نتائج البحث - "Thyroid nodules"

1

The role of fine-needle aspiration biopsy and post-operative histology in the evaluation of thyroid nodules

المؤلفون: F. Agaçi, D. Xhemalaj, E. Xhardo, P. Kapisyzi

المصدر: Mìžnarodnij Endokrinologìčnij Žurnal, Vol 17, Iss 4, Pp 315-321 (2021)

الوصف: Thyroid nodules present a serious problem, and mostly they do not carry neoplastic characteristics. Thus, they do not need to be surgically treated. The risk of malignancy varies from 5 to 15 %. Steps to diagnose malignancy should include a careful clinical evaluation, laboratory tests, a thyroid ultrasound exam and a fine-needle aspiration biopsy. Fine-needle aspiration biopsy (FNAB) is the most important diagnostic tool in the assessment of thyroid nodules. Today it is considered the gold standard for malignancy diagnosis in thyroid cancer. In this review we evaluate the role of FNAB and post-operative cytology in the evaluation of thyroid nodules. FNA results are classified as diagnostic (satisfactory) or nondiagnostic (unsatisfactory). Unsatisfactory smears (5–10 %) result from hypocellular specimens usually caused by cystic fluid, bloody smears, or suboptimal preparation. Diagnostic smears are conventionally subclassified into benign, indeterminate, or malignant categories. Benign cytology (60–70 %) is negative for malignancy, and includes cysts, colloid nodule, or Hashimoto thyroiditis. Malignant cytology (5 %) is almost always positive for malignancy, and includes primary thyroid tumors or nonthyroid metastatic cancers. Indeterminate or suspicious specimens (10–20 %) include atypical changes, Hurthle cells or follicular neoplasms. The new Bethesda Cytologic Classification has a 6-category classification, subdividing indeterminate further by risk factors. Considering the increasing worldwide incidence of thyroid microadenomas, recently it is recommended to undergo FNAB under ultrasound guidance even in small (< 1cm) nodules if they are correlated with suspicious ultrasonographic features or suspicious neck lymph nodes. FNAB is a cheap and reliable diagnostic tool that can be used in the selection candidates for surgery and pre-operative diagnosis of thyroid carcinomas. It was concluded that FNAB is the gold standard in the evaluation of thyroid nodules and can prevent many unnecessary surgeries. False-negative FNA cytology remains a concern for clinicians treating patients with thyroid nodules. Post-operative histology give the definitive diagnosis and studies confirm that it has a significant discordance between pre-operative cytology and post-operative histology in patients with thyroid nodule. Cytopathologists should strengthen their criteria for the identification of adenomatous hyperplasia, thyroiditis, cystic lesions or suspicious thyroid nodules to avoid misdiagnoses.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c329cf4c016de593ee3ed0be5416b671Test
https://doi.org/10.22141/2224-0721.17.4.2021.237346Test

2

Malignancy risk in indeterminate thyroid nodules with Hürthle cells: role of autoimmune thyroiditis

المؤلفون: Riccardo Maggiore, Stefano Frara, Roberto Lanzi, Gilberto Mari, Paola Baldassarre, Francesca Perticone, Andrea Giustina, Riccardo Rosati, Claudio Doglioni, Marco Schiavo Lena

المساهمون: Perticone, F., Maggiore, R., Mari, G., Frara, S., Baldassarre, P., Doglioni, C., Lena, M. S., Rosati, R., Lanzi, R., Giustina, A.

المصدر: Endocrine. 75:823-828

الوصف: Introduction Hurthle cells are modified follicular thyroid cells, whose development and proliferation have been related to different stimuli inducing cellular stress. Most thyroid aspirates containing Hurthle cells are classified as indeterminate, although the specific risk of malignancy for this subtype of atypia remains unclear. The aim of our study was to assess if the presence of Hurthle cells in indeterminate thyroid nodules correlates with the risk of malignancy. We further evaluated if this risk can be modified by the presence of an underlying Hashimoto's thyroiditis. Materials and methods We retrospectively analyzed all indeterminate thyroid nodules that were surgically treated at our institution between January 2010 and March 2019. For each nodule, we inferred the presence of Hurthle cells in the cytological report. Cytological findings were then correlated with histological reports. Results 354 indeterminate thyroid nodules were included in the study. The rate of malignancy resulted significantly lower in nodules exhibiting Hurthle cells compared to those negative for this cellular pattern (11.4% vs 22.5%, p = 0.01). Although there was no difference in the rate of malignancy in the whole population according to the presence or absence of Hashimoto's thyroiditis (21.5 vs 18.5%, p = 0.63), the significantly lower prevalence of malignant lesions in nodules with Hurthle cells was confirmed only in the presence of a histologically documented Hashimoto's thyroiditis (6.2% vs 32%, p = 0.005). Conclusions The finding of Hurthle cells in indeterminate thyroid nodules is associated with a low risk of malignancy in patients with an underlying Hashimoto's thyroiditis. The clinical management of these lesions may therefore be more conservative.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::301705930ea23c6208355a3d74b61950Test
https://doi.org/10.1007/s12020-021-02932-6Test

