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management of thyroid nodules

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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/28441815/-the-interpretation-of-2015-american-thyroid-association-management-guidelines-for-adult-patients-with-thyroid-nodules-and-differentiated-thyroid-cancer
#2
X Y Li, B Zhang, Y S Lin
The prevalence of thyroid nodules, especially differentiated thyroid cancer, has increased during the past decades. With the consideration of increasing prevalence of the diseases, American Thyroid Association (ATA) updated the guidelines for adult patients with thyroid nodules and differentiated thyroid carcinoma (DTC) in 2015. The aim of the new guidelines was to minimize potential harm from overtreatment in majority of patients at low risk for diseasespecific mortality and morbidity while appropriately treat and monitor those patients at higher risk...
April 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28426843/understanding-the-risks-and-harms-of-management-of-incidental-thyroid-nodules-a-review
#3
Jenny K Hoang, Xuan V Nguyen
Importance: Incidental thyroid nodules are defined as nodules originally detected in a patient with no thyroid-related clinical symptoms, examination findings, or suspected thyroid disease. Medical imaging for diseases in the neck, chest, and spine is a common source of incidental thyroid nodules. They are easily detected but poorly characterized. The next step is to decide whether the incidental thyroid nodule should be further evaluated with ultrasonography. Observations: Indiscriminate workup of incidental thyroid nodules with ultrasonography is not cost-effective and is potentially harmful...
April 20, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28423960/the-role-of-molecular-diagnostic-testing-in-the-management-of-thyroid-nodules
#4
Maureen D Moore, Suraj Panjwani, Katherine D Gray, Brendan M Finnerty, Rasa Zarnegar, Thomas J Fahey
Fine needle aspiration (FNA) with cytologic examination remains the standard of care for investigation of thyroid nodules. However, as many as 30% of FNA samples are cytologically indeterminate for malignancy, which confounds clinical management. To reduce the burden of repeat diagnostic testing and unnecessary surgery, there has been extensive investigation into molecular markers that can be detected on FNA specimens to more accurately stratify a patient's risk of malignancy. Areas Covered: In this review, the authors discuss recent evidence and progress in molecular markers used in the diagnosis of thyroid cancer highlighting somatic gene alterations, molecular technologies and microRNA analysis...
April 19, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28422844/ultrasound-is-helpful-to-differentiate-bethesda-class-iii-thyroid-nodules-a-prisma-compliant-systematic-review-and-meta-analysis
#5
Lu-Ying Gao, Ying Wang, Yu-Xin Jiang, Xiao Yang, Ru-Yu Liu, Xue-Hua Xi, Shen-Ling Zhu, Rui-Na Zhao, Xing-Jian Lai, Xiao-Yan Zhang, Bo Zhang
BACKGROUND: Fine-needle aspiration (FNA) is the most dependable tool to triage thyroid nodules for medical or surgical management. However, Bethesda class III cytology, namely "follicular lesion of undetermined significance" (FLUS) or "atypia of undetermined significance" (AUS), is a major limitation of the US-FNA in assessing thyroid nodules. As the most important imaging method, ultrasound (US) has a high efficacy in diagnosing thyroid nodules. This meta-analysis aimed to assess the role of US in evaluating Bethesda class III thyroid nodules...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28421812/the-frequency-of-incidental-findings-and-subsequent-evaluation-in-low-dose-ct-scans-for-lung-cancer-screening
#6
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/28402167/multiinstitutional-analysis-of-thyroid-nodule-risk-stratification-using-the-american-college-of-radiology-thyroid-imaging-reporting-and-data-system
#7
William D Middleton, Sharlene A Teefey, Carl C Reading, Jill E Langer, Michael D Beland, Margaret M Szabunio, Terry S Desser
OBJECTIVE: Guidelines for managing thyroid nodules are highly dependent on risk stratification based on sonographic findings. The purpose of this study is to evaluate the risk stratification system used by the American College of Radiology Thyroid Imaging Reporting and Data System (TIRADS). MATERIALS AND METHODS: Patients with thyroid nodules who underwent sonography and fine-needle aspiration were enrolled in a multiinstitutional study. The sonographic nodule features evaluated in the study were composition, echogenicity, margins, and echogenic foci...
April 12, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28397856/1-5-2%C3%A2-cm-tumor-size-was-not-associated-with-distant-metastasis-and-mortality-in-small-thyroid-cancer-a-population-based-study
#8
Kyunghwa Han, Eun-Kyung Kim, Jin Young Kwak
Most guidelines for the diagnosis and management of thyroid nodules have suggested fine-needle aspiration as a diagnostic tool, with some of these previously published guidelines suggesting a cutoff size of 1.5 cm. In thyroid cancers (1-2 cm), we hypothesized that tumors 1.5 cm or larger had more unfavorable clinical outcomes than ones smaller than 1.5 cm nodules. Using the Surveillance, Epidemiology, and End Results database, we identified 14,117 patients diagnosed with only primary thyroid cancer between 1988 and 2007...
