Ultrasonograhy, it's excellent ability of differentiating cystic from solid lesion and depicting detailedarchitecture, proved itself useful in the diagnosis of thyroid pathologies. Adanced high resolution equipmentsmade hidden small lesion detected and finer structure clearly seen. They seemed to throw light on the histologicaldiagnosis of thyroid diseases, especially differentiation of benignancy and malignancy. Author reviewed picturesof high-resolution ultrasonography of thyroid disease(24 ases0 and correlated them witn proven pathologicalfindings. The results were as follows: 1. Multiplicity of lesion favors benignancy(4 cases). 2. Well definedmargin favors benignancy(14/17), while ill defined margin favors malignancy(3/4), and lesion of no margin favorsthyroiditis(3/3). 3. Surrounding halo favors benignancy(7 cases). 4. Hypoechogenicity were found in most ofmalignancy and thyroiditis. Cystic components in solid nodule were common findings in bening and malignantlesions. Calcification was not found in malignancy.
Diagnosis ; Pathology ; Thyroid Diseases ; Thyroid Gland ; Thyroid Nodule ; Thyroiditis ; Ultrasonography

No abstract available.
Biopsy, Fine-Needle* ; Humans ; Pathology, Surgical* ; Thyroid Gland* ; Thyroid Nodule*

BACKGROUND AND OBJECTIVES : The optimal management of cytologically indeterminate thyroid nodules is controversial given the variable malignancy rates reported in this patient population. We examined the prevalence of malignancy within cytologically indeterminate atypical and follicular thyroid lesions in an attempt to predict malignancy based on cytologic features. Subjects and METHOD : Cytopathologic reports obtained after fine-needle aspiration biopsy (FNAB) examination of indeterminate follicular thyroid lesions were studied over a 2-year period. The prevalence of malignancy on final pathology was determined in 2 indeterminate cytopathologic categories. RESULTS : A total of 138 records were available (122 women, 16 men). The mean patient age was 45.5+/-13.5 years. All patients underwent surgery and had histopathologic diagnosis. The prevalence of malignancy in atypical and follicular thyroid lesions were 77.7% (42 of 54) and 17.8% (15 of 84), respectively. CONCLUSION : The high prevalence of malignancy within indeterminate atypical and follicular thyroid lesions may necessitate thyroidectomy for patients with indeterminate atypical and follicular lesions on the FNAB examination.
Biopsy, Fine-Needle ; Diagnosis ; Female ; Humans ; Incidence* ; Pathology ; Prevalence ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule* ; Thyroidectomy

No abstract available.
Calcinosis/*ultrasonography ; Female ; Humans ; Male ; Thyroid Neoplasms/*pathology/*ultrasonography ; Thyroid Nodule/*pathology/*ultrasonography

Humans ; Biopsy, Fine-Needle ; Consensus ; Thyroid Neoplasms/pathology* ; Thyroid Nodule/pathology* ; Sensitivity and Specificity

Objective: To assess the feasibility of nuclear score combined with cyclin D1 immunocytochemistry in classifying indeterminate thyroid nodules with fine-needle aspiration (FNA) cytological diagnosis of Bethesda category Ⅲ-Ⅴ. Methods: A consecutive cohort of 118 thyroid FNA specimens with indeterminate diagnosis (TBSRTC category Ⅲ-Ⅴ) and available histopathologic follow-up data were collected between December 2018 and April 2022 at the Department of Pathology, Beijing Hospital, China. These cases were subjected to cytological evaluation and cyclin D1 immunocytochemistry. The optimal cut-off points of a simplified nuclear score and the percentage of cyclin D1-positive cells for the diagnosis of malignancy or low-risk neoplasm were determined using the receiver operating characteristic (ROC) curves and area under the ROC curve (AUC). The specificity, sensitivity, positive predictive value (PPV) and negative predictive value (NPV) of nuclear score and cyclin D1 immunostaining were evaluated from the crosstabs based on cut-off points. The diagnostic accuracy of simplified nuclear score combined with cyclin D1 immunostaining was estimated using ROC curve analysis. Results: Nuclear grooves, intra-nuclear inclusions and chromatin clearing were more commonly found in malignancy/low-risk neoplasms than benign lesions (P=0.001, P=0.012 and P=0.001 respectively). A cut-off point of≥2 for the simplified nuclear score was sensitive for defining malignancy/low-risk neoplasm, and its PPV, NPV, sensitivity and specificity were 93.6%, 87.5%, 99.0% and 50.0% respectively. A positive cut-off point of 10% positive thyroid cells in cyclin D1 immunostaining demonstrated sensitivity of 88.5%, specificity of 100%, PPV of 100% and NPV of 53.8% for correctly detecting thyroid malignancy or low-risk neoplasm. The sensitivity and PPV of simplified nuclear score combined with cyclin D1 immunostaining were 93.3% and 100%, respectively. Both specificity and NPV were maintained at high levels (100% and 66.7%, respectively). The diagnostic accuracy of simplified nuclear score combined with cyclin D1 immunostaining in detecting thyroid malignancy/low-risk neoplasm was increased to 94.1% compared to using either of them alone. Conclusions: Combing simplified nuclear score and cyclin D1 immunostaining on FNA cytology specimens can increase the diagnostic accuracy in classifying thyroid nodules of indeterminate cytological categories. Thus, this supplementary approach provides a simple, accurate, and convenient diagnostic method for cytopathologists so that may reduce unnecessary thyroidectomies.
Humans ; Thyroid Nodule/pathology* ; Biopsy, Fine-Needle ; Cyclin D1 ; Immunohistochemistry ; Thyroid Neoplasms/pathology* ; Retrospective Studies