3

Microwave Ablation Vs Traditional Thyroidectomy for Benign Thyroid Nodules: A Prospective, Non-Randomized Cohort Study

المؤلفون: Hanwei Peng, Shaokun Li, Mingfeng Yang, Muyuan Liu, Shaowei Xu, Haipeng Guo

المصدر: Academic Radiology. 29:871-879

الوصف: Rationale and Objectives To evaluate the efficacy of microwave ablation (MWA) for benign thyroid nodules (BTNs) and compare trauma and complication rates between MWA and traditional thyroidectomy for BTNs. Materials and Methods 84 patients with BTNs were recruited and followed up at 1, 3, 6, and 12months. 56 and 28 patients chose to undergo MWA (group A) and traditional thyroidectomy (group B), respectively. Efficacy was assessed by volume reduction rate (VRR) and therapeutic success rate (TSR) at each follow-up. Trauma was compared using inflammation response parameters, visual analog scale (VAS) scores, quality of life (QOL) and thyroid function measures at 1, 3, and 6 months. Complications rates were also compared. Results The VRR was 80.70 ± 18.60%, and TSR was 91.70% at 6-months. Furthermore, the VRR increased to 90.45 ± 11.51%, and TSR increased to 100% at 12-months. C-reactive protein levels were significantly higher in group B on the first postoperative day (POD) (3.89 ± 0.86 mg/mL vs 3.39 ± 0.56 mg/mL, p = 0.002). Visual analog scale scores were significantly lower in group A on the first and second POD. Thyroid stimulating hormone levels were significantly lower in group A at three (1.71 ± 1.12uIU/mL vs 2.37 ± 1.24uIU/mL, p = 0.013) and 6-months (1.34 ± 0.70uIU/mL vs 1.97 ± 0.94uIU/mL, p = 0.002). There were no significant between-group differences in QOL and complication rates. Conclusion Microwave ablation shows acceptable and promising efficacy. Compared with thyroidectomy, MWA was associated with less trauma and comparable complication rates.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8667f2c3e1690681a59e9a511f3267e7Test
https://doi.org/10.1016/j.acra.2021.08.017Test

4

Application of Thyroid Imaging Reporting and Data System (TIRADS) guidelines to thyroid nodules with cytopathological correlation and impact on healthcare costs

المؤلفون: Sam Pearce, Sam Digby, Xiao Chen, Numan Kutaiba, David van Gelderen

المصدر: Internal Medicine Journal. 52:1366-1373

مصطلحات موضوعية: Thyroid nodules, medicine.medical_specialty, National Health Programs, business.industry, Australia, Health Care Costs, medicine.disease, Health care, Internal Medicine, medicine, Humans, Thyroid Neoplasms, Thyroid Nodule, Intensive care medicine, business, Aged, Retrospective Studies, Ultrasonography

