Occult papillary thyroid carcinoma presenting with cervical neck lymph node metastasis

A 74-year-old male patient was conducted total thyroidectomy with functional neck dissection and final pathologic report confirm occult thyroid carcinoma. Although the frequency of occult thyroid cancer (OTC) has decreased owing to developments in cervical ultrasonography and improved accuracy of histological tests, rare cases are still reported. Due to the decreased frequency of OTC, a benign cervical neck lymph node mass is sometimes diagnosed, which can result in delays to more accurate diagnoses and appropriate treatment. Therefore, we report our case.

Prospective Randomized Study of Six Months' Chemotherapy and Nine Months' Chemotherapy for Cervical Lymph Node Tuberculosis / 결핵

BACKGROUND: Tuberculous lymphadenitis is one of the most common forms of extrapulmonary tuberculosis. It was recently reported that the treatment for tuberculous lymphadenitis could be shortened to 6 months without increasing the risk of a relapse. However, there is no report of a prospective randomized study on the use of 6-month chemotherapy with HERZ for cervical lymphadenitis, which is regimen recommended in the areas concerned with the initial drug resistance. The aim of this study is to evaluate the efficacy of the 6-month regimen with HERZ for cervical lymphadenitis in areas where there is a high prevalence of drug resistance in Korea. METHOD: From January 1997 to February 2002, 92 patients with cervical tuberculous lymphadenitis were recruited from Kyungpook national university hospital. Forty-six patients were given the 6-month regimen (2HERZ/4HER) and the other forty-six patients were given the 9-month regimen(2HERZ/ 7HER). RESULT: Of the 46 patients given the 6-month regimen, 5 had residual lymph nodes greater than 5mm after the completion of treatment and 3 had new lymph nodes or an increased lymph node size during the follow-up period. Of the 46 patients in the 9-month regimen, 9 had residual lymph nodes and 8 had new events during the follow-up period. There were no significant differences between thetwo groups. CONCLUSION: These results suggest that the 6-month HERZ regimen can be used safely as the initial treatment for tuberculous lymphadenitis in areas with a similar prevalence of drug resistance.

The evaluation of cervical lymph node metastasis of laryngeal cancer using magnetic resonance imaging (MRI) / 临床耳鼻咽喉头颈外科杂志

Objective:To assess the potential or limitation of MRI for demontrating the pathological cervicallymphnodes. Method :A prospective diagnostic study on cervical lymphnode metastasis from laryngeal carcinomawas performed for 19 cases undergone neck dissection (5 cases undergone bilateral neck dissection, 24 specimensof neck dissection were collected in total). With pathological findings as the criterion, sensitivity and specificityand accuracy were calculated for palpation and MRI examination of all patients. Result:MRI had obviously highersensitivity specificity and accuracy than palpation. Besides the changes in size and shape of the metastaticlymphnodes, the intensity of MRI inside the metastic lymphnodes was showed as mixed hypo-isointensity inT1WI and hyper intensity in T2WI. Conclusion:MRI examination was accurate in detecting cervical lymphnodemetastasis and could image occult lymphnodes which are inaccessible on palpation. Thus, MRI will probably playan important role in the evaluation of malignant lymphnode metastasis.

Is it Necessary to Dissect Level I in Laryngeal and Hypopharyngeal Squamous Cell Carcinoma? / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Squamous cell carcinoma of the larynx and hypopharynx rarely metastasizes to the submental and submandibular lymph nodes. But comprehensive neck dissection including level I is still regarded as a standard treatment of neck in N+ laryngeal and hypopharyngeal cancer. Material and Methods: 82 comprehensive neck dissections of squamous cell carcinoma of laryngeal and hypopharyngeal cancer in 78 patients treated between 1992 to 1998 were pathologically reviewed. RESULTS: Only two cases of metastasis at the level I was noted. These 2 patients received radical neck dissection as a salvage procedure and had multiple nodes metastasis at other levels. CONCLUSION: Lymph nodes of level I are not believed to be at risk for cancers of the larynx and hypopharynx.