- Thyroid
- Utilizing Immunoglobulin G4 Immunohistochemistry for Risk Stratification in Patients with Papillary Thyroid Carcinoma Associated with Hashimoto Thyroiditis
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Faridul Haq, Gyeongsin Park, Sora Jeon, Mitsuyoshi Hirokawa, Chan Kwon Jung
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Endocrinol Metab. 2024;39(3):468-478. Published online May 20, 2024
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DOI: https://doi.org/10.3803/EnM.2024.1923
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Abstract
PDFPubReader ePub
- Background
Hashimoto thyroiditis (HT) is suspected to correlate with papillary thyroid carcinoma (PTC) development. While some HT cases exhibit histologic features of immunoglobulin G4 (IgG4)-related disease, the relationship of HT with PTC progression remains unestablished.
Methods This cross-sectional study included 426 adult patients with PTC (≥1 cm) undergoing thyroidectomy at an academic thyroid center. HT was identified based on its typical histologic features. IgG4 and IgG immunohistochemistry were performed. Wholeslide images of immunostained slides were digitalized. Positive plasma cells per 2 mm2 were counted using QuPath and a pre-trained deep learning model. The primary outcome was tumor structural recurrence post-surgery.
Results Among the 426 PTC patients, 79 were diagnosed with HT. With a 40% IgG4 positive/IgG plasma cell ratio as the threshold for diagnosing IgG4-related disease, a cutoff value of >150 IgG4 positive plasma cells per 2 mm2 was established. According to this criterion, 53% (43/79) of HT patients were classified as IgG4-related. The IgG4-related HT subgroup presented a more advanced cancer stage than the IgG4-non-related HT group (P=0.038). The median observation period was 109 months (range, 6 to 142). Initial assessment revealed 43 recurrence cases. Recurrence-free survival periods showed significant (P=0.023) differences, with patients with IgG4 non-related HT showing the longest period, followed by patients without HT and those with IgG4-related HT.
Conclusion This study effectively stratified recurrence risk in PTC patients based on HT status and IgG4-related subtypes. These findings may contribute to better-informed treatment decisions and patient care strategies.
- Thyroid
- A Narrative Review of the 2023 Korean Thyroid Association Management Guideline for Patients with Thyroid Nodules
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Eun Kyung Lee, Young Joo Park, Chan Kwon Jung, Dong Gyu Na
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Endocrinol Metab. 2024;39(1):61-72. Published online February 14, 2024
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DOI: https://doi.org/10.3803/EnM.2024.1938
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Abstract
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- The 2023 Korean Thyroid Association (KTA) Management Guideline for Patients with Thyroid Nodules constitute an update of the 2016 KTA guideline for thyroid nodules and cancers that focuses specifically on nodules. The 2023 guideline aim to offer updated guidance based on new evidence that reflects the changes in clinical practice since the 2016 KTA guideline. To update the 2023 guideline, a comprehensive literature search was conducted from January 2022 to May 2022. The literature search included studies, reviews, and other evidence involving human subjects that were published in English in MEDLINE (PubMed), Embase, and other relevant databases. Additional significant clinical trials and research studies published up to April 2023 were also reviewed. The limitations of the current evidence are discussed, and suggestions for areas in need of further research are identified. The purpose of this review is to provide a summary of the 2023 KTA guideline for the management of thyroid nodules released in May 2023 and to give a balanced insight with comparison of recent guidelines from other societies.
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Citations
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- 2023 Update of the Korean Thyroid Association Guidelines for the Management of Thyroid Nodules
Eun Kyung Lee, Young Joo Park Clinical Thyroidology®.2024; 36(4): 153. CrossRef - Systemic therapy for differentiated thyroid cancer with distant metastasis
Eun Kyung Lee Journal of the Korean Medical Association.2024; 67(7): 484. CrossRef - Educational exchange in thyroid core needle biopsy diagnosis: enhancing pathological interpretation through guideline integration and peer learning
Agnes Stephanie Harahap, Chan Kwon Jung Journal of Pathology and Translational Medicine.2024; 58(5): 205. CrossRef - Standardized Ultrasound Evaluation for Active Surveillance of Low-Risk Thyroid Microcarcinoma in Adults: 2024 Korean Society of Thyroid Radiology Consensus Statement
Ji Ye Lee, Min Kyoung Lee, Hyun Kyung Lim, Chang Yoon Lee, Jin Yong Sung, Jung Hyun Yoon, Soo Yeon Han, Jung Hee Shin, Ji-hoon Kim, So Lyung Jung, Sae Rom Chung, Jung Hwan Baek, Dong Gyu Na Korean Journal of Radiology.2024; 25(11): 942. CrossRef - Thermal ablation for Bethesda III and IV thyroid nodules: current diagnosis and management
Wen-Hui Chan, Pi-Ling Chiang, An-Ni Lin, Yen-Hsiang Chang, Wei-Che Lin Ultrasonography.2024; 43(6): 395. CrossRef
- Thyroid
- Frequency of TERT Promoter Mutations in Real-World Analysis of 2,092 Thyroid Carcinoma Patients (Endocrinol Metab 2022;37:652-63, Heera Yang et al.)
