775 results on '"Carcinoma, Papillary, Follicular"'
Search Results
2. Effectiveness of Intraoperative Neuromonitoring of External Branch of Superior Laryngeal Nerve During Thyroid Surgery
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Su-jin Kim, Associate professor
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- 2022
3. Follicular Lesions with Papillary Nuclear Characteristics: Differences in Chromatin Detected by Computerized Image Analysis
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Bárbara Parente Coelho, Flávia de Oliveira Valentim, Hélio Amante Miot, Danilo Takeshi Abe Jaune, Caroline Yuki Hayashi, Cristiano Claudino de Oliveira, Mariângela de Alencar Marques, José Vicente Tagliarini, Emanuel Celice Castilho, Paula Soares, and Gláucia Maria Ferreira da Silva Mazeto
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Carcinoma, Papillary, Follicular ,Cell nucleus ,Histology ,Thyroid neoplasms ,Medicine ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
ABSTRACT Objective: Follicular lesions of the thyroid with papillary carcinoma nuclear characteristics are classified as infiltrative follicular variant of papillary thyroid carcinoma-FVPTC (IFVPTC), encapsulated/well demarcated FVPTC with tumour capsular invasion (IEFVPTC), and the newly described category “non-invasive follicular thyroid neoplasm with papillary-like nuclear features” (NIFTP) formerly known as non-invasive encapsulated FVPTC. This study evaluated whether computerized image analysis can detect nuclear differences between these three tumour subtypes. Materials and methods: Slides with histological material from 15 cases of NIFTP and 33 cases of FVPTC subtypes (22 IEFVPTC, and 11 IFVPTC) were analyzed using the Image J image processing program. Tumour cells were compared for both nuclear morphometry and chromatin textural characteristics. Results: Nuclei from NIFTP and IFVPTC tumours differed in terms of chromatin textural features (grey intensity): mean (92.37 ± 21.01 vs 72.99 ± 14.73, p = 0.02), median (84.93 ± 21.17 vs 65.18 ± 17.08, p = 0.02), standard deviation (47.77 ± 9.55 vs 39.39 ± 7.18; p = 0.02), and coefficient of variation of standard deviation (19.96 ± 4.01 vs 24.75 ± 3.31; p = 0.003). No differences were found in relation to IEFVPTC. Conclusion: Computerized image analysis revealed differences in nuclear texture between NIFTP and IFVPTC, but not for IEFVPTC.
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- 2020
- Full Text
- View/download PDF
4. Clinicopathologic Characteristics of Pediatric Follicular Variant of Papillary Thyroid Carcinoma Subtypes: A Retrospective Cohort Study
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Stephen Halada, Julia A. Baran, Andrew J. Bauer, Julio C. Ricarte-Filho, Amber Isaza, Tasleema Patel, Aime T. Franco, Sogol Mostoufi-Moab, N. Scott Adzick, Ken Kazahaya, Tricia R. Bhatti, Zubair Baloch, and Lea F. Surrey
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Iodine Radioisotopes ,Cohort Studies ,Endocrinology ,Thyroid Cancer, Papillary ,Endocrinology, Diabetes and Metabolism ,Adenocarcinoma, Follicular ,Humans ,Neoplasm Invasiveness ,Thyroid Neoplasms ,Carcinoma, Papillary, Follicular ,Neoplasm Recurrence, Local ,Child ,Retrospective Studies - Published
- 2023
5. The follicular variant of papillary thyroid carcinoma: characteristics of preoperative ultrasonography and cytology
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Jung Hyun Yoon, Hyeong Ju Kwon, Eun-Kyung Kim, Hee Jung Moon, and Jin Young Kwak
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Thyroid gland ,Ultrasonography ,Carcinoma, papillary ,Carcinoma, papillary, follicular ,Biopsy, fine-needle ,Medical technology ,R855-855.5 - Abstract
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 BRAFV600E 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 BRAFV600E 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 BRAFV600E 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 BRAFV600E 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. BRAFV600E mutation analysis is of limited value in the diagnosis of FVPTC.
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- 2016
- Full Text
- View/download PDF
6. Tumor-to-Tumor Metastasis: Lung Typical Carcinoid Metastatic to Follicular Variant of Papillary Thyroid Carcinoma
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Ugolini Clara, Del Frate Rossella, Rossi Giulio, Materazzi Gabriele, and LiVolsi Virginia
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Endocrinology ,Thyroid Cancer, Papillary ,Endocrinology, Diabetes and Metabolism ,Adenocarcinoma, Follicular ,Humans ,Carcinoid Tumor ,Carcinoma, Papillary, Follicular ,Thyroid Neoplasms ,General Medicine ,Lung ,Carcinoma, Neuroendocrine ,Pathology and Forensic Medicine - Published
- 2022
7. Deep learning prediction of BRAF-RAS gene expression signature identifies noninvasive follicular thyroid neoplasms with papillary-like nuclear features
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Alexander T. Pearson, James M. Dolezal, Anna Trzcinska, Xavier M. Keutgen, Nishant Agrawal, Peter Angelos, Sara Kochanny, Elizabeth A. Blair, Chih-Yi Liao, and Nicole A. Cipriani
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Proto-Oncogene Proteins B-raf ,0301 basic medicine ,Pathology ,medicine.medical_specialty ,Carcinoma, Papillary, Follicular ,Article ,Pathology and Forensic Medicine ,Thyroid carcinoma ,03 medical and health sciences ,Deep Learning ,0302 clinical medicine ,Text mining ,Follicular phase ,Gene expression ,medicine ,Humans ,Neoplasm ,Thyroid Neoplasms ,Nuclear atypia ,Head and neck cancer ,business.industry ,Gene Expression Profiling ,fungi ,Thyroid ,Diagnostic markers ,medicine.disease ,Gene Expression Regulation, Neoplastic ,Thyroid diseases ,Tumor Subtype ,030104 developmental biology ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Mutation ,ras Proteins ,Transcriptome ,business - Abstract
Noninvasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP) are follicular-patterned thyroid neoplasms defined by nuclear atypia and indolent behavior. They harbor RAS mutations, rather than BRAFV600E mutations as is observed in papillary thyroid carcinomas with extensive follicular growth. Reliably identifying NIFTPs aids in safe therapy de-escalation, but has proven to be challenging due to interobserver variability and morphologic heterogeneity. The genomic scoring system BRS (BRAF-RAS score) was developed to quantify the extent to which a tumor’s expression profile resembles a BRAFV600E or RAS-mutant neoplasm. We proposed that deep learning prediction of BRS could differentiate NIFTP from other follicular-patterned neoplasms. A deep learning model was trained on slides from a dataset of 115 thyroid neoplasms to predict tumor subtype (NIFTP, PTC-EFG, or classic PTC), and was used to generate predictions for 497 thyroid neoplasms within The Cancer Genome Atlas (TCGA). Within follicular-patterned neoplasms, tumors with positive BRS (RAS-like) were 8.5 times as likely to carry an NIFTP prediction than tumors with negative BRS (89.7% vs 10.5%, P
- Published
- 2021
8. Characterization of pathological thyroid tissue using polarization-sensitive second harmonic generation microscopy
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Danielle Tokarz, Virginijus Barzda, Ariana Joseph, Sylvia L. Asa, Richard Cisek, and Brian C. Wilson
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0301 basic medicine ,Pathology ,medicine.medical_specialty ,Thyroid Gland ,Carcinoma, Papillary, Follicular ,Pathology and Forensic Medicine ,Diagnosis, Differential ,Thyroid carcinoma ,03 medical and health sciences ,0302 clinical medicine ,Microscopy ,medicine ,Carcinoma ,Humans ,Thyroid Neoplasms ,Thyroid Nodule ,Molecular Biology ,Thyroid cancer ,Pathological ,Chemistry ,Thyroid ,Cell Differentiation ,Cell Biology ,medicine.disease ,Thyroid Diseases ,Graves Disease ,3. Good health ,030104 developmental biology ,medicine.anatomical_structure ,Thyroid Cancer, Papillary ,Second Harmonic Generation Microscopy ,030220 oncology & carcinogenesis ,Ultrastructure ,Histopathology ,Collagen - Abstract
Polarization-sensitive second harmonic generation (SHG) microscopy is an established imaging technique able to provide information related to specific molecular structures including collagen. In this investigation, polarization-sensitive SHG microscopy was used to investigate changes in the collagen ultrastructure between histopathology slides of normal and diseased human thyroid tissues including follicular nodular disease, Grave's disease, follicular variant of papillary thyroid carcinoma, classical papillary thyroid carcinoma, insular or poorly differentiated carcinoma, and anaplastic or undifferentiated carcinoma ex vivo. The second-order nonlinear optical susceptibility tensor component ratios, χ(2)zzz'/χ(2)zxx' and χ(2)xyz'/χ(2)zxx', were obtained, where χ(2)zzz'/χ(2)zxx' is a structural parameter and χ(2)xyz'/χ(2)zxx' is a measure of the chirality of the collagen fibers. Furthermore, the degree of linear polarization (DOLP) of the SHG signal was measured. A statistically significant increase in χ(2)zzz'/χ(2)zxx' values for all the diseased tissues except insular carcinoma and a statistically significant decrease in DOLP for all the diseased tissues were observed compared to normal thyroid. This finding indicates a higher ultrastructural disorder in diseased collagen and provides an innovative approach to discriminate between normal and diseased thyroid tissues that is complementary to standard histopathology.
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- 2020
9. Long-term follow-up of differentiated thyroid carcinoma in children and adolescents
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Constantino Sábado Álvarez, Joan Castell Conesa, Montserrat Negre Busó, Gemma Cuberas Borrós, María Boronat-de Ferrater, Pere Galofré Mora, Marc Simó Perdigó, and Amparo García Burillo
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Adult ,Male ,medicine.medical_specialty ,Prognostic variable ,Adolescent ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,030209 endocrinology & metabolism ,Carcinoma, Papillary, Follicular ,Disease ,Thyroglobulin ,Iodine Radioisotopes ,Thyroid carcinoma ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Cancer Survivors ,Internal medicine ,Follicular phase ,Humans ,Medicine ,Thyroid Neoplasms ,Age of Onset ,Stage (cooking) ,Child ,Retrospective Studies ,business.industry ,Thyroidectomy ,Histology ,Prognosis ,Survival Analysis ,Treatment Outcome ,Spain ,Child, Preschool ,030220 oncology & carcinogenesis ,Pediatrics, Perinatology and Child Health ,Female ,Neoplasm Recurrence, Local ,business ,Follow-Up Studies - Abstract
Objectives The aims were to analyze the clinical features, response to treatment, prognostic factors and long-term follow-up of children and adolescents with differentiated thyroid carcinoma (DTC). Methods Eighty patients with DTC were studied retrospectively. All underwent total or near-total thyroidectomy, and in 75 cases, ablative iodine therapy was recommended. Patients were assessed periodically by tests for serum thyroglobulin levels and whole-body iodine scans. Age, gender, initial clinical presentation, histology, tumor stage, postoperative complications, radioiodine treatment protocol, treatment response, thyroglobulin (Tg), recurrence and long-term disease progression were evaluated. Results Seventy patients completed >2 years of follow-up (23 males, 47 females; median age: 14 years; range: 3–18 years). Sixty-two patients showed papillary DTC and eight, follicular DTC. Sixty-five percent presented nodal metastasis and 16%, pulmonary metastasis at diagnosis. Six months after first radioiodine treatment, 36.2% of patients were free of disease. Seven recurrences were documented. At the end of follow-up, overall survival was 100%, and 87.2% of patients were in complete remission. Nine patients had persistent disease. We found a significant association between stage 4 and persistent disease. Hundred percent of patients with negative Tg values at 6 months posttreatment were documented free of disease at the end of the follow-up. The analysis of disease-free survival based on radioiodine treatment protocols used showed no statistically significant differences. Conclusions DTC in children and adolescents is frequently associated with presence of advanced disease at diagnosis. Despite this, complete remission was documented after treatment in most cases, with a good prognosis in the long-term follow-up. Negative posttreatment thyroglobulin and stage 4 at diagnosis were significant prognostic variables.
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- 2020
10. THERAPY OF ENDOCRINE DISEASE Immunotherapy of advanced thyroid cancer: from bench to bedside
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Elisa Menicali, Nicole Nucci, Efisio Puxeddu, Martina Guzzetti, Sonia Moretti, and Silvia Morelli
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Oncology ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Papillary ,030209 endocrinology & metabolism ,Carcinoma, Papillary, Follicular ,Thyroid carcinoma ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Internal medicine ,medicine ,Carcinoma ,Humans ,Thyroid Neoplasms ,Thyroid cancer ,Antigen Presentation ,Endocrine disease ,business.industry ,Follicular ,Cancer ,General Medicine ,Immunotherapy ,medicine.disease ,Clinical trial ,Tumor Escape ,030220 oncology & carcinogenesis ,business - Abstract
Immunotherapy has arisen in use in the field of oncology with seven immune checkpoint inhibitors approved for the treatment of a variety of cancer histologies. Depending on the cancer type, the success rate might be different, but in average it is about 20%, with some cases showing a durable response, lasting also after the interruption of the treatment, with a clear benefit on OS. The development of an efficacious cure for advanced thyroid carcinomas is still an unmet need and immunotherapy represents an interesting alternative option also for this cancer. However, very few clinical trials have been accomplished and very few studies exploring a way to overcome resistance have been performed. In this review, we will summarize the mechanisms of immune escape, with a special reference to follicular-derived thyroid carcinoma. Furthermore, we will try to speculate on the use of immune checkpoint inhibitors for the treatment of follicular-derived advanced thyroid carcinoma. Finally, we will summarize the ongoing clinical trials and the future directions of the field.
