PURPOSE: The follicular variant of papillary thyroid carcinoma (FVPTC) is the most common subtype of papillary thyroid carcinoma (PTC). However, the clinicopathologic features of patients with FVPTC with those of patients with pure PTC is ill-understood. This study evaluated differences in clinicopathologic features of FVPTC compared with pure PTC. METHODS: All patients with FVPTC or pure PTC diagnosed between January 2006 and August 2008 at our institution were retrospectively reviewed. The two groups were compared in terms of clinocopathological features. RESULTS: Of 417 patients, 370 had PTC, and 47 patients had FVPTC. The meanage was 47.1 years. There was no differencein age and sex ratio between the two groups, and both groups were similar in terms of tumor size, presence of multifocality, thyroid capsular invasion, and extrathyroidal extension. However, FVPTC patients had significantly lower lymph node metastases (P=0.015) and significantly higher tumor encapsulation (P=0.031). Galectin-3 expression was decreased in FVPTC (P=.012). CONCLUSION: The clinicopathologic features of FVPTC are more favorable. The possibility of FVPTC could be considered when thyroid nodules with negative galectin-3 expression have suspicious or malignant fine needle aspiration biopsy.
Biopsy ; Biopsy, Fine-Needle ; Galectin 3 ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Retrospective Studies ; Sex Ratio ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule

PURPOSE: Despite the overall excellent prognosis for patients with papillary thyroid microcarcinoma (PTMC), these tumors are also associated with a 5% relatively high lymph node (LN) recurrence rate and the optimal surgical extent of papillary thyroid microcarcinoma has been controversial. Cervical LN metastases (LNMs) are found in about 40~65% of patients with PTMC. The aim of this study is to identify the factors affecting lymph node metastases (LNMs) in patients with PTMC. METHODS: We performed a retrospective study of 335 patients with PTMC who underwent total thyroidectomy or lobectomy with elective central lymph node dissection (CLND) at Kangnam St. Mary's Hospital between Jan. 2006 and Dec. 2008. We investigated the association of LNMs and clinicopathologic factors such as sex, age, multiplicity, extrathyroidal extension, and tumor size. RESULTS: LNMs were present in 88 patients (26.3%). Univariate analysis showed that less than 45 years of age, male, multiplicity, a tumor size of greater than 5 mm, thyroid capsular invasion and extrathyroidal extension were predictive factors for LNMs (P<0.05). Of these, the age, male, tumor size and extrathyroidal extension were independent predictive factors for LNMs on multivariate analysis. CONCLUSION: A tumor size (>5 mm), male, age (<45) and extrathyroidal extension were determined as the predictive factors for LNMs, which occurred in about one fourth of the patients with PTMC. Therefore, elective CLND should be considered in patients with PTMC who have these factors through a thorough investigation before surgery.
Carcinoma, Papillary ; Humans ; Lymph Node Excision ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Retrospective Studies ; Risk Factors ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy