Endocrinology and Metabolism

Original Article

A Clinical Analysis of 2,500 Cases of Thyroid Nodules in the Korean People.: Chong Suk Lee; J Korean Endocr Soc. 1996;11(4):418-430. Published online November 7, 2019

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Abstract PDF: Background
Thyroid nodules are one of the most clinical problems encounted by physieian. Palpation, radianuclide imaging, and sonography do not deterrnine whether a thyroid nodule is benign and malignant. So, the purpose of this study is to investigate how many thyroid cancer consist in thyroid nodule by using the fine needle aspiration(FNA) technique. Methods: With a disposable #23 gauge needle attached to 5rnl disposable plastic syringe was inserted at the thyroid nodules of the patients after rectinilinear thyroid scanning or ultrasono- graphy. All cells aspirated from the thyroid nodules were smeared on the 3 slide glasses and then, 2 slide glasses were immersed in 95% ethanol for Papanicolaou staining and one slide was air dried m room temperature for Giemsa staining. After complete staining the cytologic diagnosis of all slide glasses were reviewed by general light mi~eroscope. Results: Approximately, three-quarters(73.0%) of thyroid nodules aspirated by FNA were diagnosed as benign or inflammatory nodules, rnalignant neoplasia including follicular neoplasia 12.5%, and indeterminate cases 14.5% of thyroid nodules. Conclusion: Fine needle aspiration(FNA) has become the diagnostic procedure of choiee in the evaluation of the nodular thyroid disease because of its easiness, safety, cost effectiveness, and high diagnostic accuracy. Malignant neopleasia including follicular neopleasia were found 12.5% of thyroid nodules in Korean, aspirated by FNA which was same category in prevalence rate compared to known abroad results(8~20%).

Case Report

A Case of Hyalinizing Trabecular Tumor of the Thyroid Gland Misdiagnosed as Medullary Carcinoma at Cytologic Examination.: Jae Joon Han, Yun Jung Lee, Moon Chan Choi, Mikwang Kwon, Suk Chon, Juhie Lee; J Korean Endocr Soc. 2008;23(5):327-331. Published online October 1, 2008; DOI: https://doi.org/10.3803/jkes.2008.23.5.327

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Abstract PDF: A hyalinizing trabecular tumor (HTT) is a rare benign thyroid tumor that can present as a solitary thyroid nodule, a prominent nodule in a multinodular goiter, or as an incidental finding within a thyroidectomy specimen. The clinical importance of this entity is that it is frequently misdiagnosed as papillary carcinoma or medullary carcinoma on fine-needle aspiration cytology or histopathologic examination. The cytology of HTT is characterized by hypercellularity, nuclear grooves, nuclear pseudoinclusions, and powdery chromatin of the tumor cells, which is frequently seen in papillary carcinomas. The histologic findings of the tumor show polygonal and spindle cells arranged in a trabecular growth pattern with the presence of a variable hyalinized stroma. Calcitonin and other neuroendocrine markers can be used to differentiate HTT from medullary carcinoma. MIB-1, galectin-3, or other cytokeratin markers help to exclude papillary carcinoma. We report a patient with a thyroid tumor misdiagnosed as a medullary carcinoma on fine-needle aspiration and finally diagnosed as HTT after total thyroidectomy and immunohistochemical examination.

Original Articles

Galectin-3 and Thyroid Peroxidase Expression in Thyroid Nodules.: Gyu Hwan Bae, Hyun Dae Yoon, Jong Yup Bae, Ho Sang Son, Eui Dal Jung, Sung Pyo Hong, Myung Hwan Kim, Sun Ah Lee, Hyun Sook Kim, Sun Young Ahn; J Korean Endocr Soc. 2007;22(2):105-111. Published online April 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.2.105

