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Thyroid nodule management

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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
#1
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/28222584/ultrasonographic-imaging-of-papillary-thyroid-carcinoma-variants
#2
Jung Hee Shin
Ultrasonography (US) is routinely used to evaluate thyroid nodules. The US features of papillary Epub ahead of print thyroid carcinoma (PTC), the most common thyroid malignancy, include hypoechogenicity, spiculated/microlobulated margins, microcalcifications, and a nonparallel orientation. However, many PTC variants have been identified, some of which differ from the classic type of PTC in terms of biological behavior and clinical outcomes. This review describes the US features and clinical implications of the variants of PTC...
January 12, 2017: Ultrasonography
https://www.readbyqxmd.com/read/28217964/is-fine-needle-aspiration-really-not-necessary-in-patients-with-thyroid-nodules%C3%A2-%C3%A2-%C3%A2-1-cm-with-highly-suspicious-features-on-ultrasonography-and-candidates-for-active-surveillance
#3
Pedro Weslley Rosario, Alexandre Lemos Silva, Maria Regina Calsolari
BACKGROUND: The low rate of progression associated with the potential complications of thyroidectomy makes active surveillance an increasingly recommended management in low-risk papillary microcarcinomas of the thyroid (PMT). The objective of this study was to report the results of fine needle aspiration (FNA) of nodules ≤ 1 cm with highly suspicious appearance on ultrasonography (US) in patients who are potential candidates for active surveillance. METHODS: We revised thyroid nodules ≤ 1 cm with highly suspicious appearance on US in patients without known distant metastases, suspicion of extrathyroid extension, or suspicious lymph nodes on US...
February 20, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28201927/histologic-findings-and-cytological-alterations-in-thyroid-nodules-after-radioactive-iodine-treatment-for-graves-disease
#4
Siba El Hussein, Yumna Omarzai
Unlike the well-documented relation between radiation to the neck and development of papillary thyroid carcinoma, a causal association between radioactive iodine treatment for Graves' disease and development of thyroid malignancy is less defined. However, patients with a background of thyroid dysfunction presenting with clinically palpable thyroid nodules are followed more closely than the average population, and fine needle aspiration is recommended in such circumstances. Cytological examination of aspirates, and histologic examination of tissue provided from patients with a known history of Graves' disease, managed by radioactive iodine therapy can create a diagnostic dilemma, as the distinction between radiation effect and a malignant primary thyroid neoplasm can be very challenging...
February 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28194993/preoperative-prediction-of-papillary-thyroid-microcarcinoma-via-multiparameter-ultrasound
#5
Hui Juan Ma, Jing Chun Yang, Zhen Peng Leng, Ying Chang, Hua Kang, Liang Hong Teng
Background Accurate diagnosis of papillary thyroid microcarcinoma (PTMC) is important for further management. Ultrasound (US) is the most frequently used imaging modality for PTMC. Purpose To evaluate the diagnostic value of conventional US, contrast-enhanced ultrasound (CEUS) and real-time elastography (RTE) for patients with PTMC. Material and Methods In total, 135 patients with subcentimeter thyroid nodules who underwent conventional US, CEUS, and RTE before surgery were enrolled. A multivariate logistic regression analysis was performed to assess the independent predictors of PTMC...
January 1, 2017: Acta Radiologica
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
#6
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...
February 13, 2017: Cancer
https://www.readbyqxmd.com/read/28188700/how-suspicious-is-that-nodule-review-of-suspicious-afirma-gene-expression-classifier-in-high-risk-thyroid-nodules
#7
Sudarshana Roychoudhury, Melissa Klein, Fabiola Souza, Cecilia Gimenez, Alice Laser, Rubina Shaheen Cocker, Karen Chau, Kasturi Das
BACKGROUND: The Afirma gene expression classifier (GEC) is being increasingly utilized to confirm the benign nature of indeterminate FNA cytology results thus avoiding unnecessary surgical procedures. However the "suspicious" result of the Afirma GEC does not classify these indeterminate nodules further in determining appropriate management. This study investigated the outcome of the thyroid nodules deemed to be "suspicious" by the Afirma GEC in a high risk population. METHODS: The pathology database was searched for all thyroid nodules with Afirma test results over a three year period, 2013-2015...