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Sue Youn Kim, Chan Kwon Jung
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Endocrinol Metab. 2022;37(6):947-948. Published online November 10, 2022
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DOI: https://doi.org/10.3803/EnM.2022.1596
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- Korean Thyroid Association Guidelines on the Management of Differentiated Thyroid Cancers; Part I. Initial Management of Differentiated Thyroid Cancers - Chapter 5. Evaluation of Recurrence Risk Postoperatively and Initial Risk Stratification in Different
Eun Kyung Lee, Young Shin Song, Ho-Cheol Kang, Sun Wook Kim, Dong Gyu Na, Shin Je Moon, Dong-Jun Lim, Kyong Yeun Jung, Yun Jae Chung, Chan Kwon Jung, Young Joo Park International Journal of Thyroidology.2024; 17(1): 68. CrossRef - Korean Thyroid Association Management Guidelines for Patients with Thyroid Nodules 2024
Young Joo Park, Eun Kyung Lee, Young Shin Song, Su Hwan Kang, Bon Seok Koo, Sun Wook Kim, Dong Gyu Na, Seung-Kuk Baek, So Won Oh, Min Kyoung Lee, Sang-Woo Lee, Young Ah Lee, Yong Sang Lee, Ji Ye Lee, Dong-Jun Lim, Leehi Joo, Yuh-Seog Jung, Chan Kwon Jung, International Journal of Thyroidology.2024; 17(1): 208. CrossRef - 2023 Korean Thyroid Association Management Guidelines for Patients with Thyroid Nodules
Young Joo Park, Eun Kyung Lee, Young Shin Song, Soo Hwan Kang, Bon Seok Koo, Sun Wook Kim, Dong Gyu Na, Seung-Kuk Baek, So Won Oh, Min Kyoung Lee, Sang-Woo Lee, Young Ah Lee, Yong Sang Lee, Ji Ye Lee, Dong-Jun Lim, Leehi Joo, Yuh-Seog Jung, Chan Kwon Jung International Journal of Thyroidology.2023; 16(1): 1. CrossRef
- Thyroid
- Update from the 2022 World Health Organization Classification of Thyroid Tumors: A Standardized Diagnostic Approach
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Chan Kwon Jung, Andrey Bychkov, Kennichi Kakudo
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Endocrinol Metab. 2022;37(5):703-718. Published online October 4, 2022
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DOI: https://doi.org/10.3803/EnM.2022.1553
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- The fifth edition of the World Health Organization (WHO) histologic classification of thyroid neoplasms released in 2022 includes newly recognized tumor types, subtypes, and a grading system. Follicular cell-derived neoplasms are categorized into three families (classes): benign tumors, low-risk neoplasms, and malignant neoplasms. The terms “follicular nodular disease” and “differentiated high-grade thyroid carcinoma” are introduced to account for multifocal hyperplastic/neoplastic lesions and differentiated thyroid carcinomas with high-grade features, respectively. The term “Hürthle cells” is replaced with “oncocytic cells.” Invasive encapsulated follicular and cribriform morular variants of papillary thyroid carcinoma (PTC) are now redefined as distinct tumor types, given their different genetic alterations and clinicopathologic characteristics from other PTC subtypes. The term “variant” to describe a subclass of tumor has been replaced with the term “subtype.” Instead, the term “variant” is reserved to describe genetic alterations. A histologic grading system based on the mitotic count, necrosis, and/or the Ki67 index is used to identify high-grade follicular-cell derived carcinomas and medullary thyroid carcinomas. The 2022 WHO classification introduces the following new categories: “salivary gland-type carcinomas of the thyroid” and “thyroid tumors of uncertain histogenesis.” This review summarizes the major changes in the 2022 WHO classification and their clinical relevance.
