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Review Article
Thyroid
A Narrative Review of the 2023 Korean Thyroid Association Management Guideline for Patients with Thyroid Nodules
Eun Kyung Lee, Young Joo Park, Chan Kwon Jung, Dong Gyu Na
Endocrinol Metab. 2024;39(1):61-72.   Published online February 14, 2024
DOI: https://doi.org/10.3803/EnM.2024.1938
  • 2,173 View
  • 136 Download
  • 1 Crossref
AbstractAbstract PDFPubReader   ePub   
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.

Citations

Citations to this article as recorded by  
  • 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
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Letters
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.)
Sue Youn Kim, Chan Kwon Jung
Endocrinol Metab. 2022;37(6):947-948.   Published online November 10, 2022
DOI: https://doi.org/10.3803/EnM.2022.1596
  • 1,777 View
  • 158 Download
  • 1 Crossref
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Citations

Citations to this article as recorded by  
  • 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
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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
Chan Kwon Jung, Ja Seong Bae, Young Joo Park
Endocrinol Metab. 2022;37(5):816-818.   Published online October 11, 2022
DOI: https://doi.org/10.3803/EnM.2022.1586
  • 1,994 View
  • 166 Download
  • 4 Web of Science
  • 7 Crossref
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Citations

Citations to this article as recorded by  
  • Bilateral axillo-breast approach robotic total thyroidectomy without isthmectomy: a case report
    Hyeji Kim, Hyeonuk Hwang, Hyungju Kwon
    The Ewha Medical Journal.2024;[Epub]     CrossRef
  • Contents analysis of thyroid cancer-related information uploaded to YouTube by physicians in Korea: endorsing thyroid cancer screening, potentially leading to overdiagnosis
    EunKyo Kang, HyoRim Ju, Soojeong Kim, Juyoung Choi
    BMC Public Health.2024;[Epub]     CrossRef
  • Cost-Utility Analysis of Early Detection with Ultrasonography of Differentiated Thyroid Cancer: A Retrospective Study on a Korean Population
    Han-Sang Baek, Jeonghoon Ha, Kwangsoon Kim, Ja Seong Bae, Jeong Soo Kim, Sungju Kim, Dong-Jun Lim, Chul-Min Kim
    Endocrinology and Metabolism.2024; 39(2): 310.     CrossRef
  • Thyroid Cancer Incidence Among Korean Individuals: A Comparison of South Korea and the United States
    Dohun Kim, Guan Li, Peter K. Moon, Yifei Ma, Soohyun Sim, Sung Y. Park, Minkyung Oh, Uchechukwu C. Megwalu
    The Laryngoscope.2024;[Epub]     CrossRef
  • Survival Comparison of Incidentally Found versus Clinically Detected Thyroid Cancers: An Analysis of a Nationwide Cohort Study
    Shinje Moon, Eun Kyung Lee, Hoonsung Choi, Sue K. Park, Young Joo Park
    Endocrinology and Metabolism.2023; 38(1): 81.     CrossRef
  • Cumulative exposure to metabolic syndrome increases thyroid cancer risk in young adults: a population-based cohort study
    Jinyoung Kim, Kyungdo Han, Mee Kyoung Kim, Ki-Hyun Baek, Ki-Ho Song, Hyuk-Sang Kwon
    The Korean Journal of Internal Medicine.2023; 38(4): 526.     CrossRef
  • Cost-Effectiveness of Active Surveillance Compared to Early Surgery of Small Papillary Thyroid Cancer: A Retrospective Study on a Korean Population
    Han-Sang Baek, Jeonghoon Ha, Kwangsoon Kim, Jaseong Bae, Jeong Soo Kim, Sungju Kim, Dong-Jun Lim, Chulmin Kim
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
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Review Article
Thyroid
Update from the 2022 World Health Organization Classification of Thyroid Tumors: A Standardized Diagnostic Approach
Chan Kwon Jung, Andrey Bychkov, Kennichi Kakudo
Endocrinol Metab. 2022;37(5):703-718.   Published online October 4, 2022
DOI: https://doi.org/10.3803/EnM.2022.1553
  • 17,422 View
  • 2,202 Download
  • 51 Web of Science
  • 67 Crossref
AbstractAbstract PDFPubReader   ePub   
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.

