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Approach to a thyroid nodule

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https://www.readbyqxmd.com/read/28448992/bethesda-made-it-clearer-a-review-of-542-patients-in-a-single-institution
#1
Yunus Acar, Lütfi Doğan, H Erhan Güven, Bülent Aksel, Niyazi Karaman, Cihangir Özaslan, M Ali Gülçelik
BACKGROUND: It is essential to interpret fine needle aspiration biopsy (FNAB) material correctly to create a common language among pathologists and surgeons, leading to a uniform approach to thyroid nodule management. We aimed to compare FNAB reports of patients at our institution who were treated with total thyroidectomy, before and after the Bethesda classification system. PATIENTS AND METHODS: Patients who underwent total thyroidectomy for thyroid nodules are reviewed...
March 21, 2017: Oncology Research and Treatment
https://www.readbyqxmd.com/read/28432675/transoral-thyroidectomy-advantages-and-limitations
#2
G Dionigi, R P Tufano, J Russell, H Y Kim, E Piantanida, A Anuwong
In this opinion paper of the Journal of Endocrinological Investigation, leading experts in the field report on their current clinical experience with a novel approach for thyroid gland surgery, namely, "transoral thyroidectomy" (TOT). This feasible and novel surgical procedure does not require visible incisions and is, therefore, a truly scarless surgery. Patients meeting the following criteria can be considered as candidates for TOT: (a) an ultrasonographically (US) estimated thyroid diameter ≤10 cm; (b) US-estimated gland volume ≤45 mL; (c) nodule size ≤50 mm; (d) presence of a benign tumor such as a thyroid cyst or a single- or multi-nodular goiter; (e) Bethesda 3 and/or 4 category and (f) papillary microcarcinoma without the evidence of metastasis...
April 21, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28421812/the-frequency-of-incidental-findings-and-subsequent-evaluation-in-low-dose-ct-scans-for-lung-cancer-screening
#3
Lillie Morgan, Humberto Choi, Michal Reid, Ali Khawaja, Peter J Mazzone
RATIONALE: The USPSTF recommends lung cancer screening with low-dose chest CT scans (LDCT) for a well-defined high-risk population. Data on the frequency and impact of incidental findings on LDCT scans performed within a centralized lung cancer screening program has not been reported. OBJECTIVES: Previous studies have reported IFs in the setting of clinical trials. We present our findings in a real clinical setting where the decision to manage these findings may depend on factors that are not captured in a research trial such as disclosing IFs, patient preferences, severity of comorbidities, and physician expertise...
April 19, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28405949/transoral-endoscopic-thyroidectomy-preliminary-experience-in-italy
#4
Gianlorenzo Dionigi, Alessandro Bacuzzi, Matteo Lavazza, Davide Inversini, Luigi Boni, Stefano Rausei, Hoon Yub Kim, Angkoon Anuwong
Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is a feasible novel surgical procedure that does not need visible incisions. We describe our initial experience with TOETVA. We recruited 15 patients who were willing to undergo TOETVA. Inclusion criteria were (a) patients who had a neck ultrasound (US) with a estimated thyroid diameter not larger than 10 cm; (b) US estimated gland volume ≤45 mL; (c) nodule size ≤50 mm; (d) a benign tumor, such as a thyroid cyst, single-nodular goiter, or multinodular goiter; (e) follicular neoplasm; (f) papillary microcarcinoma without evidence of metastasis...
April 12, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28387647/management-of-childhood-thyroid-nodules-surgical-and-endocrinological-experience-in-more-than-one-hundred-cases
#5
Emre Divarcı, Ülgen Celtik, Zafer Dökümcü, Orkan Ergün, Geylani Özok, Samim Özen, Damla Gökşen Şimşek, Şükran Darcan, Nazan Çetingül, Aylin Oral, Yeşim Ertan, Bengü Demirağ, Ahmet Çelik
OBJECTIVE: The management of childhood thyroid nodules is still a big challenge for clinicians. In this study, we aimed to present our surgical and endocrinological experience in more than one hundred cases as a large experience in children. METHODS: Retrospective analysis of patients admitted with a thyroid nodule between 2006-2014 was performed. Detailed ultrasonography and fine needle aspiration biopsy(FNAB) were the corner stones of the diagnostic approach. RESULTS: One hundred-three children(72F,31M) with a mean age of 13...
