). 6) The most commonly performed operative procedure was a lobectomy with isthmusectomy(85.5%) for bengn nodules and a total thyroidectomy(51.2%) for malignant nodules. 7) The rate of complications was higher in the cases with malignant nodules(20.2%) than in the benign cases(0.5%). The recurrence rate was 8.3%(7 cases).

• The Journal of the Korea Contents Association
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• v.13 no.5
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• pp.303-310
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• 2013

Thyroid nodular disease is the most frequently appeared in thyroid disease. Thyroid ultrasonography offers location of nodules, size, the number, information of internal echo characteristic. Thus, it makes possible to sort high-risk nodule containing high possibility about thyroid cancer and to induct precisely when take a Fine Needle Biopsy Aspiration. On thyroid nodule, the case which is diagnosed as malignant is less than 5% but screening test is very important on ultrasound and also must be reduced unnecessary procedure. Therefore, in this study an approach for describing a region is to quantity its texture content. We applied TFA algorithm on case which has been pathologically diagnosed as papillary thyroid cancer. we obtained experiment image which set the ROI on ultrasound and cut the $50{\times}50$ pixel size, histogram equalization. Consequently, Disease recognition detection efficiency of GLavg, SKEW, UN, ENT parameter were high as 91~100%. It is suggestion about possibility on CAD which distinguishes thyroid nodule. In addition, it will be helpful to differential diagnosis of thyroid nodule. If the study on additional parameter algorithm is continuously progressed from now on, it is able to arrange practical base on CAD and it is possible to apply various disease in the thyroid US.

• Korean Journal of Head & Neck Oncology
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• v.34 no.1
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• pp.33-36
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• 2018

Hyalinizing trabecular tumor (HTT) of the thyroid gland is a rare neoplasm and only less than 100 cases have been reported so far. It is characterized by hyalinizing stroma with trabecular growth pattern and has an indolent clinical course. Because of its histologic features, it is frequently misdiagnosed as papillary or medullary carcinoma in fine needle aspiration cytologic findings. The tumor is benign or low malignant potential and thyroid lobectomy is recommended for adequate treatment. We recently experienced a case of thyroidal HTT in a 57-year-old man, who presented with a right thyroid nodule that was suspicious of papillary carcinoma in aspiration cytology. We report the unique and rare disease entity with brief literature review.

• Journal of the Korean Society of Radiology
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• v.83 no.3
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• pp.645-657
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• 2022

Purpose To evaluate and compare the diagnostic outcomes of ultrasonography (US)-guided fine needle aspiration (FNA) and core needle biopsy (CNB) performed on the same thyroid nodule using a surgical specimen for direct comparison. Materials and Methods We included 89 thyroid nodules from 88 patients from February 2015 to January 2016. The inclusion criterion was thyroid nodules measuring ≥ 20 mm (mean size: 40.0 ± 15.3 mm). Immediately after surgical resection, FNA and subsequent CNB were performed on the surgical specimen under US guidance. FNA and CNB cytopathologic results on the specimen were compared with the surgical diagnosis. Results Among the 89 nodules, 30 were malignant and 59 were benign. Significantly higher inconclusive rates were seen in FNA for malignant than benign nodules (80.0% vs. 39.0%, p < 0.001). For CNB, conclusive and inconclusive rates did not differ between benign and malignant nodules (p = 0.796). Higher inconclusive rates were seen for FNA among cancers regardless of US features, and in the subgroup of size ≥ 40 mm (62.5% vs. 22.9%, p = 0.028). Eleven cancers were diagnosed with CNB (36.7%, 11/30), while none was diagnosed using FNA. Conclusion In this experimental study using surgical specimens, CNB showed a potential to provide improved diagnostic sensitivity for thyroid cancer, especially when a conclusive diagnosis is limited with FNA.

• 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.23 no.1
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• pp.54-57
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• 2007

Fine needle aspiration biopsy(FNAB) has been used for many decades in the diagnosis of benign and malignant tumors of thyroid gland. Complications of thyroid fine-needle aspiration biopsy(FNAB) are extremely rare. Hematoma formation is the most commonly encountered complication. However, massive intrathyroid unilateral hemorrhage and hematoma formation inducing upper airway distress rarely occurs. Here, we report two cases diagnosed as having hematoma that caused upper airway distress after FNAB for thyroid nodule.

