• Title/Summary/Keyword: nodules

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A Clinical Study of Thyroid Diseases (갑상선 질환에 관한 임상적 관찰)

  • Min Byoung-Sam;Nam Young-Soo;Park Chan-Heun;Pai Soo-Tong
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.2
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    • pp.112-121
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    • 1994
  • During the 7 years period from March 1987 to Febrary 1994, 344 patients with thyroid nodules, were admitted and operated at Department of Surgery, Collage of Medicine, Hallym university. We obtained following results: 1) The thyroid nodules were prevalent in female with ratio 1:17.1, both benign and malignant nodules were prevalent in the forth decade(37.8%:25.8%). 2) The duration of illness within 6 months was most common: 47.1% and within 1 years was 66.6%. 3) The most prominent symptoms & sign were palpable mass in anterior neck(96.8%). 4) The right-sided thyroid nodules were most common. 5) Thyroid scaning and thyroid function test were found to be not much value in differentiating malignancy. 6) Accuracy of the fine needle aspiration cytology was 75.5%. 7) There were 251 cases(73.0%) of benign and 93 cases(27.0%) of malignant nodules: most frequent benign nodule was adenomatous goiter(67.7%) and the most frequent malignant nodule was papillary adenocarcinoma (86.0%). 8) The most commonly performed surgical procedure was unilateral lobectomy with isthmectomy in both benign(41.0%) and malignant(33.3%). 9) Postoperative complications are as follows: transient hypothyroidism 22cases, transient hoaseness 16 cases, hypothyroidism 6 cases, wound infection 4 cases, hematoma 3 cases, permanent hoaseness 2 cases.

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A Case of Intrapulmonary Lymph Nodes Presenting Multiple Nodules (다발성 폐결절로 나타난 폐내림프절 1예)

  • Lee, Sook-Young;Jo, Keon-Hyon;Kim, Kan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.6
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    • pp.879-883
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    • 1999
  • The lymphoid system of the lung represents a complex network of lymphoid tissue and lymphatic vessels. Lymph nodes are normally located in the hila, adjacent to the lobar bronchi and within the lung to the level of the fourth-order bronchi. Clinically apparent intrapulmonary lymph nodes are rare. Although of intrapulmonary lymph node histogenesis is uncertain, They are probably hyperplastic lymphoid nodules related to inhalation of irritant dusts and attendant distortion of local lymphatic vessels. Intrapulmonary lymph nodes are detected as solitary or multiple pulmonary nodules. These nodules are difficult to differentiate from intrapulmonary metastasis by radiologic finding. We experienced a case of intrapulmonary lymph nodes presenting multiple nodules in a 46 years old man, which was confirmed by thoracoscopic biopsy.

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Disseminated Coccidioidomycosis Presenting with Miliary Nodules (속립성 폐결절로 발현된 파종성 콕시디오이데스 진균증)

  • Kim, Jung Ha;Hur, Gyu Young;Jung, Ki Hwan;Jung, Hae Chul;Park, Dae Won;Lee, Sung Yong;Lee, Sang Yeub;Kim, Je-Hyeong;Shon, Jang Uk;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.1
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    • pp.97-101
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    • 2006
  • Coccidioidomycosis is a rare systemic fungal infection in Korea. However, the incidence of coccidioidomycosis has recently begun to increase due to the increasing incidence of people traveling overseas to endemic areas. In previously reported cases of coccidioidomycosis in Korea, the radiographic findings usually showed a solitary pulmonary nodule, pleural effusion, cavitation, and hilar lymphadenopathy, but no miliary nodules. We report a case of disseminated coccidioidomycosis with miliary nodules in an immunocompetent patient. A 32 year old male, who had traveled in Corona, New Mexico, USA, was admitted for an evaluation of persistent cough with fever. Chest radiography revealed initially diffuse multiple small nodules that appeared to be miliary tuberculosis. However, a subsequent evaluation revealed that he had disseminated coccidioidomycosis.