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- Thyroid
- Re-Increasing Trends in Thyroid Cancer Incidence after a Short Period of Decrease in Korea: Reigniting the Debate on Ultrasound Screening
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Chan Kwon Jung, Ja Seong Bae, Young Joo Park
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Endocrinol Metab. 2022;37(5):816-818. Published online October 11, 2022
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DOI: https://doi.org/10.3803/EnM.2022.1586
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- Diagnostic Performance of Thyroid Core Needle Biopsy Using the Revised Reporting System: Comparison with Fine Needle Aspiration Cytology
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Kwangsoon Kim, Ja Seong Bae, Jeong Soo Kim, So Lyung Jung, Chan Kwon Jung
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Endocrinol Metab. 2022;37(1):159-169. Published online February 28, 2022
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DOI: https://doi.org/10.3803/EnM.2021.1299
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Abstract
PDFSupplementary MaterialPubReader ePub
- Background
We aim to validate the diagnostic performance of thyroid core needle biopsy (CNB) for diagnosing malignancy in clinical settings to align with the changes made in recently updated thyroid CNB guidelines.
Methods We retrospectively analyzed 1,381 thyroid CNB and 2,223 fine needle aspiration (FNA) samples. The FNA and CNB slides were interpreted according to the Bethesda System for Reporting Thyroid Cytopathology and updated practice guidelines for thyroid CNB, respectively.
Results Compared to FNA, CNB showed lower rates of inconclusive results: categories I (2.8% vs. 11.2%) and III (1.2% vs. 6.2%), and higher rates of categories II (60.9% vs. 50.4%) and IV (17.5% vs. 2.0%). The upper and lower bounds of the risk of malignancy (ROM) for category IV of CNB were 43.2% and 26.6%, respectively. The CNB subcategory IVb with nuclear atypia had a higher ROM than the subcategory without nuclear atypia (40%–62% vs. 23%–36%). In histologically confirmed cases, there was no significant difference in the diagnostic performance between CNB and FNA for malignancy. However, neoplastic diseases were more frequently detected by CNB than by FNA (88.8% vs. 77.6%, P=0.046). In category IV, there was no difference in unnecessary surgery rate between CNB and FNA (4.7% vs. 6.9%, P=0.6361).
Conclusion Thyroid CNB decreased the rate of inconclusive results and showed a higher category IV diagnostic rate than FNA. The revised guidelines for thyroid CNB proved to be an excellent reporting system for assessing thyroid nodules.
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Xuejiao Su, Can Yue, Wanting Yang, Buyun Ma Frontiers in Endocrinology.2024;[Epub] CrossRef - The Diagnostic Role of Repeated Biopsy of Thyroid Nodules with Atypia of Undetermined Significance with Architectural Atypia on Core-Needle Biopsy
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Young Joo Park, Eun Kyung Lee, Young Shin Song, Su Hwan Kang, Bon Seok Koo, Sun Wook Kim, Dong Gyu Na, Seung-Kuk Baek, So Won Oh, Min Kyoung Lee, Sang-Woo Lee, Young Ah Lee, Yong Sang Lee, Ji Ye Lee, Dong-Jun Lim, Leehi Joo, Yuh-Seog Jung, Chan Kwon Jung, International Journal of Thyroidology.2024; 17(1): 208. CrossRef - Korean Thyroid Association Guidelines on the Management of Differentiated Thyroid Cancers; Part I. Initial Management of Differentiated Thyroid Cancers - Chapter 2. Surgical Management of Thyroid Cancer 2024
Yoon Young Cho, Cho Rok Lee, Ho-Cheol Kang, Bon Seok Koo, Hyungju Kwon, Sun Wook Kim, Won Woong Kim, Jung-Han Kim, Dong Gyu Na, Young Joo Park, Kyorim Back, Young Shin Song, Seung Hoon Woo, Ho-Ryun Won, Chang Hwan Ryu, Jee Hee Yoon, Min Kyoung Lee, Eun Ky International Journal of Thyroidology.2024; 17(1): 30. CrossRef - Long-term efficacy of lobectomy for stage T1 papillary thyroid carcinoma with varying degrees of lymph node metastasis
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Meejeong Kim, Sora Jeon, Chan Kwon Jung Endocrine Pathology.2023; 34(2): 247. CrossRef - 2023 Korean Thyroid Association Management Guidelines for Patients with Thyroid Nodules
Young Joo Park, Eun Kyung Lee, Young Shin Song, Soo Hwan Kang, Bon Seok Koo, Sun Wook Kim, Dong Gyu Na, Seung-Kuk Baek, So Won Oh, Min Kyoung Lee, Sang-Woo Lee, Young Ah Lee, Yong Sang Lee, Ji Ye Lee, Dong-Jun Lim, Leehi Joo, Yuh-Seog Jung, Chan Kwon Jung International Journal of Thyroidology.2023; 16(1): 1. CrossRef - Reevaluating diagnostic categories and associated malignancy risks in thyroid core needle biopsy
