• 대한두경부종양학회지
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• 제15권2호
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• pp.177-181
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• 1999

Objective: The clinical significance of mass screening for thyroid carcinoma remains unclear. This study was carried out to clarify the value of mass screening for thyroid carcinoma. Materials and Methods: From December 1997 through July 1998, a total of 1,401 subjects who were enrolled to receive breast screening or follow-up examination for breast cancer were included in this study. Thyroid glands were examined by 10 MHz ultrasonography by one experienced radiologist. The patients with thyroid nodules were classified into 2 groups according to their potential risk of malignancy by ultrasonographic findings(high-risk : hypoechogenicity, microcalcification, irregular margin, taller than wider shape). High-risk patients were advised to undergo fine-needle aspiration biopsy and thyroidectomy. The characteristics of the thyroid cancers detected by ultrasonographic mass screening were compared by those of clinical thyroid cancer excluding male patients during the same period. Results: Thyroid nodules were detected in 353(25.2%) of the subjects and 259(73.4%) were listed in the low-risk group and 94(26.6%) in high-risk group. Among 94 patients in the high-risk group, 43 underwent thyroidectomy and 37 turned out to have thyroid carcinomas. Thus, the detection rates for carcinoma were 2.6% of all subject, 10.5% of the detected nodules, 36.4% of the high risk women and 86.0% of the operated cases. The tumor size was significantly smaller in the mass-screening group than in the clinical cancer group(p<0.05). However, there was no statistical differences between two groups in the prevalences of neck node involvement and extracapsular invasion and the patients distributions by AMES score, MACIS score and TNM stage. Conclusion: Ultrasonogrpahic mass screening may be useful for the early detection of thyroid carcinoma in women who are scheduled to have breast examination.

• Journal of Korean Neurosurgical Society
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• 제48권5호
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• pp.406-411
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• 2010

Objective : Esophageal/hypopharyngeal injury can be a disastrous complication of anterior cervical surgery. The amount of hypopharyngeal wall exposure within the surgical field has not been studied. The objective of this study is to evaluate the chance of hypopharyngeal wall exposure by measuring the amount of axial rotation of the thyroid cartilage (ARTC) and posterior projection of the hypopharynx (PPH). Methods : The study was prospectively designed using intraoperative ultrasonography. We measured the amount of ARTC in 27 cases. The amount of posterior projection of the hypopharynx (PPH) also was measured on pre-operative CT and compared at three different levels; the superior border of the thyroid cartilage (SBTC), cricoarytenoid joint and tip of inferior horn of the thyroid cartilage (TIHTC). The presence of air density was also checked on the same levels. Results : The angle of ARTC ranged from $-6.9^{\circ}$ to $29.7^{\circ}$, with no statistical difference between the upper and lower cervical group. The amount of PPH was increased caudally. Air densities were observed in 26 cases at the SBTC, but none at the TIHTC. Conclusion : Within the confines of the thyroid cartilage, surgeons are required to pay more attention to the status of hypopharynx/esophagus near the inferior horn of the thyroid cartilage. The hypopharynx/esophagus at the TIHTC is more likely to be exposed than at the upper and middle part of the thyroid cartilage, which may increase the risk of injury by pressure. Surgeons should be aware of the fact that the visceral component at C6-T1 surgeries also rotates as much as when the thyroid cartilage is engaged with a retractor. The esophagus at lower cervical levels warrants more careful retraction because it is not protected by the thyroid cartilage.

• Clinical and Experimental Pediatrics
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• 제49권9호
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• pp.1005-1009
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• 2006

아가미틈새(branchial cleft) 낭종은 흔히 경부측면에 위치하나, 아가미틈새 낭종의 조직학적 소견을 보이는 낭종이 비전형적인 위치에서 발견되기도 한다. 갑상샘의 아가미틈새양(branchial cleft-like) 낭종은 이제까지 보고된 14례 중 7세 여아에서 발견된 1례를 제외하고는 모두 성인에서 발견되었다. 저자들은 좌측경부의 종물을 주소로 내원한 신생아에서 초음파 검사, 컴퓨터 단층촬영, 병리조직학 검사를 통하여 진단된 갑상샘의 아가미틈새양 낭종 1례를 경험하였기에 보고하는 바이다.