April 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28397450/bethesda-system-in-the-evaluation-of-thyroid-nodules-review
#9
REVIEW
Marta Wesoła, Michał Jeleń
Fine needle aspiration (FNA) biopsy is an important and widely accepted method used in the diagnosis of patients with thyroid nodules.The lack of consistency in reporting FNA taken from the thyroid gland has led to divergences in the calculation of the sensitivity and specificity of the method. Discrepancies depend on what was considered to be true or false negative/positive. This resulted in confusion among doctors, who had to decide how to manage the patient with constantly changing positive or negative results of the FNA...
January 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28389487/what-is-the-care-pathway-of-patients-who-undergo-thyroid-surgery-in-france-and-its-potential-pitfalls-a-national-cohort
#10
Muriel Mathonnet, Anne Cuerq, Christophe Tresallet, Jean-Christophe Thalabard, Elisabeth Fery-Lemonnier, Gilles Russ, Laurence Leenhardt, Claude Bigorgne, Philippe Tuppin, Bertrand Millat, Anne Fagot-Campagna
CONTEXT: The rate of thyroid cancer is increasing in France, as well as concerns about overdiagnosis and treatment. OBJECTIVES: To examine the care pathway of patients who undergo thyroid surgery in France and detect potential pitfalls. DESIGN: A large observational study based on medical reimbursements, 2009-2011. SETTING: Data from the Sniiram (National Health Insurance Information System). PATIENTS: Patients with thyroid surgery in 2010, classified into 4 groups: thyroid cancer, benign nodule, goitre or multiple nodules, other (hyperthyroidism, head-neck cancer)...
April 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/28387647/management-of-childhood-thyroid-nodules-surgical-and-endocrinological-experience-in-more-than-one-hundred-cases
#11
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/28372962/acr-thyroid-imaging-reporting-and-data-system-ti-rads-white-paper-of-the-acr-ti-rads-committee
#12
Franklin N Tessler, William D Middleton, Edward G Grant, Jenny K Hoang, Lincoln L Berland, Sharlene A Teefey, John J Cronan, Michael D Beland, Terry S Desser, Mary C Frates, Lynwood W Hammers, Ulrike M Hamper, Jill E Langer, Carl C Reading, Leslie M Scoutt, A Thomas Stavros
Thyroid nodules are a frequent finding on neck sonography. Most nodules are benign; therefore, many nodules are biopsied to identify the small number that are malignant or require surgery for a definitive diagnosis. Since 2009, many professional societies and investigators have proposed ultrasound-based risk stratification systems to identify nodules that warrant biopsy or sonographic follow-up. Because some of these systems were founded on the BI-RADS(®) classification that is widely used in breast imaging, their authors chose to apply the acronym TI-RADS, for Thyroid Imaging, Reporting and Data System...
March 31, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28372589/the-first-canadian-experience-with-the-afirma%C3%A2-gene-expression-classifier-test
#13
Emily Kay-Rivest, Jamie Tibbo, Sarah Bouhabel, Michael Tamilia, Rebecca Leboeuf, Veronique-Isabelle Forest, Michael P Hier, Loren Savoury, Richard J Payne
BACKGROUND: Thyroid nodules are common and often benign, although prove to be malignant upon surgical pathology in 5-15% of cases. When assessed with ultrasound-guided fine-needle aspiration (USFNA), 15-30% of the nodules yield an indeterminate result. The Afirma® gene expression classifier (AGEC) was developed to improve management of indeterminate thyroid nodules (ITNs) by classifying them as "benign" or "suspicious." Objectives were (1) to assess the performance of the AGEC in two Canadian academic medical centres (2), to search for inter-institutional variation and (3) to compare AGEC performance in Canadian versus American institutions...
April 4, 2017: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28348589/thyroid-imaging-reporting-and-data-system-score-combined-with-the-new-italian-classification-for-thyroid-cytology-improves-the-clinical-management-of-indeterminate-nodules
#14
Salvatore Ulisse, Daniela Bosco, Francesco Nardi, Angela Nesca, Eleonora D'Armiento, Valeria Guglielmino, Corrado De Vito, Salvatore Sorrenti, Daniele Pironi, Francesco Tartaglia, Stefano Arcieri, Antonio Catania, Massimo Monti, Angelo Filippini, Valeria Ascoli
The new Italian cytological classification (2014) of thyroid nodules replaced the TIR3 category of the old classification (2007) with two subclasses, TIR3A and TIR3B, with the aim of reducing the rate of surgery for benign diseases. Moreover, thyroid imaging reporting and data system (TI-RADS) score appears to ameliorate the stratification of the malignancy risk. We evaluated whether the new Italian classification has improved diagnostic accuracy and whether its association with TI-RADS score could improve malignancy prediction...