Citations

Citations to this article as recorded by  
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    Annales de Pathologie.2024; 44(1): 5.     CrossRef
  • Diagnostic Performance of [18F]TFB PET/CT Compared with Therapeutic Activity [131I]Iodine SPECT/CT and [18F]FDG PET/CT in Recurrent Differentiated Thyroid Carcinoma
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    Toui Nishikawa, Ibu Matsuzaki, Ayata Takahashi, Iwamoto Ryuta, Fidele Yambayamba Musangile, Kanako Sagan, Mizuki Nishikawa, Yurina Mikasa, Yuichi Takahashi, Fumiyoshi Kojima, Shin-ichi Murata
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    S.M. Cherenko
    INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine).2024; 19(8): 609.     CrossRef
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    Lindsay A. Bischoff, Ian Ganly, Laura Fugazzola, Erin Buczek, William C. Faquin, Bryan R. Haugen, Bryan McIver, Caitlin P. McMullen, Kate Newbold, Daniel J. Rocke, Marika D. Russell, Mabel Ryder, Peter M. Sadow, Eric Sherman, Maisie Shindo, David C. Shonk
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    Hassan Alzahrani
    International Journal of General Medicine.2024; Volume 17: 135.     CrossRef
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    Serge Guyétant
    Annales de Pathologie.2024; 44(2): 90.     CrossRef
  • Diagnostic implication of thyroid spherules for cytological diagnosis of thyroid nodules
    Heeseung Sohn, Kennichi Kakudo, Chan Kwon Jung
    Cytopathology.2024; 35(3): 383.     CrossRef
  • Aggressive Primary Thyroid Mucoepidermoid Carcinoma with Extensive Pulmonary Involvement
    Marius Mitrache, Dana Terzea, Anca Sirbu, Simona Fica
    Biomedicines.2024; 12(2): 285.     CrossRef
  • Unravelling the role of long non-coding RNAs in modulating the Hedgehog pathway in cancer
    Shailendra Singh Chandel, Anurag Mishra, Gaurav Dubey, Ravindra Pal Singh, Mithilesh Singh, Mohit Agarwal, Himmat Singh Chawra, Neelima Kukreti
    Pathology - Research and Practice.2024; 254: 155156.     CrossRef
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    Taylor O. Julsrud, Trenton R. Foster, Robert A. Vierkant, Melanie L. Lyden, Travis J. McKenzie, Mabel Ryder, Benzon M. Dy
    Surgical Oncology Insight.2024; 1(1): 100010.     CrossRef
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    P.Y. Marcy, M. Tassart, J.G. Marchand, J. Sanglier, A. Bizeau, E. Ghanassia
    Journal d'imagerie diagnostique et interventionnelle.2024; 7(2): 54.     CrossRef
  • Differentiating BRAF V600E- and RAS-like alterations in encapsulated follicular patterned tumors through histologic features: a validation study
    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
  • Cas no5. High-grade Tall cell papillary carcinoma
    Myriam Decaussin-Petrucci
    Annales de Pathologie.2024; 44(2): 114.     CrossRef
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    Discover Oncology.2024;[Epub]     CrossRef
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    Myriam Decaussin-Petrucci
    Annales de Pathologie.2024; 44(2): 120.     CrossRef
  • Papillary Thyroid Carcinoma With Lymphoepithelial Features and Lacking Association With Epstein-Barr Virus (EBV): A Rare Case
    Ahmed Bendari, Saroja Devi Geetha, Reham Al-Refai, Xuelin Zhong, Sunder Sham, Manju Harshan
    Cureus.2024;[Epub]     CrossRef
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    Perm Medical Journal.2024; 41(1): 90.     CrossRef
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    Clinical Hemorheology and Microcirculation.2024; : 1.     CrossRef
  • Unraveling the Significance of DGCR8 and miRNAs in Thyroid Carcinoma
    Lia Rodrigues, Arnaud Da Cruz Paula, Paula Soares, João Vinagre
    Cells.2024; 13(7): 561.     CrossRef
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    Surgical Clinics of North America.2024;[Epub]     CrossRef
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    Andrey Bychkov, Chan Kwon Jung
    Journal of Pathology and Translational Medicine.2024; 58(2): 98.     CrossRef
  • Ultrasound–Histopathological Presentation of Thyroid and Ovary Lesions in Adolescent Patients with DICER1 Syndrome: Case Reports and Literature Overview
    Dominika Januś, Monika Kujdowicz, Konrad Kaleta, Kamil Możdżeń, Jan Radliński, Anna Taczanowska-Niemczuk, Aleksandra Kiszka-Wiłkojć, Marcin Maślanka, Wojciech Górecki, Jerzy B. Starzyk
    Children.2024; 11(4): 403.     CrossRef
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  • Update on C-Cell Neuroendocrine Neoplasm: Prognostic and Predictive Histopathologic and Molecular Features of Medullary Thyroid Carcinoma