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- 2020
11. Mixed Sparsely Granulated Lactotroph and Densely Granulated Somatotroph Pituitary Neuroendocrine Tumor Expands the Spectrum of Neuroendocrine Neoplasms in Ovarian Teratomas: the Role of Pituitary Neuroendocrine Cell Lineage Biomarkers
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Julie-Ann Francis, Ozgur Mete, Anjelica Hodgson, Caroline Shenouda, and Sara Pakbaz
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Lineage (genetic) ,Somatotropic cell ,Lactotrophs ,Endocrinology, Diabetes and Metabolism ,Carcinoma, Papillary, Follicular ,Biology ,Pathology and Forensic Medicine ,Diagnosis, Differential ,Neoplasms, Multiple Primary ,Prolactin cell ,Endocrinology ,Neuroendocrine Cells ,medicine ,Humans ,Cell Lineage ,Pituitary Neoplasms ,Thyroid Neoplasms ,Ovarian Teratoma ,Neuroendocrine cell ,Ovarian Neoplasms ,Teratoma ,General Medicine ,Middle Aged ,Somatotrophs ,Neuroendocrine Tumors ,medicine.anatomical_structure ,Pituitary Gland ,Granulation Tissue ,Cancer research ,Female ,Biomarkers - Published
- 2020
12. Preoperative Diagnostic Categories of Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features in Thyroid Core Needle Biopsy and Its Impact on Risk of Malignancy
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Jae Hoon Moon, So Yeon Park, Yeo Koon Kim, Ji Won Woo, Ji Young Choe, Woo Jin Jeong, Hee Young Na, and June Young Choi
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endocrine system ,medicine.medical_specialty ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,Noninvasive follicular thyroid neoplasm with papillary-like nuclear features ,030209 endocrinology & metabolism ,Carcinoma, Papillary, Follicular ,medicine.disease_cause ,Malignancy ,Pathology and Forensic Medicine ,Thyroid carcinoma ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,medicine ,Humans ,Thyroid Neoplasms ,Nuclear atypia ,Thyroid neoplasm ,Retrospective Studies ,Suspicious for Malignancy ,business.industry ,Thyroid ,General Medicine ,medicine.disease ,Bethesda system for reporting thyroid cytopathology ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Biopsy, Large-Core Needle ,Radiology ,business - Abstract
This study was designed to evaluate the preoperative diagnostic categories of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) using thyroid core needle biopsy (CNB) and to analyze its impact on the risk of malignancy (ROM). A total of 2687 consecutive thyroid CNBs were reviewed retrospectively and classified into six diagnostic categories using a standardized reporting system similar to the Bethesda System for Reporting Thyroid Cytopathology. Diagnostic categories of CNBs were compared with the final surgical diagnoses, and the ROM in each category was calculated both before and after excluding NIFTP from malignancy. Of 946 surgically resected cases, 683 were diagnosed as papillary thyroid carcinoma (PTC), and 32 (4.7% of PTC) were reclassified as NIFTP. The CNB diagnostic categories of NIFTP were as follows: follicular neoplasm in 20 (62.5%; 14, with nuclear atypia), indeterminate lesion in 11 (34.4%), and suspicious for malignancy in one (3.1%). When combined, NIFTP and encapsulated follicular variant of PTC (EFVPTC) were more often categorized as follicular neoplasm compared with other PTC variants including infiltrative FVPTC. Exclusion of NIFTP from malignant diagnosis led to a significant decrease in the ROM in follicular neoplasm with nuclear atypia category. Thus, thyroid CNB enables to differentiate NIFTP/EFVPTC from other PTCs, providing a useful guide for optimal treatment in patients with these tumors.
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- 2019
13. High Incidence of Distant Metastasis Is Associated With Histopathological Subtype of Pediatric Papillary Thyroid Cancer - a Retrospective Analysis Based on SEER
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Dalin Zhang, Ting Zhang, Ping Zhang, Mengsu Cao, Liang Shao, Jiapeng Huang, Hao Zhang, Zhihong Wang, Chengzhou Lv, Wei Sun, Wenwu Dong, Jingzhe Xiang, Xue Zeng, Zhiqiang Gui, and Liang He
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Oncology ,Adult ,Male ,medicine.medical_specialty ,Adolescent ,Endocrinology, Diabetes and Metabolism ,Carcinoma, Papillary, Follicular ,Logistic regression ,Diseases of the endocrine glands. Clinical endocrinology ,Papillary thyroid cancer ,Thyroid carcinoma ,Endocrinology ,distant metastasis ,Risk Factors ,pediatrics - children ,CPTC ,Internal medicine ,medicine ,Humans ,Thyroid Neoplasms ,Child ,Retrospective Studies ,Original Research ,Receiver operating characteristic ,business.industry ,Mortality rate ,Incidence (epidemiology) ,Incidence ,histopathological subtype ,Distant metastasis ,medicine.disease ,RC648-665 ,Carcinoma, Papillary ,SEER ,Logistic Models ,Thyroid Cancer, Papillary ,Lymphatic Metastasis ,Propensity score matching ,FVPTC ,Thyroidectomy ,Female ,papillary thyroid carcinoma (PCT) ,business - Abstract
ObjectiveChildren with papillary thyroid cancer (PTC) have a higher invasive rate and distant metastasis rate, but the mortality rate is lower with unknown reasons. The majority of PTC cases comprise classical papillary thyroid carcinoma (CPTC) and follicular variant papillary thyroid carcinoma (FVPTC). This study aimed to determine the relationship between histopathological subtype and rate of distant metastasis and investigate factors influencing distant metastasis in pediatric PTC.MethodsA total of 102,981 PTC patients were recruited from SEER registry, 2004-2015. Proportion of distant metastasis between children (≤18 years) and adults with different histopathological subtypes was compared by propensity score matching. The cut-off age for distant metastasis in children was calculated by receiver operating characteristic (ROC) curve, and the risk factors for distant metastasis in pediatric patients were analyzed by logistic regression models.ResultsAmong the 1,484 children and 101,497 adults included in the study, the incidence of CPTC patients with distant metastasis in children was higher than that in adults (p18 years) (both pp=0.006). There was no difference between the proportion of CPTC and FVPTC with distant metastasis in adolescents (17-18 years) and adults. Logistic regression models revealed that extrathyroidal extension, lymph node metastasis and CPTC histopathological subtype were risk factors for distant metastasis in young children aged 2 -16 years.ConclusionsIn CPTC, the incidence of distant metastasis in young children (2-16 years) was significantly higher than that in adolescents (17-18 years) and adults (>18 years). In patients with distant metastasis aged 2-16 years, the proportion of CPTC was higer than that of FVPTC. Extrathyroidal extension, lymph node metastasis, and CPTC histopathological subtype were risk factors for distant metastasis in young children aged 2-16 years.
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- 2021
14. BRAF
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Meryem, Kaabouch, Hafsa, Chahdi, Naima, Azouzi, Mohammed, Oukabli, Issam, Rharrassi, Adil, Boudhas, Hassan, Jaddi, Mouna, Ababou, Nadia, Dakka, Amélie, Boichard, Youssef, Bakri, Corinne, Dupuy, Abderrahmane, Al Bouzidi, and Rabii Ameziane, El Hassani
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Adult ,Male ,Proto-Oncogene Proteins B-raf ,endocrine system ,endocrine system diseases ,Incidence ,DNA Mutational Analysis ,Carcinoma, Papillary, Follicular ,DNA, Neoplasm ,Articles ,Biomarker ,Middle Aged ,Thyroid cancer ,Morocco ,BRAFV600E ,Thyroid Cancer, Papillary ,Adenocarcinoma, Follicular ,Mutation ,Prevalence ,Humans ,Point Mutation ,Female ,Thyroid Neoplasms ,Polymorphism, Restriction Fragment Length ,Retrospective Studies - Abstract
Background The incidence of thyroid cancer is increasing worldwide at an alarming rate. BRAFV600E mutation is described to be associated with a worse prognostic of thyroid carcinomas, as well as extrathyroidal invasion and increased mortality. Objective To our knowledge, there are no reported studies neither from Morocco nor from other Maghreb countries regarding the prevalence of BRAFV600E mutation in thyroid carcinomas. Here we aim to evaluate the frequency of BRAFV600E oncogene in Moroccan thyroid carcinomas. Methods In this Single-Institution retrospective study realized in the Anatomic Pathology and Histology Service in the Military Hospital of Instruction Mohammed V ‘HMIMV’ in Rabat, we report, using direct genomic sequencing, the assessment of BRAFV600E in 37 thyroid tumors. Results We detected BRAFV600E mutation exclusively in Papillary Thyroid Carcinomas ‘PTC’ with a prevalence of 28% (8 PTC out 29 PTC). Like international trends, Papillary Thyroid Carcinomas ‘PTC’ is more frequent than Follicular Thyroid Carcinomas ‘FTC’ and Anaplastic Thyroid Carcinomas ‘ATC’ (29 PTC, 7 FTC and 1 ATC). Conclusion Our finding gives to the international community the first estimated incidence of this oncogene in Morocco showing that this prevalence falls within the range of international trends (30% to 90%) reported in distinct worldwide geographic regions.
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- 2021
15. Breast metastasis of papillary thyroid carcinoma
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Rinrada, Worapongpaiboon and Mawin, Vongsaisuwon
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Male ,Thyroid Cancer, Papillary ,Adenocarcinoma, Follicular ,Humans ,Breast Neoplasms ,Carcinoma, Papillary, Follicular ,Thyroid Neoplasms ,General Medicine - Abstract
Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer, and regional neck metastasis is more common than distant metastasis. If present, metastasis most frequently occurs in lungs and bones. Follicular variant of papillary thyroid carcinoma (FVPTC) is a mixture of the classic and follicular thyroid carcinoma and metastasizes in the same fashion as the PTC with cervical lymph nodes as the most common site. A case of atypical presentation of FVPTC with rib metastasis is reported. We present a case of an old man with a left-sided palpable breast mass for 2 months in duration without breast pain. Initially, the breast mass was categorised as Breast Imaging Reporting and Data System (BI-RADS) 4a via ultrasonography. Subsequent immunohistochemistry demonstrated that the mass was metastatic thyroid cancer. Consequently, a CT scan revealed a tumour originating from the rib. The patient was finally diagnosed with metastatic FVPTC.
