Value of specimen radiographs in diagnosing multifocality of thyroid cancer.
ABSTRACT Specimen radiography has been used widely to evaluate the complete excision of calcified breast lesions but has not been evaluated for thyroid cancer.
Specimen radiographs were evaluated retrospectively to identify additional cancers that were demonstrated only as calcifications. Receiver operating characteristic curve analysis was performed to compare the combination of specimen radiography and ultrasonography versus ultrasonography alone for detecting multifocality.
Some 122 thyroid cancer specimens were obtained from 122 patients between January and April 2008. Specimen radiography detected 27 cancers (18.5 per cent) not detected by ultrasonography. Diagnoses were changed after evaluation of specimen radiographs in three of these patients. The area under the curve of the combination of specimen radiography and ultrasonography was significantly higher than that of ultrasonography alone (P = 0.005).
Specimen radiography is a potentially useful tool for diagnosing cancer type and predicting the extent of thyroid cancer.
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ABSTRACT: Diffuse sclerosing variant of papillary thyroid carcinoma (DSVPTC) is an uncommon variant of papillary thyroid carcinoma. The aim of this review is to critically analyse the features of this entity. A search of the literature revealed 25 clinicopathological studies with in-depth analysis of features of DSVPTC. Overall, the prevalence of DSVPTC varies from 0.7-6.6% of all papillary thyroid carcinoma. Higher prevalence of DSVPTC was noted in paediatric patients and in patients affected by irradiation. DSVPTC tends to occur more frequently in women and in patients in the third decade of life. Macroscopically, DSVPTC can involve the thyroid gland extensively without forming a dominant mass. Microscopic examination of DSVPTC revealed extensive fibrosis, squamous metaplasia and numerous psammoma bodies. The latter pathological feature can aid in the pre-operative diagnosis of the entity by fine needle aspiration and ultrasound. Compared to conventional papillary thyroid carcinoma, DSVPTC had a higher incidence of lymph node metastases at presentation. Distant metastases were noted in approximately 5% of the cases. Patients with DSVPTC were recommended to be managed by aggressive treatment protocols. It is likely that as a result of this, the prognosis of the patients with DSVPTC was noted to be similar to conventional papillary thyroid carcinoma. Overall, cancer recurrence and cancer related mortality have been reported in 14% and 3%, respectively, of patients with DSVPTC. In immunohistochemical studies, DSVPTC showed different expression patterns of epithelial membrane antigen, galectin 3, cell adhesion molecules, p53 and p63 when compared to conventional papillary thyroid carcinoma. On genetic analysis, the occurrence of BRAF and RAS mutations are uncommon events in DSVPTC and activation of RET/PTC rearrangements are common. To conclude, DSVPTC has different clinical, pathological and molecular profiles when compared to conventional papillary thyroid carcinoma.Critical Reviews in Oncology/Hematology 12/2014; · 4.05 Impact Factor
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ABSTRACT: The aim of this study was to evaluate the diagnostic utility of PAI at detecting thyroid microcalcifications at 700 nm laser wavelengths. This study included 36 resected samples in 18 patients. To evaluate the PA manifestation of microcalcifications in PAI, gray level histogram and co-occurrence matrix (COM) texture parameters were extracted from the 3 fixed ROI US and PA images, respectively, per sample. We compared the textural parameters obtained from specimen PAIs between samples with punctate microcalcifications on specimen radiography and those without microcalcifications. On specimen US, the mean value (2748.4±862.5) of samples with microcalcifications on specimen radiography was higher than that (1961.9±780.2) of those without microcalcifications (P = 0.007). However, there were no significant differences in textural parameters obtained from specimen PAIs between samples with punctate microcalcifications on specimen radiography and those without when applying both the mean value of the three slices of thyroid specimens and the value of the thyroid specimen slice which had the highest value of the mean values in specimen US. PAI did not show significant PA contrast on thyroid microcalcifications indicating that the experimental setup and protocols should be enhanced, e.g., method of complete blood rejection from ex vivo specimens, the multi-wavelength spectroscopic PA imaging method which can solely extract the PA signal from microcalcifications even with high spectral interferences, or PA imaging with narrower slice thickness using 2-dimensional array transducer, etc.PLoS ONE 11/2014; 9(11):e113358. · 3.53 Impact Factor
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ABSTRACT: To evaluate the clinical implications and diagnostic approach of lesions showing only diffuse microcalcifications on thyroid ultrasound (US). From January 2004 to January 2011, a total of 31 patients had lesions showing diffuse microcalcifications alone on thyroid US. Among them, 26 patients (M:F ratio 4:22; mean age 37.5 years, range 15-56 years) who had underwent US-guided fine-needle aspiration biopsy (US-FNAB), subsequent surgery, or follow-up US after 1 year after initial US-FNAB were included. Histopathologic results from surgery or US-FNAB were considered as standard reference. Clinical and US features were compared to standard reference. Of the disease of 26 patients, 16 (61.5%) were diagnosed as malignancy and 10 (38.5%) as benign. Seventeen (65.4%) of the 26 patients included were diagnosed as having Hashimoto thyroiditis (HT) on a clinical basis. Eight (80.0%) of the 10 benign lesions were diagnosed as benign on initial US-FNAB, and the remaining 2 lesions (20.0%) were nondiagnostic. All malignant lesions were diagnosed as suspicious for papillary thyroid carcinoma (PTC) or PTC by US-FNAB. Of the US features, presence of pathologic lymph nodes were significantly higher in malignant disease compared to benign findings, 10 (62.5%) to 0 (0.0%) (P = 0.003). Diffuse microcalcifications only lesions of the thyroid show high prevalence of PTC and lymphocytic thyroiditis. US-FNAB shows an acceptable performance in lesions showing microcalcifications only on thyroid US.Annals of Surgical Oncology 04/2011; 18(10):2899-906. · 3.94 Impact Factor