• The Korean Journal of Nuclear Medicine
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• v.12 no.2
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• pp.23-31
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• 1978

Hyperthyroidism may be defined as those clinical conditions which result from an increase in the circulating levels of one or both thyroid hormones. Hyperthyroidism in broad sense could be classified with toxic diffuse goiter, toxic adenomatous goiter, and toxic multinodular goiter on the basis of the circulating thyroid hormone levels. For this study, the subject included 94 cases with hyperthyroidism were presented in 77 with toxic diffuse goiter, 8 with toxic adenomatous goiter, and 9 with toxic multinodular goiter on the levels of $^{125}IT_3$ resin uptake rate and serum thyroxine ($T_4$). The observed results were as follows: 1) In the cases of hyperthyroidism including toxic diffuse goiter, toxic adenomatous goiter, and toxic multinodular goiter, 20.21% of the patients were male and 79.79% female. The majority of the patients were in 2nd to 4th decades of their lives. 2) There were objective signs clearly manifested in hyperthyroidism including toxic diffuse goiter and toxic adenomatous goiter which were rare in the multinodular goiter. The clinical signs in toxic diffuse and toxic adenomatous goiter included wide pulse pressure, tachycardia, systolic murmur, exophthalmos, tremor and warm skin etc. (Table 3.) 3) The most freauent complaints of the patients with hyperthyroidism were palpitation, weight loss, increased appetite, perspiration, heat intolerance, nervousness, exertional dyspnea, and menstrual disturbance etc. (Table 4.) There was no clear difference in the incidence of symptoms between toxic diffuse goiter and toxic adenomatous goiter, but there was clear difference between toxic multinodular goiter. 4) Considering of results of $^{125}IT_3$ resin uptake rate and serum $T_4$ level in toxic diffuse goiter, toxic adenomatous goiter and toxic multinodular goiter, $^{125}I\;T_3$ resin uptake rate was $49.15{\pm}9.94%$ (mean) and serum $T_4\;21.29{\pm}7.04ug/dl$ (mean) in toxic diffuse goiter. In toxic multinodular goiter, $^{125}I\;T_3$ resin uptake rate was $32.47{\pm}6.74%$ (mean) and serum $T_4$ level $11.03{\pm}5.0ug/dl$, and then there was clear difference in the results of $^{125}I\;T_3$ resin uptake rate and serum $T_4$ between toxic diffuse goiter and toxic multinodular goiter. The levels of $^{125}I\;T_3$ resin uptake rate and serum $T_4$ in toxic adenomatous goiter were $40.32{\pm}13.08%$ (mean), $15.47{\pm}8.25ug/dl$ (mean) respectively, so there was no clear difference between toxic diffuse goiter and toxic adenomatous goiter. 5) There was no significant differnece in length and width performed with thyroid scanning in toxic diffuse goiter, toxic adenomatous goiter, and toxic multinodular goiter.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.13
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• pp.5541-5547
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• 2015

Background: The role of surgical resection for patients with single large (${\geq}5cm$) and/or multinodular (${\geq}2$) hepatocellular carcinoma (HCC) is still controversial. This systematic review was performed to evaluate the safety and efficacy of resection for patients with single large and/or multinodular HCC. Materials and Methods: Databases (the PubMed, Web of Science, Embase, and Cochrane databases) were systematically searched to identify relevant studies exploring the safety and efficacy of resection for single large and/or multinodular HCC, published between January 2000 and December 2014. Perioperative morbidity and mortality, overall survival, and disease-free survival of the resection group were calculated. In addition, these outcome variables were also calculated for the control group in the included studies. Results: One randomized controlled trial and 42 nonrandomized studies involving 9,580 patients were eligible for analysis. Eight (1,594 patients) of the 43 studies also reported the outcomes of transarterial chemoembolization (TACE). Although 51.4% of patients featured cirrhosis, 90.7% of them demonstrated Child-Pugh A liver function in the resection group. The median rates of morbidity (24.5%) and mortality (2.5%) after resection were significantly higher than that of TACE (11.0%, P<0.001; 1.9%, P<0.001). However, patients who underwent resection had significantly higher median one-, three-, and five-year overall survival (76.1%, 51.7%, and 37.4%) than those who underwent TACE (68.3%, 31.5%, and 17.5%, all P<0.001). The median 1-, 3-, and 5-year DFS rates after resection were 58.3%, 34.6%, and 24.0%, respectively. Conclusions: Although tumor recurrence after resection for patients with single large and/ or multinodular HCC continues to be a major problem, resection should be considered as a strategy to achieve long-term survival.