April 7, 2017: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/28371486/identification-of-parathyroid-tissue-in-thyroid-fine-needle-aspiration-a-combined-approach-using-cytology-immunohistochemical-and-molecular-methods
#6
Robert P Domingo, Lorna L Ogden, Laura C Been, Giulia C Kennedy, S Thomas Traweek
OBJECTIVES: Parathyroid (PT) lesions can be difficult to recognize in thyroid fine needle aspirations (FNAs), and when not identified correctly, PT cells may be mistaken for potentially abnormal thyroid cells. We therefore studied the utility of combining cytology, immunohistochemistry, and a molecular classifier to identify PT cells in thyroid FNAs. METHODS: Thyroid FNAs were received in CytoLyt, and were evaluated initially using The Bethesda System for Reporting Thyroid Cytology (TBSRTC)...
March 30, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28361927/molecular-profiling-of-thyroid-nodule-fine-needle-aspiration-cytology
#7
REVIEW
Markus Eszlinger, Lorraine Lau, Sana Ghaznavi, Christopher Symonds, Shamir P Chandarana, Moosa Khalil, Ralf Paschke
The differential diagnosis and malignancy risk stratification of thyroid nodules requires multidisciplinary expertise and knowledge of both local ultrasonography practices and the local malignancy rates for a given fine-needle aspiration (FNA) result. Even in such a multidisciplinary setting, FNA cytology has the inherent limitation that indeterminate cytology results cannot distinguish between follicular adenomas, follicular thyroid carcinomas or follicular variant papillary thyroid carcinomas. Accumulating evidence suggests that this limitation can be overcome by using molecular diagnostic approaches...
March 31, 2017: Nature Reviews. Endocrinology
https://www.readbyqxmd.com/read/28332158/first-clinical-use-of-the-echotrack-guidance-approach-for-radiofrequency-ablation-of-thyroid-gland-nodules
#8
Alfred Michael Franz, Alexander Seitel, Nasrin Bopp, Christian Erbelding, Dominique Cheray, Stefan Delorme, Frank Grünwald, Hüdayi Korkusuz, Lena Maier-Hein
PURPOSE: Percutaneous radiofrequency ablation (RFA) of thyroid nodules is an alternative to surgical resection that offers the benefits of minimal scars for the patient, lower complication rates, and shorter treatment times. Ultrasound (US) is the preferred modality for guiding these procedures. The needle is usually kept within the US scanning plane to ensure needle visibility. However, this restricts flexibility in both transducer and needle movement and renders the procedure difficult, especially for inexperienced users...
March 22, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28332058/bilateral-axillo-breast-approach-robotic-thyroidectomy-baba-rt-does-not-interfere-with-breast-image-follow-up
#9
Hyeong Won Yu, Young Jun Chai, Hyungju Kwon, Su-Jin Kim, June Young Choi, Kyu Eun Lee
BACKGROUND: Bilateral axillo-breast approach robotic thyroidectomy (BABA RT) is frequently performed and has excellent cosmetic results. However, there has been concern that subcutaneous tunneling in construction of the operation field might interfere with subsequent breast imaging. In this study, we evaluated whether BABA RT interferes with breast imaging by evaluating serial perioperative results of mammography and ultrasonography. METHODS: We selected female patients who underwent BABA RT between 2008 and 2012, and who also had mammography or ultrasonography pre- and postoperatively, and compared the results of pre- and postoperative imaging...
March 22, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28331494/an-approach-to-macroscopic-central-lymph-nodes-detected-during-surgery-in-patients-with-thyroid-micropapillary-carcinoma-should-we-resort-to-dissection
#10
Osman Kurukahvecioglu, Kursat Dikmen, Hasan Bostanci, Murat Akin, Ferit Taneri
Background. High-resolution ultrasonography and the ability to perform fine-needle aspiration biopsy even for nodules smaller than three millimeters have considerably increased the detection rate of thyroid micropapillary carcinoma (TMPC). Despite favorable prognosis, the prevalence of cervical lymph node metastases in patients with TMPC is approximately 30%. Aim. In this study, we aimed to determine the central lymph node metastasis rate and its relation to the characteristics of the tumor. Methods. One hundred nine patients who underwent surgery due to TMPC between December 2009 and January 2014 were analyzed retrospectively...