• Journal of Yeungnam Medical Science
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• 제38권2호
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• pp.169-174
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• 2021

Mucoepidermoid carcinoma (MEC) is the most common malignant neoplasm of the salivary gland, but primary thyroid MEC has rarely been reported and usually has a good prognosis. Herein, I report a case of thyroidal MEC with a poor prognosis in an 82-year-old woman with an anterior neck mass. Ultrasonography and computed tomography revealed a thyroid mass. The patient initially underwent fine-needle aspiration, was diagnosed with malignancy, and underwent a right lobectomy. On gross examination, a 4.0×3.6×2.6 cm-sized ill-defined, unencapsulated, and infiltrative tan to whitish mass with necrosis was identified. Microscopically, epidermoid tumor cell nests or solid sheets were identified. Mucous cells that were positive for periodic acid-Schiff and mucicarmine stains were also identified within epidermoid cell nests. Frequent mitosis and necrosis were observed. Immunohistochemical staining for p40 and p63 was positive, and that for thyroid transcription factor-1 and paired box gene 8 was focally positive. According to the Armed Forces Institute of Pathology grading system for salivary gland MEC, the current case was classified as high-grade MEC. After surgery, the patient suffered from dyspnea due to a remnant neck mass that compressed and obstructed the trachea; therefore, the patient refused further treatment. Thyroidal MECs are considered low-grade with a favorable prognosis, but there are several reported cases of thyroidal MEC with poor prognosis. The current case is a rare presentation of high-grade thyroidal MEC with a poor prognosis.

• 대한두경부종양학회지
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• 제15권1호
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• pp.66-69
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• 1999

Background and Objectives: It is critical to distinguish benign from malignant thyroid nodule and to select a patient for surgery. Even though the U/S study dose not make great contribution to diagnose a malignant thyroid nodule, it is widely used in the evaluation of anatomic feature of thyroid. The authors tried to estimate the efficacy of the U/S study in preoperative diagnosis of malignant thyroid nodule. Materials and Method: At the department of General Surgery of Ajou University, 75 patients who were operated after diagnosis with thyroid nodule by U/S study between July 1996 to June 1997 were retrospectively analyzed. By comparing the U/S impression that implies malignant thyroid nodule to FNAC and post-operative pathologic results ware as follows. Results: 1) Absence of cystic change, presence of internal hypoechogenicity, lobulation, calcification, thick and irregular halo, and nodule more than 4cm in diameter on U/S were considered significant statistically for the diagnosis of malignancy(Chi-square test, p<0.05) 2) Presence of internal hypoechogenicity or thick and irregular halo has the validity in Logistic regression analysis. 3) FNAC was done in 65 case. 19 case were malignant, 11 case were suspicious and 46 patients were benign (sensitivity 52.6%, specificity 87%). 4) The findings of U/S which are hypoechogenic and thick and irregular halo show 82% sensitivity and 97% specificity. In combination with the findings of FNAC that imply benign or suspicious lesions, the sensitivity was 100% and the specificity was 97%. Conclusion: This study suggest that the hypoechogenicity and thick and irregular halo on U/S are important information for the diagnosis of thyroid malignancy which were considered benign or suspicious after FNAC.

• 대한방사선기술학회지:방사선기술과학
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• 제42권3호
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• pp.201-207
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• 2019

The purpose of this study was to evaluate the prevalence of thyroid nodules and malignant findings of thyroid nodules in 1,954 patients (654 males and 1,300 females) aged 20 years or older who underwent thyroid ultrasound from January 2018 to December 2018. Examination of the thyroid gland was performed, and fine needle aspiration cytology was performed on the thyroid nodule. As a result, 108 (16.5%) out of 654 males and 368 (28.3%) out of 1,300 females showed higher prevalence than males. The prevalence of single nodules and multiple nodules in gender and age groups was significantly higher for women and for ages (male p=.001, female p=.001). There was a significant difference in males in the nodule size (p=.001) and no significant difference in females (p=.069). Fine - needle aspiration cytology of 476 patients with nodules was diagnosed as malignant in 46 patients (9.6%). Based on pathologic results, 383 benign and 93 malignant groups were analyzed. Ultrasonographic findings were as follows single nodule (p=.000), solid(p=.004), hypoechoic (p=.000), ill-defined peripheral boundary (p=.000), and calcification (p=.000), respectively. In the diagnosis of thyroid nodule, primary ultrasonographic findings through morphological classification of the nodules may reduce indiscriminate fine needle aspiration cytology in benign and malignant nodules.

• 한국임상수의학회지
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• 제17권1호
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• pp.205-208
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• 2000

소에서 경정맥, 경동맥 및 갑상선의 초으파상에 관한 기초자료를 확립하기 위하여 본 연구를 실시하였다. 한우 9두에서 6개월경으로부터 12개월령에 도달할 때까지 1개월 간격으로 성장에 따른 경정맥, 경동맥 및 갑상선의 초음파상을 측정하였다. 경정맥, 경도맥 및 갑상선은 경부의 양측에서 관찰하였다. 경정맥의 내경은 6, 7, 8, 9, 10, 11, 12 및 13개월령에서, 각각 8.5, 8.7, 8.8, 9.5, 10.0, 10.5, 11.5 및 12.2mm를 나타내었다. 경동맥의 내경은, 6, 7, 8, 9, 10, 11, 12 및 13개월령에서, 각각 7.4, 7.5, 8.6, 9.1, 9.4, 9.7, 10.1 및 10.3mm 이었다. 갑상선엽의 길이는 6, 7, 8, 9, 10, 11, 12 및 13개월령에서, 각각 28.0, 32.1, 36.4, 42.2, 51.7, 53.2, 55.1 and 58.8mm이었다. 갑상선엽의 높이는 6, 7, 8, 9. 10, 11, 12 및 13개월령에서, 각각 13.6, 15.3, 16.1, 20.7, 22.9, 25.6, 28.9 and 29.4mm를 나타내었다. 본 연구에서는 초음파측정 결과는 한우에서의 경정맥, 경동맥 및 갑상선에서의 형태학적 변화의 진단을 위한 참고자료가 될 수 있을 것으로 사료된다.