- Published
- 2022
16. Analise critica da expressão do gene da mucina 1(MUC1) no carcinoma papilifero da tireoide
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Silva, Joyce do Rosario da, Ward, Laura Sterian, 1956, Mazeto, Glaucia Maria Ferreira da Silva, Tincani, Alfio José, Vassallo, José, Tomimori, Eduardo, Universidade Estadual de Campinas. Faculdade de Ciências Médicas, Programa de Pós-Graduação em Clínica Médica, and UNIVERSIDADE ESTADUAL DE CAMPINAS
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Thyroid ,Carcinoma Papilar, Variante Folicular ,Neoplasias da glândula tireóide ,Genetic predisposition to disease ,Predisposição genetica para doenças ,Neoplasms, Thyroid ,Carcinoma, Papillary, Follicular ,Carcinoma papilar ,Carcinoma, Papillary ,Glândula tireóide - Abstract
Orientador: Laura Sterian Ward Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas Resumo: A maior expressão de MUC1 tem sido relacionada com o pior prognóstico de diversas malignidades como o câncer de mama e pâncreas. Aproximadamente 20% dos carcinomas diferenciados da tiróide (CDT) evoluem com recidivas locais e a distância. O nosso objetivo foi o de avaliar o gene da MUC1 nos pacientes com CDT e relacionar com aspectos clínicos e anatomo-patológicos. CASUÍSTICA E MÉTODOS: Selecionamos 150 pacientes portadores de carcinoma papilífero (CP), 57 oriundos do Hospital das Clínicas da UNICAMP, acompanhados por 67 (73,29±39,83) meses, de 1995 a 2008 e 93 pacientes do Hospital AC Camargo - Fundação Antônio Prudente em São Paulo acompanhados por 41,37 (32,5±34,30) meses, de 1998 a 2008. Realizamos análise da expressão do gene da MUC 1 por imunoistoquímica e por PCR em Tempo Real e comparamos com dados de evolução clínica e do anatomopatológico. RESULTADOS: Observamos a expressão da proteína MUC1 em 82,19% dos pacientes com CP, no entanto, sem diferenças estatísticas para os dados de evolução clínica e do anatomo-patológico. A análise do RNA-m de MUC1 se correlacionou com a menor expressão nos indivíduos que apresentaram metástases ao diagnóstico (p valor=0,0216). Observamos a pior evolução: no sexo masculino, quando havia metástases ao diagnóstico, na ausência de tiroidite e nos tumores maiores que 4 cm. A presença de invasão tumoral foi mais freqüente nos indivíduos com ausência de tiroidite em 47% dos casos (p=0,0132; OR 2,473 - 95%IC: 1,198-5,104). CONCLUSÃO: Não conseguimos correlacionar a análise do gene MUC1 com aspectos clínicos e anatomo-patológicos de pior prognóstico para o CDT. Abstract: The over expression of MUC1 has been related with the worst prognosis in malignancies like breast and pancreas cancer. We know that around 20% of the patients with differentiated thyroid cancer (DTC) can develop local and/or distant recurrences and because of that we decide to analyze the MUC1 gene in patients with DTC and tried to relate it with clinical and pathological patterns of the thyroid cancer. PATIENTS AND METHODS: We selected 150 patients with Papillary Thyroid Cancer: 57 from the Clinical Hospital of Campinas State University, followed up for 67 (73,29±39,83) months, since 1995 to 2008 and 93 patients from the A. C. Camargo Hospital - Antonio Prudente Foundation - São Paulo for 41,37 (32,5±34,3) months since 1998 to 2008. We analyzed the MUC1 gene with the immunohistochemistry and the Real Time - PCR techniques and compared the results with clinical and pathological data. RESULTS: The MUC1 expression was positive in 82,19% of the patients with papillary thyroid cancer, however, when we compared with clinical and pathological data, there was not statistical significance. The MUC1 m-RNA analysis was correlated with the less expression of the gene in the individuals who had had metastases at the diagnosis. We could observe the worst outcome in the individuals of the male gender, in the presence of metastases at the diagnosis, in the absence of thyroiditis in the non-neoplasic tissue and in tumors larger than 4 cm. The presence of tumoral invasion was significant in the patients with metastases to the diagnosis and in the ones without thyroiditis in 47% (p=0,0132; OR 2,473 - 95% CI: 1,198-5,104). CONCLUSION: We conclude that MUC1gene analysis was not useful to determine aggressive tumors nor to predict prognosis in papillary thyroid carcinomas. Doutorado Clínica Médica Doutor em Clínica Médica
- Published
- 2021
17. Struma ovarii and peritoneal strumosis during pregnancy
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Jingxue Wang, Qian Chen, and Zheng Li
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Adult ,medicine.medical_specialty ,medicine.medical_treatment ,030209 endocrinology & metabolism ,Case Report ,Carcinoma, Papillary, Follicular ,Malignancy ,Cystectomy ,Complete resection ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Medicine ,Humans ,Neoplasm Invasiveness ,Benign Struma Ovarii ,Ovarian Neoplasms ,Struma ovarii ,business.industry ,Cesarean Section ,Infant, Newborn ,Obstetrics and Gynecology ,Ultrasonography, Doppler ,Gynecology and obstetrics ,medicine.disease ,Ovarian dermoid cyst ,Struma Ovarii ,030220 oncology & carcinogenesis ,RG1-991 ,Disease Progression ,Female ,Radiology ,Presentation (obstetrics) ,Peritoneum ,business - Abstract
Background Struma ovarii is a special type of ovarian dermoid cyst and accounts for approximately 2–3 % of all dermoid tumours. Benign struma ovarii may manifest as distant metastasis, called peritoneal strumosis, which makes it biologically similar to malignancy, and has been reported in limited cases but never discovered during pregnancy. Case presentation We report a patient with a history of right struma ovarii cystectomy. During pregnancy, pelvic masses with non-specific clinical presentation were found again. During the caesarean section, contralateral struma ovarii with dissemination of nodules in the peritoneal cavity was found, and pathology revealed that the masses were thyroid follicle ovarian goitres. Discussion and conclusions Recurrent benign struma ovarii with extraovarian dissemination is a rare aggressive clinical manifestation different from malignancy. It is emphasized that adequate assessment and complete resection of suspicious masses are of great importance.
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- 2021
18. Retracted: A Comparative Study of ARHI Imprinted Gene Detection and Fine-Needle Aspiration Cytology in the Differential Diagnosis of Benign and Malignant Thyroid Nodules
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Wenlong Huang, Chengwei Wu, Jixuan Miao, Dazhong Zou, Qing Zhang, Jianda Huang, Qing Shao, and Guihua Wu
- Subjects
Male ,rho GTP-Binding Proteins ,0301 basic medicine ,Pathology ,Thyroid Gland ,Carcinoma, Papillary, Follicular ,0302 clinical medicine ,Fine needle aspiration cytology ,Cytology ,Adenocarcinoma, Follicular ,Thyroid Nodule ,Genetics (clinical) ,Ultrasonography ,medicine.diagnostic_test ,Thyroid ,General Medicine ,Middle Aged ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,imprinted gene ,Female ,Goiter, Nodular ,Adult ,Thyroid nodules ,medicine.medical_specialty ,Adolescent ,Biopsy, Fine-Needle ,Hashimoto Disease ,ARHI ,Diagnosis, Differential ,Genomic Imprinting ,Young Adult ,03 medical and health sciences ,Biopsy ,medicine ,Humans ,Thyroid Neoplasms ,Thyroiditis, Subacute ,Aged ,Puncture Biopsy ,business.industry ,Epithelial Cells ,Original Articles ,medicine.disease ,Retraction ,fine-needle aspiration cytology ,030104 developmental biology ,Differential diagnosis ,business ,Genomic imprinting - Abstract
Aims: To compare fine-needle aspiration cytology (FNAC) with imprinted gene detection in the differential diagnosis of benign and malignant thyroid nodules. Methods: A total of 34 patients (35 cases of thyroid nodules) were examined using fine-needle puncture biopsy under ultrasound guidance, and the biopsy tissues were examined by cytologic examination and imprinted gene detection. Combined with postoperative pathology and follow-up results, the diagnostic value and consistency of the two methods were analyzed and compared. Results: The detection of benign and malignant thyroid nodules by ARHI imprinted gene had a high consistency with FNAC, and ARHI imprinted gene detection had a higher detection rate, sensitivity, and accuracy. Conclusions: Imprinted gene detection has high accuracy and sensitivity in the differential diagnosis of benign and malignant thyroid nodules. It provides a scientific reference for clinical treatment and should be incorporated into diagnostic protocols for thyroid tumor.
- Published
- 2019
19. Systematic Review and Meta-analysis of the Impact of Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features (NIFTP) on Cytological Diagnosis and Thyroid Cancer Prevalence
- Author
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Rupendra T. Shrestha, Darin Ruanpeng, Wisit Cheungpasitporn, Charat Thongprayoon, and James V. Hennessey
- Subjects
Thyroid nodules ,medicine.medical_specialty ,Cytodiagnosis ,Endocrinology, Diabetes and Metabolism ,Biopsy, Fine-Needle ,Noninvasive follicular thyroid neoplasm with papillary-like nuclear features ,Bethesda system ,030209 endocrinology & metabolism ,Carcinoma, Papillary, Follicular ,medicine.disease_cause ,Gastroenterology ,Pathology and Forensic Medicine ,Papillary thyroid cancer ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Predictive Value of Tests ,Internal medicine ,Prevalence ,medicine ,Humans ,Thyroid Neoplasms ,Thyroid Nodule ,Thyroid cancer ,Thyroid neoplasm ,Cell Nucleus ,medicine.diagnostic_test ,business.industry ,Thyroid ,General Medicine ,medicine.disease ,medicine.anatomical_structure ,Thyroid Cancer, Papillary ,Cytopathology ,030220 oncology & carcinogenesis ,Guideline Adherence ,business - Abstract
A re-named diagnosis of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) likely impacts the prevalence of thyroid cancer and risk of malignancy in populations based on the established Bethesda System of Reporting Thyroid Cytopathology (TBSRTC). This study was done to investigate the prevalence and cytological distribution of NIFTP. PRISMA guided systematic review was done from a database search of Pubmed, EMBASE, and Medline using the search terms "non-invasive follicular thyroid neoplasm with papillary-like nuclear features", "non-invasive follicular variant of papillary carcinoma", "niftp", and "Bethesda" until November 2018. Original articles with surgically proven diagnoses of NIFTP using strict NIFTP criteria were included. Twenty-nine studies with 1563 cases of NIFTP were included. The pooled prevalence of NIFTP in cases which would be classified previously as the follicular variant of papillary thyroid cancer (FVPTC) and papillary thyroid cancer (PTC) were 43.5% (95% CI 33.5-54.0%) and 4.4% (95% CI 2.0-9.0%) respectively. The pooled TBSRTC distribution of cases diagnosed as NIFTP was: from the non-diagnostic category 3.6% (95% CI 2.4-5.3%), benign 10.0% (95% CI 7.2-13.6%), AUS/FLUS 34.2% (95% CI 28.2-40.8%), FN/SFN 22.7% (95% CI 17.2-29.4%), suspicious for malignancy 22.4% (95% CI 17.7-27.9%), and malignant 7.5% (95% CI 4.2-12.9%). While a significant reduction in FVPTC prevalence is anticipated, a modest reduction of PTC prevalence is also expected with adoption of the NIFTP terminology that would be distributed mainly among lesions classified as indeterminate thyroid nodules. Further studies are needed to identify unique clinical characteristics of these lesions preoperatively.
- Published
- 2019
20. Risk of Malignancy According to the Sub-classification of Atypia of Undetermined Significance and Suspicious Follicular Neoplasm Categories in Thyroid Core Needle Biopsies
- Author
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Min Ji Jeon, Jung Hwan Baek, Sae Rom Chung, Tae Yong Kim, Won Bae Kim, Yu-Mi Lee, Ki-Wook Chung, Young Kee Shong, Jeong Hyun Lee, Suck Joon Hong, Tae-Yon Sung, Dong Eun Song, and Won Gu Kim
- Subjects
Adult ,Male ,Core needle ,Thyroid nodules ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Risk of malignancy ,030209 endocrinology & metabolism ,Carcinoma, Papillary, Follicular ,Risk Assessment ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Follicular neoplasm ,Predictive Value of Tests ,Cytology ,Biopsy ,medicine ,Atypia ,Humans ,Thyroid Neoplasms ,Ultrasonography, Interventional ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Thyroid ,General Medicine ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Female ,Biopsy, Large-Core Needle ,Radiology ,business - Abstract
The objective of this study was to evaluate the risk of malignancy (ROM) associated with atypia of undetermined significance (AUS) and suspicious follicular neoplasm (SFN) core needle biopsy (CNB) categories after further sub-classification. Data from 2267 thyroid nodules evaluated by ultrasound-guided CNB, from January to December 2015, were retrospectively reviewed. AUS nodules (n = 556) were sub-classified as follows: (1) architectural atypia (AUS-A; n = 369, 66.4%), (2) cytologic atypia (AUS-C; n = 35, 6.3%), (3) cytologic/architectural atypia (AUS-C/A; n = 85, 15.3%), or (4) oncocytic atypia (AUS-O; n = 67, 12.1%). SFN nodules (n = 172) were sub-classified as follows: (1) architectural atypia only (SFN-A; n = 110, 64%), (2) cytologic/architectural atypia (SFN-C/A; n = 24, 14%), or (3) oncocytic atypia (SFN-O; n = 38, 22%). Diagnostic surgery was performed in 162 (30.2%) AUS cases and 105 (61%) SFN cases. The ROM of each sub-category was evaluated. The overall ROM was 15.3-52.5% in AUS nodules and 35.5-58.1% in SFN nodules. The ROM was higher in the AUS-C (22.9-88.9%) and AUS-C/A (32.9-90.3%) groups than AUS-A (11.9-40%) and AUS-O (7.5-41.7%). In the SFN category, ROM in the SFN-C/A group was also higher than SFN-A or SFN-O (37.5-75%, 40-57.9%, and 21.1-47.1%, respectively). Our study shows that the ROM was higher in AUS or SFN sub-categories with cytologic atypia than those without cytologic atypia. Because of the heterogeneous nature of AUS and SFN categories, sub-classification may be a more effective approach for risk stratification, allowing optimal management of patients with thyroid nodules.
