• 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.22 no.2
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• pp.137-141
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• 2006

Purpose : It has been generally accepted that lobectomy is a standard surgical procedure in treatment of benign thyroid nodules. However lobectomy may cause postoperative hypothyroidism. Most of surgeons believe that nodulectomy has its limitation in treatment of thyroid nodules due to recurrence of nodules and presence of cancer. The current study attempts to determine whether nodulectomy is justified in aspects of preservation of thyroid function, risk of recurrence and complications. Methods: Data was collected retrospectively on 74 patients undergoing thyroidectomy(single nodulectomy, n=43;bilateral nodulectomies, n=9;lobectomy with nodulectomy, n=22) for benign thyroid nodules from 1999 to 2004. All patients were evaluated for complication, postoperative thyroid function, and recurrence of benign nodule and cancer were followed by regular ultrasonographic examination for 2-6 years. Results : The pathologic results of 74 patients were nodular hyperplasia(55 patients), Hashimoto's thyroiditis(8 patients), follicular adenoma(7 patients) and papillary carcinoma(4 patients). Average operation time was 30 minutes from skin incision to specimen out. In postoperative follow-up of 70 patients, six cases(8.5%) became mild hypothyroid, and ultrasonographically detected micronodule was also six cases(8.5%). There were no other complications. Conclusion : Thyroid nodulectomy appears to have advantages of relatively few complication and simple procedure with no access to laryngeal nerves. Therefore, it may be one of treatment options in selected cases of benign thyroid nodules.

• Advances in pediatric surgery
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• v.6 no.2
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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.

• Journal of the Korean Society of Radiology
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• v.84 no.5
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• pp.1017-1030
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• 2023

Radiofrequency ablation (RFA) is a non-surgical treatment for symptomatic, benign thyroid nodules. This treatment works by heating and destroying the nodule tissue, which results in reduction of its size and alleviation of the symptoms involved. RFA is indicated for nodules which are confirmed to be benign on two or more cytological or histological examinations, and which result in clinical symptoms requiring medical treatment. It is associated with good short-term outcomes on one-year follow-up; however, 20%-30% of the nodules regrow after more than three years. Therefore, on the basis of long-term follow-up, management of regrowth is key to patient care following RFA. Regrowth is more likely to occur in nodules that are large in size prior to RFA, and in those with high or increased vascularity. Recently, new techniques such as hydrodissection, artery-first ablation, and venous ablation have been introduced to inhibit regrowth. In addition, appropriate criteria for additional RFA should be applied to manage regrowth and prolong its therapeutic effects. RFA is essentially an alternative to surgery; therefore, the ultimate goal of this procedure is to avoid surgery permanently, rather than to achieve temporary effects.

• Journal of radiological science and technology
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• v.38 no.2
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• pp.145-153
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• 2015

Thyroid nodules are an endocrine disease often found in clinical practice, and patients with thyroid nodules found by chance have rapidly increased alongside development of thyroid ultrasound techniques for health examination purposes. This study analyzes the subjects' general characteristics, thyroid ultrasounds, and fine needle aspiration cytology in order to find out the relationship between male and female thyroid nodules and thyroid cancer frequency. An ultrasound examination of the thyroid was performed for 32,973 individuals who visited the K Hospital of Health Examination. Subjects have no history of thyroid disease and are 20 years old or over. Data of general characteristics, diabetes) was collected by a written survey completed by the subject, and the ultrasound of the thyroid(thyroid nodules existence, size, number) and FNAC was used to find out the malignancy rate. Frequency of patients with thyroid nodule was 4,611(26.1%) in men and 5,341(34.9%) in women between 32,973 individuals. Women's prevalence rate is significantly higher than men, and the prevalence rate significantly increased with age in men and women(p < 0.05). The prevalence of multiple nodules was significantly higher in women(43.5%) than in men(35.6%), and significantly increased with age in men and women(p < 0.05). The fine needle aspiration cytology was performed in 692(men 342, women 350) subjects who showed signs of malignancy through ultrasound. Prevalence of malignancy of the nodules was higher in men(33.3%) than in women(29.4%) although it is not statistically significant. It is known that thyroid nodule prevalence in women is much higher than in men. But this study shows the men's prevalence rate was not too low compared with women, and the men showed a rather higher malignancy rate in nodules than women. It is considered that the role of thyroid ultrasound is both important in men and women.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.1135-1138
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• 2015

Background: The objective of this study was to investigate the MSCT characteristics of PTL in order to enhance the awareness of this uncommon entity among both clinicians and radiologists. Materials and Methods: The clinicopathological data and MSCT images of 27 patients with PTL were retrospectively reviewed. The MSCT appearances were classified into three types: type 1, solitary nodule surrounded by normal thyroid tissue; type 2, multiple nodules in the thyroid, and type 3, enlarged thyroid glands with a reduced attenuation with or without peripheral thin hyperattenuating thyroid tissue. Results: The patients were enrolled in the study with a mean age of 68 years (range, 51-86years) and compression symptoms or enlarged cervical lymph nodes at diagnosis. Hashimoto's thyroiditis was in 20 patients. All patients had non-Hodgkin lymphoma of B-cell in origin, including 22 cases of diffuse large B-cell lymphoma (DLBCL) and 5 of low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT). For MSCT appearance, type 1 pattern was observed in 2 patients, type 2 in 8, and seventeen type 3 in 17. The lesions occurred in more than one lobe with a mean maximal transverse diameter of 6.9 cm and an ill-defined margin. Most tumors showed a homogeneous attenuation equal to that of surrounding muscles before contrast and obvious enhancement after contrast. Cervical lymph node involvement and invasion of the trahea and (or) esophagus were mainly observed in patients with DLBCL. Conclusions: PTL should be clinically considered in elder patients presenting with a history of Hashimoto's thyroiditis and cervical lymphadenopathy. The MSCT characteristics of PTL includes a mass diffusely affecting more than one thyroid lobe, isointense to muscle and obvious enhancement before and after contrast. DLBCL, the most common histological subtype of PTL, is associated with a higher invasive tendency.