Chan Kwon Jung Journal of Pathology and Translational Medicine.2023; 57(4): 208. CrossRef - A Matched-Pair Analysis of Nuclear Morphologic Features Between Core Needle Biopsy and Surgical Specimen in Thyroid Tumors Using a Deep Learning Model
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- Clinicopathological Characteristics and Recurrence-Free Survival of Rare Variants of Papillary Thyroid Carcinomas in Korea: A Retrospective Study
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Mijin Kim, Sun Wook Cho, Young Joo Park, Hwa Young Ahn, Hee Sung Kim, Yong Joon Suh, Dughyun Choi, Bu Kyung Kim, Go Eun Yang, Il-Seok Park, Ka Hee Yi, Chan Kwon Jung, Bo Hyun Kim
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Endocrinol Metab. 2021;36(3):619-627. Published online June 10, 2021
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DOI: https://doi.org/10.3803/EnM.2021.974
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- Background
We aimed to evaluate the clinicopathological features and biological behaviors of Korean thyroid cancer patients with rare variants of papillary thyroid carcinoma (PTC) to address the ambiguity regarding the prognostic consequences of these variants.
Methods We retrospectively reviewed the medical records of 5,496 patients who underwent thyroid surgery for PTC, between January and December 2012, in nine tertiary hospitals. Rare PTC variants included tall cell (TCV), columnar cell (CCV), diffuse sclerosing (DSV), cribriform-morular (CMV), solid (SV), hobnail, and Warthin-like variants. Recurrence-free survival (RFS) was defined as the time from the date of thyroidectomy until recurrence.
Results Rare variants accounted for 1.1% (n=63) of the PTC patients; with 0.9% TCV, 0.02% CCV, 0.1% DSV, 0.1% CMV, and 0.1% SV. The mean age of patients and primary tumor size were 42.1±13.1 years and 1.3±0.9 cm, respectively. Extrathyroidal extension and cervical lymph node metastasis were observed in 38 (60.3%) and 37 (58.7%) patients, respectively. Ultrasonographic findings revealed typical malignant features in most cases. During a median follow-up of 7 years, 6.3% of patients experienced a locoregional recurrence. The 5-year RFS rates were 71.4% in patients with DSV or SV, 95.9% for TCV, or CCV, and 100% for other variants. DSV emerged an independent risk factor associated with shorter RFS.
Conclusion In this multicenter Korean cohort, rare variants accounted for 1.1% of all PTC cases, with TCV being the most frequent subtype. DSV emerged as a significant prognostic factor for RFS.
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- Diagnosis for Pheochromocytoma and Paraganglioma: A Joint Position Statement of the Korean Pheochromocytoma and Paraganglioma Task Force
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Eu Jeong Ku, Kyoung Jin Kim, Jung Hee Kim, Mi Kyung Kim, Chang Ho Ahn, Kyung Ae Lee, Seung Hun Lee, You-Bin Lee, Kyeong Hye Park, Yun Mi Choi, Namki Hong, A Ram Hong, Sang-Wook Kang, Byung Kwan Park, Moon-Woo Seong, Myungshin Kim, Kyeong Cheon Jung, Chan Kwon Jung, Young Seok Cho, Jin Chul Paeng, Jae Hyeon Kim, Ohk-Hyun Ryu, Yumie Rhee, Chong Hwa Kim, Eun Jig Lee
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Endocrinol Metab. 2021;36(2):322-338. Published online April 6, 2021
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DOI: https://doi.org/10.3803/EnM.2020.908
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- Pheochromocytoma and paraganglioma (PPGLs) are rare catecholamine-secreting neuroendocrine tumors but can be life-threatening. Although most PPGLs are benign, approximately 10% have metastatic potential. Approximately 40% cases are reported as harboring germline mutations. Therefore, timely and accurate diagnosis of PPGLs is crucial. For more than 130 years, clinical, molecular, biochemical, radiological, and pathological investigations have been rapidly advanced in the field of PPGLs. However, performing diagnostic studies to localize lesions and detect metastatic potential can be still challenging and complicated. Furthermore, great progress on genetics has shifted the paradigm of genetic testing of PPGLs. The Korean PPGL task force team consisting of the Korean Endocrine Society, the Korean Surgical Society, the Korean Society of Nuclear Medicine, the Korean Society of Pathologists, and the Korean Society of Laboratory Medicine has developed this position statement focusing on the comprehensive and updated diagnosis for PPGLs.