• Korean Journal of Radiology
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• 제22권12호
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• pp.2094-2123
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• 2021

Incidental thyroid nodules are commonly detected on ultrasonography (US). This has contributed to the rapidly rising incidence of low-risk papillary thyroid carcinoma over the last 20 years. The appropriate diagnosis and management of these patients is based on the risk factors related to the patients as well as the thyroid nodules. The Korean Society of Thyroid Radiology (KSThR) published consensus recommendations for US-based management of thyroid nodules in 2011 and revised them in 2016. These guidelines have been used as the standard guidelines in Korea. However, recent advances in the diagnosis and management of thyroid nodules have necessitated the revision of the original recommendations. The task force of the KSThR has revised the Korean Thyroid Imaging Reporting and Data System and recommendations for US lexicon, biopsy criteria, US criteria of extrathyroidal extension, optimal thyroid computed tomography protocol, and US follow-up of thyroid nodules before and after biopsy. The biopsy criteria were revised to reduce unnecessary biopsies for benign nodules while maintaining an appropriate sensitivity for the detection of malignant tumors in small (1-2 cm) thyroid nodules. The goal of these recommendations is to provide the optimal scientific evidence and expert opinion consensus regarding US-based diagnosis and management of thyroid nodules.

• 대한두경부종양학회지
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• 제23권2호
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• pp.133-137
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• 2007

갑상선 미세유두암종은 영상 기술의 발달로 더욱 그 빈도가 높아질 것이 예상되므로 진단의 정확도를 높이는 것이 무엇보다 중요하다. 갑상선 미세 유두암종으로 진단 받은 37예를 대상으로 galectin-3, cytokeratin 19와 HBME-1 분자 표지자들을 면역조직화학적 염색을 시행한 결과 cytokeratin 19에서 1예를 제외하고 모든 예에서 갑상선 종양 세포에서 발현하였다. Galectin-3는 갑상선 종양 세포의 세포질에 강하게 염색되었으며 cytokeratin 19는 세포질과 세포막을 따라 강하게 염색되었다. HBME-1은 종양 세포의 세포막에 강하게 염색되었으나 3가지 분자 표지자 모두 정상 갑상선 조직에서는 염색되지 않았다. 이상의 결과에서 볼 때 galectin-3, cytokeratin 19와 HBME-1은 병리조직학적 소견과 함께 갑상선 미세 유두암종을 진단함에 있어 보조적 도움이 되는 표지자로 생각된다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.855-860
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• 2014

Background: The purpose of this study was to assess the relationship between different sonographic features of papillary thyroid carcinoma (PTC) on high-frequency ultrasound and cervical lymph node metastasis (CLNM). Materials and Methods: We enrolled 548 patients who underwent initial surgery for PTC between May 2011 and December 2012 in our hospital at diagnosis. The sonographic features of 513 PTC nodules in 513 eligible patients, who had single PTC nodules in their thyroid glands, were retrospectively investigated. All patients with a suspect malignant nodule (d<0.5cm) among multiple nodules were initially diagnosed by fine-needle aspiration biopsy (FNAB) to ascertain if the suspect nodule was PTC. The final diagnosis of all the thyroid nodules and existence of CLNM were based on postoperative pathology. Patients were divided into two groups: a positive group with CLNM (224 nodules) and a negative group without CLNM (289 nodules). The following factors were investigated: gender, age, echogenicity, echotexture, size, shape, location, margin, contour, calcification morphology, distance between the nodule and pre- or post-border of the thyroid capsule, vascularity and the differences between the two groups. Results: Correlation analysis showed that shorter distances between the nodule and pre- or postborder of thyroid capsule resulted in greater risk of CLNM (Spearman correlation coefficient=-0.22, p<0.0001). The significant factors in multivariate analysis were age<45yrs, larger size (d>1cm), "wider than tall" shape, extrathyroid extension and mixed flow (internal and peripheral) (p<0.05, OR=0.406, 2.093, 0.461, 1.610, 1.322). Conclusions: Significant sonographic features of PTC nodules in preoperative high-frequency ultrasound are crucial for predicting CLNM.