• 제목/요약/키워드: thyroid nodule

검색결과 128건 처리시간 0.032초

갑상전 절제술시 동결절편조직검사의 유용성에 대한 평가 (Validity of Frozen Biopsy during Thyroidectomy)

  • 김성렬;김중규;최영식
    • 대한두경부종양학회지
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    • 제14권1호
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    • pp.81-87
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    • 1998
  • Fine needle aspiration cytology was used widely to select thyroid nodules for surgery. The result could be highly reliable for most malignancies and for benign nodules. The purpose of this study was to determine the value of frozen biopsy by directly comparing the results of preoperative fine needle aspiration cytology to frozen biopsy examination. In our university hospital, 103 patients with thyroid nodule were operated during the years 1996 through 1997. A comparison of accuracy of the fine needle aspiration cytology with frozen biopsy was made for 85 patients who underwent both procedures. The 85 patients were separated into two groups. The group I included 65 patients, whose preoperative fine needle aspiration cytology results were reported as benign or malignant lesion definitely. The group II included 85 patients, the patients whose reported fine needle aspiration cytologic result was suspicious for malignancy were regarded .as malignant lesion and results for follicular neoplasm were regarded as benign lesion. The accuracy of both procedures was compared on two group also. The sensitivity, specificity, and accuracy of frozen biopsy were 76.7%, 93.5%, and 85.2% in group I and 75.6%, 95.5%, and 85.9% in group II, respectively, compared with 63.3%, 87.1%, and 75.4% in group I and 65.4%, 81.8%, and 72.9% in group II for fine needle aspiration cytology. On benign lesion, the accuracy was 95.5% in frozen biopsy and 68.2% in fine needle aspiration cytology, 75.6% in frozen biopsy and 53.7% in fine needle aspiration cytology on malignant lesion. We conclude that although fine needle aspiration cytology is the reliable diagnostic test in the evaluation of thyroid nodule, frozen biopsy should be performed intraoperatively, because fine needle aspiration cytology is insufficiently sensitive for reliable surgical planning.

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갑상선 절제술 후 합병증 (Complications in thyroid surgery)

  • 태경;최용승;심봉택;신창식;박철원;이형석
    • 대한기관식도과학회지
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    • 제2권1호
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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.

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인후두부 이상감을 호소하는 환자와 갑상선 병변과의 임상적 연관성 (The Clinical Association of Thyroid Lesions in Patients with Globus Pharyngeus)

  • 박경호;박영학;황성재;강민곤;박홍진;김민식;조승호
    • 대한기관식도과학회지
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    • 제10권2호
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    • pp.43-48
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    • 2004
  • Background and Objectives : Globus pharyngeus is the feeling of a lump or foreign body in the throat. Otolaryngologists are often confronted with this condition, and some author reported that it represents 3 percent of all new clinic referral. The purpose of this study is to estimate the incidence of impalpable thyroid lesion in patients with globes pharyngeus and investigate possible association between globus pharyngeus and thyroid lesions. Material and Method : 146 patients with globus pharyngeus and 30 controls were prospectively examined by high resolution ultrasound. Results: Thyroid abnormalities were present in $75/146(51\%)$ patients with globus pharyngeus and in $7/30(23\%)$ controls. Of the patients with globus, 55 patients had a nodule or nodules, 11 patients had a cyst or cysts, 9 patients had diffuse abnormalities. Solitary nodule ranged from 4mm to 20mm. Conclusion : Impalpable, ultrasound detectable thyroid abnormailities are significantly more common in patients with globus pharyngeus than in controls. The thyroid abnormalities may be the cause of globus symptoms in some patients, and high resolution ultrasound is an important modality in patients presenting with globus.

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방사선 요오드-131의 국소주입에 의한 양성 갑상선 결절의 치료 (Percutaneous Intranodular Injection Therapy of Radioactive Iodine-131 in Treatment of Benign Thyroid Nodules: A Preliminary Study)

