Young Lyun Oh

Sungkyunkwan University, Sŏul, Seoul, South Korea

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Publications (66)125.37 Total impact

  • [show abstract] [hide abstract]
    ABSTRACT: The "atypia of undetermined significance/follicular lesion of undetermined significance" (AUS/FLUS) category in the Bethesda System for Reporting Thyroid Cytopathology is a heterogeneous category of cases that are not clearly benign or malignant. We conducted an analysis of cytologic and histologic evaluations of thyroid nodules that had been interpreted as AUS/FLUS on fine-needle aspiration (FNA) at a single institution from April 2011 to April 2012. Those cases were classified into 2 subgroups according to the predominance of nuclear atypia (AUS) or microfollicular architecture (FLUS). In addition, for a number of these cases, BRAF gene mutation analyses were performed. Of 6402 thyroid FNAs performed, 431 cases were diagnosed as AUS and 120 as FLUS. Follow-up cytologic or histologic outcome data were available for 315 AUS cases and 73 FLUS cases. Among AUS cases, 52.7% were malignant on repeat FNA or histologic diagnosis. In contrast, for FLUS, 6.8% were malignant on repeat FNA or histologic diagnosis. Among AUS/FLUS cases, 147 had adequate BRAF mutation analysis, which accompanied the histologic diagnosis. BRAF mutations were found in 87 AUS cases, 86 of which were papillary carcinoma. In contrast, there was only 1 case of BRAF mutation in FLUS. Correlating molecular results with histologic outcome revealed a 98.9% cancer probability for AUS cases with BRAF mutation. The AUS subcategory indicates a higher risk of malignancy than the FLUS subcategory. Furthermore, BRAF molecular testing is helpful in stratifying the malignant risk of AUS cases into high-risk and low-risk groups. Cancer (Cancer Cytopathol) 2014. © 2014 American Cancer Society.
    Cancer Cytopathology 03/2014; · 4.43 Impact Factor
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    ABSTRACT: Further management for thyroid nodules with cytological atypia of undetermined significance (AUS) has made controversial conclusions. The aim of this study was to evaluate the most reliable ultrasonography (US) findings to predict malignancy in thyroid nodules with AUS, and to compare inconclusive rates of repeat fine-needle aspiration (rFNA) and core needle biopsy (CNB) in nodules with AUS. We retrospectively reviewed cases of thyroid nodules with AUS from 8,421 US-guided fine-needle aspirations in our institution between 2010 and 2012. Nodules were confirmed either surgically or followed-up for at least 1 year and were compared based on nodule size, US findings, and US diagnosis to predict malignancy. Inconclusive rates of rFNA and CNB after initial AUS were compared. The incidence of AUS in all thyroid nodules was 3.2 % (273 of 8,421). Malignancies were identified in 42.1 % (64 of 152) nodules with surgery or sufficient follow-up. In univariate analysis, not-oval to round shape, irregular margin, taller-than-wide orientation, hypoechogenicity, marked hypoechogenicity, microcalcifications, and malignant US diagnosis were more frequent in actual malignancies (p < 0.05). In multivariate analysis, hypoechogenicity, marked hypoechogenicity, and malignant US diagnosis were significantly more frequent in malignancies (p < 0.05). With respect to further management of AUS, the inconclusive rate of CNB (17.6 %, 6/34) was significantly lower than that of rFNA (37.3 %; 44 of 118) (p = 0.032). Nodule echogenicity and US diagnosis can be predictive factors of malignancies for the thyroid nodules with cytological AUS. The CNB is more useful than rFNA for reducing the frequency of inconclusive results after initial AUS.
    Annals of Surgical Oncology 02/2014; · 4.12 Impact Factor
  • Clinical Chemistry and Laboratory Medicine 02/2014; · 3.01 Impact Factor
  • Soomin Ahn, Yuil Kim, Young Lyun Oh
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    ABSTRACT: Objective: The aim of this study was to evaluate the diagnostic accuracy of fine needle aspiration (FNA) cytology of benign salivary gland tumors with myoepithelial cell participation, namely, pleomorphic adenoma, basal cell adenoma and myoepithelioma, at a single institution over a period of 10 years. Study Design: This study was based on 575 cytologic and matching histological samples (534 pleomorphic adenomas, 26 basal cell adenomas and 15 myoepitheliomas). Results: In most cases (393/534) of pleomorphic adenoma, a precise diagnosis was given. However, only 2 cases of basal cell adenoma and 1 case of myoepithelioma were diagnosed definitively. Descriptive diagnosis, instead of a definite diagnosis, was rendered in 16.9% of pleomorphic adenomas, 53.8% of basal cell adenomas and 40.0% of myoepitheliomas. Among all cases, the possibility of malignancy was raised in 5.2% of pleomorphic adenomas, 15.4% of basal cell adenomas and 20.0% of myoepitheliomas with a variable degree of suspicion. Conclusion: In some cases, the distinction between these three neoplasms remains difficult in that all exhibit some degree of myoepithelial participation. However, FNA showed a high diagnostic accuracy in diagnosing benign salivary tumors with myoepithelial differentiation, and triage into this category provides sufficient information for clinicians to make treatment decisions. © 2013 S. Karger AG, Basel.
    Acta cytologica 10/2013; · 0.69 Impact Factor
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    ABSTRACT: Background The association of vascular invasion with tumor aggressiveness and poor prognosis in follicular thyroid carcinoma (FTC) remains controversial. Methods We reviewed medical records of 204 patients with histologically confirmed FTC. Results The disease-specific survival rates at 5 and 10 years were 94% and 85%, respectively. Using Cox proportional hazard model, the extent of invasiveness and the frequency of distant metastasis were found to be independent prognostic factors for survival in all patients with FTC. When we performed individual analyses stratified by the extent of invasiveness, vascular invasion was an independent predictor of disease-specific survival in minimally invasive FTC, but that did not independently affect survival in widely invasive FTC. Conclusions This study suggests that vascular invasion is associated with aggressive features of FTC and independently influences outcomes in minimally invasive FTC. For patients aged <45 years with minimally invasive FTC without vascular invasion, thyroid lobectomy alone may be adequate. © 2013 Wiley Periodicals, Inc. Head Neck, 2013.
    Head & Neck 09/2013; · 2.83 Impact Factor
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    ABSTRACT: Recently, BRAF inhibitors showed dramatic treatment outcomes in BRAF V600 mutant melanoma. Therefore, the accuracy of BRAF mutation test is critical. BRAF mutations were tested by dual-priming oligonucleotide-polymerase chain reaction (DPO-PCR), direct sequencing and subsequently retested with a real-time PCR assay, cobas 4800 V600 mutation test. In total, 64 tumors including 34 malignant melanomas and 16 papillary thyroid carcinomas were analyzed. DNA was extracted from formalin-fixed paraffin embedded tissue samples and the results of cobas test were directly compared with those of DPO-PCR and direct sequencing. BRAF mutations were found in 23 of 64 (35.9%) tumors. There was 9.4% discordance among 3 methods. Out of 6 discordant cases, 4 cases were melanomas; 3 cases were BRAF V600E detected only by cobas test, but were not detected by DPO-PCR and direct sequencing. One melanoma patient with BRAF mutation detected only by cobas test has been on vemurafenib treatment for 6 months and showed a dramatic response to vemurafenib. DPO-PCR failed to detect V600K mutation in one case identified by both direct sequencing and cobas test. In direct comparison of the currently available DPO-PCR, direct sequencing and real-time cobas test for BRAF mutation, real-time PCR assay is the most sensitive method.