2017: International Journal of Endocrinology
https://www.readbyqxmd.com/read/28322617/clinicians-views-on-management-and-terminology-for-papillary-thyroid-microcarcinoma-a-qualitative-study
#11
Brooke Nickel, Juan P Brito, Alexandra Barratt, Susan Jordan, Ray Moynihan, Kirsten McCaffery
BACKGROUND: There is growing acceptance that the increase in thyroid cancer incidence is in part a result of overdiagnosis of small low-risk papillary microcarcinomas (PMCs) with indolent clinical course. Although surgery is the cornerstone treatment for patients with PMCs, recent management guidelines are shifting toward inclusion of more conservative treatments such as active surveillance. There is little evidence on clinicians' experience in managing PMC patients and their attitudes toward treatment options, including their willingness to accept a nonsurgical option...
March 21, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28266693/fine-needle-thyroid-aspiration-biopsy-clinical-experience-at-the-endocrinology-clinics-of-the-university-hospital-of-puerto-rico
#12
Milliette Alvarado-Santiago, Dalitza Alvarez-Valentin, Oscar Ruiz-Bermudez, Lorena Gonzalez-Sepulveda, Myriam Allende-Vigo, Eduardo Santiago-Rodriguez, Sona Rivas-Tumanyan
OBJECTIVE: This study aimed to establish a profile of the ultrasound-guided thyroid fine-needle aspiration biopsies (FNABs) performed at the endocrinology clinics of the University Hospital of Puerto Rico. METHODS: A retrospective study was conducted to assess all the thyroid FNABs performed from July 1, 2011, to December 31, 2013. Data on socio-demographic, FNAB cytology, surgery, and histopathology were collected from medical records. A chi-square test was used to assess associations between predictors and outcome...
March 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/28266288/parathyroid-adenomas-in-adults-and-adolescents-critical-appraisal-and-surgical-strategy-in-18-cases
#13
Mihai Radu Diaconescu, Ioan Costea, Mihai Glod, Radu Terinte, Smaranda Diaconescu
Background: Our study underline scarcity of isolated case reports or small case series of parathyroid adenoma (PA) published in autochthonous medical literature,their variable clinical expression among the "historic" varieties but also the diagnostic difficulties and delays of diagnosis as well consecration of surgery as the golden therapeutic standard of this disorder. PATIENTS AND METHOD: Demographic, clinical presentations, laboratory and imaging data, operative findings and procedures together with pathology account and outcome from the case reports of 18 patients with documented PHP were retrospectively analyzed...
January 2017: Chirurgia
https://www.readbyqxmd.com/read/28222720/birt-hogg-dub%C3%A3-syndrome-a-literature-review-and-case-study-of-a-chinese-woman-presenting-a-novel-flcn-mutation
#14
Shengyu Hao, Fei Long, Fenglan Sun, Teng Liu, Daowei Li, Shujuan Jiang
BACKGROUND: The Birt-Hogg-Dubé (BHD) syndrome is a very rare autosomal dominant form of genodermatosis caused by germline mutations in the folliculin (FLCN) gene, which is mapped to the p11.2 region in chromosome 17. BHD commonly presents cutaneous fibrofolliculomas, pulmonary cysts, renal cell carcinoma, and recurrent pneumothoraxes. The disease is easily ignored or misdiagnosed as pneumothorax, pulmonary lymphangiomyomatosis (LAM), or emphysema. Follow-up and guidelines for managing recurrent pneumothoraxes in these patients are lacking...
February 21, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28217407/elastography-targeted-thyroid-nodule-aspiration-a-novel-approach
#15
Elliot Landau, Danielle Del Re, Bina Kviatkovsky, Aryeh Rothstein, Jonathan Scheiner, Cheryl Lin
OBJECTIVES: Since 2009, the rate of nondiagnostic (ND) thyroid nodule fine-needle aspiration (FNA) has ranged from 2% to 20%. A ND result can cause further patient morbidity secondary to repeated procedures and delay in diagnosis. The use of real-time strain elastography (RTE) in determining nodule malignant risk has gained considerable focus recently. A less studied area where RTE may prove beneficial is its role in targeting areas for FNA. Our hypothesis is that FNA performed in concurrence with RTE will show a decreased rate of ND results leading to fewer repeated FNA...
