PURPOSE: The purpose of this study was to evaluate and compare the sonographic findings of a conventional papillary carcinoma, follicular carcinoma and a follicular variant of a papillary carcinoma. MATERIALS and METHODS: A total of 308 nodules from 231 patients that were diagnosed with a papillary carcinoma and a follicular carcinoma by surgery after sonography were analyzed. The nodules consisted of a conventional papillary carcinoma (255, 83%), a follicular variant of a papillary carcinoma (25, 8%), and a follicualar carcinoma (28, 9%). We compared and analyzed the sonographic findings of each nodule for content, margin, echotexture, shape, calcification and halo sign. RESULTS: A conventional papillary carcinoma showed significant different sonographic findings than a follicular carcinoma and a follicular variant of a papillary carcinoma for an ill-defined or well-defined spiculated margin (63.1%), marked hypoechogenicity (85.9%) and microcalcification (49%). A follicular carcinoma showed a significant difference than a conventional papillary carcinoma for a well-defined smooth margin (92.9%), iso, hypo- or hyperechogenicity (89.3%), wider than tall shape (100%) and halo sign (82.1%). The follicular variant of a papillary carcinoma showed similar findings to a follicular carcinoma except for marked hypoechogenicity (44%, p = 0.006) and taller than wide shape (16%, p = 0.027). CONCLUSION: The follicular carcinoma and follicular variant of a papillary carcinoma showed similar sonographic findings, but findings of a conventional papillary carcinoma were different.
Carcinoma, Papillary* ; Diagnosis, Differential* ; Humans ; Thyroid Gland* ; Ultrasonography*

PURPOSE: The goal of this study was to validate the ultrasonography (US) and cytopathological features that are used in the diagnosis of the follicular variant of papillary thyroid carcinoma (FVPTC) and to characterize the role of BRAF(V600E) mutation analysis in the diagnosis of FVPTC. METHODS: From May 2012 to February 2014, 40 thyroid nodules from 40 patients (mean age, 56.2 years; range, 26 to 81 years) diagnosed with FVPTC were included in this study. The US features of the nodules were analyzed and the nodules were classified as probably benign or suspicious for malignancy. Twenty-three thyroid nodules (57.5%) underwent BRAF(V600E) mutation analysis. Clinical information and histopathologic results were obtained by reviewing the medical records of the patients. RESULTS: Thirty nodules (75.0%) were classified as suspicious for malignancy, while 10 (25.0%) were classified as probably benign. Seven of the eight nodules (87.5%) with atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) cytology showed suspicious US features, while one of the two nodules (50.0%) with follicular neoplasm cytology presented suspicious US features. Five of the 23 nodules (21.7%) that underwent BRAF(V600E) mutation analysis had positive results, all of which were diagnosed as suspicious for malignancy or malignant based on cytology. None of the nodules with benign, AUS/FLUS, or follicular neoplasm cytology were positive for the BRAF(V600E) mutation. CONCLUSION: US features allow nodules to be classified as suspicious for malignancy, and the presence of suspicious US features in nodules with ambiguous cytology may aid in the diagnosis of FVPTC. BRAF(V600E) mutation analysis is of limited value in the diagnosis of FVPTC.
Biopsy, Fine-Needle ; Carcinoma, Papillary ; Carcinoma, Papillary, Follicular ; Diagnosis ; Humans ; Medical Records ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule ; Ultrasonography*

We report the sonographic features of an intracystic papillary carcinoma of the breast presenting as recurrent hemorrhagic cysts following trauma. A 56-year-old woman presented with palpable breast masses after a traumatic event; sonography showed multiple, well-defined, hemorrhagic cysts. Hemorrhagic fluid was evacuated by fine needle aspiration with no residual lesions. Cytology was negative for malignancy. Five months later, the mass reappeared; sonography demonstrated multiple cysts with solid nodules. US-guided core biopsy and surgery revealed invasive papillary carcinoma. We suggest close follow-up of cystic masses, even with negative cytology, and performance of surgical excisional biopsy in cases of rapid refilling after aspiration.
Ultrasonography, Mammary/methods ; Recurrence ; Middle Aged ; Mammography/methods ; Lymphatic Metastasis ; Humans ; Hemorrhage/*diagnosis/ultrasonography ; Female ; Diagnosis, Differential ; Cysts/*diagnosis/ultrasonography ; Carcinoma, Papillary/*diagnosis/ultrasonography ; Breast Neoplasms/*diagnosis/ultrasonography

