Histopathological Evaluation of Solitary Nodules of Thyroid

Introduction: Solitary Thyroid nodules (STNs) can be ofboth non-neoplastic or neoplastic in nature and it is difficultto assess whether an STN is neoplastic or non-neoplasticby clinical examination alone. Imaging technique mayhelp in differentiating them preoperatively but histologicalexamination offers the final diagnosis. This study was aimedat studying the incidence rates of various types of STNs as itvaries from one geographical area to another.Material and methods: A total of 58 cases of STNsreceived over the period of 18 months were studied andhistopathological features were analysed.Results: In this study, non-neoplastic STNs were 32 (55.17%)and neoplastic were 26 (44.82%), the former being morecommon. There was a female preponderance in both nonneoplastic and neoplastic STNs with an incidence of 90.62%and 84.61% respectively. Mean age of presentation of STNswas 42.09 years. Non-neoplastic lesions of thyroid were; 18cases of colloid nodules, 10 cases of hyperplastic nodulargoitre, 04 cases of Hashimoto Thyroiditis and the neoplasticlesions were; 05 cases of follicular adenoma, 11 cases oftypical/conventional papillary carcinoma of thyroid (PTC),6 cases of papillary carcinoma thyroid variants, 01 case offollicular carcinoma 01 case of Undifferentiated carcinoma,01 case of Squamous cell carcinoma and 01 case of medullarycarcinoma.Conclusion: STNs are not so uncommon and comprise of agamut of both non-neoplastic and neoplastic lesions. Colloidnodule and PTC are the most common of non-neoplastic andneoplastic STNs respectively.

Diagnostic utility of FNAC in thyroid lesions and their histological correlation – A case study

Fine needle aspiration of thyroid lesions forms the first diagnostic tool in the preoperative evaluation of thyroid lesions. Thyroid diseases are important as these are curable with medical as well as surgical treatment. Enlargement of thyroid called as goiter is the most common manifestation of thyroid diseases. FNAC forms an important role to determine the nature of thyroid lesion whether benign or malignant. It is simple, safe, accurate and cost effective method. This was a prospective and descriptive study done for the period of 2 years from January 2016 to December 2017 in the Department of Pathology at our tertiary care hospital. A total of 100 patients with thyroid lesions came for FNAC, out of which 50 cases were received for histopathological correlation. There were 39 cases of benign thyroid lesions out of which multinodular goiter were the commonest. Papillary carcinoma was the most common malignant lesion amongst 11 cases. Benign lesions presented in younger age group (20-40 years) whereas malignant lesions had bimodal presentation (20-40 years and 40-60 years). Hereby I have analyzed different types of thyroid lesions in different age groups based on cytological evaluation followed by its histopathological confirmation.

Carcinoma papilar de tiroides y pancreatitis autoinmune: a propósito de un caso / Thyroid Papillary Carcinoma and Autoimmune Pancreatitis: A case study

El objetivo de este caso es resaltar la utilidad del ultrasonido endoscópico en pacientes con trastornos gastrointestinales. Este caso es interesante en vista que involucra dos patologías que no tienen relación entre si y que se diagnosticaron por ultrasonido endoscópico en una misma paciente, hablamos de la pancreatitis inmunológica y del carcinoma papilar de tiroides. El carcinoma papilar de tiroides se presenta en el 80 % de los casos de pacientes con neoplasia endocrina afectando a mujeres blancas, con una sobrevida mayor al 90 % si se diagnostica en estadios tempranos. En los últimos años se han descrito, cada vez con mayor frecuencia, enfermedades inflamatorias pancreáticas provocadas por mecanismos inmunológicos, que responden a tratamiento con esteroides. La disponibilidad de herramientas diagnósticas basadas en la imagen, la histología y la serología establecidas en los últimos años sirvió para determinar con exactitud la etiología de estas enfermedades.Se presenta el caso de femenina de 48 años, diabética tipo II, en tratamiento regular, cuyo motivo de consulta fue dolor abdominal difuso, gases y distensión abdominal. Se le realizó ecoendoscopia superior que concluyó lesión neoproliferativa de la cola del páncreas y aumento de volumen del lóbulo tiroideo derecho. La punción aspiración por ecoendoscopia de lesión en cola de páncreas reportó células acinares dispersas y dispuestas en grupos entremezclados con exudado inflamatorio mixto a predominio de linfocitos típicos y reactivos, histiocitos, compatibles con pancreatitis autoinmune y la punción aspiración de tiroides reportó células foliculares dispuestas en placas y papilas con atipias nucleares, abundante citoplasma denso, agrandamiento nuclear con anisonucleosis moderada, aclaramiento cromatínico con micro nucléolos, numerosas hendiduras y pseudoinclusiones nucleares concluyendo carcinoma papilar. También se le realizó determinación de IgG4 que resultó positiva...