- Published
- 2019
21. Modified Transverse-Vertical Gross Examination: a Better Method for the Detection of Definite Capsular Invasion in Encapsulated Follicular-Patterned Thyroid Neoplasms
- Author
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Yu-Mi Lee, Tae Yong Kim, Tae-Yon Sung, Won Gu Kim, Eyun Song, Hye-Seon Oh, Dong Eun Song, and Sun Jae Kim
- Subjects
Adult ,Male ,Capsular Invasion ,Thyroid nodules ,Pathology ,medicine.medical_specialty ,Tissue Fixation ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Carcinoma, Papillary, Follicular ,Pathology and Forensic Medicine ,Diagnosis, Differential ,Gross examination ,Thyroid carcinoma ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Adenocarcinoma, Follicular ,Follicular phase ,medicine ,Humans ,Neoplasm Invasiveness ,Thyroid Neoplasms ,Aged ,Centimeter ,business.industry ,Thyroid ,Reproducibility of Results ,General Medicine ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Thyroid Cancer, Papillary ,030220 oncology & carcinogenesis ,Female ,Differential diagnosis ,business - Abstract
The diagnosis of encapsulated follicular-patterned thyroid carcinoma (EFPTC) is challenging, and the detection of capsular invasion and/or vascular invasion is essential in distinguishing benign lesions from malignant lesions. In this study, we present a modified transverse-vertical gross examination method with additional vertical cuts at the upper and lower ends of thyroid nodules. In addition, we compared the clinicopathological characteristics of patients with EFPTC between conventional and modified methods. The diagnostic rate of follicular thyroid carcinoma and invasive encapsulated follicular variant of papillary thyroid carcinoma was higher with the modified method (p = 0.003 and p = 0.028, respectively). Furthermore, the paraffin block number and the number of capsular invasion per centimeter were significantly higher with the modified method (p
- Published
- 2019
22. Distinguishing non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) from classic and invasive follicular-variant papillary thyroid carcinomas based on cytologic features
- Author
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Jonathon Heath, Lynnette Parker, Paul N. Staats, and Teklu Legesse
- Subjects
Pathology ,medicine.medical_specialty ,endocrine system diseases ,030209 endocrinology & metabolism ,Carcinoma, Papillary, Follicular ,medicine.disease_cause ,Pathology and Forensic Medicine ,Diagnosis, Differential ,Thyroid carcinoma ,03 medical and health sciences ,0302 clinical medicine ,Cytology ,Adenocarcinoma, Follicular ,Follicular phase ,Atypia ,Humans ,Medicine ,Thyroid Neoplasms ,Thyroid neoplasm ,Suspicious for Malignancy ,medicine.diagnostic_test ,business.industry ,Thyroid ,medicine.disease ,medicine.anatomical_structure ,Fine-needle aspiration ,Thyroid Cancer, Papillary ,030220 oncology & carcinogenesis ,business - Abstract
Introduction An international panel recently recommended reclassification of non-invasive follicular variant of papillary thyroid carcinoma (PTC) to non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). NIFTPs have little or no risk of recurrence and can be treated with lobectomy alone. Preoperative distinction of NIFTP from PTC will help avoid overtreatment. Materials and Methods All thyroid tumors with a histologic diagnosis of PTC and preceding diagnostic cytology (n = 299) over a 5-year period were identified. Cases meeting criteria for NIFTP were reclassified as such. All NIFTP cases with available cytology (n = 6) and a similar number of randomly selected invasive follicular variant of papillary thyroid carcinoma (IFVPTC; n = 9) and classic PTC (cPTC, n = 11) were evaluated for 18 cytologic features. Results A total of 35 (12%) lesions were reclassified as NIFTP, 194 (65%) were cPTC, and 70 (23%) were IFVPTC. The NIFTPs had a preceding cytologic interpretation of benign (31%), atypia of undetermined significance (34%), follicular neoplasm (9%), suspicious for malignancy (12%), or malignant (14%). Cytologically, NIFTP was distinguished from cPTC by absence of any architectural features in all 6 cases, and by absence of pseudoinclusions ( P P = 0.027) in nearly all. Nuclear pseudoinclusions ( P = 0.001), marginal micronucleoli ( P = 0.018), irregular branching sheets ( P = 0.025), and linear arrangement ( P = 0.025) favored IFVPTC over NIFTP. Conclusions NIFTPs were originally assigned to a variety of cytologic categories. There are several cytologic differences between NIFTP and cPTC or IFVPTC. Our findings support restricting the definitive diagnosis of PTC to cases with architectural features of PTC and/or intranuclear pseudoinclusions.
- Published
- 2019
23. Cytomorphological Analysis of Thyroid Nodules Diagnosed as Follicular Variant of Papillary Thyroid Carcinoma: a Fine Needle Aspiration Study of Diagnostic Clues in 42 Cases and the Impact of Using Bethesda System in Reporting—an Institutional Experience
- Author
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Nadir Paksoy and Levent Trabzonlu
- Subjects
Adult ,Male ,Thyroid nodules ,Pathology ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Biopsy, Fine-Needle ,Bethesda system ,030209 endocrinology & metabolism ,Carcinoma, Papillary, Follicular ,medicine.disease_cause ,Pathology and Forensic Medicine ,Thyroid carcinoma ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Cytology ,medicine ,Humans ,Thyroid Neoplasms ,Thyroid neoplasm ,medicine.diagnostic_test ,business.industry ,Thyroid ,General Medicine ,Middle Aged ,medicine.disease ,Fine-needle aspiration ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Female ,business ,Hyperchromasia - Abstract
Follicular variant of papillary thyroid carcinoma (FVPTC) is the second most common subtype of papillary thyroid carcinoma (PTC) after classical PTC (cPTC). Follicular thyroid lesions such as follicular adenomas/carcinomas, FVPTC, and noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) pose some diagnostic challenges for FNAC. In this study, we aimed to explore whether FNAC can demonstrate diagnostic clues by re-evaluating cytology slides from histopathologically diagnosed FVPTC cases. A total of 42 patients were enrolled in this study: patients were diagnosed with FVPTC via surgical resection between 2006 and 2016, and all patients were subjected to preoperative FNAC, which was conducted at either a private center or at the teaching hospital of Kocaeli University and reported by the same cytopathologist (NP). Clinical and cytomorphological characteristics were reviewed by both authors .Most cases (76.2%) are diagnosed either Bethesda IV or V. The majority of cases had a high cellularity (38/42; 90.5%), and the most frequent observations were monolayer and large syncytial groups of cells (95.2%). While microfollicular structures were observed in 30 (71.4%) cases, nuclear crowding and large naked nuclei were observed in all cases. Nuclear grooves were sparsely detected in 23 (54.8%) cases, and nuclear pseudoinclusions were detected in only six (14.3%) cases. Because thyrocytes often have a mixed architecture in FVPTC, despite a distinct follicular morphology, we believe that nuclear overcrowding, enlargement, and hyperchromasia in cases presenting with increased cellularity are notable clues for the cytodiagnosis of FVPTC. We believe that the primary aim of FNAC in such cases is to give preoperative diagnosis as either category IV or V. Nuclear crowding, monolayered clusters with large syncytial formations, nuclear enlargement, and hyperchromasia are notable cytomorphologic clues for the diagnosis of FVPTC on FNAC.
- Published
- 2018
24. AIBx, artificial intelligence model to risk stratify thyroid nodules
- Author
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Johnson Thomas and Tracy Haertling
- Subjects
Thyroid nodules ,Endocrinology, Diabetes and Metabolism ,Thyroid Gland ,030209 endocrinology & metabolism ,Carcinoma, Papillary, Follicular ,Malignancy ,Risk Assessment ,Sensitivity and Specificity ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Text mining ,Similarity (network science) ,Artificial Intelligence ,Adenocarcinoma, Follicular ,Image Interpretation, Computer-Assisted ,Biopsy ,Humans ,Medicine ,Thyroid Neoplasms ,Thyroid Nodule ,Thyroid cancer ,Ultrasonography ,medicine.diagnostic_test ,Contextual image classification ,business.industry ,Benignity ,Ultrasound ,Thyroid ,Nodule (medicine) ,medicine.disease ,medicine.anatomical_structure ,Thyroid Cancer, Papillary ,030220 oncology & carcinogenesis ,Artificial intelligence ,medicine.symptom ,business ,Algorithms - Abstract
BackgroundCurrent classification systems for thyroid nodules are very subjective. Artificial intelligence (AI) algorithms have been used to decrease subjectivity in medical image interpretation. 1 out of 2 women over the age of 50 may have a thyroid nodule and at present the only way to exclude malignancy is through invasive procedures. Hence, there exists a need for noninvasive objective classification of thyroid nodules. Some cancers have benign appearance on ultrasonogram. Hence, we decided to create an image similarity algorithm rather than image classification algorithm.MethodsUltrasound images of thyroid nodules from patients who underwent either biopsy or thyroid surgery from February of 2012 through February of 2017 in our institution were used to create AI models. Nodules were excluded if there was no definitive diagnosis of benignity or malignancy. 482 nodules met the inclusion criteria and all available images from these nodules were used to create the AI models. Later, these AI models were used to test 103 thyroid nodules which underwent biopsy or surgery from March of 2017 through July of 2018.ResultsNegative predictive value of the image similarity model was 93.2%. Sensitivity, specificity, positive predictive value and accuracy of the model was 87.8%, 78.5%, 65.9% and 81.5% respectively.ConclusionWhen compared to published results of ACR TIRADS and ATA classification system, our image similarity model had comparable negative predictive value with better sensitivity specificity and positive predictive value. By using image similarity AI models, we can eliminate subjectivity and decrease the number of unnecessary biopsies. Using image similarity AI model, we were able to create an explainable AI model which increases physician’s confidence in the predictions.
- Published
- 2021
25. Clinicopathologic Characteristics of Thyroid Nodules Positive for the
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Elena M, Morariu, Kelly L, McCoy, Simion I, Chiosea, Alyaksandr V, Nikitski, Pooja, Manroa, Marina N, Nikiforova, and Yuri E, Nikiforov
- Subjects
Biopsy, Fine-Needle ,Preoperative Care ,Biomarkers, Tumor ,Thyroidectomy ,Humans ,RNA-Binding Proteins ,Carcinoma, Papillary, Follicular ,Thyroid Neoplasms ,Thyroid Nodule ,Gene Fusion ,Pathology, Molecular ,Neoplasm Proteins ,Retrospective Studies - Published
- 2021
26. Whole Tumor Capsule Is Prognostic of Very Good Outcome in the Classical Variant of Papillary Thyroid Cancer
- Author
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Liborio Torregrossa, Cristina Romei, Antonio Matrone, Clara Ugolini, Gabriele Materazzi, Laura Agate, Teresa Ramone, Paolo Piaggi, Carlotta Giani, Rossella Elisei, Eleonora Molinaro, Raffaele Ciampi, and Fulvio Basolo
- Subjects
Male ,Proto-Oncogene Proteins B-raf ,medicine.medical_specialty ,whole tumor capsule ,Endocrinology, Diabetes and Metabolism ,Clinical Biochemistry ,Thyroid Gland ,030209 endocrinology & metabolism ,Context (language use) ,Carcinoma, Papillary, Follicular ,medicine.disease_cause ,Biochemistry ,Gastroenterology ,Papillary thyroid cancer ,Thyroid carcinoma ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Internal medicine ,Follicular phase ,Adenocarcinoma, Follicular ,medicine ,Humans ,papillary thyroid cancer ,Thyroid Neoplasms ,Good outcome ,Thyroid cancer ,Pathological ,Thyroid neoplasm ,follicular variant ,business.industry ,Biochemistry (medical) ,Middle Aged ,medicine.disease ,Prognosis ,classical variant ,Thyroid Cancer, Papillary ,030220 oncology & carcinogenesis ,Mutation ,Female ,business - Abstract
Context Tumor capsule integrity is becoming a relevant issue to predict the biological behavior of human tumors, including thyroid cancer. Objective This work aims to verify whether a whole tumor capsule in the classical variant of papillary thyroid carcinoma (CVPTC) could have as a predictive role of a good outcome as for follicular variant (FVPTC). Methods FVPTC (n = 600) and CVPTC (n = 554) cases were analyzed. We distinguished between encapsulated-FVPTC (E-FVPTC) and encapsulated-CVPTC (E-CVPTC) and, thereafter, invasive (Ei-FVPTC and Ei-CVPTC) and noninvasive (En-FVPTC and En-CVPTC) tumors, according to the invasion or integrity of the tumor capsule, respectively. Cases without a tumor capsule were indicated as invasive-FVPTC (I-FVPTC) and invasive-CVPTC (I-CVPTC). The subgroup of each variant was evaluated for BRAF mutations. Results E-FVPTC was more frequent than E-CVPTC (P Conclusion En-CVPTC is less prevalent than En-FVPTC. However, it has good clinical/ pathological behavior comparable to En-FVPTC. This finding confirms the good prognostic role of a whole tumor capsule in CVPTC as well. New nomenclature for En-CVPTC, similar to that introduced for En-FVPTC (ie, noninvasive follicular thyroid neoplasm with papillary-like nuclear features; NIFTP) could be envisaged.
- Published
- 2021
27. Follicular Lesions with Papillary Nuclear Characteristics: Differences in Chromatin Detected by Computerized Image Analysis
- Author
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Coelho, Bárbara Parente, Valentim, Flávia de Oliveira, Miot, Hélio Amante, Jaune, Danilo Takeshi Abe, Hayashi, Caroline Yuki, Oliveira, Cristiano Claudino de, Marques, Mariângela de Alencar, Tagliarini, José Vicente, Castilho, Emanuel Celice, Soares, Paula, and Mazeto, Gláucia Maria Ferreira da Silva
- Subjects
Histology ,Thyroid neoplasms ,Carcinoma, Papillary, Follicular ,Cell nucleus - Abstract
Objective: Follicular lesions of the thyroid with papillary carcinoma nuclear characteristics are classified as infiltrative follicular variant of papillary thyroid carcinoma-FVPTC (IFVPTC), encapsulated/well demarcated FVPTC with tumour capsular invasion (IEFVPTC), and the newly described category “non-invasive follicular thyroid neoplasm with papillary-like nuclear features” (NIFTP) formerly known as non-invasive encapsulated FVPTC. This study evaluated whether computerized image analysis can detect nuclear differences between these three tumour subtypes. Materials and methods: Slides with histological material from 15 cases of NIFTP and 33 cases of FVPTC subtypes (22 IEFVPTC, and 11 IFVPTC) were analyzed using the Image J image processing program. Tumour cells were compared for both nuclear morphometry and chromatin textural characteristics. Results: Nuclei from NIFTP and IFVPTC tumours differed in terms of chromatin textural features (grey intensity): mean (92.37 ± 21.01 vs 72.99 ± 14.73, p = 0.02), median (84.93 ± 21.17 vs 65.18 ± 17.08, p = 0.02), standard deviation (47.77 ± 9.55 vs 39.39 ± 7.18; p = 0.02), and coefficient of variation of standard deviation (19.96 ± 4.01 vs 24.75 ± 3.31; p = 0.003). No differences were found in relation to IEFVPTC. Conclusion: Computerized image analysis revealed differences in nuclear texture between NIFTP and IFVPTC, but not for IEFVPTC.
