1.Radiological Spectrum of Intraductal Papillary Tumors of the Bile Ducts.
Jae Hoon LIM ; Chin A YI ; Hyo Keun LIM ; Won Jae LEE ; Soon Jin LEE ; Seung Hoon KIM
Korean Journal of Radiology 2002;3(1):57-63
Papillary tumor of the bile duct is characterized by the presence of an intraductal tumor with a papillary surface comprising innumerable frondlike infoldings of proliferated columnar epithelial cells surrounding slender fibrovascular stalks. There may be multiple tumors along the bile ducts (papillomatosis or papillary carcinomatosis), which are dilated due to obstruction by a tumor per se, by sloughed tumor debris, or by excessive mucin. Radiologically, the biliary tree is diffusely dilated, either in a lobar or segmental fashion, or aneurysmally, depending on the location of the tumor, the debris, and the amount of mucin production. A tumor can be depicted by imaging as an intraductal mass with a thickened and irregular bile duct wall. Sloughed tumor debris and mucin plugs should be differentiated from bile duct stones. Cystically or aneurysmally, dilated bile ducts in mucin-hypersecreting variants (intraductal papillary mucinous tumors) should be differentiated from cystadenoma, cystadenocarcinoma and liver abscess.
Bile Duct Neoplasms/*radiography
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*Bile Ducts, Extrahepatic
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*Bile Ducts, Intrahepatic
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Carcinoma, Papillary/radiography
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Cystadenoma, Mucinous/radiography
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Diagnosis, Differential
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Female
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Human
;
Male
;
Middle Age
2.A Case of an Ectopic Thyroid Gland at the Lateral Neck Masquerading as a Metastatic Papillary Thyroid Carcinoma.
Jae Young CHOI ; Jeong Hoon KIM
Journal of Korean Medical Science 2008;23(3):548-550
Ectopic thyroid glands generally occur in the midline as a result of abnormal median migration, and their presence lateral to the midline is rare. We present one case of an ectopic thyroid gland masquerading as a lateral neck metastasis of a papillary thyroid carcinoma (PTC). In this case of a 54-yr-old woman with left PTC, we suspected left lateral neck metastasis on preoperative neck computed tomography. The patient underwent total thyroidectomy, central compartment neck dissection, and left modified radical neck dissection (MRND). The patient was diagnosed as having an accessory thyroid gland on the lateral neck on the final pathologic report. Surgeons should be aware of the existence of an ectopic thyroid gland in unusual locations.
Biopsy
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Carcinoma, Papillary/radiography/*secondary
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Choristoma/*pathology/radiography
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Diagnosis, Differential
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Female
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Humans
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Middle Aged
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Neck
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*Thyroid Gland
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Thyroid Neoplasms/*pathology/radiography
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Tomography, X-Ray Computed
3.Primary Papillary Carcinoma Arising in a Thyroglossal Duct Cyst.
Young Chae CHU ; Jee Young HAN ; Hye Seung HAN ; Joon Mee KIM ; Soo Kee MIN ; Young Mo KIM
Yonsei Medical Journal 2002;43(3):381-384
We report a case of papillary carcinoma arising in a thyroglossal duct cyst, presenting with an anterior neck mass of a 31-year-old woman. The tumor was judged to be a primary lesion on the basis of intraoperative examination of the thyroid and pathologic findings of the mass. One year later, a small nodular mass in the left thyroid gland and lymph node enlargement of the right cervical lymph node were noted by follow-up imaging studies. Total thyroidectomy, right modified radical neck dissection and central neck dissection were performed. The thyroid gland revealed nodular hyperplasia without evidence of malignancy. On the other hand, the dissected neck lymph nodes revealed metastatic papillary carcinoma. Taken together, these findings suggested the tumor was a primary papillary carcinoma arising in the thyroglossal duct cyst.
Adult
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Carcinoma, Papillary/*complications/*pathology/radiography
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Case Report
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Female
;
Human
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Thyroglossal Cyst/*complications/*pathology/radiography
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Thyroid Neoplasms/*complications/*pathology/radiography
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Tomography, X-Ray Computed
4.Primary Papillary Carcinoma Arising in a Thyroglossal Duct Cyst.