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- Clinical Study
- Molecular Correlates and Nuclear Features of Encapsulated Follicular-Patterned Thyroid Neoplasms
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Chan Kwon Jung, Andrey Bychkov, Dong Eun Song, Jang-Hee Kim, Yun Zhu, Zhiyan Liu, Somboon Keelawat, Chiung-Ru Lai, Mitsuyoshi Hirokawa, Kaori Kameyama, Kennichi Kakudo
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Endocrinol Metab. 2021;36(1):123-133. Published online February 24, 2021
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DOI: https://doi.org/10.3803/EnM.2020.860
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Abstract
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- Background
Assessing nuclear features is diagnostically challenging in the aspect of thyroid pathology. The aim of this study was to determine whether pathologists could distinguish BRAF-like and RAS-like nuclear features morphologically and identify morphological features to differentiate thyroid tumors with RAS-like mutations from encapsulated papillary thyroid carcinoma (PTC) with predominant follicular growth and BRAFV600E mutation.
Methods Representative whole slide images of 16 encapsulated thyroid tumors with predominant follicular growth were reviewed by 12 thyroid pathologists using a web browser-based image viewer. Total nuclear score was calculated from semi-quantitatively scored eight nuclear features. The molecular profile of RAS and BRAF genes was determined by Sanger sequencing.
Results Total nuclear score ranging 0 to 24 could differentiate BRAF-like tumors from RAS-like tumors with a cut-off value of score 14. The interobserver agreement was the highest for the assessment of nuclear pseudoinclusions (NPIs) but the lowest for nuclear elongation and sickle-shaped nuclei. NPIs were found in tumors with BRAFV600E mutation, but not in tumors with RAS-like mutations. Total nuclear scores were significantly higher for tumors with BRAFV600E than for those with RAS-like mutations (P<0.001).
Conclusion Our results suggest that NPIs and high nuclear scores have diagnostic utility as rule-in markers for differentiating PTC with BRAFV600E mutation from benign or borderline follicular tumors with RAS-like mutations. Relaxation of rigid criteria for nuclear features resulted in an overdiagnosis of PTC. Immunostaining or molecular testing for BRAFV600E mutation is a useful adjunct for cases with high nuclear scores to identify true PTC.
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Chankyung Kim, Shipra Agarwal, Andrey Bychkov, Jen-Fan Hang, Agnes Stephanie Harahap, Mitsuyoshi Hirokawa, Kennichi Kakudo, Somboon Keelawat, Chih-Yi Liu, Zhiyan Liu, Truong Phan-Xuan Nguyen, Chanchal Rana, Huy Gia Vuong, Yun Zhu, Chan Kwon Jung Virchows Archiv.2024; 484(4): 645. CrossRef - Clinicopathologic Features and Cytologic Correlation of ALK-Rearranged Papillary Thyroid Carcinoma: A Series of Eight Cases
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Kennichi Kakudo, Chan Kwon Jung, Zhiyan Liu, Mitsuyoshi Hirokawa, Andrey Bychkov, Huy Gia Vuong, Somboon Keelawat, Radhika Srinivasan, Jen-Fan Hang, Chiung-Ru Lai Journal of Pathology and Translational Medicine.2023; 57(6): 289. CrossRef - Noninvasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features (NIFTP): Tumour Entity with a Short History. A Review on Challenges in Our Microscopes, Molecular and Ultrasonographic Profile
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- Updates in the Pathologic Classification of Thyroid Neoplasms: A Review of the World Health Organization Classification
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Yanhua Bai, Kennichi Kakudo, Chan Kwon Jung
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Endocrinol Metab. 2020;35(4):696-715. Published online December 2, 2020
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DOI: https://doi.org/10.3803/EnM.2020.807
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- Advances in medical sciences and evidence-based medicine have led to momentous changes in classification and management of thyroid neoplasms. Much progress has been made toward avoiding overdiagnosis and overtreatment of thyroid cancers. The new 2017 World Health Organization (WHO) classification of thyroid neoplasms updated the diagnostic criteria and molecular and genetic characteristics reflecting the biology and behavior of the tumors, and newly introduced the category of borderline malignancy or uncertain malignant potential. Some neoplasms were subclassified, renamed, or redefined as a specific entity. This review introduces changes in the fourth edition WHO classification of thyroid tumors and updates the contemporary diagnosis and classification of thyroid tumors. We also discuss several challenges with the proposal of new diagnostic entities, since they have unique histopathologic and molecular features and clinical relevance.