- Published
- 2020
28. Findings other than age that help identify possible cases of non-invasive follicular thyroid neoplasm with nuclear characteristics of the papillary carcinoma type
- Author
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Fábio Massahito Yamamoto and José Cândido Caldeira Xavier-Junior
- Subjects
Pathology ,medicine.medical_specialty ,business.industry ,Thyroid ,Non invasive ,Age Factors ,Cancer ,Carcinoma, Papillary, Follicular ,General Medicine ,medicine.disease_cause ,medicine.disease ,Pathology and Forensic Medicine ,Fine needle biopsy ,medicine.anatomical_structure ,Clinical Decision Rules ,Follicular phase ,Humans ,Medicine ,Thyroid Neoplasms ,Papillary carcinoma ,business ,Thyroid neoplasm ,Ultrasonography - Published
- 2022
29. Analysis of Malignant Thyroid Nodules That Do Not Meet ACR TI-RADS Criteria for Fine-Needle Aspiration
- Author
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Margaret M. Szabunio, Carl C. Reading, Terry S. Desser, Jill E. Langer, William D. Middleton, Franklin N. Tessler, Jenny K. Hoang, Sharlene A. Teefey, and Michael D. Beland
- Subjects
Thyroid nodules ,Adult ,Male ,medicine.medical_specialty ,Diagnostic ultrasound ,Adolescent ,Biopsy, Fine-Needle ,Carcinoma, Papillary, Follicular ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Thyroid Nodule ,Thyroid cancer ,Aged ,Retrospective Studies ,Ultrasonography ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Patient Selection ,Thyroid ,Nodule (medicine) ,General Medicine ,Middle Aged ,medicine.disease ,Fine-needle aspiration ,medicine.anatomical_structure ,Thyroid Cancer, Papillary ,030220 oncology & carcinogenesis ,Female ,Radiology ,medicine.symptom ,business ,Reporting system - Abstract
OBJECTIVE. Compared with other guidelines, the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) has decreased the number of nodules for which fine-needle aspiration is recommended. The purpose of this study was to evaluate the characteristics of malignant nodules that would not be biopsied when the ACR TI-RADS recommendations are followed. MATERIALS AND METHODS. We retrospectively reviewed a total of 3422 thyroid nodules for which a definitive cytologic diagnosis, a definitive histologic diagnosis, or both diagnoses as well as diagnostic ultrasound (US) examinations were available. All nodules were categorized using the ACR TI-RADS, and they were divided into three groups according to the recommendation received: fine-needle aspiration (group 1), follow-up US examination (group 2), or no further evaluation (group 3). RESULTS. Of the 3422 nodules, 352 were malignant. Of these, 240 nodules were assigned to group 1, whereas 72 were assigned to group 2 and 40 were included in group 3. Sixteen of the 40 malignant nodules in group 3 were 1 cm or larger, and, on the basis of analysis of the sonographic features described in the ACR TI-RADS, these nodules were classified as having one of five ACR TI-RADS risk levels (TR1-TR5), with one nodule classified as a TR1 nodule, eight as TR2 nodules, and seven as TR3 nodules. If the current recommendation of no follow-up for TR2 nodules was changed to follow-up for nodules 2.5 cm or larger, seven additional malignant nodules and 316 additional benign nodules would receive a recommendation for follow-up. If the current size threshold (1.5 cm) used to recommend US follow-up for TR3 nodules was decreased to 1.0 cm, seven additional malignant nodules and 118 additional benign nodules would receive a recommendation for follow-up. CONCLUSION. With use of the ACR TI-RADS, most malignant nodules that would not be biopsied would undergo US follow-up, would be smaller than 1 cm, or would both undergo US follow-up and be smaller than 1 cm. Adjusting size thresholds to decrease the number of missed malignant nodules that are 1 cm or larger would result in a substantial increase in the number of benign nodules undergoing follow-up.
- Published
- 2020
30. Pathologic Features Associated With Molecular Subtypes of Well-Differentiated Thyroid Cancer
- Author
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Meredith E. Tabangin, Mara Y. Roth, Benjamin Aunins, Tammy M. Holm, Richard T. Kloos, Gregory W. Randolph, Alice Tang, Mekibib Altaye, Michael W. Yeh, and David L. Steward
- Subjects
Oncology ,Proto-Oncogene Proteins B-raf ,medicine.medical_specialty ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Carcinoma, Papillary, Follicular ,Metastasis ,Papillary thyroid cancer ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Thyroid Neoplasms ,Pathological ,Thyroid cancer ,Retrospective Studies ,Angioinvasion ,medicine.diagnostic_test ,business.industry ,Thyroid ,General Medicine ,medicine.disease ,medicine.anatomical_structure ,Fine-needle aspiration ,Lymphatic Metastasis ,Cohort ,Mutation ,business - Abstract
To determine the association between pathologic features and molecular classes (BRAF-like, RAS-like, and non-BRAF-like non-RAS-like [NBNR]).Retrospective review of a merged database containing 676 patients, 84% (571/676) were assigned to a molecular class from publicly accessible sequenced data of thyroid neoplasms.The merged cohort included 571 neoplasms: 353 (62%) BRAF-like, 172 (30%) RAS-like, and 46 (8.1%) NBNR. Lymph node metastasis (any N1 disease) was present in 166/337 (49%) of BRAF-like, 23/164 (14%) of RAS-like, and 0/46 (0%) of NBNR and are significantly different (P.001). Gross extra-thyroidal extension was observed in 27 patients, including 24/331 (7%) of BRAF-like, 2/160 (1%) of RAS-like, and 1/46 (2%) of NBNR (P = .01). N1B lymph node metastases or T4 disease was present in 74/333 (22%) of BRAF-like, 10/160 (6%) of RAS-like, and 1/46 (2%) of NBNR (P.0001). Distant metastasis was present in 4/151 (2.6%) of BRAF-like, 2/50 (4%) of RAS-like and 0/46 for NBNR (P = .627). Angioinvasion was present in 0/81 (0%) of BRAF-like, 3/53 (6%) of RAS-like, and 3/46 (7%) of NBNR (P = .08); and multifocality was present in 27/81 (33%) of BRAF-like, 9/53 (17%) of RAS-like, and 1/46 (2%) for NBNR (P = .0001).Pathological features of metastasis, gross extra-thyroidal extension, and multifocality were more prevalent in BRAF-like samples compared to RAS-like and NBNR. A trend towards increased frequency of angioinvasion in RAS-like and NBNR cancers compared to BRAF-like samples was observed. Further studies are needed to evaluate if preoperative knowledge of molecular mutations in thyroid tumors aids in decision-making regarding extent of surgery.
- Published
- 2020
31. [Mutation of RAS gene in follicular-differentiated thyroid tumors and its significance]
- Author
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L P, Liu, J Y, Hao, H, Pan, C, Wang, and P, Yue
- Subjects
Male ,Proto-Oncogene Proteins B-raf ,Genes, ras ,Mutation ,Humans ,Female ,Carcinoma, Papillary, Follicular ,Thyroid Neoplasms ,Middle Aged - Published
- 2020
32. Impact of Noninvasive Follicular Thyroid Neoplasm With Papillary-Like Nuclear Features on Revised Bethesda System Malignancy Rates at a Single Institution
- Author
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John I. Lew, Bryan W. Whitfield, Samantha M. Linhares, Mohammed Jeraq, Josefina C. Farrá, Omar Picado, Daniela Gordillo, and Amy F. Lee
- Subjects
Adult ,Male ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Noninvasive follicular thyroid neoplasm with papillary-like nuclear features ,Bethesda system ,Thyroid Gland ,Carcinoma, Papillary, Follicular ,medicine.disease_cause ,Risk Assessment ,Thyroid carcinoma ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,stomatognathic system ,medicine ,Humans ,Thyroid Neoplasms ,Child ,Thyroid cancer ,Thyroid neoplasm ,Aged ,Retrospective Studies ,Gynecology ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Thyroidectomy ,nutritional and metabolic diseases ,Middle Aged ,medicine.disease ,Bethesda system for reporting thyroid cytopathology ,Fine-needle aspiration ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Surgery ,Female ,business - Abstract
Background The Bethesda System for Reporting Thyroid Cytopathology (BSRTC) standardizes thyroid cytopathology reporting in six tier diagnostic categories. In recent years, noninvasive encapsulated follicular variant of papillary thyroid carcinoma was reclassified as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). This study examines the impact of NIFTP on the BSRTC risk of malignancy (ROM). Methods This was a retrospective review of prospectively collected data from 565 patients who underwent fine needle aspiration and thyroidectomy at a single institution. ROM for each Bethesda category was analyzed and calculated with NIFTP classified as a malignant and nonmalignant lesion. Absolute and relative differences between ROM were compared. Results Of 565 patients, 19 were Bethesda I, 159 were Bethesda II, 178 were Bethesda III, 46 were Bethesda IV, 42 were Bethesda V, and 121 were Bethesda VI. ROM differences with NIFTP classified as malignant versus nonmalignant for each class were as follows: Bethesda I, no change; Bethesda II, 18%-14%; Bethesda III, 55%-48%; Bethesda IV, 50%-35%; Bethesda V, 93%-91%; and Bethesda VI, 99%-98%. Absolute ROM differences for each category were as follows: Bethesda I, 0%; Bethesda II, 4%; Bethesda III, 7%; Bethesda IV, 15%; Bethesda V, 2%; and Bethesda VI, 1%. Conclusions A decreasing trend in absolute and relative ROM was seen in Bethesda II, III, and IV categories; however, exclusion of NIFTP as a malignant lesion did not significantly alter the ROM of BSRTC categories. Surgeons should assess their respective institution's experiences with NIFTP and the BSRTC.