Intracystic papillary carcinoma (IPC) of the breast is very rare, and it has a much better prognosis than the other types of breast carcinoma. We experienced a case of intracystic papillary carcinoma that we diagnosed in an 83-year-old-woman. MR imaging of the IPC shows a multicystic appearance with a subacute or chronic stage of intracystic hemorrhage. The contrast-enhanced MR imaging demonstrates enhancement of the cyst wall and mural nodules, and this modality proved to be successful for making an accurate preoperative diagnosis.
Breast Neoplasms ; Breast* ; Carcinoma, Papillary* ; Diagnosis ; Hemorrhage* ; Magnetic Resonance Imaging ; Prognosis ; Ultrasonography*

PURPOSE: Papillary thyroid carcinoma is the most common malignant tumor originating from the thyroid. The recent increase in frequency of thyroid ultrasonography is increasing the diagnostic rate of thyroid cancer, especially of the small-sized cancer. The appropriate extent of surgery for thyroid micropapillary carcinoma is still under debate, and bilaterality of the tumor may be an important factor determining the extent. Therefore, this study analyzed the clinicopathologic factors related to tumor bilaterality in order to help decide the extent of treatment. METHODS: Subjects included 134 patients who received total thyroidectomy and central neck lymph node dissection at Wonju Christian Hospital under the diagnosis of thyroid micropapillary cancer from January 1(st), 1994 to December 31(st), 2009. The frequency of bilateral tumor among the subjects were studied, and the relationship between bilaterality and clinicopathologic factors, including patients' gender, age, tumor size, multiple mass in single lobe, capsule invasion, extrathyroidal extension, lymphovascular space invasion, central neck node invasion and lateral neck node invasion was analyzed. RESULTS: There were 32 cases (23.9%) of bilateral tumor. Statistically significant factors related to bilaterality included two or more mass in a single lobe, perithyroidal soft tissue invasion. CONCLUSION: When we plan thyroidectomy for thyroid micropapillary cancer, one cannot rule out the possibility of bilateral thyroid micropapillary cancer in patients with clinicopathologic factors related to bilaterality. Closer preoperative examination is thought to be required for such patients.
Carcinoma, Papillary* ; Diagnosis ; Gangwon-do ; Humans ; Lymph Node Excision ; Neck ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy ; Ultrasonography

We report here on a case of diffuse sclerosing papillary carcinoma (DSPC), which is a subtype of papillary carcinoma of thyroid, in a 27-year-old female. The ultrasound images showed diffuse enlargement of the thyroid lobes and this was associated with underlying diffuse scattered microcalcifications and a heterogeneous hypoechoic background parenchyma that was without any masses. The CT image showeddiffuse scattered dot-like hyperdensities with bilateral multiple metastastic lymph nodes. Because making the cytological diagnosis of DSPC is still challenging, the radiological findings that show this disease's characteristic features may be important clues for making the correct diagnosis.
Adult ; Carcinoma, Papillary* ; Diagnosis ; Female ; Humans ; Lymph Nodes ; Thyroid Gland* ; Ultrasonography*

Well differentiated papillary mesothelioma (WDPM) is an unusual variant of epithelial mesothelioma. Most WDPMs exhibit either benign or indolent behavior. Making the differential diagnosis between this rare tumor and serous papillary carcinoma can be problematic. We report here on a case of a 43-year-old woman with a WDPM of the surface. She presented to our hospital for a routine gynecologic evaluation, and she had no specific symptoms or a history of asbestos exposure. Gynecologic ultrasonography revealed a right ovarian mass that measured 6 x 3.8 x 3 cm in size. No ascites was detected. Right salpingo-oophorectomy was performed; grossly, the tumor was a yellowish firm, multinodular mass. Microscopically, the tumor consisted of numerous papillae that were lined by a single layer of uniform mesothelial cells. Nuclear pleomorphism and mitoses were not found. On immunohistochemical study, the tumor cells were positive for calretinin and cytokeratin, but they were negative for CEA. It is important to differentiate WDPM from serous papillary carcinoma or other malignant tumors to avoid treating them as malignant tumors.
Adult ; Asbestos ; Ascites ; Calbindin 2 ; Carcinoma, Papillary ; Diagnosis, Differential ; Female ; Humans ; Keratins ; Mesothelioma* ; Mitosis ; Ovary ; Ultrasonography

