- Molecular Diagnosis of Recurrent Thyroid Cancer by Reverse Transcription-Polymerase Chain Reaction of Thyroglobulin Messenger Ribonucleic Acid in Peripheral Blood.
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Sung Il Kwon, Ki Ryong Park, Hyun Young Kim, Chae Hee Shin, Young Chan Lim, Young Sik Choi, Yo Han Park, Kang Dae Lee, Hee Kyung Chang, Jae Hwa Lee, Ha Yong Yum
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J Korean Endocr Soc. 2002;17(4):501-513. Published online August 1, 2002
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 Abstract
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- BACKGROUND
Differentiated thyroid cancer is the most common endocrine malignancy. Despite advances in the treatment of thyroid cancer, disease recurrence and metastasis may occur in as many as 20% of patients, and so continues to pose major problems in its clinical management. Serum thyroglobulin (Tg) measurements, by immunoassay, are used to detect residual or recurrent thyroid cancer following thyroid ablation. However, the usefulness of immunoassay is limited by both the requirement for thyroid hormone withdrawal, to attain optimal test sensitivity, and interference by the antithyroglobulin antibody (Anti-Tg Ab). Recent studies have reported the clinical usefulness of reverse transcription-polymerase chain reaction (RT-PCR) detection of Tg mRNA in the peripheral blood of patients with differentiated thyroid carcinomas. We performed this study to evaluate the usefulness RT-PCR of Tg mRNA in peripheral blood of patients with thyroid carcinoma following a total thyroidectomy and radioiodine ablation therapy. METHODS: Forty cases that underwent a total thyroidectomy and radioiodine ablation therapy were included in this study. Of the 40 patients, 35 were papillary carcinomas and 5 were follicular carcinomas. Ten normal control subjects were also studied. Tg mRNA was extracted. Then RT-PCR, and nested RT-PCR, were run with specific Tg primers. Concurrently, DNA sequencing of the isolates was carried out to prove the isolates were identical to the nucleotide sequence of the Tg. RESULTS: The Tg was detected in 4 of 19 patients, with either a residual thyroid bed, or metastasis, on a 131I whole body scan and in 1 of 21 patients with a negative radioiodine scan. Surprisingly, the Tg mRNA was detected in all the patients and normal controls. CONCLUSION: From our results we can not recommend Tg mRNA, detected by RT-PCR in peripheral blood, as a tumor marker superior to that of the Tg serum level. We consider an intensive re-evaluation of the method is required before considering its clinical applications.
- The Diahnostic Value of Ultrasound-Guided Fine Needle Aspiration Cytology in the Thyroid Indedentaloma.
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Young Sik Choi, Kibum Kwon, Seong Man Kim, Yo Han Park, Kyung Seung Oh, Ji young Seo, Bong Kwon Chun, Hee Kyung Chang
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J Korean Endocr Soc. 1999;14(1):71-80. Published online January 1, 2001
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Abstract
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- BACKGROUND
The introductian of highly sensitive imaging techniques has made it possible to detect many nonpalpable nodules, or incidentaloma. Because these nodules are small sized or deep seated, the diagnostic approach is difficult with conventional methods but it is easy with ultrasound-guided fine needle aspiration (FNA). However, the role of ultrasound-guided FNA on the incidentalomas has been poorly evaluated, so we tried to assess the diagnostic value of high resolution ultrasound-guided FNA in the incidentalomas. METHODS: One hundred forty-nine patients who underwent high resolution ultrasound-guide FNA for nonpalpable nodules that was smaller than 1.5 cm in diameter at Kosin Medical Center from June, 1996 to April, 1998 were included in the study. Ultrasound-guided FNA was performed with a 22-guage needle attached to 10 mL syringe with 10 MHz linear transducer in a free hand fashion. The aspirated materials were smeared and stained with Papanicolaou stain. For those who underwent surgery histopathologic diagnoses were compared to cytological diagnoses. RESULTS: The mean age of the patients was 45 and most of them were middle aged. Male to female ratio was 1:11.4. Of 149 patients 16 were involutional change, 55 hyperplasia, 42 Hashimotos thyroiditis, 8 follicular neoplasm, 19 papillary carcinoma, 1 subacute thyroiditis, and 6 inadequate specimen. Of the 149 nodules, 123 cases were solid, 11 cystic, and 15 mixed. Malignant nodules were more frequent in the solid nodule, but there was no significant difference between each group. Ten of 93 cases (10.7%) measured less than 1 cm and nine of 56 cases (16.1%) between 1.0 cm to 1,5 cm were malignant nodules. The difference of incidence rate of malignant nodules between each group was not significant. The incidence of malignancy was 13.6% (12/88) in solitary nodule and 11.5% (7/61) in multiple nodules. The difference of incidence rate of malignant nodules between each group was not significant. Eighteen cases including 14 malignancies diagnosed by FNA underwent operation. Of those 13 were papillary carcinoma and 5 adenomatous goiter. Upon the correlation of ultrasound-guided FNA cytology with pathologic diagnosis, the sensitivity of ultrasound-guided FNA cytology in differentiating benign and malignant nodule was 92.3% and overall diagnostic accuracy was 80.0%. The obtainability of adequate cytologic specimen by ultrasound-guided FNA was 95.9%. No complication except pain was noted during this study. CONCLUSION: High resolution ultrasound-guided FNA cytology may be useful for the diagnosis of thyroid cancer in the thyroid incidentalomas and also useful for early detection of recurrence of thyroid cancer .