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- 2020
33. Outcome of classical (CVPTC) and follicular (FVPTC) variants of papillary thyroid cancer: 15 years of follow-up
- Author
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L. De Napoli, Clara Ugolini, Carlotta Giani, Fulvio Basolo, Cristina Romei, Eleonora Molinaro, Liborio Torregrossa, David Viola, Rossella Elisei, Gabriele Materazzi, Laura Agate, Paolo Piaggi, and Antonio Matrone
- Subjects
Tumor capsule ,medicine.medical_specialty ,Multivariate analysis ,Endocrinology, Diabetes and Metabolism ,Follicular variant ,Papillary thyroid cancer ,030209 endocrinology & metabolism ,Disease ,Carcinoma, Papillary, Follicular ,Classical variant ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Tumor dimension ,Internal medicine ,Follicular phase ,Epidemiology ,medicine ,Humans ,Thyroid Neoplasms ,Lymph node ,Pathological ,Retrospective Studies ,business.industry ,Soft tissue ,medicine.disease ,medicine.anatomical_structure ,Thyroid Cancer, Papillary ,030220 oncology & carcinogenesis ,business ,Follow-Up Studies - Abstract
To compare the epidemiological, clinical, and pathological features of follicular (FVPTC) and classical (CVPTC) variants of papillary thyroid cancer and to correlate their outcomes according to different features. Retrospective analysis of FVPTC and CVPTC patients selected at the moment of surgical treatment from 1999 to 2004, with a median follow-up of 15 years. Several significant differences were found between FVPTC and CVPTC such as the mean age at diagnosis, the presence of tumor capsule, the presence of thyroid capsule invasion, the presence of perithyroid soft tissue invasion, the lymph node metastases, the multifocality and bilaterality. At the end of follow-up only 9% (77/879) patients were not cured. However, a statistically significant lower percentage of persistent disease was found in the FVPTC than in the CVPTC group (3% vs. 14.5%, respectively, p
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- 2020
34. Follicular lesions with papillary nuclear characteristics: Differences in chromatin detected by computerized image analysis
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Flávia de Oliveira Valentim, Caroline Y Hayashi, Cristiano Claudino Oliveira, José Vicente Tagliarini, Gláucia Maria Ferreira da Silva Mazeto, Paula Soares, Mariângela de Alencar Marques, Danilo T A Jaune, Bárbara P Coelho, Emanuel Celice Castilho, Hélio Amante Miot, Instituto de Investigação e Inovação em Saúde, Universidade Estadual Paulista (Unesp), Universidade do Porto, Instituto de Patologia Molecular e Imunologia da Universidade do Porto (IPATIMUP), and Faculdade de Medicina da Universidade do Porto
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Pathology ,medicine.medical_specialty ,Histology ,Endocrinology, Diabetes and Metabolism ,Coefficient of variation ,Thyroid neoplasms ,Carcinoma, Papillary, Follicular ,medicine.disease_cause ,Diseases of the endocrine glands. Clinical endocrinology ,Adenocarcinoma, Follicular / genetics ,Follicular phase ,Adenocarcinoma, Follicular ,Medicine ,Humans ,Thyroid Neoplasms / diagnostic imaging ,Thyroid neoplasm ,Retrospective Studies ,business.industry ,Image (category theory) ,Thyroid ,RC648-665 ,Carcinoma, Papillary ,Chromatin ,Cell nucleus ,medicine.anatomical_structure ,Thyroid Cancer, Papillary ,business ,Thyroid Neoplasms / genetics ,Adenocarcinoma, Follicular / diagnostic imaging - Abstract
Made available in DSpace on 2021-06-25T10:36:13Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-09-01 Objective: Follicular lesions of the thyroid with papillary carcinoma nuclear characteristics are classified as infiltrative follicular variant of papillary thyroid carcinoma-FVPTC (IFVPTC), encapsulated/ well demarcated FVPTC with tumour capsular invasion (IEFVPTC), and the newly described category “non-invasive follicular thyroid neoplasm with papillary-like nuclear features” (NIFTP) formerly known as non-invasive encapsulated FVPTC.This study evaluated whether computerized image analysis can detect nuclear differences between these three tumour subtypes. Materials and methods: Slides with histological material from 15 cases of NIFTP and 33 cases of FVPTC subtypes (22 IEFVPTC, and 11 IFVPTC) were analyzed using the Image J image processing program.Tumour cells were compared for both nuclear morphometry and chromatin textural characteristics. Results: Nuclei from NIFTP and IFVPTC tumours differed in terms of chromatin textural features (grey intensity): mean (92.37 ± 21.01 vs 72.99 ± 14.73, p = 0.02), median (84.93 ± 21.17 vs 65.18 ± 17.08, p = 0.02), standard deviation (47.77 ± 9.55 vs 39.39 ± 7.18; p = 0.02), and coefficient of variation of standard deviation (19.96 ± 4.01 vs 24.75 ± 3.31; p = 0.003). No differences were found in relation to IEFVPTC. Conclusion: Computerized image analysis revealed differences in nuclear texture between NIFTP and IFVPTC, but not for IEFVPTC. Departamento de Cirurgia e Ortopedia Faculdade de Medicina de Botucatu Universidade Estadual de São Paulo (Unesp) Departamento de Dermatologia Faculdade de Medicina de Botucatu Universidade Estadual de São Paulo (Unesp) Departamento de Medicina Interna Faculdade de Medicina de Botucatu Universidade Estadual de São Paulo (Unesp) Departamento de Patologia Faculdade de Medicina de Botucatu Universidade Estadual de São Paulo (Unesp) Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço Faculdade de Medicina de Botucatu Universidade Estadual de São Paulo (Unesp) Instituto de Investigação e Inovação em Saúde (i3S) Universidade do Porto Grupo de Sinalização e Metabolismo do Câncer Instituto de Patologia Molecular e Imunologia da Universidade do Porto (IPATIMUP) Departamento de Patologia Faculdade de Medicina da Universidade do Porto Departamento de Cirurgia e Ortopedia Faculdade de Medicina de Botucatu Universidade Estadual de São Paulo (Unesp) Departamento de Dermatologia Faculdade de Medicina de Botucatu Universidade Estadual de São Paulo (Unesp) Departamento de Medicina Interna Faculdade de Medicina de Botucatu Universidade Estadual de São Paulo (Unesp) Departamento de Patologia Faculdade de Medicina de Botucatu Universidade Estadual de São Paulo (Unesp) Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço Faculdade de Medicina de Botucatu Universidade Estadual de São Paulo (Unesp)
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- 2020
35. Is isthmic enucleo-resection a reliable treatment for isthmic differentiated thyroid carcinoma? A note of caution
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R Piantanida, Luca Giovanella, and Alfredo Campennì
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Adult ,Male ,medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,Cell Differentiation ,Carcinoma, Papillary, Follicular ,Middle Aged ,Resection ,Thyroid carcinoma ,Endocrinology ,Lymphatic Metastasis ,medicine ,Thyroidectomy ,Humans ,Neck Dissection ,Pharynx ,Female ,Radiology ,Thyroid Neoplasms ,Differentiated thyroid cancer ,Isthmus ,Isthmusectomy ,Lymph-node metastases ,Thyroid surgery ,business - Published
- 2020
36. [Hereditary predispositions to follicular thyroid tumors]
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Myriam, Decaussin-Petrucci
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Ribonuclease III ,Thyroid Gland ,Carcinoma, Papillary, Follicular ,Oncogenes ,Hyperthyroidism ,DEAD-box RNA Helicases ,Adenomatous Polyposis Coli ,Neoplastic Syndromes, Hereditary ,Thyroid Cancer, Papillary ,Humans ,Genetic Predisposition to Disease ,Genetic Testing ,Thyroid Neoplasms ,Werner Syndrome ,Hamartoma Syndrome, Multiple ,Goiter, Nodular - Abstract
Familial thyroid cancers of follicular origin are rare and include syndromic and non-syndromic tumours. In familial adenomatous polyposis, the prevalence of papillary thyroid cancer is 2-12% and in 20-40% of cases it is a cribriform-morular papillary thyroid carcinoma. Morules and cribriform pattern are the two main typical criteria, associated with a nuclear and cytoplasmic immunopositivity for beta catenin. DICER1 syndrome is associated with pleuropneumoblastoma, ovarian tumors and thyroid pathology (multinodular goiter and less frequently a well-differentiated thyroid cancer without microscopic particularity). Cowden syndrome is characterized by multiple hamartomas and two-thirds of patients develop thyroid pathology, including multinodular goiter (50-67%) and cancer (35%), the latter being one of the major diagnostic criteria of the syndrome. Classic triad of Carney complex associates lentiginosis, myxoid tumors, and various endocrine abnormalities; thyroid pathology occurs in 10% of cases and may be benign or malignant. In Werner's syndrome, thyroid cancer is present in 18% of cases. McCune-Albright syndrome is characterized by fibrous dysplasia, café-au-lait spots and various endocrinopathies including hyperthyroidism and nodular hyperplasia. Non-syndromic thyroid cancers, which represent the majority of familial cancers, are most often papillary carcinomas. In daily practice, in the presence of multiple benign thyroid nodules and/or thyroid cancer in a young person, or with family thyroid diseases, the pathologist should be aware about hereditary predispositions to propose an oncogenetic consultation.
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- 2019
37. OTUD6B-AS1 Inhibits Viability, Migration, and Invasion of Thyroid Carcinoma by Targeting miR-183-5p and miR-21
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Zhuolu Wang, Xinying Li, Wenlong Wang, Bo Jiang, Tiecheng Feng, and Fada Xia
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0301 basic medicine ,Adult ,Male ,Cell Survival ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Carcinoma, Papillary, Follicular ,Biology ,lcsh:Diseases of the endocrine glands. Clinical endocrinology ,Metastasis ,Thyroid carcinoma ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,lncRNA ,Cell Movement ,microRNA ,medicine ,Carcinoma ,Cell Adhesion ,Humans ,Neoplasm Invasiveness ,RNA, Antisense ,OTUD6B-AS1 ,Thyroid Neoplasms ,Original Research ,lcsh:RC648-665 ,miR-183-5p ,Oncomir ,Middle Aged ,medicine.disease ,thyroid carcinoma ,Long non-coding RNA ,Antisense RNA ,Gene Expression Regulation, Neoplastic ,Clear cell renal cell carcinoma ,MicroRNAs ,030104 developmental biology ,Case-Control Studies ,Lymphatic Metastasis ,Cancer research ,Disease Progression ,Female ,miR-21 - Abstract
Background: The long noncoding RNA (lncRNA) functions as a regulator of initiation, progression, and metastasis of thyroid carcinomas. lncRNA OTUD6B antisense RNA 1 (OTUD6B-AS1) is a tumor-suppressive noncoding RNA in clear cell renal cell carcinoma. The role of OTUD6B-AS1 in thyroid carcinomas has not been reported yet. We aim to investigate the expression and biological functions of OTUD6B-AS1 in thyroid carcinomas. Methods: The expression level of OTUD6B-AS1 was measured in 60 paired human thyroid carcinoma tissues and corresponding adjacent normal thyroid tissues. The correlations between the OTUD6B-AS1 expression levels and clinicopathological features were evaluated using the Mann-Whitney test. The effects of OTUD6B-AS1 on thyroid carcinoma cells were determined via the MTT and transwell assays. The potential targets of OTUD6B-AS1 were screened using the online programs OncomiR and StarBase 3.0, and the LncBase Predicted v.2. Luciferase reporter assay was used to confirm the interactions between OTUD6B-AS1 and its potential targets. Results: OTUD6B-AS1 was downregulated in thyroid carcinoma tissue samples. The expression of OTUD6B-AS1 correlated with tumor size, clinical stage, and lymphatic metastasis of thyroid carcinoma. Overexpression of OTUD6B-AS1 significantly decreased the viability, migration, and invasion of thyroid carcinoma cells. Online programs predicted miR-183-5p and miR-21 as potential targets of OTUD6B-AS1. Luciferase reporter assays showed miR-183-5p and miR-21 bound to OTUD6B-AS1. Moreover, overexpression of miR-183-5p and miR-21 compromised the inhibitory effects of OTUD6B-AS1 on viability, migration, and invasion of thyroid carcinoma cells. Conclusions: Taken together, our findings present in vitro evidence of lncRNA OTUD6B-AS1 as a tumor suppressor in thyroid carcinomas. OTUD6B-AS1 inhibits viability, migration, and invasion of thyroid carcinoma by targeting miR-183-5p and miR-21.
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- 2019
38. Lingual Thyroid Carcinoma: A Case Report and Review of Surgical Approaches in the Literature
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William A. Stokes, Eric Interval, and Rusha Patel
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medicine.medical_specialty ,Normal diet ,Carcinoma, Papillary, Follicular ,Papillary thyroid cancer ,Thyroid carcinoma ,03 medical and health sciences ,0302 clinical medicine ,Tongue ,Swallowing ,Carcinoma ,Humans ,Medicine ,Thyroid Neoplasms ,030223 otorhinolaryngology ,Thyroid cancer ,Ultrasonography ,Aged, 80 and over ,business.industry ,Thyroid ,General Medicine ,medicine.disease ,Dysphagia ,Surgery ,medicine.anatomical_structure ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Thyroidectomy ,Female ,medicine.symptom ,Tomography, X-Ray Computed ,business - Abstract
Introduction: Lingual thyroid cancer is a rare entity with a paucity of literature guiding methods of surgical treatment. Its location presents anatomic challenges with access and excision. Objective: We present a case of T4aN1b classical variant papillary thyroid carcinoma of the lingual thyroid that was removed without pharyngeal entry. We also present a review of the literature of this rare entity and propose a treatment algorithm to provide safe and oncologic outcomes. Findings: Our review of the literature found 28 case reports of lingual thyroid carcinoma that met search criteria. The trans-cervical/trans-hyoid approach was the most frequently used and provides safe oncologic outcomes. This was followed by the transoral approach and then lateral pharyngotomy. Complications reported across the series include 1 case of pharyngocutaneous fistula associated with mandibulotomy and postoperative respiratory distress requiring reintubation or emergent tracheostomy in 2 patients. Conclusion: The location of lingual thyroid carcinoma can be variable, and surgical management requires knowledge of adjacent involved structures to decrease the risk of dysphagia and airway compromise. In particular, for cases where there is extensive loss to swallowing mechanisms, laryngeal suspension can allow the patient to resume a normal diet after treatment.