2017: International Journal of Endocrinology
https://www.readbyqxmd.com/read/28338469/the-utility-of-thyroid-ultrasonography-in-the-management-of-thyroid-nodules
#15
Gary Gamme, Tyler Parrington, Edward Wiebe, Sunita Ghosh, Brendan Litt, David C Williams, Todd P W McMullen
BACKGROUND: Ultrasonography for thyroid nodules is one of the most common imaging tests performed in the general population. Details from ultrasound reports guide biopsies and surgery. This study quantifies the completeness of these reports based on Thyroid Imaging and Reporting System (TI-RADS) criteria and considers their utility in predicting malignant disease. METHODS: We retrospectively reviewed ultrasound reports for 329 thyroidectomy patients and extracted data elements using the TI-RADS criteria: nodule size, echogenicity, margins, vascularity, solid/cystic composition and the presence or absence of microcalcifications and the halo sign...
April 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28327204/lung-adenocarcinoma-with-thyroid-metastasis-a-case-report
#16
A Dao, H Jabir, A Taleb, N Benchakroun, Z Bouchbika, T Nezha, H Jouhadi, S Sahraoui, A Benider
BACKGROUND: The metastases of a primary lung cancer over the thyroid gland are extremely rare. We report on an unusual presentation of thyroid metastasis of lung cancer in order to improve the management of similar cases. CASE PRESENTATION: Three years ago, a Moroccan male 59-year-old was admitted for dyspnea, dry cough, and chest pain. He had smoked about 30 cigarette packs a year. Clinical examination revealed a right thyroid nodule. Chest and neck computed tomography (CT) scan showed a proximal left tumor in contact with the pulmonary artery and revealed a suspected nodule in the right lobe of the thyroid with homolateral neck node...
March 21, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28326900/ultrasound-pathology-discordant-nodules-on-core-needle-biopsy-malignancy-risk-and-management-strategy
#17
Sae Rom Chung, Jung Hwan Baek, Hye Sun Park, Young Jun Choi, Tae-Yon Sung, Dong Eun Song, Tae Yong Kim, Jeong Hyun Lee
BACKGROUND: The reported malignancy rates of thyroid nodules that appear suspicious on ultrasound (US) but yield benign fine-needle aspiration (FNA) cytology results range from 13.6% to 56.6%. However, the malignancy risk of nodules that are discordant on US and core-needle biopsy (CNB) pathological findings has not been evaluated. This study evaluated the malignancy risk associated with thyroid nodules that are suspicious on US but yield benign CNB results. METHODS: Between July 2008 and November 2011, 1309 patients with 1313 thyroid nodules underwent US-guided CNB...
March 22, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28322617/clinicians-views-on-management-and-terminology-for-papillary-thyroid-microcarcinoma-a-qualitative-study
#18
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/28283790/a-retrospective-study-of-ultrasound-and-fna-cytology-investigation-of-thyroid-nodules-working-towards-combined-risk-stratification
#19
Zi Wei Liu, Richard Fox, Samit Unadkat, Roy Farrell
The British Thyroid Association recommended in new guidelines on thyroid cancer treatment [Kwak et al. (Korean J Radiol 14:110-117, 2013)] that ultrasound grading of thyroid nodules should be incorporated into MDT management. A retrospective study was carried out to determine that the impact of US grading has had on MDT decision making in practice. The design used in the study is a retrospective review of case notes. The study was carried out in the hub hospital for thyroid cancer in the North west London Cancer network...
March 10, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28282233/dietary-management-of-hyperthyroidism-in-a-dog
#20
Andrea Looney, Joseph Wakshlag
An 8 yr old female spayed golden retriever presented for a routine exam during which ventral cervical soft tissue masses were identified. History included weight loss, increased activity and appetite, gagging, and occasional diarrhea. Exam findings included a body condition score of 4/9 and palpable ventral cervical nodules. A serum thyroxine (T4) value was 8.0 ug/dL (normal = 0.8-3.5ug/dL). Doppler systolic blood pressure readings ranged from 200-210 mmHg (normal systolic blood pressure <150 mmHg). The diagnosis was hyperthyroidism due to active thyroid masses...
March 2017: Journal of the American Animal Hospital Association
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