  • 하일주;임동표;윤정한;제갈영종;범희승
    • 대한두경부종양학회지
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    • 제17권2호
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    • pp.174-178
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    • 2001
  • Background and Objective: Percutaneous ethanol injection therapy has been used in the treatment of the benign thyroid diseases. Although the reported side-effects of the therapy was mild and transient, some side-effects including local or radiating pain are troublesome to the patients. Radioactive iodine-131($Ra-^{131}I$) also has been effectively and safely used for management of the benign thyroid diseases. So we developed the percutaneous intranodular injection therapy of $Ra-^{131}I$ as an alternative of percutaneous ethanol injection therapy. Materials and Methods: From December 1998 to October 1999, we treated 29 outpatients (25 women and 4 men, mean age: $47{\pm}12$ years). Inclusion criteria were follows; age >30 years, cytologically benign, with normal thyroid function, cold nodule on thyroid scintigram, solid or mixed natured nodules in sonographical evaluation. Nodular volume was estimated by sonography according to the ellipsoid formula. $Ra-^{131}I$(0.1mCi/ml) was administered in a single dose injection. Follow-up studies every 3 months consisted of full history, thyroid function test, and sonography. We determined the therapeutic response is effective if the volume reduction of the nodule occurred above 30%. Results: After at least 3 months follow-up, 11 patients showed effective response, 12 patients showed minimal or unchanged response and 6 patients showed progression. Although side-effects such as injection pain, febrile reaction, and hormonal changes were absent, an infectious complication in injection site was developed from 1 case. Conclusion: Although we need a more prolonged follow-up to evaluate the delayed sequelae, we can suggest that percutaneous intranodular injection therapy of $Ra-^{131}I$ may be an attractive non-surgical treatment in selected cases of benign thyroid nodules.

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혈액투석 환자에서 갑상선 초음파의 추적 (Follow-up of thyroid ultrasonography in patients with hemodialysis)

  • 김현정;김보라;서영미;조윤영;백종하;김경영;김수경;우승훈;정정화;정재훈;함종렬
    • Journal of Yeungnam Medical Science
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    • 제34권1호
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    • pp.69-74
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    • 2017
  • Background: Chronic kidney disease is considered a risk factor for thyroid nodules as well as thyroid dysfunction such as hypothyroidism. Among patients on hemodialysis, we assessed the size of thyroid nodule and goiter at baseline and 1 year later with ultrasonography. Methods: We prospectively selected 47 patients with hemodialysis at January 2012 and reviewed their medical records. We checked goiter and thyroid nodules at January 2012 and December 2012. Results: In the hemodialysis patients (n=47), 24 patients (51.1%) had thyroid nodules and 33 patients (70.2%) had goiter at baseline. Parathyroid hormone (PTH) was higher in patients with thyroid nodules ($204.4{\pm}102.9$ vs. $129.9{\pm}93.6pg/mL$, p=0.01). Thyroid ultrasonography was conducted in 29 patients after 1 year. The thickness of the thyroid isthmus increased ($2.8{\pm}1.6$ vs. $3.2{\pm}1.9mm$, p=0.003), but the number of nodules did not change ($1.2{\pm}1.9$ vs. $1.4{\pm}2.0$, p=0.109). PTH was associated with the enlargement of thyroid nodules significantly through logistic regression analysis. Conclusion: Thyroid goiter and nodules in hemodialysis patients were more prevalent than in the general population. PTH influenced the production of thyroid nodules in hemodialysis patients. Regular examination with thyroid ultrasonography and thyroid function test should be considered in hemodialysis patients.

갑상선 결절의 진단에 있어서 고해상능 초음파검사의 가치 (The Value of High Resolution Ultrasonography in Diagnosis of Thyroid Nodule)

  • 심형진;정희문;윤정한;제갈영종;박진균
    • 대한두경부종양학회지
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    • 제6권2호
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    • pp.114-118
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    • 1990
  • A clinical study of 37 cases with thyroid nodules, which were treated by surgical excision and confirmed pathologically at the Department of Surgery, Chonnam National University Medical School, from Dec. 1988 to Feb. 1990, was conducted and following results were obtained in ultrasonographic evaluation of thyroid nodules. 1) The thyroid adenoma were showed well-defined margin, homogenous internal echo and surrounding Halo, but thyroid cancer were showed ill-defined margin, inhomogenous internal echo and no surrounding Halo. 2) The sensitivity of high resoution ultrasonography compared with pathologic diagnosis to thyroid cancer was 87.5%, specificity 94.1%, accuracy 88%, false positive 5.88%, and negative 12.5%.