February 11, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28182068/evaluation-of-thyroid-nodules-classified-as-bethesda-category-iii-on-fnac
#8
Shiwani Garg, Leena P Naik, Kanchan S Kothari, Gwendolyn C Fernandes, Mona A Agnihotri, Jagruti C Gokhale
BACKGROUND: The Bethesda (BSRTC) category III has been ascribed a malignancy rate of 5-15%, however, the probability of malignancy remains variable. AIM: To evaluate category III with respect to its rate and risk of malignancy and substratify it. SETTINGS AND DESIGN: Atypia of undetermined significance/Follicular lesion of undetermined significance (AUS/FLUS) percentage, cytohistological correlation, and risk of malignancy were analyzed and substratification was done...
January 2017: Journal of Cytology
https://www.readbyqxmd.com/read/28178124/anaplastic-thyroid-carcinoma-and-foscarnet-use-in-a-multitarget-treatment-documented-by-18f-fdg-pet-ct-a-case-report
#9
Elisa Giannetta, Andrea M Isidori, Cosimo Durante, Cira Di Gioia, Flavia Longo, Vincenzo Tombolini, Nadia Bulzonetti, Chiara Graziadio, Riccardo Pofi, Daniele Gianfrilli, Antonella Verrienti, Raffaella Carletti, Sebastiano Filetti, Andrea Lenzi, Alberto Baroli
RATIONALE: The case reported the rapid remission of disease recurrence achieved adding foscarnet, a DNA polymerase inhibitor that interacts with fibroblast growth factor 2, to low molecular weight heparin and sunitinib for the first time in a patient with an anaplastic thyroid cancer (ATC). PATIENT CONCERNS: A 65-year-old woman with a multinodular goiter referred for a rapid enlargement of a nodule. Histological examination revealed an ATC with a little area of papillary thyroid cancer (PTC)...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28175931/determining-patient-preferences-for-indeterminate-thyroid-nodules-observation-surgery-or-molecular-tests
#10
Daniel Joonil Lee, Jason J Xu, Dale H Brown, Ralph W Gilbert, Patrick J Gullane, Jonathan C Irish, Lorne E Rotstein, David P Goldstein, John R de Almeida
BACKGROUND: Gene-expression classifiers (GEC) and genetic mutation panels (GMP) have been shown to improve preoperative diagnostic evaluations of indeterminate thyroid nodules. Despite the improvement, uncertainty regarding the proper management exists. Patient preferences may better inform the management of these indeterminate thyroid nodules. METHODS: Hypothetical scenarios were administered to two groups of patients: those with previous FNA-confirmed indeterminate thyroid nodules (Group A, n = 50) and those presenting to a general otolaryngology clinic for other reasons (Group B, n = 50)...
February 7, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28166595/basal-serum-calcitonin-after-calcium-stimulation-and-in-the-needle-washout-of-patients-with-thyroid-nodules-and-mild-or-moderate-basal-hypercalcitoninemia
#11
P W Rosario, M R Calsolari
This prospective study evaluated the concentrations of basal serum calcitonin (Ctn), Ctn after stimulation with calcium, and Ctn in the needle washout (FNA-Ctn) as predictors of sporadic medullary thyroid carcinoma (MTC) in patients with thyroid nodules and basal Ctn between 10 and 100 pg/ml. Forty-one patients were included in the study. MTC was diagnosed in only 6 patients (14.6%). None of the patients with basal Ctn≤24.6 pg/ml (n=26) or stimulated Ctn≤186.5 pg/ml (n=21) had MTC. All patients without MTC had basal Ctn<47 pg/ml and stimulated Ctn<655...
February 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
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
#12
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/28127634/ultrasound-risk-stratification-for-malignancy-using-the-2015-american-thyroid-association-management-guidelines-for-children-with-thyroid-nodules-and-differentiated-thyroid-cancer
#13
Jennifer E Lim-Dunham, Iclal Erdem Toslak, Khalid Alsabban, Amany Aziz, Brendan Martin, Gokcan Okur, Katherine C Longo
BACKGROUND: The 2015 American Thyroid Association (ATA) Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer provides selection criteria for nodules prior to ultrasound-guided fine-needle aspiration biopsy. OBJECTIVE: To evaluate the diagnostic performance of pediatric thyroid nodule risk stratification for predicting malignancy when applying the ultrasound (US) criteria recommended. MATERIALS AND METHODS: US characteristics of 39 thyroid nodules in 33 pediatric patients who underwent US fine-needle aspiration biopsy were reviewed by two radiologists...