    The Korean Journal of Pathology 08/2013; 47(4):348-54. · 0.17 Impact Factor
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    ABSTRACT: Our aim was to evaluate predictive factors of malignancy in patients with cytologically suspicious for Hurthle cell neoplasm (HCN) of thyroid nodules. We searched cases with cytologically suspicious for HCN from 11,569 ultrasound-guided fine-needle aspirations (US-FNA) performed at our institution. Nodules that were confirmed surgically or followed-up for at least 2 years were compared with respect to age, gender, tumor size, US diagnosis, and US findings to predict malignancy. The incidence of cases with cytologically suspicious for HCN was 1.2% (143 of 11,569). Of 75 nodules that underwent sufficient follow-up or surgery, malignancies were found in 11 (14.7%). Malignant histological examination revealed oncocytic variants of papillary thyroid carcinoma (PTC) in 3 cases, classic PTC in 1, Hurthle cell carcinoma in 3, follicular carcinoma in 3 and an unclassified carcinoma in 1. In univariate analysis, tumor size was significantly larger in malignant nodules compared to benign nodules (p = 0.026). The best cut-off value of tumor size in predicting malignancy was 2.5 cm. (p = 0.006, sensitivity: 63.6%, specificity: 79.7%). The incidences of hypoechogenicity and malignant US diagnoses were higher in malignant nodules than in benign nodules (p < 0.001). In multivariate analysis, tumor size was an independent factor in predicting malignancies. (p = 0.037, odd ratio: 2.09, confidence interval: 1.046-4.161). Preoperative US provides predictive factors of malignancy in thyroid nodules with cytologically suspicious for HCN. Predictive factors include tumor size of 2.5 cm or greater, hypoechoic nodule and malignant US diagnosis.
    International journal of surgery (London, England) 07/2013;
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    ABSTRACT: BRAF mutation is an important diagnostic and prognostic marker in patient s with papillary thyroid carcinoma (PTC). To be applicable in clinical laboratories with limited equipment, diverse testing methods are required to detect BRAF mutation. A shifted termination assay (STA) fragment analysis was used to detect common V600 BRAF mutations in 159 PTCs with DNAs extracted from formalin-fixed paraffin-embedded tumor tissue. The results of STA fragment analysis were compared to those of direct sequencing. Serial dilutions of BRAF mutant cell line (SNU-790) were used to calculate limit of detection (LOD). BRAF mutations were detected in 119 (74.8 %) PTCs by STA fragment analysis. In direct sequencing, BRAF mutations were observed in 118 (74.2 %) cases. The results of STA fragment analysis had high correlation with those of direct sequencing (p < 0.00001, kappa = 0.98). The LOD of STA fragment analysis and direct sequencing was 6 % and 12.5 %, respectively. In PTCs with pT3/T4 stages, BRAF mutation was observed in 83.8 % of cases. In pT1/T2 carcinomas, BRAF mutation was detected in 65.9 % and this difference was statistically significant (p = 0.007). Moreover, BRAF mutation was more frequent in PTCs with extrathyroidal invasion than tumors without extrathyroidal invasion (84.7 % versus 62.2 %, p = 0.001). To prepare and run the reactions, direct sequencing required 450 minutes while STA fragment analysis needed 290 minutes. STA fragment analysis is a simple and sensitive method to detect BRAF V600 mutations in formalin-fixed paraffin-embedded clinical samples.Virtual Slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/5684057089135749.
    Diagnostic Pathology 07/2013; 8(1):121. · 1.85 Impact Factor
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    ABSTRACT: To evaluate telomerase activity as an adjunct in the cytologic diagnosis of malignant ascites. Malignant ascites collected from 19 gastrointestinal or liver cancer patients with clinical or pathologic evidence of peritoneal metastasis were tested for routine cytology with a liquid-based preparation, and telomerase activity was measured by telomere-repeat amplification protocol (TRAP) and real-time quantitative TRAP (RTQ-TRAP) assays. For comparison, controls from peritoneal washings from 8 early gastric cancer patients were used. Cytological examination detected cancer cells in 8 patients (42%), and 3 cases (16%) were diagnosed as "atypia." With TRAP and RTQ-TRAP assays 16 (84%) and 15 (78%) cases, respectively, were positive for telomerase activity. The sensitivity of telomerase activity by TRAP, RTQ-TRAP assays, and cytology was 84%, 78%, and 58%, respectively. All cases with "atypia" by cytological examination were positive for both TRAP and RTQ-PCR assays. In all negative controls, cytology, TRAP and RTQ-TRAP assays were negative. Based on our findings telomerase activity is a more sensitive method than ascitic fluid cytology and therefore can be considered as a useful diagnostic adjunct to current standard diagnostic methods. However, further large cohort studies with clinical correlation are needed to confirm our findings.