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- Recent Advances in Core Needle Biopsy for Thyroid Nodules
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Chan Kwon Jung, Jung Hwan Baek
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Endocrinol Metab. 2017;32(4):407-412. Published online December 14, 2017
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DOI: https://doi.org/10.3803/EnM.2017.32.4.407
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Abstract
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Core needle biopsy (CNB) was introduced as an alternative diagnostic tool to fine-needle aspiration (FNA), and is increasingly being used in the preoperative assessment of thyroid nodules. CNB provides a definitive diagnosis in most cases, but it sometimes may be inconclusive. CNB has the advantage of enabling a histologic examination in relation to the surrounding thyroid tissue, immunohistochemistry, and molecular testing that can provide a more accurate assessment than FNA in selected cases. Nevertheless, CNB should be performed only by experienced experts in thyroid interventions to prevent complications because CNB needles are larger in caliber than FNA needles. As recent evidence has accumulated, and with improvements in the technique and devices for thyroid CNB, the Korean Society of Thyroid Radiology released its 2016 thyroid CNB guidelines and the Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Group published a consensus statement on the pathology reporting system for thyroid CNB in 2015. This review presents the current consensus and recommendations regarding thyroid CNB, focusing on indications, complications, and pathologic classification and reporting.
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Ka Hee Yi, Young Joo Park, Sung Soo Koong, Jung Han Kim, Dong Gyu Na, Jin Sook Ryu, So Yeon Park, In Ae Park, Chung Hwan Baek, Young Kee Shong, Young Don Lee, Jaetae Lee, Jeong Hyun Lee, Jae Hoon Chung, Chan Kwon Jung, Seung Ho Choi, Bo Youn Cho
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Endocrinol Metab. 2010;25(4):270-297. Published online December 1, 2010
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DOI: https://doi.org/10.3803/EnM.2010.25.4.270
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3,769
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- No abstract available.
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- A Patient with Concurrent Medullary and Papillary Carcinoma of the Thyroid.
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Seung Hee Yoo, Keun Joon Lim, Seung Hwan Lee, Ji Hyun Kim, Soon Hwa Hong, Jae Hyoung Cho, Chan Kwon Jung, Hyuk Sang Kwon, Kun Ho Yoon, Min Sik Kim, Bong Yun Cha, Ho Young Son
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J Korean Endocr Soc. 2007;22(3):235-240. Published online June 1, 2007
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DOI: https://doi.org/10.3803/jkes.2007.22.3.235
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2,064
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- The origin of medullary thyroid carcinoma and papillary thyroid carcinoma are embryogenically different, so these tumors have been thought to be independent of each other. We experienced a case of concurrent medullary and papillary thyroid carcinoma in one patient. The patient underwent total thyroidectomy and both two tumors were located at different lobes, respectively. Both tumors showed their own characteristic pathologic and immunohistochemical findings. The patient's elevated calcitonin level returned to the normal range after operation and there has been no evidence of recurrence. It is still controversial whether the concurrency is just coincidental or it arises from activation of a common tumorigenic pathway.
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- A Case of Concurrent Papillary and Medullary Thyroid Carcinomas Detected as Recurrent Medullary Carcinoma after Initial Surgery for Papillary Carcinoma
Dongbin Ahn, Jin Ho Sohn, Ji Young Park Journal of Korean Thyroid Association.2013; 6(1): 80. CrossRef
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