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2 Crossref

Abstract PDF

BACKGROUND
The accurate diagnosis of a thyroid nodule is important in deciding a patient's treatment plan and for predicting the prognosis. The histopathological diagnosis of resected specimens are largely positively accomplished, but the consistency of the diagnosis is low when the specimen shows a small carcinomatous cytological feature or the nodule does not express papillary proliferation. Therefore, the need for supplementary diagnostic measures is increased. Herein, the expressions of galectin-3 and thyroid peroxidase (TPO) of resected specimens were investigated using immunohistochemical staining, and their potential for contributing to an accurate diagnosis studied. METHODS: The specimens included 195 resected thyroid nodules obtained from 179 patients having undergone thyroid surgery. Immunohistochemical staining for two useful antibodies, galectin-3 and TPO, were performed, and the expressions of these two antibodies investigated with regard to the histological diagnosis. RESULTS: The sensitivity, specificity, and positive and negative predictive values of galectin-3 and TPO for detecting papillary carcinomas were all 100%, but these values were low for other forms of carcinoma. CONCLUSION: Our data showed the diagnosis of thyroid nodules, using immunohistochemical staining for galectin-3 and TPO, was very useful for detecting thyroid papillary carcinoma, but insufficiently sensitive for follicular carcinoma. Immunohistochemical staining for TPO is also useful for distinguishing cases when a false positive result for galectin-3 is obtained.

Citations

Citations to this article as recorded by

Immunohistochemical Expression of CXC Chemokine Receptor 4 and Galectin-3 in Follicular Tumors of Thyroid
Ji Eun Park, Bu Kyung Kim, Sangeon Gwoo, Yo-Han Park, Young Sik Choi, Young Ok Kim
Journal of Korean Thyroid Association.2012; 5(1): 45. CrossRef
The Significance of Immunohistochemical Staining in Thyroid Nodule: TPO and Galectin-3
G Gong
Journal of Korean Endocrine Society.2007; 22(2): 95. CrossRef

Usefulness of Thallium-201 Scintigraphy for Differentiating Benign and Malignant Thyroid Nodules in Inconclusive Cases with Fine Needle Aspiration.: Young Sil Lee, Chang Won Lee, Mi Hwa Jang, Ju Won Seok, Seok Man Son, Seok Dong Yoo, In Joo Kim, Yong Ki Kim; J Korean Endocr Soc. 2001;16(4-5):447-456. Published online October 1, 2001

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Abstract PDF: BACKGROUND
Although fine needle aspiration(FNA) is recognized as the most accurate procedure in the differential diagnosis of thyroid nodules, about 20~30% of nodules remain inconclusive in FNA. Therefore, we assessed the usefulness of Thallium-201 scintigraphy in differentiating benign from malignant thyroid nodules in patients with inconclusive diagnosis by FNA. METHODS: We studied 43 patients with inconclusive diagnosis(29 of follicular neoplasm, 11 of cystic change and 3 of inadequate) by FNA, with the results being confirmed histopathologically by operation. Thallium-201 scintigraphy was performed at 15 minutes(early scan) and 2-3 hours(late scan) after the intravenous administration of 37 MBq of thallium-201. Malignant nodules were defined by the retention of Thallium-201 on delayed images. RESULTS: In the 43 patients with inconclusive FNA diagnosis, Thallium-201 scan had a sensitivity of 75.0%, specificity of 62.9% and accuracy of 65.1%. The positive and negative predictive values were 31.6% and 91.7%, respectively. In the 29 patients with follicular neoplasm by FNA, Thallium-201 scan had a sensitivity of 83.3%, specificity of 60.9% and accuracy of 65.5%. The positive and negative predictive values were 35.7% and 93.3%, respectively. CONCLUSION: In particular, Thallium-201 scintigraphy demonstrated a high negative predictive value, Therefore, for patients with inconclusive FNA findings, Thallium-201 scintigraphy might be useful in differentiating between benign and malignant thyroid nodules, and has the potential to reduce the rate of unnecessary operations in benign nodules.

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