الوصف: To assess the application of American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) guidelines and the potential reduction of unnecessary fine-needle aspirate (FNA) and cost savings through examination of cytopathological correlation.All ultrasound-guided thyroid FNA performed between December 2017 and July 2019 at our institution were included in this study. Prior to performing each FNA, the nodules were scored according to ACR-TIRADS criteria with subsequent cytology scored according to Bethesda criteria. FNA request forms and preceding diagnostic ultrasound reports were analysed for clinical rationale behind each FNA. Collected data were applied to ACR-TIRADS, American Thyroid Association (ATA) and Korean TIRADS (K-TIRADS) criteria. Rate of reduction of unnecessary thyroid FNA and associated costs were subsequently calculated.A total of 125 patients and 146 nodules were evaluated. A malignancy rate of 7.5% was obtained. Sensitivity and specificity for detection of malignancy were 75% and 41% for ACR-TIRADS, 91% and 26% for ATA and 92% and 19% for K-TIRADS. Reduction in the rate of unnecessary FNA was most superior for ACR-TIRADS at 54.8%. Based on Australian Medicare Benefits Schedule item codes, a total of $18 452.70 might have been saved over the study period had ACR-TIRADS guidelines been uniformly followed.This study highlights the strengths and limitations of guidelines in the investigative pathway of thyroid nodules, including superiority of ACR-TIRADS in reducing the rate of unnecessary FNA. Continued education is needed towards application of guidelines among radiologists and referring clinicians, given the potential to reduce unnecessary FNA and achieve economic savings.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::145c8f2232d873e4994f2b82e405e872Test
https://doi.org/10.1111/imj.15343Test

5

Thermoablation of thyroid nodules reveals excellent results with low morbidity

المؤلفون: Philipp R Scherber, Monika Schlüter, Thorsten Drews, Gereon Gäbelein, Matthias Glanemann, Robert M. Eisele

المصدر: Technology and Health Care. 30:683-689

الوصف: BACKGROUND: Thermoablation is an attractive treatment of thyroid nodules for its minimal-invasiveness. It remains unclear whether results and morbidity meet the patients’ expectations. OBJECTIVE: The aim of the presented study is to show data obtained after microwave thyroid ablation from a patients’ perspective. METHODS: Indications and preoperative diagnosis were chosen according to international guidelines. Thermoablation was achieved using a CE certified microwave system. The procedures heeded the published recommendations of the European Federation of Societies for Ultrasound in Medicine and Biology. Follow-up included ultrasound, laboratory parameters and a standardized questionnaire. RESULTS: Thirty patients were enrolled into the study. All patients reported an improvement of complaints following the procedure. Scar formation occurred in 3 cases (10%) with 0.5 ± 1.3 mm length and 0.4 ± 1.0 mm width. No cosmetic, neurological, vocal or pharyngeal complication occurred. Energy required for non-functioning nodules (n= 15, 50%) was 2.56 ± 3.41 kJ/mL, for autonomous adenoma (n= 8, 27%) 0.96 kJ/mL (p< 0.05, t-test). CONCLUSION: The presented data summarize an initial experience in selected patients and resemble excellent patient reported outcome with minimal morbidity. These preliminary data indicate the majority of patients satisfied with the procedure. Further trials will be required to endorse these findings.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5ee895bcfdf73ac2ed1c412e387f81bbTest
https://doi.org/10.3233/thc-213181Test

6

Shear-wave elastography as a tool in the assessment of thyroid nodules

المؤلفون: Andrés Magdalena-Buitrago, Carlos Paredes-Manjarrez, José F. Avelar-Garnica, Aldo Ferreira-Hermosillo, Rocío Arreola-Rosales, Demetrio Arreola-Cháidez

المصدر: Gaceta Médica de México, Vol 157, Iss 1 (2021)

الوصف: Shear-wave elastography (SWE) has been shown to be predictive of malignancy in thyroid nodules.To determine, by SWE, the stiffness cutoff point with the highest specificity and sensitivity to detect thyroid nodules that require surgery.Cross-sectional study of ultrasonographically-evaluated patients for thyroid nodules over a period of three years; the TI-RADS classification system was used, and nodule stiffness was determined by SWE. Histopathological specimens were classified using the Bethesda system, and the stiffness cutoff point with the highest specificity and sensitivity was obtained using ROC curves.Forty-one percent of the nodules were classified as TI-RADS 5, and 59 %, as TI-RADS 1-4. In TI-RADS 5 nodules, median stiffness of those in Bethesda system IV-VI categories was 35.9 kPa; in nodules with TI-RADS 1-4, 21.6 kPa. In TI-RADS 5 nodules, a cutoff point32.5 kPa had a specificity of 75 % and sensitivity of 57 % to detect those requiring surgery; in TI-RADS 1 to 4 nodules, a cutoff point of 21.5 kPa had a specificity of 63 % and sensitivity of 51 %.SWE-determined stiffness is useful to detect nodules that require surgical evaluation.La elastografía por ondas de corte (SWE) ha demostrado ser predictiva de malignidad en nódulos tiroideos.Determinar mediante SWE, el punto de corte de la rigidez con mayor especificidad y sensibilidad para detectar nódulos tiroideos que requieren cirugía.Estudio transversal de pacientes con nódulos tiroideos evaluados ultrasonográficamente en un periodo de tres años; se empleó la clasificación TI-RADS y mediante SWE se determinó la rigidez de los nódulos. Con el sistema Bethesda se clasificaron las muestras histopatológicas y mediante curva ROC se obtuvo el punto de corte de la rigidez con mayor especificidad y sensibilidad.41 % de los nódulos fue TI-RADS 5 y 59 %, TI-RADS 1-4. En los TI-RADS 5, la mediana de rigidez de los nódulos con categoría IV-VI del sistema Bethesda fue de 35.9 kPa y en los nódulos con TI-RADS 1-4, 21.6 kPa. En los nódulos TI-RADS 5, la rigidez32.5 kPa tuvo especificidad de 75 % y sensibilidad de 57 % para detectar los que requieren cirugía; en los TI-RADS 1-4, el valor de corte de 21.5 kPa tuvo especificidad de 63 % y sensibilidad de 51 %.La rigidez determinada por SWE es útil para detectar nódulos que requerirán exploración quirúrgica.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b28e83b9d40b9a0a5f1a4b21d1607563Test
https://doi.org/10.24875/gmm.m21000531Test