• Journal of Chest Surgery
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• v.7 no.1
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• pp.37-46
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• 1974

52 cases of metastatic lung tumor, including 22 [42.3%] choriocarcinoma., 13[25%] liver cancer, 6 [7.5%] stomach cancer, 2 bone tumor, etc, were reviewed at Busan National University Hospital, during a 5 year period ending with 1974. The age distribution of metastatic lung tumor were same in second decade to 5th decade. The most common appearances of roentgenograms of metastatic lung tumor were that of multinodular [42.3%], diffuse acinar [21.1%],infiltrative or pneumonic[21.1%], solitary lesion [9.6%] and diffuse micronodular [5.7%]. The metastatic lesions originated from choriocarcinoma revealed multinodular and acinar in roentgenogram, and the lesions originated from liver and stomach cancer revealed infiltrative and acinar. In our series, the positive hilar lymph node enlargement was encountered in 12 cases, of which 4 were in liver cancer and 3 were in stomach cancer. Pleural effusion was also encountered in 5 cases, of which 3 were in liver cancer. The treatment of this series was almost conservative except of 2 cases of pulmonary resection, and the reason of this limited cases of surgical treatment was seemed due to the delayed direction of metastasis to lung beyond the proper indication of surgery.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.9
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• pp.3875-3879
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• 2015

Background: The neutrophil/lymphocyte ratio (NLR) is a simple index of systemic inflammatory response, and has been shown to be a prognostic indicator in some types of cancer. Inflammation has been implicated in the initiation and progression of thyroid cancer. The aim of this study was to examine the relationship of NLR with papillary thyroid cancer (PTC) and different benign thyroid pathologies like multinodular goiter (MNG) and lymphocytic thyroiditis (LT). Materials and Methods: We retrospectively evaluated the neutrophil, lymphocyte counts and NLR calculated from these parameters of 232 patients with histologically confirmed as multinodular goiter (group MNG) (n=70), lymphocytic thyroiditis (group LT) (n=97), LT with PTC (group LT-PTC) (n=25) and PTC (group PTC) (n=40). The optimal cut-off value for NLR was determined. Results: NLR level was significantly higher in groups LT-PTC and PTC as compared to groups MNG and LT (p<0.05). NLR of LT subgroups according to TSH levels were not different (p>0.05). When we grouped the patients as benign and malignant according to PTC presence, the optimum NLR cut-off point obtained from ROC analysis was 1.91 (sensitivity 89.0% and specificity 54.5%). Conclusions: Since NLR was significantly elevated in group LT-PTC and group PTC, NLR value may give an opinion as a potential marker in differentiation of benign and malign thyroid disorders. For this purpose a cut-off value of 1.91 for NLR may be accepted.

• Tuberculosis and Respiratory Diseases
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• v.65 no.6
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• pp.532-536
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• 2008

We report on a case of a patient with laryngo-tracheobronchial amyloidosis who complained of cough, sputum, and hoarseness. A chest X-ray showed consolidation in the right middle lobe. A chest CT scan showed diffuse, irregular narrowing of the tracheobronchial tree and atelectasis of the right middle lobe, with calcification of bronchial wall. Bronchoscopic findings were multinodular submucosal thickening of the right vocal cord, and yellowish multinodular submucosal thickening from the lower trachea through both main bronchi, as well as the lingular division of the left upper lobe, the right middle lobe, and the right lower lobe. The right middle lobe bronchus was nearly obstructed. The diagnosis of amyloidosis was made by multiple ronchoscopic biopsies on the right vocal cord and both bronchi. Pathologic findings were characteristic apple-green birefringence under polarized microscopy with Congo-red stain. The patient had no evidence of systemic amyloidosis. The patient is under conservative symptomatic treatment.