Young Chae CHU ; Jee Young HAN ; Hye Seung HAN ; Joon Mee KIM ; Soo Kee MIN ; Young Mo KIM
Yonsei Medical Journal 2002;43(3):381-384
We report a case of papillary carcinoma arising in a thyroglossal duct cyst, presenting with an anterior neck mass of a 31-year-old woman. The tumor was judged to be a primary lesion on the basis of intraoperative examination of the thyroid and pathologic findings of the mass. One year later, a small nodular mass in the left thyroid gland and lymph node enlargement of the right cervical lymph node were noted by follow-up imaging studies. Total thyroidectomy, right modified radical neck dissection and central neck dissection were performed. The thyroid gland revealed nodular hyperplasia without evidence of malignancy. On the other hand, the dissected neck lymph nodes revealed metastatic papillary carcinoma. Taken together, these findings suggested the tumor was a primary papillary carcinoma arising in the thyroglossal duct cyst.
Adult
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Carcinoma, Papillary/*complications/*pathology/radiography
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Case Report
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Female
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Human
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Thyroglossal Cyst/*complications/*pathology/radiography
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Thyroid Neoplasms/*complications/*pathology/radiography
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Tomography, X-Ray Computed
5.Solid Pseudopapillary Tumor of the Pancreas with Hepatic Metastasis: Spontaneous Regression Over 10-Year Follow-Up Period.
Korean Journal of Radiology 2012;13(5):648-651
A solid-pseudopapillary tumor (SPT) of the pancreas is known as a low grade malignant tumor with a good prognosis; therefore, surgical intervention is necessary. A 14-year-old boy presented with a large pancreatic SPT and three hepatic metastases. The patient and his family refused surgery. Two serial follow-up CT scans over a period of 13 years demonstrated almost complete disappearance of the pancreatic tumor and three hepatic metastases without relevant treatment. Although there have been a few reports of spontaneous healing of SPT, there has been no report regarding spontaneous disappearance of SPT and distant metastasis. Herein, we report on the spontaneous regression of a large SPT and the disappearance of three hepatic metastases.
Adolescent
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Carcinoma, Papillary/radiography/*secondary
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Humans
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Liver Neoplasms/radiography/*secondary
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Male
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Pancreatic Neoplasms/*pathology/radiography
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Remission, Spontaneous
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Tomography, X-Ray Computed
6.Solid Pancreatic Tumors with Unilocular Cyst-Like Appearance on CT: Differentiation from Unilocular Cystic Tumors Using CT.
Ju Hee LEE ; Jae Ho BYUN ; Jin Hee KIM ; Seung Soo LEE ; Hyoung Jung KIM ; Moon Gyu LEE
Korean Journal of Radiology 2014;15(6):704-711
OBJECTIVE: To describe the computed tomography (CT) features of neuroendocrine tumors (NETs) and solid pseudopapillary tumors (SPTs) with unilocular cyst-like appearance, and to compare them with those of unilocular cystic tumors of the pancreas. MATERIALS AND METHODS: This retrospective study was approved by our Institutional Review Board, and informed consent was waived. We included 112 pancreatic tumors with unilocular cyst-like appearance on CT (16 solid tumors [nine NETs and seven SPTs] and 96 cystic tumors [45 serous cystadenomas, 30 mucinous cystic neoplasms, and 21 branch-duct intraductal papillary mucinous neoplasms]). Two radiologists reviewed the CT images in consensus to determine tumor location, long diameter, morphological features, wall thicknesses, ratio of wall thickness to tumor size, wall enhancement patterns, intratumoral contents, and accompanying findings. Fisher's exact test was used to analyze the results. RESULTS: All 16 solid tumors had perceptible walls (mean thickness, 2.7 mm; mean ratio of wall thickness to tumor size, 7.7%) with variable enhancement. Four NETs and seven SPTs had hemorrhage, calcifications, and/or mural nodules. Six CT findings were specific for solid tumors with unilocular cyst-like appearance: a thick (> 2 mm) wall, uneven thickness of the wall, high ratio of wall thickness to tumor size, hyper- or hypo-attenuation of the wall in the arterial and portal phase, and heterogeneous internal contents. When three or more of the above criteria were used, 100% specificity and 87.5-92% accuracy were obtained for solid tumors with unilocular cyst-like appearance. CONCLUSION: A combination of CT features was useful for distinguishing solid tumors with unilocular cyst-like appearance from unilocular cystic tumors of the pancreas.