The objective of this work is the importance of using endoscopic ultrasound in patients with gastrointestinal disorders; this case is interesting given that it involves two unrelated pathologies, which were diagnosed by endoscopic ultrasound in a same patient. We talk about the immunological Pancreatitis and Papillary Carcinoma of Thyroid. The Papillary Carcinoma of Thyroid is the Endocrine Neoplasm that occurs in 80 % cases, affecting white women, with one survival rate greater than 90 %, if diagnosed in early stages. In recent years more and more frequently pancreatic inflammatory diseases caused by immunological mechanisms, which respond to treatment with steroids have been described. The availability of diagnostic tools based on the image, the histology and serology, established in recent years, served to determine accurately the etiology of these diseases. The case of female 48 years, diabetic type II, under regular treatment, whose reason for consultation was: the presence of diffuse abdominal pain, gas, as well as positive abdominal distension. The patient underwent upper digestive ecoendoscopy. It concludes: pancreas´s tail neoproliferative lesion, as well as, and increase in volume of the right thyroid lobe, etiology to be clarify. FNA of the lesion of the tail of the pancreas reported acinar, scattered cells, arranged in groups intermingled with mixed inflammatory exudate, with predominance of typical and reactive lymphocytes, histiocytes, consistent with Immunological Pancreatitis. FNA of thyroid reported groups of follicular cells arranged in plates and papillae with nuclear atypias, abundant dense cytoplasm, and nuclear enlargement with moderate anisonucleosis, chromatinic, with micronucleus, numerous cracks and nuclear pseudo inclusions, which concludes Thyroid Papillary Carcinoma. Also it was done Ig4, proving positive. The patient underwent surgery of the thyroid, currently responding well to medical treatment.

A Case of Papillary Carcinoma of Thyroid Gland Arising from Ovarian Mature Cystic Teratoma / 대한산부인과학회잡지

Malignant transformation is a rare complication in a mature cystic teratoma of the ovary, usually being reported less than 2% of cases. The most common malignant tumor arising from a mature cystic teratoma of the ovary is a squamous cell carcinoma. However, adenocarcinoma is reported extremely rare, in most cases it was impossible to tell the source of the malignancy. We experienced a case of papillary carcinoma of thyroid glands arising from mature cystic teratoma of the ovary and report this case with a brief review of literature.

Concurrent Medullay and Papillary Carcinoma of the Thyroid / 대한내분비학회지

The origins of medullary carcinoma and papillary carcinoma of thyroid are embryologically different. We report a case of simultaneous occurrence of medullary carcinoma and papillary carcinoma of the thyroid in the same thyroid gland. In this case, the occurrence of the two tumors may be a coincidence, does not have embryological or genetical significance.

Analysis of Prognostic Factors Determining the Recurrences in Patients with Papillary Thyroid Cancer After Surgical Treatment / 대한내분비학회지

BACKGROUND: It is important to recognize the independent prognostic factors of papillary carcinoma of thyroid in therapeutic and follow up planning. However, its good prognosis and its low prevalence make it difficult to analyze prognostic factors determining patients survival in a relatively short period of time. We retrospectively investigated the independent prognostic factors for determining disease recurrence after surgery which, in adults, are known to be closely related to the prognosis of cancer. METHOD: We retrospectively reviewed the clinical records of 456 patients (male 70, female 381, unknown 5, mean age of 43.9+-12.9 years) who had visited the thyroid clinic in Seoul National University Hospital and analyzed the data with statistical software program. RESULTS: 1) At initial visit, chief complaint of the patients was abnormal neck mass in 90 percent. 2) In preoperative thyroid scan study, 82% showed cold area and 16% showed diffuse enlargement. 3) Of the 50 recurrent cases after surgery (11.5% of the total cases), 39 cases (78%) had recurred disease in neck area and 11 cases (22%) had recurrences at distant sites. (Lung 9 cases, Brain I case, Mediastinum 1case) 4) Statistically significant risk factors for recurrence after surgery were male sex, size of tumor (above 4.5cm in this study), extrathyroidal invasion of cancer, involvement of resection margin and no remnant ablation of thyroid tissue using radioiodine. CONCLUSION: Through retrospective study, we presented some clinical characteristics of papillary thyroid cancer in Korea and independent risk factors of cancer recurrences after surgery.