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- 2018
39. BRAF and RAS Mutational Status in Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features and Invasive Subtype of Encapsulated Follicular Variant of Papillary Thyroid Carcinoma in Korea
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Won Bae Kim, Dong Eun Song, Young Kee Shong, Min Ji Jeon, Kyunggon Kim, Won Gu Kim, Suyeon Park, Hye-Seon Oh, Mijin Kim, and Tae Yong Kim
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Adult ,Male ,Proto-Oncogene Proteins B-raf ,Neuroblastoma RAS viral oncogene homolog ,Endocrinology, Diabetes and Metabolism ,Noninvasive follicular thyroid neoplasm with papillary-like nuclear features ,030209 endocrinology & metabolism ,Carcinoma, Papillary, Follicular ,medicine.disease_cause ,GTP Phosphohydrolases ,Proto-Oncogene Proteins p21(ras) ,Thyroid carcinoma ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Republic of Korea ,medicine ,Humans ,Thyroid Neoplasms ,HRAS ,Thyroid neoplasm ,Mutation ,business.industry ,Thyroid ,Membrane Proteins ,Middle Aged ,medicine.anatomical_structure ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,Cancer research ,Female ,KRAS ,business - Abstract
Background Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is an indolent thyroid tumor previously known as noninvasive subtype of encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC). The absence of BRAFV600E mutations has been considered characteristic of NIFTPs. However, a recent study from Korea found that 28.6% of NIFTPs harbored a BRAF mutation. This study evaluated BRAF and RAS mutations in NIFTPs and invasive subtype of EFVPTCs. Methods This study enrolled 32 patients with NIFTP and 48 with invasive EFVPTC. BRAF, NRAS, HRAS, and KRAS mutations were evaluated by direct sequencing using DNA from fresh-frozen tissues and formalin-fixed, paraffin-embedded tissue samples. Results The primary tumor size of NIFTP was smaller than that of invasive EFVPTC (median 2.8 cm vs. 3.2 cm; p = 0.03). Cervical lymph node metastases were found in only four (8%) patients with invasive EFVPTC. There was no BRAF mutation in NIFTPs, whereas invasive EFVPTCs had three (6%) BRAFV600E mutations and one (2%) BRAFK601E mutation. RAS mutations were detected in 15 (47%) NIFTPs and 22 (46%) invasive EFVPTCs. NRAS mutations in codon 61 were the most common mutations in NIFTPs (34%) and invasive EFVPTCs (27%). There was no significant difference in the frequency of RAS mutations between the two groups. Conclusions There was no BRAF mutation in any of the NIFTPs. RAS mutations, particularly mutations in codon 61 of NRAS, were the most common mutations in both NIFTPs and invasive EFVPTCs. The presence of a RAS mutation is not helpful for preoperative differentiation between NIFTPs and invasive EFVPTCs.
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- 2018
40. Characteristics of Follicular Variant Papillary Thyroid Carcinoma in a Pediatric Cohort
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Stephanie L Samuels, Tricia R. Bhatti, N. Scott Adzick, Sogol Mostoufi-Moab, Madeline Amberge, Jill E. Langer, Andrew J. Bauer, Colin P. Hawkes, Ken Kazahaya, Lea F. Surrey, Zubair W. Baloch, and Virginia A. LiVolsi
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Clinical Biochemistry ,030209 endocrinology & metabolism ,Context (language use) ,Carcinoma, Papillary, Follicular ,Biochemistry ,Metastasis ,Thyroid carcinoma ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Internal medicine ,medicine ,Carcinoma ,Humans ,Thyroid Neoplasms ,Child ,Prospective cohort study ,Lymph node ,Clinical Research Articles ,Retrospective Studies ,business.industry ,Biochemistry (medical) ,Thyroidectomy ,Retrospective cohort study ,medicine.disease ,Treatment Outcome ,medicine.anatomical_structure ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,Female ,Radiology ,business - Abstract
CONTEXT: In adults, noninvasive follicular variant of papillary thyroid carcinoma (FVPTC) is considered a low risk for metastasis and persistent/recurrent disease. OBJECTIVE: The goal of this study was to assess the clinical, sonographic, and histopathologic features of FVPTC in a pediatric cohort. DESIGN: A retrospective review of subjects
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- 2018
41. Successful Prediction of a Left Nonrecurrent Laryngeal Nerve in a Patient With Right-Sided Aorta and Aberrant Left Subclavian Artery
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Henry R. Diggelmann, Xiaoyang Hua, Vishram Jalukar, Joseph W. Turek, and Nitin A. Pagedar
- Subjects
Adult ,Aortic arch ,medicine.medical_specialty ,medicine.medical_treatment ,Subclavian Artery ,Aorta, Thoracic ,Carcinoma, Papillary, Follicular ,03 medical and health sciences ,0302 clinical medicine ,Ductus arteriosus ,medicine.artery ,DiGeorge Syndrome ,medicine ,Paralysis ,Humans ,Medical history ,Thyroid Neoplasms ,030223 otorhinolaryngology ,Aorta ,Aberrant left subclavian artery ,business.industry ,Thyroidectomy ,Laryngeal Nerves ,General Medicine ,medicine.disease ,Graves Disease ,medicine.anatomical_structure ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Female ,Radiology ,medicine.symptom ,Tomography, X-Ray Computed ,business ,Diverticulum - Abstract
Background: Left nonrecurrent laryngeal nerve (LNRLN) is an extremely rare anatomic variant. The development of such anatomic variation requires the regression of both the fourth (aortic arch) and sixth (ductus arteriosus, DA) arches on the left side. Preoperative prediction of this variant is difficult but might reduce risk of nerve injury. Methods: A 34-year-old female was indicated for thyroidectomy for a 2.4 cm follicular neoplasm and Graves’ disease. Due to a positive medical history of 22q11.2 microdeletion and unexplained left vocal cord paralysis, a preoperative chest computed tomography (CT) scan was obtained and revealed a right-sided aorta (RSA) and aberrant left subclavian artery (ALSA) without Kommerell’s diverticulum. A left-sided NRLN was then highly suspected. Results: Thyroidectomy was performed under general anesthesia with the utilization of intraoperative laryngeal nerve monitoring. A LNRLN was confirmed intraoperatively. Conclusions: Right-sided aorta and ALSA indicate embryologic regression of the left fourth primitive aortic arch. The absence of Kommerell’s diverticulum at the origin of the ALSA indicates the lack of high-pressure blood flow from the pulmonary artery to the ALSA through the ductus arteriosus during embryogenesis, suggesting the embryologic regression of the left sixth primitive aortic arch. The presence of all 3 radiologic features thus highly suggests the possibility of a LNRLN.
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- 2017
42. Long-term Outcomes and Prognostic Factors in Patients with Differentiated Thyroid Cancer and Distant Metastases
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Ilana Slutzky-Shraga, Ilan Shimon, Eyal Robenshtok, Gloria Tsvetov, Alexander Gorshtein, Dania Hirsch, Sigal Levy, Amit Akirov, and Carlos Benbassat
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Adult ,Male ,Oncology ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Carcinoma, Papillary, Follicular ,Disease-Free Survival ,Thyroid carcinoma ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Internal medicine ,medicine ,Carcinoma ,Humans ,Thyroid Neoplasms ,Neoplasm Metastasis ,Stage (cooking) ,Lymph node ,Thyroid cancer ,Survival analysis ,Aged ,business.industry ,Thyroid ,General Medicine ,Middle Aged ,Prognosis ,medicine.disease ,Survival Analysis ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Disease Progression ,Female ,Histopathology ,business ,Follow-Up Studies - Abstract
Distant metastatic spread is the most frequent cause of thyroid cancer-related death. The objective of this study was to evaluate overall and disease-related survival of patients with differentiated thyroid cancer (DTC) and distant metastases (DM) attending a single medical center and to investigate variables predictive of better long-term outcomes.The Rabin Medical Center Thyroid Cancer Registry was searched for patients with DM from DTC.The cohort included 138 patients (58.7% female) diagnosed at age 54.7 ± 19.5 years. Mean primary tumor size was 33.9 ± 26 mm. Most patients (57.7%) were stage T3/T4; 48.7% had extrathyroidal extension; 53.5% had lymph node metastases. Histopathology yielded papillary and follicular thyroid carcinoma in 66.7% and 13.8%, respectively, and intermediate/poorly differentiated carcinoma in 19.6%. All but 2 patients underwent total thyroidectomy, and 133/138 (96.4%) received radioactive iodine (RAI) therapy. DM were synchronous in 55.1%. The mean follow-up was 8.2 years from detection of metastases. The common sites of metastases were the lungs (85.6% of patients), bones (39.9%), brain (5.8%) and liver (3.6%). At last follow-up, resolution was documented in 24.6% of patients, improvement/stable disease in 31.6%, and structurally progressive disease in 43.4%. By the end of the study, 40.6% of patients died, 23.2% of DTC. Improved overall survival and disease progression were associated with younger age, lung-only DM, and metastatic RAI avidity.Patients with DTC and DM treated by standard-of-care approaches frequently achieve favorable long-term outcomes. Novel therapies might be necessary in only a minority of these patients, and the reported prognostic factors can aid in their identification.CR = complete response; DM = distant metastases; DTC = differentiated thyroid cancer; ETE = extra-thyroidal extension; M0 = detected during follow-up; M1 = detected at diagnosis; MSKCC = Memorial Sloan Kettering Cancer Center; NED = no evidence of disease; OS = overall survival; PFS = progression free survival; PTC = papillary thyroid cancer; RAI = radioactive iodine; Tg = thyroglobulin.
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- 2017
43. Características clínicas del carcinoma folicular de tiroides.
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Gutiérrez-Hermosillo, Hugo, Tamez-Peréz, Héctor Eloy, de León-Gonzaléz, Enrique Díaz, Gutiérrez-Hermosillo, Violeta, and Ávila-Sanchéza, Jair
- Subjects
- *
THYROID cancer patients , *DISEASE prevalence , *COMORBIDITY , *ADENOMA , *PAPILLARY carcinoma , *ADENOCARCINOMA ,THYROID cancer diagnosis - Abstract
Background: the prevalence of thyroid follicular carcinoma (TFC) is 39 % in patients with an undetermined histological diagnosis. The aim was to know the prevalence of TFC in a hospital with high population concentration. Methods: surgical reports with a final diagnosis of TFC were reviewed. The size of the tumor, age, gender, pre and post-surgical diagnosis and comorbidities were retrieved. Results: a total of 35 reports with a diagnosis of TFC were found, 30 (85 %) were females with a mean age 44 ± 16.9 years. The mean age was 57 ± 6.6 in males. The diagnoses before surgery were follicular carcinoma 14 (40 %), thyroid cancer 6 (17.1 %), thyroid adenoma 4 (11.4 %), goiter 3 (8.5 %), thyroid nodule 3 (8.5 %), one papillary carcinoma (2.8 %), one thyroid neoplasm (2.8 %), one poorly differentiated adenocarcinoma (2.8 %), one well differentiated follicular adenocarcinoma (2.8 %), and one medullary thyroid cancer (2.8 %). The comorbidities found were Hashimoto disease 2 (5.6 %) and papillary contralateral carcinoma 2 patients (5.6 %). Conclusions: follicular carcinomas of the thyroid of our population differ in clinical presentation compared with previous reports. [ABSTRACT FROM AUTHOR]
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- 2013
44. Tumor-to-Tumor Metastasis: Lung Typical Carcinoid Metastatic to Follicular Variant of Papillary Thyroid Carcinoma.
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Clara U, Rossella DF, Giulio R, Gabriele M, and Virginia L
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- Humans, Lung pathology, Thyroid Cancer, Papillary, Adenocarcinoma, Follicular pathology, Carcinoid Tumor, Carcinoma, Neuroendocrine, Carcinoma, Papillary, Follicular, Thyroid Neoplasms pathology
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- 2022
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45. Role of Ultrasound in Predicting Tumor Invasiveness in Follicular Variant of Papillary Thyroid Carcinoma
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Soo Yeon Hahn, Young Lyun Oh, Ji Soo Choi, Yaeji Lim, Jung Hee Shin, and Tae Hyuk Kim
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Adult ,Male ,Capsular Invasion ,Pathology ,medicine.medical_specialty ,Adolescent ,Seoul ,Endocrinology, Diabetes and Metabolism ,Thyroid Gland ,030209 endocrinology & metabolism ,Carcinoma, Papillary, Follicular ,medicine.disease_cause ,Tertiary Care Centers ,Thyroid carcinoma ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Follicular phase ,Humans ,Medicine ,Neoplasm Invasiveness ,Thyroid Neoplasms ,Thyroid Nodule ,Thyroid neoplasm ,Aged ,Retrospective Studies ,Ultrasonography ,business.industry ,Ultrasound ,Thyroid ,Ultrasonography, Doppler ,Nodule (medicine) ,Middle Aged ,Carcinoma, Papillary ,Lymphovascular ,Tumor Burden ,medicine.anatomical_structure ,Thyroid Cancer, Papillary ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,Practice Guidelines as Topic ,Female ,medicine.symptom ,business - Abstract
Follicular variant of papillary thyroid carcinoma (FVPTC) is traditionally divided into infiltrative and encapsulated types. Adding to this classification, noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) represents a reclassification of a subset of cases (encapsulated tumors without lymphovascular or capsular invasion). The purpose of this study was to assess the role of ultrasound (US) in predicting tumor invasiveness in FVPTC.From January 2014 to May 2016, preoperative US examinations were performed on 151 patients with 152 FVPTCs who underwent surgery. Based on a pathologic analysis, the FVPTCs were categorized into three groups: NIFTP, invasive encapsulated FVPTC (iE-FVPTC), or infiltrative FVPTC (I-FVPTC). Each nodule was categorized based on the US pattern according to the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and the American Thyroid Association (ATA) guidelines. The correlation between tumor invasiveness and the K-TIRADS or ATA category was investigated using Spearman's rank correlation coefficient.Among the 152 FVPTCs, there were 48 (31.6%) NIFTPs, 60 (39.5%) iE-FVPTCs, and 44 (28.9%) I-FVPTCs. US characteristics of the FVPTCs differed significantly according to tumor invasiveness (p ≤ 0.030). Tumor invasiveness showed a significant positive correlation with K-TIRADS (tumors of all sizes: r = 0.591, p 0.001; tumors ≥1.0 cm: r = 0.427, p 0.001) and ATA categories (tumors of all sizes: r = 0.532, p 0.001; tumors ≥1.0 cm: r = 0.466, p 0.001). According to both K-TIRADS and ATA guidelines for all-sized tumors, the most common subtype was NIFTP in low-suspicion nodules (52.6% and 51.6%), iE-FVPTC in intermediate-suspicion nodules (52.7% and 54.2%), and I-FVPTC in high-suspicion nodules (82.5% and 69.4%). After surgery, lymph node metastases were confirmed in two (4.2%) NIFTP cases, three (5.0%) iE-FVPTC cases, and eight (18.2%) I-FVPTC cases (p = 0.001). The results of the BRAF mutation analysis were not significantly different between the groups (p = 0.507).Increasing tumor invasiveness from NIFTP to iE-FVPTC to I-FVPTC is positively correlated with the level of suspicion on US using both K-TIRADS and ATA guidelines.