    Chan Kwon Jung, Shipra Agarwal, Jen-Fan Hang, Dong-Jun Lim, Andrey Bychkov, Ozgur Mete
    Endocrine Pathology.2023; 34(1): 1.     CrossRef
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  • Preoperative Risk Stratification of Follicular-patterned Thyroid Lesions on Core Needle Biopsy by Histologic Subtyping and RAS Variant-specific Immunohistochemistry
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    Fareeda Joshi, Shreya Hegde
    Indian Journal of Pathology and Oncology.2023; 10(2): 132.     CrossRef
  • Papillary thyroid carcinoma associated with non‑functioning parathyroid carcinoma with Warthin's tumor of the parotid gland: A case report and brief literature review
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    Chan Kwon Jung
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    身吾 王
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    Frontiers in Medicine.2023;[Epub]     CrossRef
  • Utility of the Growth Differentiation Factor-15 in the Differential Diagnosis of Follicular-Patterned Lesions of the Thyroid on Cytopathologic and Histopathologic Samples
    Prasanna V Perumal, Neelaiah Siddaraju, Sunil K Saxena, Soundravally Rajendiran, Ramachandra V Bhat
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  • Investigation of pre‐operative demographic, biochemical, sonographic and cytopathological findings in low‐risk thyroid neoplasms
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    Clinical Endocrinology.2023; 99(5): 502.     CrossRef
  • Applications of machine and deep learning to thyroid cytology and histopathology: a review
    Greg Slabaugh, Luis Beltran, Hasan Rizvi, Panos Deloukas, Eirini Marouli
    Frontiers in Oncology.2023;[Epub]     CrossRef
  • The Asian Thyroid Working Group, from 2017 to 2023
    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
  • Anaplastic thyroid cancer: Pathogenesis, prognostic factors and genetic landscape (Review)
    Abdul-Mohsen Alhejaily, Omar Alhuzim, Yazeed Alwelaie
    Molecular and Clinical Oncology.2023;[Epub]     CrossRef
  • Simultaneous Occurrence of Medullary Thyroid Carcinoma and Papillary Thyroid Carcinoma: A Case Series with Literature Review
    Poupak Fallahi, Armando Patrizio, Giulio Stoppini, Giusy Elia, Francesca Ragusa, Sabrina Rosaria Paparo, Eugenia Balestri, Valeria Mazzi, Chiara Botrini, Gilda Varricchi, Salvatore Ulisse, Marco Ghionzoli, Alessandro Antonelli, Silvia Martina Ferrari
    Current Oncology.2023; 30(12): 10237.     CrossRef
  • Construction and validation of a nomogram for predicting cervical lymph node metastasis in diffuse sclerosing variant of papillary thyroid carcinoma
    Xunyi Lin, Jiaxing Huo, Huan Zhang, Hang Su, Fenghua Zhang
    Langenbeck's Archives of Surgery.2023;[Epub]     CrossRef
  • Canine follicular cell and medullary thyroid carcinomas: Immunohistochemical characterization
    Jana Jankovic, Eve Tièche, Martina Dettwiler, Kerstin Hahn, Stephanie Scheemaeker, Martin Kessler, Sylvie Daminet, Sven Rottenberg, Miguel Campos
    Veterinary Pathology.2023;[Epub]     CrossRef
  • A 16-Year Single-Center Series of Trachea Resections for Locally Advanced Thyroid Carcinoma
    Julia I. Staubitz-Vernazza, Sina Schwind, Oana Lozan, Thomas J. Musholt
    Cancers.2023; 16(1): 163.     CrossRef
  • Reprogramming of Cellular Metabolism and Its Therapeutic Applications in Thyroid Cancer
    Yuji Nagayama, Koichiro Hamada
    Metabolites.2022; 12(12): 1214.     CrossRef
  • Developments to improve outcomes in thyroid surgery
    Thomas J. Musholt
    Innovative Surgical Sciences.2022; 7(3-4): 77.     CrossRef
  • The relationship of the clinicopathological characteristics and treatment results of post-Chornobyl papillary thyroid microcarcinomas with the latency period and radiation exposure
    Tetiana Bogdanova, Serhii Chernyshov, Liudmyla Zurnadzhy, Tatiana I. Rogounovitch, Norisato Mitsutake, Mykola Tronko, Masahiro Ito, Michael Bolgov, Sergii Masiuk, Shunichi Yamashita, Vladimir A. Saenko
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
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Original Articles
Thyroid
Diagnostic Performance of Thyroid Core Needle Biopsy Using the Revised Reporting System: Comparison with Fine Needle Aspiration Cytology
Kwangsoon Kim, Ja Seong Bae, Jeong Soo Kim, So Lyung Jung, Chan Kwon Jung
Endocrinol Metab. 2022;37(1):159-169.   Published online February 28, 2022
DOI: https://doi.org/10.3803/EnM.2021.1299
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AbstractAbstract 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.

