Clinical Manifestation and Differential Diagnosis of Thyroid Follicular Neoplasm / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: A preoperative differential diagnosis between follicular adenoma and follicular carcinoma of thyroid is very difficult, and the standard basis for distinction is the presence of capsular and/or vascular invasion. In this study, we analyzed the findings of preoperative tests and clinical features to facilitate the differential diagnosis and treatment of the follicular neoplasm. SUBJECTS AND METHOD: A retrospective review of medical records was carried out on 104 patients who had undergone thyroid surgery and had been diagnosed with thyroid follicular adenoma or carcinoma from 1995 through 2004. The final pathologic diagnosis was compared to the various clinical data including the result of fine needle aspiration cytology (FNAC) and ultrasonographic findings. RESULTS: Of total 104 cases, 82 were follicular adenoma and 22 were follicular carcinoma. The incidence of carcinoma was significantly higher in male than in female. The result of FNAC were divided into 6 cytodiagnostic groups, namely, inadequate, colloid nodule without atypia, colloid nodule with atypia, follicular neoplasm without atypia, follicular neoplasm with atypia, or highly suspicious malignancy. The incidence of carcinoma was significantly higher in the groups with atypia such as colloid nodule with atypia, follicular neoplasm with atypia, and highly suspicious malignancy than in the groups without atypia. The incidence of follicular carcinoma was significantly higher in ill-defined marginal cases. Calcification on ultrasonography also indicated the possibility of malignancy. CONCLUSION: The incidence of follicular carcinoma was significantly high in male patients, atypia in FNAC, and ill-defined margin and calcification on ultrasonography.

Polymorphism of the Transporters Associated with Antigen Processing 1 (TAP1) Gene in Korean Patients with Allergic Rhinitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Antigen peptides are actively transported across the endoplasmic reticulum by the transporters associated with antigen processing (TAP) and presented to self-restricted cytotoxic T lymphocytes by the HLA class I molecules. Polymorphisms in TAP genes could influence the selection of peptides that bind to class I molecules. We designed a case-control study to investigate the frequencies of TAP1 gene in control group and allergic rhinitis group, to analyze the association of TAP1 polymorphism with allergic rhinitis, and to compare the frequencies of TAP1 haplotypes among the various ethnic groups. SUBJECTS AND METHOD: TAP1 genotyping were performed for 110 Korean allergic rhinitis patients and 107 healthy controls. TAP1 polymorphic residues at codon 333 and 637 were found using amplification refractory mutation system-polymerase chain reaction (ARMS-PCR). RESULTS: The frequencies of Ile/Ile and Ile/Val genotypes at TAP1 codon 333 were 74.5%, 23.7% in allergic rhinitis, and 50.5%, 49.5% in controls, respectively. The odds ratio of Ile/Val was 0.43 (95%CI, 0.24-0.80) in relation to Ile/Ile (p=0.001). The frequencies of Asp/Asp and Asp/Gly genotypes at TAP1 codon 637 were 69.0%, 27.3% in allergic rhinitis, and 51.4%, 46.7% in controls, respectively. The odds ratio of Asp/Gly was 0.43 (95%CI, 0.24-0.80) in relation to Asp/Asp (p=0.011). CONCLUSION: TAP1 gene polymorphism may be an important factor for the pathogenesis of allergic rhinitis and it could determine the individual susceptibility of allergic rhinitis in the Korean population.

Pattern and Treatment of Papillary Thyroid Carcinoma with Cervical Lymph Node Metastasis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Cervical lymph node metastasis develops in approximately 30% to 80% of patients with papillary thyroid carcinoma. In papillary thyroid carcinoma, lymph node metastasis at presentation do not seem to adversely affect survival, but do increase the risk of loco-regional recurrence. The management of cervical metastasis in thyroid papillary carcinoma ranges from selective removal to a formal comprehensive neck dissection. In this study, we analyzed the pattern of cervical lymph node metastasis and the impact of prognostic variables in oder to plan how to manage the cervical lymph node metastasis in patients with papillary thyroid carcinoma. SUBJECTS AND METHOD: The clinical records and pathological reports of 114 patients who underwent surgery for thyroid papillary carcinoma at the Department of Otolaryngology-Head and Neck Surgery, Hanyang university from 1996 to 2002 were analyzed retrospectively. RESULTS: Cervical nodal metastasis was found in 57 (50.0%) patients. Occult metastasis was found in 26 (22.8%) patients. Cervical lymph node metastasis was most frequently noted in the level VI (38.6%). The size of primary tumor and extrathyroidal invasion were associated with cervical metastasis. CONCLUSION: Based on our results, it might be suggested that elective central neck dissection is needed for patients with papillary thyroid carcinoma which is larger than 35mm or has extrathyriodal extension.

A Case of Nasal Involvement of Sarcoidosis

Sarcoidosis is a chronic systemic disease of unknown etiology characterized by non-caseating granulomatous inflammation of various organs. Nasal involvement of sarcoidosis is rare. Typical symptoms are nonspecific for sinonasal sarcoidosis and include nasal obstruction, postnasal drip, headache and recurrent sinus infection. We experienced a woman who had sarcoidosis involving the inferior turbinate. She was treated with en block resection, systemic steroids and immunosuppressive agents. So, we report this case with the review of literature.