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갑상선에서 발견된 림프상피종성 암종 1예 (A Case of Lymphoepithelioma-Like Carcinoma in the Thyroid Gland)

  • 노영진;김현기;홍종철
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • 제61권11호
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    • pp.611-614
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    • 2018
  • Lymphoepithelioma-like carcinoma exhibits immunohistochemically similar features to lymphoepithelioma and commonly occurs in the skin, salivary gland, breast, lung, gastrointestinal tract, liver, urinary tract, prostate, vulva and vagina. Lymphoepithelioma-like carcinoma from the thyroid gland is extremely rare. We recently experienced a case of lymphoepithelioma-like carcinoma of thyroid gland in a 28-year-old female, who presented a thyroid nodule that was suspicious of papillary carcinoma. We report this unusual case of lymphoepithelioma-like carcinoma of thyroid gland with a brief review of literature.

양성갑상선결절에 대한 효과적이고 안전한 고주파절제의 적용 (Effective and Safe Application of Radiofrequency Ablation for Benign Thyroid Nodules)

  • 성진용
    • 대한영상의학회지
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    • 제84권5호
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    • pp.985-998
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    • 2023
  • 고주파절제는 외모상의 문제나 경부 압박 증상을 유발하는 양성갑상선결절에 대한 대표적인 비수술적 치료법으로 시술은 효과적이면서도 안전하게 시행되어야 한다. 이 종설은 갑상선고주파절제에 대한 권고안들과 연구 논문들을 참조하여 대상 환자 선정, 시술 전 평가 및 치료 계획, 치료 원리 및 치료 기구, 시술법, 합병증 등에 대한 정보를 제공하려는 목적으로 작성되었다. 특히 시술법에 많은 부분을 할애해 시술 시행에 실질적인 도움을 주고자 한다.

갑상샘 악성결절의 초음파영상에서 GLCM 알고리즘을 이용한 세포병리 진단의 후향적 분석 (Retrospective Analysis of Cytopathology using Gray Level Co-occurrence Matrix Algorithm for Thyroid Malignant Nodules in the Ultrasound Imaging)

  • 김영주;이진수;강세식;김창수
    • 대한방사선기술학회지:방사선기술과학
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    • 제40권2호
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    • pp.237-243
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    • 2017
  • 본 연구는 갑상샘 초음파 영상에서 정상 및 악성결절의 세포병리 진단결과를 바탕으로 GLCM 알고리즘분석을 통한 후향적 연구를 시행하여 컴퓨터보조진단의 적용 가능성을 평가하였다. GLCM 알고리즘의 6가지 파라미터를 이용한 갑상샘 악성결절의 인식률 평가와 ROC 곡선을 분석하였다. 실험 결과는 에너지 97%, 대조도 93%, 상관관계 92%, 동질성 92%, 엔트로피 100%, 분산 100%의 높은 질환인식률을 나타내었다. ROC 곡선 분석에서 각 파라미터의 곡선아래면적이 0.947(p=0.001) 이상을 나타내어 갑상샘 악성결절의 인식에 의미가 있는 결과로 나타났다. 또한 GLCM에서 각 파라미터의 cut-off값 결정으로 정량적인 컴퓨터보조진단의 분석을 통한 질환예측이 가능할 것으로 판단된다.

Thyroid Nodules with Atypia or Follicular Lesions of Undetermined Significance (AUS/FLUS): Analysis of Variables Associated with Outcome

  • Kayilioglu, Selami Ilgaz;Dinc, Tolga;Sozen, Isa;Senol, Kazim;Katar, Kagan;Karabeyoglu, Melih;Tez, Mesut;Coskun, Faruk
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권23호
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    • pp.10307-10311
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    • 2015
  • Background: The Bethesda System for Reporting Thyroid Cytopathology is one of the main classification systems for thyroid nodules. It expects that 7% of all fine needle aspiration biopsies will be reported as atypia or follicular lesions of undetermined significance, and 5-15% of these undetermined nodules are malignant. Our study is a retrospective analysis of variables that may be associated with outcome in patients with indeterminate thyroid nodules. Materials and Methods: Patients who underwent thyroidectomy in our institution between 2010 and 2014 were retrieved from the institutional records database. Patient demographics and medical histories were recorded. All ultrasonography reports were examined for nodule features and biochemical blood levels, hormone levels and complete blood counts were recorded. Results: A total of 103 patient cytopathology reports were regarded as belonging to the undetermined category. Some 35% of patients had malignant nodules. Median preoperative red cell distribution width (RDW) level was 13.6 inthe benign group, while it was 14.3 in patients with malignancy, demonstrating a significant correlation (p=0.003). Only calcification presence was significantly different between benign and malignant groups on ultrasonography (p=0.034). Conclusions: Ultrasonography is one of the primary tools for this matter. RDW levels may become another promising tool to predict malignancy.