January 27, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28125944/applying-criteria-of-active-surveillance-to-low-risk-thyroid-papillary-cancer-over-a-decade-how-many-surgeries-and-complications-can-be-avoided
#14
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 is to determine the proportion of PTC that would meet criteria for active surveillance and the surgeries and complications that could have been avoided. METHODS: We retrospectively reviewed 681 patients with thyroid cancer who underwent thyroid surgery from 2003 to 2012...
January 26, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28118436/management-of-adult-patients-with-thyroid-nodules-and-differentiated-thyroid-cancer
#15
Ronald N Cohen, Andrew M Davis
No abstract text is available yet for this article.
24, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28116986/diagnostic-value-of-ras-mutations-in-indeterminate-thyroid-nodules
#16
William Clinkscales, Adrian Ong, Shaun Nguyen, Elizabeth Emily Harruff, Marion Boyd Gillespie
Objectives To determine the diagnostic value of HRAS, KRAS, and NRAS mutations in fine-needle aspiration biopsies of thyroid nodules that are nondiagnostic on cytology. Data Sources PubMed, Scopus, Embase, CINAHL. Review Methods Two authors independently searched the data sources. To be included, studies reported the RAS mutational status and postoperative histopathologic diagnosis of nodules that exhibited indeterminate cytology after fine-needle aspiration biopsy. Data were extracted to calculate sensitivity, specificity, and positive/negative predictive values of any HRAS, KRAS, or NRAS mutation...
January 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28114862/the-ata-guidelines-on-management-of-thyroid-nodules-and-differentiated-thyroid-cancer-task-force-review-and-recommendation-on-the-proposed-renaming-of-efvptc-without-invasion-to-niftp
#17
Bryan R Haugen, Anna M Sawka, Erik K Alexander, Keith C Bible, Patrizio Caturegli, Gerard Doherty, Susan J Mandel, John C Morris, Aziza Nassar, Furio Pacini, Martin Schlumberger, Kathryn G Schuff, Steven I Sherman, Hilary Somerset, Julie Ann Sosa, David L Steward, Leonard Wartofsky, Michelle D Williams
American Thyroid Association (ATA) leadership asked the ATA Thyroid Nodules and Differentiated Thyroid Cancer Guidelines Task Force to review, comment on and make recommendations related to the suggested new classification of Encapsulated Follicular Variant Papillary Thyroid Carcinoma (eFVPTC) without capsular or vascular invasion to noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). The task force consists of members from the 2015 guidelines task force with the recusal of three members who were authors on the paper under review...
January 23, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28114855/niftp-accounts-for-over-half-of-carcinomas-harboring-ras-mutations
#18
Vera A Paulson, Priyanka Shivdasani, Trevor E Angell, Erik K Alexander, Edmund Cibas, Jeffrey F Krane, Neal I Lindeman, Justine Barletta
BACKGROUND: Molecular testing of thyroid nodules is increasingly being utilized to guide clinical management decisions. RAS mutations are the most frequent mutations detected in the context of an indeterminate fine needle aspiration (FNA) diagnosis. The term noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was recently introduced to promote conservative management of tumors previously classified as noninvasive follicular variant of papillary thyroid carcinoma (FVPTC)...
January 23, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28109248/characteristics-of-incidentally-found-thyroid-nodules-in-computed-tomography-comparison-with-thyroid-scintigraphy
#19
Shahin Zandieh, Dina Muin, Reinhard Bernt, Karl Hittmair, Joerg Haller, Klaus Hergan
BACKGROUND: In our daily experience, the differentiation between a cold and hot nodule is a very important factor for further clinical management of the patient. In this study, we compared the characteristics of incidentally found thyroid nodules detected on computed tomography (CT) to thyroid scintigraphy (TS). METHODS: Diagnostic reports from chest CT with intravenous contrast and TS examinations performed from January 2013 to January 2016 were analyzed retrospectively...
January 21, 2017: BMC Medical Imaging
https://www.readbyqxmd.com/read/28087101/current-management-of-low-risk-differentiated-thyroid-cancer-and-papillary-microcarcinoma
#20
V D Tarasova, R M Tuttle
Each year, the proportion of thyroid cancer patients presenting with low risk disease is increasing. Moreover, the definition of low risk thyroid cancer is expanding and several histological subtypes beyond papillary microcarcinomas are now classified as low risk disease. This shift in the landscape of thyroid cancer presentation is forcing clinicians to critically re-evaluate whether or not traditional management paradigms that were effective in treating intermediate and high risk disease are applicable to these low risk patients...
January 10, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
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