- The Diagnostic Value of Ultrasound-Guided Fine Needle Aspiration Cytology in the Thyroid Nodules.
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Yang Hun Koo, Sung Jun Hong, Hwi Choi, Hark Rim, Young Sik Choi, Yo Han Park, Kyung Seung Oh, Hee Kyung Chang
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J Korean Endocr Soc. 1996;11(4):391-400. Published online November 7, 2019
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- Background
Thyroid nodule is a common disease of thymid gland. The incidence of malignant nodule is about 3%, so most of thyroid nodules are benign. Because most thyroid nodule morbidity is related to cancerous lesions, early detection of malignant nodule is important. However, some of these nodules are srnall sized or deep seated which were not detected by physieal exarnination but by ultrasonography incidentally. In these cases the diagnostic approach is difficult with conventional methods but it is easy with ultrasound-guided fine needle aspiration (FNA). However, the role of ultrasound-guided FNA on the thyroid nodules has been poorly evaluated, so we tried to assess the diagnostic value of high resolution ultrasound-guided FNA in the thyroid nodules. Methods: We examined the medical records retrospectively of all patients who were engaged in high resolution ultrasonography(ATL Ultramark-9, 10 MHz linear transducer) due to thyroid nodules and/or other thyroid abnormalities from September, 1995 to March, 1996. Ultrasound- guided FNA was performed in 137 patients with palpable or nonpalpable(small sized or deep seated) nodules which were detected by high resolution ultrasonography. Results: The mean age of the patients was 45 and most of them were middle aged. Male to female ratio was 1:8.1. Malignant nodules were frequent in patients over 30 yus of age. Of 137 patients 43 were involutional change, 45 hyperplasia, 12 Hashimotos thyroiditis, 12 follicular neoplasm, ll papillary carcinoma, 1 Hurthle cell tumor, 1 medullary carcinoma, and 12 inadequate specimen. In 22 cases thyroid nodules were not detected by physical examinatian but by ultrasonography and in 31 cases additional thyroid nodules were detected by ultrasonography. In the nature of thyroid nodules, 99 cases were solid, 16 cystic, 22 mixed. Malignant nodule were more frequent in the solid nodule, but thete was no significant difference between each group. The size of masses was categorized into four groups. Thirty-one cases measured less than 1cm, 63 between 1cm and 1.9cm, 29 between 2cm to 2.9cm, and 14 over 3cm. The malignant nodule was not palpable in 3 cases and the smallest was 0.7cm in diameter. Most of malignant lesions were between 1cm and 2.9cm, but the difference of incidence rate of rnalignant nodules between each group was not significant. The incidence rate of malignancy was 8.8% in solitary nodule and 8.7% in multiple nodules. Twenty-three cases including 12 malignancies diagnosed by FNA underwent operation. Of those 13 were papillary earcinoma, 1 follicular carcinoma, 1 medullary carcinoma. Upon the correlation of ultrasound-guided FNA cytology with pathologic diagnosis, the sensitivity of ultrasound-guided FNA cytology in differentiating benign and malignant nodule was 80.0%, the specificity 100% and overall diagnostic accuracy was 86.1%. The obtainability of adequate cytologic specimen by ultrasound-guided FNA was 91%. No complication except pain was noted during this study. Conclusion: High resolution ultrasound-guided FNA cytology in the thyroid nodules may be useful in the diagnosis of thyroid cancer especially in the nodules which were small sized or deep seated and also useful in early detection of recurrence of thyroid cancer.
- A Case of Follicular Carcinoma Associated with Hashimoto's Thyroiditis Arising in a Thyroglossal Duct Remnant.
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Jin Choi, Jun Cheol Lee, Sun Mi Park, Tae Joon Cha, Hark Rim, Young Sik Choi, Yo Han Park, Hee Kyung Chang
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J Korean Endocr Soc. 1996;11(3):336-342. Published online November 7, 2019
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- Thyroglossal duct remnants are common congenital abnormalities of the thyroid development but malignant tumors arising in the thyroglossal duct remnants are rare, occuring in less than 1%. In the literature, about 160 cases of malignancy in the thyroglossal duct remnant have been reported. Among the various types of carcinoma being found from the thyroglossal duct remnants, most are papillary carcinoma(79.8%) and Mixed follicular-papillary carcinoma(9.5%). Others are squamous cell carcinoma(7.6%), follicular carcinoma(1.2%), and anaplastic carcinoma(0.6%). Hashimotos thyroiditis is a common autoimmune disease of the thyroid gland. Malignant tumors of the thyroid gland with Hashimotos thyroiditis are rare disorder except malignant lymphoma whose association with Hashimotos thyroiditis is well known. Malignant tumors associated with Hashimotos thyroiditis arising in a thyroglossal duct remnant are extremely rare. Recently the authors experienced a case of follicular carcinoma associated with Hashimotos thyroiditis arising in a thyroglossal duct remnant, which was removed by local excision and reported with literature review.
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