Citations

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    Muzaffer Serdar Deniz, Merve Dindar
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    Meejeong Kim, Sora Jeon, Chan Kwon Jung
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Thyroid
Clinicopathological Characteristics and Recurrence-Free Survival of Rare Variants of Papillary Thyroid Carcinomas in Korea: A Retrospective Study
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
Endocrinol Metab. 2021;36(3):619-627.   Published online June 10, 2021
DOI: https://doi.org/10.3803/EnM.2021.974
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AbstractAbstract PDFPubReader   ePub   
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.

Citations

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Close layer
Special Article
Adrenal gland
Diagnosis for Pheochromocytoma and Paraganglioma: A Joint Position Statement of the Korean Pheochromocytoma and Paraganglioma Task Force
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
Endocrinol Metab. 2021;36(2):322-338.   Published online April 6, 2021
DOI: https://doi.org/10.3803/EnM.2020.908
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AbstractAbstract PDFPubReader   ePub   
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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Original Article
Clinical Study
Molecular Correlates and Nuclear Features of Encapsulated Follicular-Patterned Thyroid Neoplasms
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
Endocrinol Metab. 2021;36(1):123-133.   Published online February 24, 2021
DOI: https://doi.org/10.3803/EnM.2020.860
  • 5,271 View
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AbstractAbstract PDFPubReader   ePub   
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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Review Articles
Thyroid
Updates in the Pathologic Classification of Thyroid Neoplasms: A Review of the World Health Organization Classification
Yanhua Bai, Kennichi Kakudo, Chan Kwon Jung
Endocrinol Metab. 2020;35(4):696-715.   Published online December 2, 2020
DOI: https://doi.org/10.3803/EnM.2020.807
  • 16,540 View
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  • 40 Web of Science
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AbstractAbstract PDFPubReader   ePub   
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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Close layer
Recent Advances in Core Needle Biopsy for Thyroid Nodules
Chan Kwon Jung, Jung Hwan Baek
Endocrinol Metab. 2017;32(4):407-412.   Published online December 14, 2017
DOI: https://doi.org/10.3803/EnM.2017.32.4.407
  • 5,735 View
  • 83 Download
  • 28 Web of Science
  • 26 Crossref
AbstractAbstract PDFPubReader   

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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Close layer
Revised Korean Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Thyroid Cancer.
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
Endocrinol Metab. 2010;25(4):270-297.   Published online December 1, 2010
DOI: https://doi.org/10.3803/EnM.2010.25.4.270
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AbstractAbstract PDF
No abstract available.

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Case Report
A Patient with Concurrent Medullary and Papillary Carcinoma of the Thyroid.
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
J Korean Endocr Soc. 2007;22(3):235-240.   Published online June 1, 2007
DOI: https://doi.org/10.3803/jkes.2007.22.3.235
  • 1,889 View
  • 19 Download
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AbstractAbstract PDF
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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