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- 2017
46. Noninvasive Follicular Tumor With Papillary-Like Nuclear Features: Not A Tempest In A Teapot
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Stella K. Kang, Lizabeth King, Michael Bannan, Mark S. Persky, Nidhi Agrawal, Cheng Liu, Kepal N. Patel, Jennifer B. Ogilvie, Steven P. Hodak, Laura Tipton, Keith S. Heller, Fang-Ming Deng, and Collette E. Abbott
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Adult ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Carcinoma, Papillary, Follicular ,medicine.disease_cause ,Papillary thyroid cancer ,Iodine Radioisotopes ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Follicular phase ,medicine ,Humans ,Neoplasm Invasiveness ,Thyroid Neoplasms ,Thyroid neoplasm ,Retrospective Studies ,Cell Nucleus ,Total thyroidectomy ,Completion thyroidectomy ,business.industry ,Cancer ,Retrospective cohort study ,Health Care Costs ,General Medicine ,Middle Aged ,medicine.disease ,Tumor Burden ,Surgery ,030220 oncology & carcinogenesis ,Thyroidectomy ,Health Resources ,Female ,Follicular variant ,business ,Organ Sparing Treatments - Abstract
Encapsulated non-invasive follicular variant papillary thyroid cancer (ENIFVPTC) has recently been retermed noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). This designation specifically omits the word "cancer" to encourage conservative treatment since patients with NIFTP tumors have been shown to derive no benefit from completion thyroidectomy or adjuvant radio-active iodine (RAI) therapy.This was a retrospective study of consecutive cases of tumors from 2007 to 2015 that met pathologic criteria for NIFTP. The conservative management (CM) group included patients managed with lobectomy alone or appropriately indicated total thyroidectomy. Those included in the aggressive management (AM) group received either completion thyroidectomy or RAI or both.From 100 consecutive cases of ENIFVPTC reviewed, 40 NIFTP were included for the final analysis. Of these, 10 (27%) patients treated with initial lobectomy received completion thyroidectomy and 6 of 40 (16%) also received postsurgical adjuvant RAI. The mean per-patient cost of care in the AM group was $17,629 ± 2,865, nearly twice the $8,637 ± 309 costs in the CM group, and was largely driven by the cost of completion thyroidectomy and RAI.The term NIFTP has been recently promulgated to identify a type of thyroid neoplasm, formerly identified as a low-grade cancer, for which initial surgery represents adequate treatment. We believe that since the new NIFTP nomenclature intentionally omits the word "cancer," the clinical indolence of these tumors will be better appreciated, and cost savings will result from more conservative and appropriate clinical management.AM = aggressive management CM = conservative management ENIFVPTC = encapsulated noninvasive form of FVPTC FVPTC = follicular variant of papillary thyroid carcinoma NIFTP = noninvasive follicular thyroid neoplasm with papillary-like nuclear features PTC = papillary thyroid carcinoma PTMC = papillary thyroid microcarcinoma RAI = radio-active iodine US = ultrasound.
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- 2017
47. Follicular Variant of Papillary Thyroid Carcinoma: A Long-term Follow-up.
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Passler, Christian, Prager, Gerhard, Scheuba, Christian, Neiderle, Barbara E., Kaserer, Klaus, Zettinig, Georg, and Niederle, Bruno
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THYROID cancer ,THYROID gland tumors ,SURGERY - Abstract
Hypothesis: The clinical behavior of the follicular variant of papillary thyroid carcinoma (FVPTC) is similar to pure papillary thyroid carcinoma (PPTC) and completely different from follicular thyroid carcinoma (FTC). Design: Retrospective analysis of prospectively documented data. Setting: Referral center of a university hospital. Patients: Two hundred thirty-seven consecutive patients with follicular cell–derived thyroid carcinomas were operated on in our institution during a 15-year period, from January 1, 1980, to December 31, 1994. Of the 154 PTC patients, 37 (24%) had FVPTC. The mean follow-up was 128.2 months (10.7 years). Main Outcome Measures: Demographic features, tumor characteristics, local and distant spread, persistence or recurrence of disease, and carcinoma-related mortality were compared between the groups with FVPTC, PPTC, and non–Hürthle cell FTC (NHFTC). Results: The frequency of multicentricity was significantly higher in the FVPTC group than in the PPTC group (P = .03) or in the NHFTC group (P = .01) (12 [32%] of 37 patients vs 17 [15%] of 117 patients vs 6 [10%] of 58 patients, respectively). The incidence of cervical lymph node metastases was lower in the FVPTC group than in the PPTC group (P = .30) and higher than in NHFTC group (P = .004) (12 [32%] of 37 patients vs 53 [45%] of 117 patients vs 6 [10%] of 58 patients, respectively). At diagnosis, no patient with FVPTC showed distant metastases, compared with 5 patients (4%) with PPTC (P = .34) and 19 (33%) with NHFTC (P<.001). There was no carcinoma-related death in the FVPTC group. The strikingly poorer prognosis for the NHFTC group was statistically significant (P<.001), whereas the difference in carcinoma-specific survival between the PPTC and the FVPTC groups did show a trend toward better survival in the FVPTC group. Conclusion: The clinical behavior of the FVPTC group did not differ significantly from that of the PPTC group, whereas compared with the NHFTC group, the FVPTC group showed statistically significant differences for most of the analyzed variables. [ABSTRACT FROM AUTHOR]
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- 2003
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48. Nodular thyroid disease in the elderly: novel molecular approaches for the diagnosis of malignancy
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Francesco Tartaglia, Salvatore Ulisse, Stefano Arcieri, Enke Baldini, Daniele Pironi, Angelo Filippini, Pietro Giorgio Calò, Salvatore Sorrenti, and Antonio Catania
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Oncology ,Thyroid nodules ,endocrine system ,Aging ,medicine.medical_specialty ,Pathology ,endocrine system diseases ,Biopsy, Fine-Needle ,030209 endocrinology & metabolism ,Carcinoma, Papillary, Follicular ,Thyroid Carcinoma, Anaplastic ,Malignancy ,Thyroid cancer ,Malignant transformation ,Thyroid carcinoma ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Prevalence ,Humans ,Medicine ,Thyroid Neoplasms ,Aged ,Thyroid nodule ,High prevalence ,business.industry ,Incidence ,Thyroid ,Molecular diagnosis ,Geriatrics and Gerontology ,Prognosis ,medicine.disease ,Nodular thyroid disease ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Disease Progression ,business - Abstract
Epithelial thyroid cancers (TC) comprise two differentiated histotypes (DTC), the papillary (PTC) and the follicular (FTC) thyroid carcinomas which, following dedifferentiation, are assumed to give rise to the poorly differentiated thyroid carcinomas and the rare, but highly aggressive and invariably fatal, anaplastic thyroid carcinomas. Although thyroid cancer mortality has not been changed, its annual incidence has increased over the last two decades, mainly because of the improved ability to diagnose malignant transformation in small non-palpable thyroid nodules. Despite DTC patients have a favorable prognosis, aggressive disease is more frequently observed in the elderly showing a higher disease-specific mortality. Of relevance is the high prevalence of nodular thyroid disease in aged patients being higher than 90%, in women older than 60 year, and 60% in men older than 80 year. This implies a careful evaluation of thyroid nodules in this group of patients in order to exclude malignancy. In fact, despite the tremendous progress in the comprehension of the underlying molecular mechanisms deregulated in DTC progression, several aspects of their clinical management remain to be solved and novel diagnostic strategies are sorely needed. Here, we will attempt to review new molecular approaches, which are currently being exploited in order to ameliorate the diagnosis of thyroid nodules.
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- 2016
49. Molecular Profiling of Follicular Variant of Papillary Thyroid Cancer
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I. V. Kondakova, L. V. Spirina, and S. Yu. Chizhevskaya
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0301 basic medicine ,Adult ,Male ,Proto-Oncogene Proteins B-raf ,endocrine system ,Mutation, Missense ,Glutamic Acid ,Disease ,Carcinoma, Papillary, Follicular ,General Biochemistry, Genetics and Molecular Biology ,Papillary thyroid cancer ,03 medical and health sciences ,0302 clinical medicine ,Transcription (biology) ,Medicine ,Humans ,Thyroid Neoplasms ,Transcription factor ,Protein kinase B ,chemistry.chemical_classification ,business.industry ,Kinase ,Gene Expression Profiling ,Valine ,General Medicine ,Middle Aged ,medicine.disease ,Gene Expression Regulation, Neoplastic ,030104 developmental biology ,Enzyme ,chemistry ,Amino Acid Substitution ,Cancer research ,Female ,Signal transduction ,business ,030217 neurology & neurosurgery ,Signal Transduction - Abstract
The molecular features of the follicular variant of papillary thyroid cancer are closely related to the clinical behavior of the tumor and the prognosis of the disease. BRAF-V600E mutations in patients with a follicular variant of papillary thyroid cancer have not been identified; however, the majority of patients had T3-4N0M0 stage of the disease. Changes in the expression of transcription and growth factors and AKT/m-TOR signaling pathway components were detected. In addition, hyperexpression of m-TOR and 4EBP1 kinases and CAIX enzyme was shown compared to the classical variant of papillary thyroid cancer, where an increase in the nuclear factor NF-κB p65 and c-RAF kinase expression was observed.
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- 2019
50. Diagnostic performance of thyroid ultrasound in Hürthle cell carcinomas
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Felipe Augusto Brasileiro Vanderlei, Vinicius Neves Marcos, Nathalie Oliveira Santana, Rosalinda Camargo, Debora Lucia Seguro Danilovic, Cláudia Kliemann Schmerling, Suemi Marui, Maria Cristina Chammas, Ricardo Miguel Costa de Freitas, and Ana O. Hoff
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Adenoma ,Adult ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Hürthle cell ,Thyroid Gland ,lcsh:Medicine ,030209 endocrinology & metabolism ,Carcinoma, Papillary, Follicular ,Malignancy ,lcsh:Diseases of the endocrine glands. Clinical endocrinology ,Likelihood ratios in diagnostic testing ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Ultrasound ,Carcinoma ,medicine ,thyroid cancer ,Humans ,Thyroid Neoplasms ,Thyroid cancer ,neoplasms ,Aged ,Retrospective Studies ,lcsh:RC648-665 ,business.industry ,lcsh:R ,Thyroid ,Doppler ,Retrospective cohort study ,Ultrasonography, Doppler ,Odds ratio ,HCCS ,Middle Aged ,medicine.disease ,digestive system diseases ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Female ,Radiology ,business - Abstract
Objective Hürthle cell carcinomas (HCCs) of the thyroid have been recently reclassified as a separate entity due to their distinct clinical and molecular profiles. Few studies have assessed the ability of preoperative characteristics in differentiating HCCs from Hürthle cell adenomas (HCAs) due to the low prevalence of both lesions. This study aimed to compare the preoperative features of HCCs and HCAs and evaluate the diagnostic performance of ultrasound in distinguishing between both. Subjetcs and methods Retrospective study including 101 patients (52 HCCs and 49 HCAs) who underwent thyroid surgery from 2000 to 2016. Clinical, ultrasonographic, and histological data were reviewed. Diagnostic performance of suspicious sonographic features was analyzed in 51 cases (24 HCCs and 27 HCAs). Results Hürthle cell neoplasms were predominant in females. Subjects ≥ 55 years represented 58% of the cases of HCCs and 53% of those of HCAs. Carcinomas were significantly larger (p < 0.001), and a tumor size ≥ 4 cm significantly increased the risk of malignancy (odds ratio 3.67). Other clinical, cytologic, and sonographic data were similar between HCCs and HCAs. Among the HCCs, the lesions were purely solid in 54.2%, hypoechoic in 37.5%, and had coarse calcifications in 12.5%, microcalcifications in 8.3%, irregular contours in 4.2%, and a taller-than-wide shape in 16.7%. Predominantly/exclusive intranodular vascularization was observed in 52.6%. Overall, 58% of the HCCs were classified as TI-RADS 4 or 5 compared with 48% of the HCAs. TI-RADS 4 or 5 had a specificity of only 51.8% and a positive likelihood ratio of 1.21. Conclusions Apart from the lesion size, no other preoperative feature adequately distinguished HCCs from HCAs. Sonographic characteristics raising suspicion for malignancy, which are mostly present in papillary carcinomas, were infrequent in HCCs. New tools must be developed to improve preoperative diagnosis and deferral of surgery in cases of adenomas.
- Published
- 2019
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