Auditory-Perceptual and Acoustic Assessment in Measuring Dysphonia Severity of Vocal Fold Nodules (성대결절 환자의 음성장애에 대한 청지각적 및 음향학적 평가)

  • Kim, Geun-Hyo;Kwon, Soon-Bok
    • The Journal of the Korea Contents Association
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    • v.18 no.1
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    • pp.108-116
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    • 2018
  • The purpose of this study was to investigate the relationship between the differences in the acoustic measurements (AVQI) and the auditory-perceptual assessments (GRBAS, CAPE-V) of the normal and vocal fold nodules. For this purpose, Total 335 voice samples were analyzed acoustically and three raters performed auditory-perceptual assessments. in the results, AVQI, G, and OS scores of the normal group were lower than those of the vocal fold nodules group. The correlations between the G scale and the OS scale were highly correlated, and the correlation between the AVQI, and auditory-perceptual results (G and OS) was also high value. The threshold values for discriminating AVQI, G, and OS between the two groups were ${\leq}4.06$, ${\leq}1$, and ${\leq}26$, respectively, and the predictive diagnostic power was 0.840, 0.860, and 0.848. In conclusion, AVQI and auditory-perceptual evaluation can improve potentiality the screening of vocal fold nodules and help to determine the diagnosis and treatment plan of voice disorders.

Detection of Lung Nodule on Temporal Subtraction Images Based on Artificial Neural Network

  • Tokisa, Takumi;Miyake, Noriaki;Maeda, Shinya;Kim, Hyoung-Seop;Tan, Joo Kooi;Ishikawa, Seiji;Murakami, Seiichi;Aoki, Takatoshi
    • International Journal of Fuzzy Logic and Intelligent Systems
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    • v.12 no.2
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    • pp.137-142
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    • 2012
  • The temporal subtraction technique as one of computer aided diagnosis has been introduced in medical fields to enhance the interval changes such as formation of new lesions and changes in existing abnormalities on deference image. With the temporal subtraction technique radiologists can easily detect lung nodules on visual screening. Until now, two-dimensional temporal subtraction imaging technique has been introduced for the clinical test. We have developed new temporal subtraction method to remove the subtraction artifacts which is caused by mis-registration on temporal subtraction images of lungs on MDCT images. In this paper, we propose a new computer aided diagnosis scheme for automatic enhancing the lung nodules from the temporal subtraction of thoracic MDCT images. At first, the candidates regions included nodules are detected by the multiple threshold technique in terms of the pixel value on the temporal subtraction images. Then, a rule-base method and artificial neural networks is utilized to remove the false positives of nodule candidates which is obtained temporal subtraction images. We have applied our detection of lung nodules to 30 thoracic MDCT image sets including lung nodules. With the detection method, satisfactory experimental results are obtained. Some experimental results are shown with discussion.

The Usefulness of Immunocytochemistry of CD56 in Determining Malignancy from Indeterminate Thyroid Fine-Needle Aspiration Cytology

  • Cha, Hyunseo;Pyo, Ju Yeon;Hong, Soon Won
    • Journal of Pathology and Translational Medicine
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    • v.52 no.6
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    • pp.404-410
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    • 2018
  • Background: Fine-needle aspiration cytology serves as a safe, economical tool in evaluating thyroid nodules. However, about 30% of the samples are categorized as indeterminate. Hence, many immunocytochemistry markers have been studied, but there has not been a single outstanding marker. We studied the efficacy of CD56 with human bone marrow endothelial cell marker-1 (HBME-1) in diagnosis in the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) category III. Methods: We reviewed ThinPrep liquid-based cytology (LBC) samples with Papanicolaou stain from July 1 to December 31, 2016 (2,195 cases) and selected TBSRTC category III cases (n=363). Twenty-six cases were histologically confirmed as benign (six cases, 23%) or malignant (20 cases, 77%); we stained 26 LBC slides with HBME-1 and CD56 through the cell transfer method. For evaluation of reactivity of immunocytochemistry, we chose atypical follicular cell clusters. Results: CD56 was not reactive in 18 of 20 cases (90%) of malignant nodules and showed cytoplasmic positivity in five of six cases (83%) of benign nodules. CD56 showed high sensitivity (90.0%) and relatively low specificity (83.3%) in detecting malignancy (p=.004). HBME-1 was reactive in 17 of 20 cases (85%) of malignant nodules and was not reactive in five of six cases (83%) of benign nodules. HBME-1 showed slightly lower sensitivity (85.0%) than CD56. The specificity in detecting malignancy by HBME-1 was similar to that of CD56 (83.3%, p=.008). CD56 and HBME-1 tests combined showed lower sensitivity (75.0% vs 90%) and higher specificity (93.8% vs 83.3%) in detecting malignancy compared to using CD56 alone. Conclusions: Using CD56 alone showed relatively low specificity despite high sensitivity for detecting malignancy. Combining CD56 with HBME-1 could increase the specificity. Thus, we suggest that CD56 could be a useful preoperative marker for differential diagnosis of TBSRTC category III samples.