    Analytical and quantitative cytology and histology / the International Academy of Cytology [and] American Society of Cytology 06/2013; 35(3):146-51. · 0.60 Impact Factor
  • Sang Yun Ha, Yun Kyung Lee, Young Lyun Oh
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    ABSTRACT: Objective: The purpose of this study is to report our experience with the implementation of the ThinPrep Imaging System (TIS) in a tertiary hospital in Korea and to evaluate the effectiveness of the TIS compared to manual methods in the screening of cervical cytology. Study Design: Detection rates of cervical abnormalities in the pre- and post-TIS periods (January 2009 to February 2010 and March 2010 to December 2010, respectively) were compared. Follow-up cytological and histological results with concurrent or subsequent human papillomavirus (HPV) tests were retrieved. Results: ASC-US, ASC-H, LSIL, and HSIL were more frequently detected in the post-TIS period than in the pre-TIS period (p < 0.005). The proportions of correlated cases of ASC-US were 42.2 and 40.4% in the pre- and post-TIS periods, respectively. The detection rates of high-risk types of HPV in ASC-US were not significantly different between the two groups. The proportion of correlated biopsy for ASC-H, LSIL, and HSIL was similar in both periods. HPV positivity for ASC-H, LSIL, and HSIL showed no significant change between the two periods. Conclusion: The TIS is potentially useful for the detection of abnormal cervical cytology on the basis of the increased detection rate of squamous cell abnormalities, with a relatively similar proportion of correlated cases compared to the manual screening method.
    Acta cytologica 01/2013; 57(2):159-63. · 0.69 Impact Factor
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    ABSTRACT: Background: The cribriform-morular variant of papillary thyroid carcinoma (cmvPTC) is rare. There are few if any studies of the ultrasonographic (US) features of cmvPTC. The aim of this study was to determine the characteristic US and clinical features of the cmvPTC. Methods: A retrospective review of the US and clinical features was performed on 18 surgically confirmed cmvPTCs in five patients who were seen at our institution between January 2000 and December 2010. Results: All patients were female with a mean age of 28 years (range, 19-46 years). Two patients presented with palpable lesions, and the other patients were incidentally detected during screening US. At US, the majority of nodules had well-defined, oval to round shapes, and were hypoechoic and solid without calcifications. However, 6 (33.3%) of 18 nodules did have a cystic change. The size of the lesions varied from 0.3 to 3.0 cm (mean, 1.11 cm). None of the nodules were diagnosed as malignant based on the US criteria, but all except one patient had cytology of their thyroid nodules that were read as malignant, without revealing the subtype of their PTC. Two of the five patients had familial adenomatous polyposis (FAP), and they had bilateral multiple nodules. No metastatic lymph nodes or extrathyroidal extension were identified. To date, none of the patients has had recurrence or metastasis during their mean follow-up of 25 months after thyroidectomy. Conclusion: It appears that most cases of cmvPTC do not have features of malignancy on US and are indolent tumors as far as their clinical and histological features are concerned.
    Thyroid: official journal of the American Thyroid Association 08/2012; · 2.60 Impact Factor
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    ABSTRACT: Purpose. Discrepancies between the uptakes of (18)F-fluorodeoxyglucose ((18)F-FDG) and (131)I in papillary thyroid carcinoma have been reported. We compared (18)F-FDG uptake with the expressions of glucose transporter type 1 (GLUT1) and sodium-iodide symporter (NIS) in untreated papillary thyroid carcinoma. Materials and methods. A total of 33 consecutive patients (Male:Female = 12:21; mean age, 46.6 ± 13.0 years) with initially diagnosed papillary thyroid carcinoma were prospectively included in the study. All subjects underwent preoperative (18)F-FDG positron emission tomography/computerized tomography scans followed by surgery. The expressions of GLUT1 and NIS were evaluated in resected primary tumors and metastatic lymph nodes by immunohistochemical staining and were compared with the maximum standard uptake value of each lesion, respectively. Results. None of the 40 primary tumors showed significant expressions of GLUT1. Significant expressions of NIS were found in 14 primary tumors (35.0%). Among 36 metastatic lymph nodes, only 1 showed GLUT1 expression. Significant expression of NIS was found in 13 (36.1%) metastatic nodes. The maximum standard uptake value of both primary tumors and metastatic nodes with negative expression of NIS was significantly higher than those with a positive expression of NIS (10.6 ± 10.8 vs. 4.9 ± 5.2, p = 0.011). Conclusions. The (18)F-FDG uptake of untreated papillary thyroid carcinoma has an inverse correlation with NIS expression. However, GLUT1 expression does not appear to be associated with (18)F-FDG uptake in untreated papillary thyroid carcinoma.