Adenocarcinoma, Mucinous/diagnosis/*radiography
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Adult
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Aged
;
Carcinoma, Papillary/diagnosis/*radiography
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Cystadenoma, Serous
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Diagnosis, Differential
;
Female
;
Humans
;
Male
;
Middle Aged
;
Neuroendocrine Tumors/diagnosis/*radiography
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Pancreatic Neoplasms/diagnosis/*radiography
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Retrospective Studies
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Sensitivity and Specificity
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Tomography, X-Ray Computed
7.Kartagener syndrome and papillary thyroid carcinoma: an unusual combination.
Jingyuan REN ; Xurui WANG ; Zhongyin HE
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(21):1911-1914
A case of a papillary thyroid carcinoma in a patient with situs inversus with associated bronchiectasis and chronic sinusitis (Kartagener's syndrome) is reported. A 61-year-old male patient has the symptoms of nasal obstruction. nasal purulent discharge and headache for 2 years. Physical examination: right nasal purulent in right nasal cavity and multiple lychee-like opaque mass in right middle meatus. A nodule, one centimeter in diameter, locates in the upper pole of right thyroid. Evidence of full situs inversus viscerum can be confirmmed by chest radiographs and ultrasound doppler. Pathology: right nasal polyps, the right small papillary thyroid cancer. TEM Tip primary ciliary dyskinesia. Clinical diagnosis: Kartagener syndrome, papillary thyroid carcinoma (T1a N0 M0, I period), chronic sinusitis-nasal polyps.
Carcinoma
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complications
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diagnosis
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Carcinoma, Papillary
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Chronic Disease
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Humans
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Kartagener Syndrome
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complications
;
diagnosis
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Male
;
Middle Aged
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Nasal Obstruction
;
pathology
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Nasal Polyps
;
pathology
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Radiography, Thoracic
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Rhinitis
;
pathology
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Sinusitis
;
pathology
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Situs Inversus
;
pathology
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Thyroid Cancer, Papillary
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Thyroid Neoplasms
;
complications
;
diagnosis
8.Whether VI region lymph nodes belong to primary site of the thyroid carcinoma or lateral cervical lymph node metastases.
Yong-xue ZHU ; Hong-shi WANG ; Yi WU ; Qing-hai JI ; Cai-ping HUANG
Chinese Journal of Surgery 2004;42(14):867-869
OBJECTIVETo discuss the evaluation of elective neck dissection (END) for the cN(0) patients with papillary thyroid carcinoma (PTC).
METHODSBy analyzing the recurrent and metastatic region (thyroid, group VI lymph nodes, lateral neck region, beyond neck) of 139 PTC patients treated secondly in our hospital, group VI lymph nodal metastasis is divided into recurrence of primary site and distinguished from lateral neck lymph nodes. The clinical value of END for cN(0) PTC patients is also retrospectively analyzed.
RESULTSThyroidal recurrence accounts for 83% (73/88). Level VI metastasis accounts for 76% (67/88), 17 patients have received END and account for 65% (17/26). Metastasis to lateral neck lymph nodes account for 17% (17/98), among these patients, 5 patients have received END and account for 19% (5/26).
CONCLUSIONSFor the patients with cN(0) PTC, ipsilateral thyroid lobectomy plus level VI dissection is recommended and lateral END (level II-V) is not supported. For the patients with cN(0) but UB N(+) and/or CT N(+), lateral END (level II-V) is recommended. The necessity of CT examination in the diagnosis and treatment of thyroid cancer should be emphasized.
Adolescent ; Adult ; Aged ; Carcinoma, Papillary ; diagnostic imaging ; secondary ; surgery ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck Dissection ; Radiography ; Reoperation ; Retrospective Studies ; Thyroid Neoplasms ; diagnostic imaging ; pathology ; surgery ; Thyroidectomy ; methods