The detection of thyroid nodules has become more common with the widespread use of ultrasonography (US). US is the mainstay for detecting and making the differential diagnosis of thyroid nodules as well as for providing guidance for a biopsy. The Task Force on Thyroid Nodules of the Korean Society of Thyroid Radiology has developed recommendations for the US diagnosis and US-based management of thyroid nodules. The review and recommendations in this report have been based on a comprehensive analysis of the current literature, the results of multicenter studies and from the consensus of experts.
Biopsy, Fine-Needle ; Diagnosis, Differential ; Humans ; Thyroid Gland/pathology/ultrasonography ; Thyroid Neoplasms/pathology/ultrasonography ; Thyroid Nodule/pathology/*ultrasonography ; Ultrasonography, Interventional

BACKGROUND: The Bethesda System for Reporting Thyroid Cytopathology (BSRTC) uses six diagnostic categories to standardize communication of thyroid fine-needle aspiration (FNA) interpretations between clinicians and cytopathologists. Since several studies have questioned the diagnostic accuracy of this system, we examined its accuracy in our hospital. METHODS: We calculated the incidences and malignancy rates of each diagnostic category in the BSRTC for 1,730 FNAs that were interpreted by four cytopathologists in Gangnam Severance Hospital between October 1, 2011, and December 31, 2011. RESULTS: The diagnostic incidences of categories I-VI were as follows: 13.3%, 40.6%, 9.1%, 0.4%, 19.3%, and 17.3%, respectively. Similarly, the malignancy rates of these categories were as follows: 35.3%, 5.6%, 69.0%, 50.0%, 98.7%, and 98.9%, respectively. In categories II, V, and VI, there were no statistically significant differences in the ranges of the malignancy rates among the four cytopathologists. However, there were significant differences in the ranges for categories I and III. CONCLUSIONS: Our findings suggest that institutions that use the BSRTC should regularly update their diagnostic criteria. We also propose that institutions issue an annual report of incidences and malignancy rates to help other clinicians improve the case management of patients with thyroid nodules.
Biopsy, Fine-Needle ; Case Management ; Diagnosis* ; Humans ; Incidence* ; Pathology ; Thyroid Gland* ; Thyroid Nodule

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

Planar scintigraphy using Tc-99mpertechnetate is useful for snapshot evaluation of hot thyroid nodules, which are pathologically follicular adenoma and seldom, if ever, malignant. The autonomy of the hot nodules has been demonstrated by the presence of thyroid-stimulating hormone-dependent extra-nodular thyroid tissue besides the hot nodules. Here, we present two cases of hot thyroid nodules in patients who underwent quantitative single-photon emission computed tomography/computed tomography (SPECT/CT). In addition to the nodules, contralateral normal thyroid parenchyma was evaluated based on standardized uptake values. One patient had a traditional follicular adenoma suppressing other thyroid tissue, whereas the other patient seemed to have a nodule erupting from underlying hyperfunctioning, not suppressed, thyroid tissue. This novel approach using quantitative SPECT/CT unveils a new pathology of hot thyroid nodule that does not suppress, but coincides with hyperfunctioning thyroid tissue.
Adenoma ; Humans ; Pathology ; Radionuclide Imaging ; Sodium Pertechnetate Tc 99m ; Thyroid Gland ; Thyroid Nodule