    Endocrine Research 08/2012; · 1.03 Impact Factor
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    The Korean Journal of Internal Medicine 06/2012; 27(2):229-31.
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    ABSTRACT: Our aim was to determine whether sonographically guided radiofrequency ablation with superficial saline injection can minimize thermal injury of the skin without an influence on therapeutic efficacy. Institutional Animal Care Committee approval was obtained. Twelve percutaneous radiofrequency ablation procedures were performed in the thighs of 6 rabbits (control, n = 6, right thigh; experimental, n = 6, left thigh). The ablation with local anesthesia was performed in the most superficial area of the thigh muscle. In the experimental group, 1 mL of saline was injected before the ablation at the tissue layer between the skin and ablated muscle. The duration and energy of the ablation were the same in the control and experimental groups. Rabbits were compared for their gross skin state and histopathologic findings after the ablation. The degree of thermal coagulation of the muscle was similar in both groups at pathologic examination. Grossly, skin redness was mild in the experimental group but moderate in the control group. Of the 6 rabbits, 5 tended to show more frequent histopathologic changes, including an inflammatory reaction, interruption of collagen fibers, injury of the skin adnexa, and fibrosis, in the control group when compared with the experimental group. However, there was no statistically significant difference (all P> .05). One rabbit that underwent ablation at higher energy had a partially dissected epidermis in the control group only. Sonographically guided radiofrequency ablation with a saline injection superficial to a tumor might prevent skin burns and provide equivalent therapeutic efficacy for ablating superficial lesions.
    Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 06/2012; 31(6):873-8. · 1.40 Impact Factor
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    ABSTRACT: Background: The cribriform-morular variant of papillary thyroid carcinoma (cmvPTC) is rare. There are few if any studies of the ultrasonographic (US) features of cmvPTC. The aim of this study was to determine the characteristic US and clinical features of the cmvPTC. Methods: A retrospective review of the US and clinical features was performed on 18 surgically confirmed cmvPTCs in 5 patients who were seen at our institution between January 2000 and December 2010. Results: All patients were female with a mean age of 28 years (range, 19-46 years). Two patients presented with palpable lesions and the other patients were incidentally detected during screening US. At US, the majority of nodules had well-defined, oval to round shapes and were hypoechoic and solid nodule without calcifications. However, 6 (33.3%) of 18 nodules did have cystic change. The size of the lesions varied from 0.3 to 3.0 cm (mean, 1.11 cm). None of the nodules were diagnosed as malignant based on US criteria but all except one patient had cytology of their thyroid nodules that were read as malignant, without revealing the subtype of their PTC. Two of the 5 patients had familial adenomatous polyposis (FAP) and they had bilateral multiple nodules. No metastatic lymph nodes or extrathyroidal extension were identified. To date, none of the patients has had recurrence or metastasis during their mean follow-up of 25 months after thyroidectomy. Conclusion: It appears that most cases of cmvPTC do not have features of malignancy on US and are indolent tumors as far as their clinical and histological features are concerned.