2017: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/28192631/thyroid-cytology-nuclear-versus-architectural-atypia-within-the-atypia-of-undetermined-significance-follicular-lesion-of-undetermined-significance-bethesda-category-have-significantly-different-rates-of-malignancy
#16
COMPARATIVE STUDY
Tiffany Rui Xuan Gan, Min En Nga, Jeffrey Huey Yew Lum, Wendy Meihua Wong, Wee Boon Tan, Rajeev Parameswaran, Kee Yuan Ngiam
BACKGROUND: The Bethesda System for Reporting Thyroid Cytopathology is the most widely used classification system for the reporting of thyroid fine-needle aspiration cytology (FNAC) specimens. However, the "atypical" category ("atypia of undetermined significance" [AUS] or "follicular lesion of undetermined significance" [FLUS]) continues to cause diagnostic and therapeutic dilemmas. The objectives of this study were to describe the differential malignancy rates of FNACs diagnosed as AUS/FLUS based on nuclear or architectural atypia and to assess the significance of demographic and ultrasonographic features in predicting malignancy in this category...
April 2017: Cancer
https://www.readbyqxmd.com/read/28182829/transoral-endoscopic-thyroidectomy-vestibular-approach-toetva-from-a-to-z
#17
Gianlorenzo Dionigi, Matteo Lavazza, Alessandro Bacuzzi, Davide Inversini, Vincenzo Pappalardo, Ralph P Tufano, Hoon Yub Kim, Angkoon Anuwong
We depict the transoral endoscopic thyroidectomy vestibular approach (TOETVA). Patient selection criteria are (1) ultrasonographically (US) estimated thyroid diameter no larger than 10cm, (2) US estimated gland volume ≥45mL, (3) nodule size ≥5mm, (4) a benign tumor, such as a thyroid cyst, single-nodular goiter, or multinodular goiter, (5) follicular neoplasm, and (6) papillary microcarcinoma without evidence of metastasis. TOETVA is carried out through a three-port technique placed at the oral vestibule, one 10mm port for 30° endoscope and two additional 5mm ports for dissecting and coagulating instruments...
February 7, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28149809/transoral-endoscopic-thyroidectomy-via-vestibular-approach-operative-steps-and-video
#18
Gianlorenzo Dionigi, Alessandro Bacuzzi, Matteo Lavazza, Davide Inversini, Vincenzo Pappalardo, Luigi Boni, Stefano Rausei, Marcin Barczynski, Ralph P Tufano, Hoon Yub Kim, Angkoon Anuwong
In this video we describe transoral endoscopic thyroidectomy vestibular approach (TOETVA). Inclusion criteria are (I) patients who had a ultrasonographically (US) estimated thyroid diameter not larger than 10 cm; (II) US estimated gland volume ≤45 mL; (III) nodule size ≤50 mm; (IV) a benign tumor, such as a thyroid cyst, single-nodular goiter, or multinodular goiter; (V) follicular neoplasm; (VI) papillary microcarcinoma without evidence of metastasis. The procedure is carried out through three-port technique placed at the oral vestibule, one 10-mm port for 30° endoscope and two additional 5-mm ports for dissecting and coagulating instruments...
December 2016: Gland Surgery
https://www.readbyqxmd.com/read/28144094/evaluation-of-thyroid-lesions-by-fine-needle-aspiration-cytology-based-on-bethesda-system-for-reporting-thyroid-cytopathology-classification-among-the-population-of-south-bihar
#19
Richa Bhartiya, Mahasweta Mallik, Nawanita Kumari, Brijendra Narayan Prasad
BACKGROUND: Fine-needle aspiration (FNA) of the thyroid gland has proven to be an important and widely accepted, cost-effective, simple, safe, and accurate method triaging patients with thyroid nodules. Awareness and understanding of wide spectrum thyroid disorders are of great value because most lesions are treatable by medical or surgical management. AIM: The aim of this study is to determine the accuracy of FNA cytology (FNAC) in the diagnosis of thyroid lesion using the Bethesda system for reporting thyroid cytopathology nomenclature (BSRTC) and to correlate these with histopathological findings...
October 2016: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/28125944/applying-criteria-of-active-surveillance-to-low-risk-papillary-thyroid-cancer-over-a-decade-how-many-surgeries-and-complications-can-be-avoided
#20
Andrew Griffin, Juan P Brito, Manisha Bahl, Jenny K Hoang
BACKGROUND: The 2015 American Thyroid Association guidelines acknowledged that "an active surveillance management approach can be considered as an alternative to immediate surgery" in patients with low-risk papillary thyroid carcinoma (PTC). The aim of this study was to determine the proportion of PTC that would meet the criteria for active surveillance and the surgeries and complications that could have been avoided. METHODS: A total of 681 patients with thyroid cancer who underwent thyroid surgery from 2003 to 2012 were retrospectively reviewed...
April 2017: Thyroid: Official Journal of the American Thyroid Association
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