• Journal of the Korean Society of Radiology
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• v.83 no.4
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• pp.958-964
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• 2022

Pulmonary epithelioid hemangioendothelioma (PEH) is a rare vascular tumor of borderline or low-grade malignancy, and its prognosis is unpredictable. Herein, we describe the case of a 47-year-old asymptomatic female with a diagnosis of multinodular PEH. During a 7-year follow-up, the nodules with large size and high ¹⁸F-fluorodeoxyglucose uptake in the initial study showed progression with increasing sizes; however, most small nodules (size < 1 cm) demonstrated spontaneous regression with peripheral rim or nodular calcification. The patient underwent surgical resection for an enlarged nodule. Of note, it is unusual for an individual to have mixed progression and regression concomitantly, which may be helpful in predicting the prognosis.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.217-223
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• 2013

Background: Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide, and the outcomes for patients are still poor. It is important to determine the original type of synchronous multinodular HCC for preoperative assessment and the choice of treatment therapy as well as for the prediction of prognosis after treatment. Aims: To analyze clinicopathologic characteristics and prognoses in patients with multicentric occurrence (MO) and intrahepatic metastasis (IM) of synchronous multinodular hepatocellular carcinoma (HCC). Methods: The study group comprised 42 multinodular HCC patients with a total of 112 nodules. The control group comprised 20 HCC patients with 16 single nodular HCC cases and 4 HCC cases with a portal vein tumor emboli. The mitochondrial DNA (mtDNA) D-loop region was sequenced, and the patients of the study group were categorized as MO or IM based on the sequence variations. Univariate and multivariate analyses were used to determine the important clinicopathologic characteristics in the two groups. Results: In the study group, 20 cases were categorized as MO, and 22 as IM, whereas all 20 cases in the control group were characterized as IM. Several factors significantly differed between the IM and MO patients, including hepatitis B e antigen (HBeAg), cumulative tumor size, tumor nodule location, cirrhosis, portal vein and/or microvascular tumor embolus and the histological grade of the primary nodule. Multivariate analysis further demonstrated that cirrhosis and portal vein and/or microvascular tumor thrombus were independent factors differentiating between IM and MO patients. The tumor-free survival time of the MO subjects was significantly longer than that of the IM subjects ($25.7{\pm}4.8$ months vs. $8.9{\pm}3.1$ months, p=0.017). Similarly, the overall survival time of the MO subjects was longer ($31.6{\pm}5.3$ months vs. $15.4{\pm}3.4$ months, p=0.024). The multivariate analysis further demonstrated that the original type (p=0.035) and Child-Pugh grade (p<0.001) were independent predictors of tumor-free survival time. Cirrhosis (p=0.011), original type (p=0.034) and Child-Pugh grade (p<0.001) were independent predictors of overall survival time. Conclusions: HBeAg, cumulative tumor size, tumor nodule location, cirrhosis, portal vein and/or microvascular tumor embolus and histological grade of the primary nodule are important factors for differentiating IM and MO. MO HCC patients might have a favorable outcome compared with IM patients.

• Korean Journal of Head & Neck Oncology
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• v.29 no.1
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• pp.26-28
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• 2013

Thyroid hemiagenesis is rare congenital anomaly that one lobe of thyroid fails to develop. It is often asymptomatic and discovered incidentally with other thyroid disease such as hypothyroidism, hyperthyroidism, multinodular goiter, benign adenoma and cancer. Most cases reported are left thyroid lobe agenesis and occurred in female. Compensatory hypertrophy occurs in most cases. Many cases are asymptomatic and detected incidentally, so awareness of its existence can help its detection and proper treatment. Here, we report a case of thyroid hemiagenesis accompanying hypothyroidism with a review of literature.

• Tuberculosis and Respiratory Diseases
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• v.42 no.2
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• pp.256-259
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• 1995

The diffuse nodular lung lesion has a diagnostic problem and should be made differential diagnosis. A chest X-ray of 62-year-old male patient with dyspnea showed small-sized scattered multinodular lesion on entire lung field. Bronchoalveolar lavage and transbronchial needle aspiration showed the non-specific findings, so open lung biopsy was done and revealed bronchioloalveolar cell carcinoma.

• Journal of Chest Surgery
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• v.50 no.1
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• pp.68-70
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• 2017

The actual incidence of multiple thymoma is unknown and rarely reported because it remains controversial whether the cases represent a disease of multicentric origin or a disease resulting from intrathymic metastasis. In this case, a patient underwent total thymectomy for multiple thymoma with myasthenia gravis via bilateral video-assisted thoracic surgery. A well-encapsulated multinodular cystic mass, measuring $57mm{\times}50mm{\times}22mm$ in the right lobe of the thymus, and a well-encapsulated mass, measuring $32mm{\times}15mm{\times}14mm$ in the left lobe, were found. Both tumors were type B2 thymoma. Few cases of multiple thymoma with myasthenia gravis have ever been reported in the literature. We report a case of synchronous multiple thymoma associated with myasthenia gravis.