    Thyroid: official journal of the American Thyroid Association 05/2012; · 2.60 Impact Factor
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    ABSTRACT: Papillary thyroid carcinoma (PTC) is the most common malignant thyroid tumor, and 36-69% of PTC cases are caused by mutations in the BRAF gene. The substitution of a valine for a glutamic acid (V600E) comprises up to 95-100% of BRAF mutations; therefore, most diagnostic methods, including allele-specific PCR and real-time PCR, are designed to detect this mutation. Nevertheless, other mutations can also comprise the genetic background of PTC. Recently, a novel and sensitive technique called mutant enrichment with 3'-modified oligonucleotides (MEMO) PCR has been introduced. When we applied allelespecific PCR and MEMO-PCR for the detection of the BRAF V600E mutation, we found an unusual 3' bp deletion mutation (c.1799_1801delTGA) only when using MEMO-PCR. This deletion results in the introduction of a glutamic acid into the B-Raf activation segment (p.V600_K601delinsE), leading to an elevated basal kinase activity of BRAF. This is the first report of a rare 3 bp BRAF deletion in a PTC patient that could not be detected by allele-specific PCR.
    Annals of laboratory medicine. 05/2012; 32(3):238-41.
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    ABSTRACT: Detection of the BRAF V600E mutation in fine-needle aspiration cytology (FNAC) specimens may increase the value of FNAC. The objectives of the study was to compare the diagnostic performance of BRAF assays that differ in sensitivity and to examine the associations between the BRAF V600E mutation status and the clinicopathological features in papillary thyroid carcinoma (PTC). Three molecular assays were performed in all subjects and compared with regard to FNAC and histology results. We evaluated 4585 consecutive patients who were found to have malignant or indeterminate thyroid nodules by ultrasonography. All FNAC samples were tested for the BRAF V600E mutation using conventional Sanger sequencing, dual-priming oligonucleotide-PCR, and mutant enrichment with 3'-modified oligonucleotide (MEMO) sequencing. The detection sensitivities of the three molecular assays for the BRAF V600E mutation were 20, 2, and 0.1%, respectively. Compared with conventional Sanger sequencing (n = 673), dual-priming oligonucleotide-PCR and MEMO sequencing detected more tumors with the BRAF V600E mutation (n = 919 and n = 1044, respectively), especially tumors with a benign, indeterminate, or nondiagnostic cytology. All BRAF-positive tumors that were histologically examined were shown to be PTC, regardless of cytology results. The clinical sensitivities of the three assays for detecting PTC were 54.8, 74.4, and 79.7%, respectively. BRAF V600E mutations in microcarcinomas (≤ 10 mm) were detected more efficiently as the detection sensitivity of the assay increased (P < 0.001). Tumor size correlated significantly with multifocality, extrathyroidal extension, and lymph node metastasis (P = 0.003, P < 0.001 and P < 0.001, respectively), but the BRAF V600E mutation status was not associated with any of those features. Highly sensitive and specific molecular assays such as MEMO sequencing are optimal for detecting the BRAF mutations in thyroid FNAC because these techniques can detect PTC that might be missed by cytology or less sensitive molecular assays.
    The Journal of clinical endocrinology and metabolism 04/2012; 97(7):2299-306. · 6.50 Impact Factor
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    ABSTRACT: BACKGROUND: Recent studies have shown that BRAF(V600E) mutation is associated with poor prognostic factors in papillary thyroid carcinoma (PTC). However, there are no studies about the association of the BRAF(V600E) mutation with poor prognostic factors according to tumor size in PTC. METHODS: We investigated the prevalence of the BRAF(V600E) mutation and its association with prognostic factors according to tumor size of PTC. BRAF(V600E) mutation status was assessed in thyroid fine-needle aspiration (FNA) specimens from 605 patients before thyroidectomy for PTC, and its association with postoperative clinicopathologic factors was evaluated. RESULTS: The overall prevalence of the BRAF(V600E) mutation was 67%, and larger tumors more often had the BRAF(V600E) mutation (p for trend < .05). The BRAF(V600E) mutation was significantly associated with male sex, tumor size, extrathyroidal invasion, nodal metastasis, and advanced tumor stage (p < .05). There was a significant size-dependent relationship between the presence of the BRAF(V600E) mutation and extrathyroidal invasion, nodal metastasis, and advanced tumor stage (p for trend < .05). CONCLUSION: The prevalence of the BRAF(V600E) mutation increased with increased tumor size. Preoperative FNA-detected BRAF(V600E) mutation was associated with poor prognostic factors, and the association was stronger in larger tumors. © 2012 Wiley Periodicals, Inc. Head Neck, 2012.