PURPOSE: To analyze the ultrasonographic (US) findings of thyroid nodules that yielded false negative results after an initial ultrasound-guided fine needle aspiration biopsy (FNAB). MATERIALS AND METHODS: Between August 2003 and February 2006, 389 patients with 405 thyroid nodules received a repeat US-guided FNAB. We retrospectively reviewed the US findings, cytology results and postsurgical pathological results. The cytology diagnoses were classified as benign, a suspicious malignancy, a follicular neoplasm, a papillary carcinoma, and a non-diagnostic result. The US findings of the thyroid nodules were analyzed with regard to size, internal content, shape, margin, echogenecity, and calcification pattern. RESULTS: Of the 405 thyroid nodules, 17 nodules were false negative. The major US findings of these nodules were a solid internal component in 16 nodules, hypoechogenicity or marked hypoechogenicity in 14 nodules, microcalcifications in 12 nodules, an ovoid to round shape in 9 nodules and a well-defined smooth margin in 9 nodules. CONCLUSION: An repeat US-guided FNAB should be performed if the thyroid nodules have one of the malignant US features such as hypoechogenecity or marked hypoechogenecity, a microcalcification, a taller than wide shape or a well-defined spiculate margin although the cytology results indicated a benign lesion. In addition, thyroid nodules with findings of a well-defined smooth margin, ovoid to round shape, and solid internal component might also be subject to a repeat US-guided FNAB to exclude a malignancy.
Biopsy* ; Biopsy, Fine-Needle* ; Carcinoma, Papillary ; Diagnosis ; Humans ; Retrospective Studies ; Thyroid Diseases ; Thyroid Nodule ; Ultrasonography*

OBJECTIVE: To test whether the impact of thyroid-nodule size on the malignancy risk differs according to the ultrasonography (US) patterns of nodules. MATERIALS AND METHODS: This study is a post hoc analysis using data from the Thyroid Imaging Reporting and Data System (TIRADS) multicenter retrospective study which included 2000 consecutive thyroid nodules (≥ 1 cm) with final diagnoses. A total of 2000 consecutive thyroid nodules from 1802 patients (1387 women and 613 men; mean age, 51.2 ± 12.2 years) were enrolled in this study. The malignancy risk of the nodules was assessed according to the nodule size and US patterns (Korean-TIRADS). RESULTS: Overall, the malignancy risk did not increase as nodules enlarged. In high-suspicion nodules, the malignancy rate had no association with nodule size (p = 0.467), whereas in intermediate- or low-suspicion nodules there was a trend toward an increasing malignancy risk as the nodule size increased (p = 0.004 and 0.002, respectively). The malignancy rate of large nodules (≥ 3 cm) was higher than that of small nodules (< 3 cm) in intermediate-suspicion nodules (40.3% vs. 22.6%, respectively; p = 0.001) and low-suspicion nodules (11.3% vs. 7.0%, respectively; p = 0.035). There was a trend toward a decreasing risk and proportion of papillary carcinoma and an increasing risk and proportion of follicular carcinoma or other malignant tumors as nodule size increased (p < 0.001, respectively). CONCLUSION: The impact of nodule size on the malignancy risk differed according to the US pattern. A large nodule size (≥ 3 cm) showed a higher malignancy risk than smaller nodules in intermediate- and low-suspicion nodules.
Carcinoma, Papillary ; Diagnosis ; Female ; Humans ; Information Systems ; Male ; Retrospective Studies ; Thyroid Gland* ; Thyroid Nodule* ; Ultrasonography*

Objective To evaluate extrathyroidal extension (ETE) in papillary thyroid microcarcinoma (PTMC) with three-dimensional tomographic ultrasound imaging (3D-TUI). Methods A total of 97 thyroid nodules of 79 patients with PTMC treated in PUMC Hospital from February 2016 to January 2018 were included in this study.Two ultrasound experts performed independent blinded assessment of the relationship between thyroid nodules and thyroid capsule by two-dimensional ultrasound (2D-US) and 3D-TUI.The results of 2D-US and 3D-TUI in evaluating ETE were compared with intraoperative findings and postoperative histological and pathological results. Results Among the 97 nodules,54 (55.7%) nodules had ETE.The diagnostic sensitivity (68.5% vs.37.0%;χ²=10.737,P=0.002),accuracy (74.5% vs.56.7%;χ²=6.686,P=0.015),and area under the receiver operating characteristic curve[0.761 (95%CI=0.677-0.845) vs.0.592 (95%CI=0.504-0.680);Z=3.500,P<0.001] of 3D-TUI were higher than those of 2D-US.However,3D-TUI and 2D-US showed no significant difference in the specificity (84.1% vs.81.4%;χ²=0.081,P=0.776),negative predictive value (67.9% vs.50.7%;χ²=3.645,P=0.066),or positive predictive value (84.1% vs.71.4%;χ²=1.663,P=0.240). Conclusion Compared with 2D-US,3D-TUI demonstrates increased diagnostic efficiency for ETE of PTMC.
Humans ; Thyroid Nodule ; Thyroid Neoplasms/diagnosis* ; Carcinoma, Papillary/pathology* ; Ultrasonography/methods* ; Retrospective Studies