7

Comments to 'Usefulness of Doppler ultrasound-obtained resistance index in thyroid nodules with ultrasonographic malignant characteristics'

المؤلفون: José Francisco Gallegos-Hernández

المصدر: Gaceta Médica de México. 154

مصطلحات موضوعية: Thyroid nodules, medicine.medical_specialty, Index (economics), business.industry, medicine, General Medicine, Doppler ultrasound, Radiology, medicine.disease, business

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::ed6743be8b26059137b2daa6a3a78397Test
https://doi.org/10.24875/gmm.m18000179Test

8

Intrathyroidal Ectopic Thymus and Sonoelastographic Findings

المؤلفون: Murat Serhat Aygun, Bülent Çolakoğlu, Serkan Guneyli, Ergin Sagtas, Orhun Cig Taskin

المصدر: Current Medical Imaging Formerly Current Medical Imaging Reviews. 17:1209-1215

الوصف: Background: Intrathyroidal ectopic thymus (IET) can be misdiagnosed as thyroid nodules. Purpose: The purpose of this study is to evaluate the sonoelastographic findings of IET in pediatric population. Methods: Twelve children who had been examined with ultrasound (US) and strain elastography between December 2012 and December 2019 were included in this retrospective study. The patients’ demographics and ultrasonographic findings, including the location, margin, shape, diameters, volume, structure, vascularity, and elastography values of the lesions were evaluated. Results: Twelve lesions were detected in 12 asymptomatic patients (3 females and 9 males) with a mean age of 4.67 ± 2.27 years. The most common location of the IET was in posterior part and middle third of thyroid, and the most common appearance on US was a well-defined, ovoid-shaped, and predominantly hypoechoic solid lesion with punctate/linear branching hyperechogenities. The lesions were mostly hypovascular on Doppler US. The mean strain ratio on elastography was found to be 1.10 ± 0.04. In the follow-up of 7 patients with available information, there was no significant change in size or appearance of IET on US. Conclusion: IET should be considered in the differential diagnosis of the lesions within the thyroid. The first step to accurately diagnose an IET is to consider it in the differential diagnosis. In addition to US, strain elastography findings can be used to distinguish IETs from papillary thyroid cancers which can have similar US appearance, and help avoid unnecessary biopsies.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c4272adcd1d82413efe499a6139acde0Test
https://doi.org/10.2174/1573405617666210329095227Test

9

Solitary Extramedullary Plasmacytoma of the Thyroid Gland in a Patient With Subclinical Hyperthyroidism

المؤلفون: Kaare Weber, Matthew S. Wysocki

المصدر: AACE Clinical Case Reports, Vol 7, Iss 5, Pp 303-306 (2021)
AACE Clinical Case Reports