Thyroid Radiology Practice: Diagnosis and Interventional Treatment of Patients with Thyroid Nodules (갑상선 영상의학 진료: 갑상선 결절 환자의 진단과 중재적 치료)

  • Jung Hwan Baek;Dong Gyu Na
    • Journal of the Korean Society of Radiology
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    • v.81 no.3
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    • pp.530-548
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    • 2020
  • Thyroid radiology practice is a medical practice in which thyroid diseases are diagnosed using imaging modality and treated by imaging-based interventional techniques, and the primary care target is thyroid nodular disease. Diagnosis of thyroid nodules is primarily done by ultrasound imaging and biopsy; thyroid nodules can be treated by non-surgical interventional treatment and thyroidectomy. Ethanol ablation is the first-line treatment for cystic benign nodules, and radiofrequency ablation is used for the treatment of benign solid nodules and recurrent thyroid cancers. Thyroid radiology practice has an essential clinical role in diagnosis and nonsurgical treatment of thyroid nodular diseases, and treatment should be performed based on standard care guidelines for proper patient care. In order to provide the best care to patients with thyroid nodular disease, it is desirable to treat patients in the radiology outpatient clinic. Thyroid radiology practice centered on outpatient clinic practice needs to be expanded.

Comparison of the Therapeutic Efficacy and Technical Outcomes between Conventional Fixed Electrodes and Adjustable Electrodes in the Radiofrequency Ablation of Benign Thyroid Nodules

  • Jae Ho Shin;Minkook Seo;Min Kyoung Lee;So Lyung Jung
    • Korean Journal of Radiology
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    • v.25 no.2
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    • pp.199-209
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    • 2024
  • Objective: This study aimed to compare therapeutic efficacy and technical outcomes between adjustable electrode (AE) and conventional fixed electrode (FE) for radiofrequency ablation (RFA) of benign thyroid nodules. Materials and Methods: Between 2013 and 2021, RFA was performed on histologically proven benign thyroid nodules. For the AE method, AE length ≥ 1 cm with higher power and < 1 cm with lower power were utilized for ablating feeding vessels and nodules, especially those near anatomical structures, respectively. The therapeutic efficacy (volume reduction rate [VRR], complication rate, and regrowth rate) and technical outcomes (total energy delivery, ablated volume/energy, RFA time, and ablated volume/time) of FE and AE were compared. Continuous parameters were compared using a two-sample t-test or Mann-Whitney U test, and categorical parameters were compared using a chi-squared test or Fisher's exact test. Results: A total of 182 nodules (FE: 92 vs. AE: 90) in 173 patients (mean age ± standard deviation, 47.0 ± 14.7 years; female, 90.8% [157/173]; median follow-up, 726 days [interquartile range, 441-1075 days]) were analyzed. The therapeutic efficacy was comparable, whereas technical outcomes were more favorable for AE. Both electrodes demonstrated comparable overall median VRR (FE: 92.4% vs. AE: 84.9%, P = 0.240) without immediate major complications. Overall regrowth rates were comparable between the two groups (FE: 2.2% [2/90] vs. AE: 1.1% [1/90], P > 0.99). AE demonstrated a shorter median RFA time (FE: 811 vs. AE: 627 seconds, P = 0.009). Both delivered comparable median energy (FE: 42.8 vs. AE: 29.2 kJ, P = 0.069), but AE demonstrated higher median ablated volume/energy and median ablated volume/time (FE: 0.2 vs. AE: 0.3 cc/kJ, P < 0.001; and FE: 0.7 vs. AE: 1.0 cc/min, P < 0.001, respectively). Conclusion: Therapeutic efficacy between FE and AE was comparable. AE demonstrated better technical outcomes than FE in terms of RFA time, ablated volume/energy, and ablated volume/time.