• Journal of the Korean Society of Radiology
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• v.18 no.4
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• pp.373-381
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• 2024

This study aimed to identify and assess the influence of risk factors on the frequency of thyroid nodules diagnosed through ultrasonography among adults visiting for health screenings. The study analyzed 210 adult men and women who underwent thyroid ultrasound at J Hospital in Busan. The differences in variables were analyzed using Chi-square and independent t-tests, and risk ratios were calculated using binary logistic regression. The results showed significant differences in gender, age, T3, Free T4, Uric acid, T-chol, HDL-C and LDL-C. The risk ratios for risk factors indicated that women had a 2.42 times higher risk compared to men, and the age groups 41-50 and over 61 had risks 2.32 and 2.22 times higher, respectively compared to those under 40. Conversely, and increase in T3 and Free T4 levels was associated with a decreased risk of 0.12 and 0.86 times, respectively, while lipid levels had negligible influence. Based on these findings, it is concluded that regular ultrasonography monitoring, rather than solely relying on biochemical markers, is crucial for the early detection and management of thyroid nodules.

• Journal of Yeungnam Medical Science
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• v.27 no.2
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• pp.139-145
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• 2010

Cystic parathyroid adenoma is one of rare causes of hyperparathyroidism, and tends to cause increased serum level of parathyroid hormone, alkaline phosphate and serum calcium level similar to when compared to those of solid adenoma. The possibility of a coincidental appearance of primary hyperparathyrodism and nonmedullary thyroid cancer is rare, and often neglected. A 40-year-old female presented with constipation and weight loss for 3 months. The serum calcium, phosphate and alkaline phosphate were 16.6 mg/dl, 2.2 mg/dl and 505 IU/L respectively and serum parathyroid hormone level was 1556.2 pg/mL. Neck US showed mixed nodules at both thyroid lobes, and PET-CT showed a right thyroid nodule without FDG uptake. The patient was diagnosed of primary hyperparathyroidism and underwent parathyroidectomy and a total thyroidectomy. Histopathologic results revealed parathyroid adenoma with cystic change (2 cm greater diameter) in the right lower parathyroid gland and coexistent papillary carcinoma of the right lobe of thyroid gland (infiltrating, 0.3 cm in greater diameter). She remained well and serum calcium, phosphate, parathyroid hormone level were normalized within 24 hours.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.8
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• pp.4689-4692
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• 2013

Ultrasound-guided fine needle aspiration biopsy (FNAB) is a costly diagnostic item with a low yield in identifying the tiny proportion of nodules that actually represent malignant disease. Our aim through this study was to obtain an ultrasound (US) score for selecting subcentimeter-sized thyroid nodules requiring FNAB in eastern China. Some 248 patients for a total of 270 thyroid nodules less than 1 cm in diameter underwent FNAB and subsequent surgery from January 2006 to March 2012 at our hospital. The clinicopathological and US data from all the nodules were analyzed retrospectively. An US score was developed on the basis of independent predictive factors for malignancy. Irregular shape, hypoechogenicity, no well-defined margin, presence of calcifications and ratio between antero-posterior and transversal diameters (AP/TR) ${\geq}1$ were independent predictive factors for malignancy on logistic regression analysis. US score were statistically significant, with ${\leq}2$ favoring benignancy with an 80.3% sensitivity and a 72.7% specificity. US score is useful for differentiating between malignant and benign subcentimeter-sized thyroid nodules. We suggest FNAB for nodules when the US score is higher than 2.

• Journal of Korean Traditional Oncology
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• v.19 no.1
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• pp.53-59
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• 2014

Objectives : Thyroid cancer is one of the most common and rapid increases of malignancy worldwide. It is the aim of the present a case of papillary thyroid microcarcinoma (PTMC) treated with acupuncture alone to derive further studies of the determination of treatment options for PTMC, such as surgery, acupuncture and observation alone, etc. Method : A 51-year-old woman with malignancy of thyroid nodule ($0.89{\times}0.59cm$) was referred to our hospital on January 2010. We applied to the acupuncture alone three times weekly by the patient's decision from January 2010 to November 2014. Blood tests were conducted three times during the treatment period and ultrasonography was performed every 6 months. Results : Both laboratory data and tumor size results showed no deteriorations as compared with those of initial examination. The patients has been survived in healthy state without any metastasis or disease progression on November, 2014. Conclusion : This case presents a possibility that acupuncture or observation alone can be provided as an option in the treatment means for patients with PTMC. Further study will need to study more longer follow-up and a large number of patients for PTMC using acupuncture or observation alone.