    Head & Neck 04/2012; · 2.83 Impact Factor
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    ABSTRACT: The purpose of this study was to correlate the clinicoradiologic and pathologic features of thyroid lymphoma and to identify the most useful diagnostic method for thyroid lymphoma as the first line. Our study population included 16 patients with a diagnosis of thyroid lymphoma by fine-needle aspiration, core biopsy, or surgery from 1995 to 2010. We retrospectively reviewed imaging and medical records. Sonographic findings were correlated with histopathologic results. Of the 16 patients, primary lymphomas were found in 13 and secondary in 3. The mean ages of the patients with primary and secondary lymphomas were 60.8 and 42.7 years, respectively. Most patients with primary lymphomas had symptoms of rapid neck swelling or a mass sensation. All primary lymphomas revealed non-Hodgkin B-cell lymphoma, and secondary lymphomas included a B-cell origin in 2 and a T-cell origin in 1. On sonography, 10 (77%) of 13 primary lymphomas showed diffuse heterogeneous hypoechoic parenchyma with intervening echogenic septa-like structures, whereas all secondary lymphomas showed markedly hypoechoic nodules. Markedly hypoechoic parenchyma was correlated with lymphoepithelial lesions and neoplastic cells, whereas the intervening echogenic septa-like structures were consistent with fibrosis on pathologic examination. The exact diagnosis of thyroid lymphoma was possible with core biopsy in all 9 cases (100%) but with fine-needle aspiration in only 3 of 10 (30%), which included 7 under sonographic guidance and 3 under palpation (P = .0030). Diffuse hypoechoic parenchyma with intervening echogenic septa on sonography under the impression of a primary thyroid lymphoma, particularly in the setting of a rapidly enlarging mass, should prompt core biopsy rather than fine-needle aspiration.
    Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 04/2012; 31(4):589-94. · 1.40 Impact Factor
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    ABSTRACT: Anaplastic thyroid carcinoma (ATC) is one of the most aggressive malignancies. Nevertheless, there have been reports that some patients experience long-term survival and those in whom ATCs of small size are often detected. We evaluated the time trend of characteristics of ATC such as size and association with coexistent differentiated thyroid carcinoma (DTC). We also found the characteristics of patients showing long-term survival. This is a retrospective observational cohort study from the two major tertiary referral hospitals in Seoul, Korea. Ninety-five patients who had been diagnosed with ATC from 1995 to 2010 were included. We classified them into three groups according to the time of initial diagnosis: group 1 (1995-1999), group 2 (2000-2004) and group 3 (2005-2010). The mean tumour size decreased significantly according to groups; 6·2, 5·5 and 4·0 cm in group 1, 2 and 3, respectively (P = 0·02). The frequency of cases with coexistent DTC increased; 10·3%, 35·1% and 48·3% in group 1, 2 and 3, respectively (P = 0·02). Fifteen of 95 patients survived more than 24 months, and among them, 13 are still alive who underwent curative surgery. Among 15 long-term survivors, nine patients with ATC arising from DTC had ATC tumour portion less than 1 cm. Another five patients with ATC without coexistent DTC had relatively small-sized tumours (1·0-4·0 cm). The tumour size of ATC decreased, and cases with coexistent DTC increased over the last two decades. We found that patients with ATC showing long-term survival are those who had atypical presentations such as anaplastic transformation in early stage of DTC or small size of tumours without coexistent DTC.
    Clinical Endocrinology 03/2012; 77(3):459-64. · 3.40 Impact Factor

Publication Stats

291 Citations
351 Downloads
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125.37 Total Impact Points

Institutions

  • 2002–2014
    • Sungkyunkwan University
      • • Department of Pathology
      • • Department of Radiology
      • • School of Medicine
      • • Samsung Medical Center
      Sŏul, Seoul, South Korea
  • 2013
    • Inje University
      Kŭmhae, South Gyeongsang, South Korea
  • 2011
    • Kangbuk Samsung Hospital
      Sŏul, Seoul, South Korea
  • 2009
    • Catholic University of Korea
      • Department of Hospital Pathology
      Sŏul, Seoul, South Korea