مصطلحات موضوعية: Thyroid nodules, medicine.medical_specialty, endocrine system, endocrine system diseases, Case Report, 030209 endocrinology & metabolism, Physical examination, Diseases of the endocrine glands. Clinical endocrinology, 03 medical and health sciences, 0302 clinical medicine, Immunophenotyping, Biopsy, Medicine, SEP, solitary extramedullary plasmacytoma, Multiple myeloma, Subclinical infection, medicine.diagnostic_test, business.industry, thyroid nodules, Thyroid, General Medicine, medicine.disease, RC648-665, medicine.anatomical_structure, 030220 oncology & carcinogenesis, solitary extramedullary plasmacytoma, Radiology, Differential diagnosis, subclinical hyperthyroidism, business, thyroid surgery

الوصف: Objective Solitary extramedullary plasmacytoma (SEP) of the thyroid is rare, and its clinical and pathologic features are not entirely understood. Generally, patients with SEP of the thyroid also present with Hashimoto thyroiditis. We report, for the first time, a case of SEP of the thyroid in a patient with subclinical hyperthyroidism. Methods A 46-year-old woman presented to the emergency department with symptoms consistent with a panic attack. Following a physical examination, neck ultrasonography, and laboratory tests, we determined that the patient was hyperthyroid and possessed a toxic multinodular goiter. The patient elected to undergo a total thyroidectomy to treat the subclinical hyperthyroidism and to remove the nodules. Results SEP diagnosis requires consideration of the systemic spread of multiple myeloma and a combination of immunohistochemical examination, imaging, and other laboratory tests. Upon further examination, we confirmed SEP through the following criteria: the absence of kidney failure or hypercalcemia, a biopsy demonstrating plasma cell histology, a lack of bone or tissue involvement, and low serum myeloma protein concentration. The immunophenotype of the tumor cells further confirmed SEP diagnosis, with positivity for CD138, CD79a, and lambda light chain antibodies and no reactivity toward cyclin D1. Conclusion This case fulfilled the criteria for SEP, and we were able to rule out multiple myeloma. Currently, no standard treatment exists for SEP. Yet, the prognosis remains encouraging. Going forward, SEP of the thyroid should be considered in the differential diagnosis of a patient with subclinical hyperthyroidism and a toxic multinodular goiter.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b47279223fdb661c53ec8027636672b2Test
http://www.sciencedirect.com/science/article/pii/S2376060521000420Test

10

The Relationship of Thyroid Nodules with Total Serum IgE Level and Metabolic Parameters in Patients with Hashimoto Thyroiditis

المؤلفون: Hanife Usta Atmaca, İdris Kalkan, Feray Akbas

المصدر: İstanbul Medical Journal, Vol 22, Iss 3, Pp 218-222 (2021)

مصطلحات موضوعية: Thyroid nodules, endocrine system, hashimoto thyroiditis, medicine.medical_specialty, serum total ige level, endocrine system diseases, business.industry, thyroid nodules, medicine.disease, Gastroenterology, Serum ige, Internal medicine, Hashimoto thyroiditis, medicine, Medicine, In patient, business

الوصف: Introduction:The literature demonstrates elevated immunoglobulin E (IgE) levels in autoimmune thyroid diseases and their relationship with allergic diseases. The purpose of this study was to describe the relationship between thyroid nodules and total serum IgE levels and metabolic parameters in patients with Hashimoto thyroiditis.Methods:The study included 627 Hashimoto thyroiditis patients [500 (female: 406, male: 94) with and 127 (female: 101, male: 26) without thyroid nodules] and 292 (female: 224, male: 68) healthy control patients. Total serum IgE levels, metabolic parameters, fasting blood glucose (FBG), hemoglobin A1c (HbA1c), total cholesterol, low-density lipoprotein cholesterol, triglyceride, uric acid, free-T4, free-T3, thyroid stimulating hormone, anti-thyroglobulin, anti-thyroid peroxidase, C-reactive protein (CRP) levels, and sedimentation rate were measured in all groups. Moreover, SPSS was used to analyze the results.Results:The mean age, serum IgE levels, mean FBG, HbA1c, and CRP levels of the thyroid nodule group were statistically significantly higher than the non-nodule and control groups (p˂0.05). In all Hashimoto thyroiditis patients, metabolic parameter levels were statistically significantly higher than in control groups (p˂0.05).Conclusion:There is a significant relationship between serum total IgE levels and thyroid nodules. Furthermore, thyroid nodule development appears to be influenced by metabolic and inflammatory abnormalities. These findings confirm the presence of multisystem factors in the development of thyroid nodules.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::488e08d3b28b77369819fdfc091b4499Test
https://doi.org/10.4274/imj.galenos.2021.94770Test

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