Diffuse Large B-Cell Lymphoma Manifesting as Miliary Nodules in the Lung: A Case Report (폐의 좁쌀 결절로 발현된 림프종 사례: 증례 보고)

  • Hyo Ju Na;Hyeyoung Kwon;Song Soo Kim;Hyung Kyu Park
    • Journal of the Korean Society of Radiology
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    • v.84 no.6
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    • pp.1391-1396
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    • 2023
  • Malignant lymphoma has various pulmonary manifestations on chest CT, including nodules, masses, areas of consolidation, and ground-glass opacity. These presentations can pose a diagnostic challenge, as they mimic other disease patterns. Herein, we report a case of diffuse large B-cell lymphoma (DLBCL) manifesting as miliary nodules in a 67-year-old male initially presenting with dyspnea and fever. Radiologic findings included diffuse, bilateral, multiple tiny nodules consistent with metastasis, miliary tuberculosis, and fungal infection. However, further investigations, including laboratory tests, imaging, and biopsies, led to the diagnosis of DLBCL involving the lungs. Herein we reported a rare case of lymphoma involvement of the lung presenting as miliary nodules. Accurate diagnosis relies on a comprehensive evaluation of the clinical history, physical features, laboratory test results, and imaging findings.

Thyroid Nodules with Isolated Macrocalcifications: Malignancy Risk of Isolated Macrocalcifications and Postoperative Risk Stratification of Malignant Tumors Manifesting as Isolated Macrocalcifications

  • Hye Yun Gwon;Dong Gyu Na;Byeong-Joo Noh;Wooyul Paik;So Jin Yoon;Soo-Jung Choi;Dong Rock Shin
    • Korean Journal of Radiology
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    • v.21 no.5
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    • pp.605-613
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    • 2020
  • Objective: To determine the malignancy risk of isolated macrocalcifications (a calcified nodule with complete posterior acoustic shadowing) detected on ultrasonography (US) and to evaluate the postoperative American Thyroid Association (ATA) risk stratification of malignant tumors manifesting as isolated macrocalcifications. Materials and Methods: A total of 3852 thyroid nodules (≥ 1 cm) of 3061 consecutive patients who had undergone biopsy between January 2011 and June 2018 were included in this study. We assessed the prevalence, malignancy rate, and size distribution of isolated macrocalcifications and evaluated the histopathologic features and postoperative ATA risk stratification of malignant tumors manifesting as isolated macrocalcifications. Results: Isolated macrocalcifications were found in 38 (1.2%) of the 3061 patients. Final diagnosis was established in 30 (78.9%) nodules; seven malignant tumors were diagnosed as papillary thyroid carcinomas (PTCs). The malignancy rate of the isolated macrocalcifications was 23.3% in the 30 nodules with final diagnoses and 18.4% in all nodules. Among the six surgically-treated malignant tumors, five (83.3%) had an extrathyroidal extension (ETE) (minor ETE 1, gross ETE 4), and two (33.3%) had macroscopic lymph node metastasis. Four (66.7%) malignant tumors were categorized as high-risk tumors, one as an intermediate-risk tumor, and one as a low-risk tumor using the ATA risk stratification. Histopathologically, out of the six malignant tumors, ossifications were noted in four (66.7%) and predominant calcifications in two (33.3%). Conclusion: The US pattern of isolated macrocalcifications (≥ 1 cm) showed an intermediate malignancy risk (at least 18.4%). All malignant tumors were PTCs, and most showed an aggressive behavior and a high or intermediate postoperative ATA risk.