• Korean Journal of Bronchoesophagology
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• v.2 no.1
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• pp.111-119
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• 1996

The medical records of 87 patients with thyroid nodule treated from May 1992 to February 1996 were retrospectively reviewed to assess complication with age, sex, pathologic classification, location of lesions, and surgical procedures. The overall rate of complication were observed 10(11.5%) in thyroid surgery. The most common complication was transient hypoparathyroidism, which occurred in 6(6.9%) of 87 patients. The 2(2.3%) patients experienced Permanent hypoparathyroidism and each 1(1.1%) patient was reported in transient recurrent laryngeal nerve paralysis and hematoma.. Well-performed thyroid surgery usually produces few complications. More extensive resections, involving bilateral thyroidectomy are associated with a higher incidence of postoperative morbidity, in particular vocal cord paralysis and hypoparathyroidism, than procedures that consist essentially of unilateral thyroidectomy. Our experience suggests that the postoperative complication relates primarily to the surgical procedure. The low incidence of permanent complications in thyroid surgery suggests the feasibility of total thyroidectomy as the operation of choice when thyroid nodules were malignant and surgeons are familiar with the technique and indications.

• Korean Journal of Head & Neck Oncology
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• v.27 no.2
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• pp.198-203
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• 2011

Background and Objectives : Distinguishing benign from malignant lesion in thyroid noddex is important but clinically difficult. FNAB is the first investigation of choice. However, cytologic results are often indeterminable. In those cases, additional molecular biologic tests are helpful. If serologic tests are available to predict malignancy, it can be useful to fortify accurate diagnosis. We analyzed whether TSH or FreeT4 level could be used as a predictor of malignancy. Materials and Methods : From January 2008 to March 2009, 540 patients received one of thyroidectomy in a single center. We only included 167 patients from 18 to 65 years old without cardiopulmonary or renal disorders. All the patients were in euthyroid state and took no medications, which affect the thyroid function. We reviewed charts retrospectively to find out differences in TSH level and FreeT4 level between the benign and malignant groups. Results : In this study, all the patients with malignancy had the papillary cancer. In benign group, average TSH level came out to be 1.48mU/L, whereas the average TSH level of malignant group was 1.98 mU/L. Moreover, the higher the cancer stage was, the higher the TSH level was. Although we have adjusted factors that can affect TSH level(age, sex, race, goiter type), we still received the same result. The risk of malignant cancer increased in proportion with TSH level within the normal range. In free T4 level, there was no difference between benign and malignant group. Conclusion : We propose that TSH level can play a role as one of the predictors for thyroid cancer. However, there is limitation because all the patients with malignancy in this study have papillary cancer. Thus, we can apply this result only in papillary cancer, and we need more study for other types of thyroid cancer.

• Journal of Yeungnam Medical Science
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• v.28 no.2
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• pp.206-210
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• 2011

The occurrence of a mixed tumor containing papillary thyroid carcinoma (PTC) and primary squamous-cell carcinoma (SCC) is rare because there is no squamous epithelium in the thyroid gland. Reported herein is a 30-year-old female with mixed PTC and primary sec of the thyroid presented as thyroid incidentaloma. Fine-needle aspiration biopsy of the thyroid nodule revealed the presence of malignant thyroid cells. The histopathological examination following total thyroidectomy yielded two mixed, morphologically distinct histotypes that included PTC and sec. After total thyroidectomy, the patient underwent radioactive iodine therapy. No recurrence or metastasis occurred during the 20-month follow-up period after the operation.

• Journal of Korea Multimedia Society
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• v.20 no.1
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• pp.43-50
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• 2017

According to living environment, the number of deaths due to thyroid diseases increased. In this paper, we proposed an algorithm for recognizing a thyroid detection using texture analysis based on shape, gray level co-occurrence matrix and gray level run length matrix. First of all, we segmented the region of interest (ROI) using active contour model algorithm. Then, we applied a total of 18 features (5 first order descriptors, 10 Gray level co-occurrence matrix features(GLCM), 2 Gray level run length matrix features and shape feature) to each thyroid region of interest. The extracted features are used as statistical analysis. Our results show that first order statistics (Skewness, Entropy, Energy, Smoothness), GLCM (Correlation, Contrast, Energy, Entropy, Difference variance, Difference Entropy, Homogeneity, Maximum Probability, Sum average, Sum entropy), GLRLM features and shape feature helped to distinguish thyroid benign and malignant. This algorithm will be helpful to diagnose of thyroid nodule on ultrasound images.