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Rate of malignancy in exophytic thyroid nodules

Dellal F.D. | Baser H. | Arpaci D. | Tam A.A. | Ozdemir D. | Kilicarslan A. | Dumlu E.G.

Article | 2017 | Iranian Journal of Radiology14 ( 2 )

Background: There are ultrasonography (US) features suggested to be associated with a higher risk of malignancy in thyroid nodules. However, exophytic appearence of thyroid nodules has not been studied previously. Objectives: To evaluate US features, and cytological and histopathological findings in exophytic thyroid nodules. Patients and Methods: Patients with an exophytic thyroid nodule who underwent fine needle aspiration biopsy (FNAB) between January and July 2015 were evaluated prospectively. Demographical data, US features, and cytology results were noted and histopathological findings were determined in operated patients. The . . . results were compared with non-exophytic nodules of age and sex matched patients. Results: Data of 253 exophytic nodules in 247 patients and 529 non-exophytic nodules in 357 patients were analyzed. Hypoechogen-ity, mixed texture, and absence of peripheral halo were significantly higher in exophytic nodules (P < 0.001, P < 0.001, and P = 0.018, respectively). Nondiagnostic, atypia of undetermined significance/follicular lesion of undetermined significance and suspicious for malignancy cytology results were significantly higher in exophytic nodules (P = 0.002, P < 0.001 and P < 0.001 respectively). 6.7% of exophytic nodules and 1.9% of non-exophytic nodules had malignant cytology (P = 0.001). Histopathologically, 35 (47.9%) of 73 exophytic nodules and 18 (24.3%) of 74 non-exophytic nodules were malignant (P < 0.01). Capsular invasion was higher in the malignant exophytic group (53.5% vs 14.3%, P = 0.027). US features other than hypoechoic pattern which was higher in the malignant group were similar in benign and malignant exophytic nodules. Conclusions: Exophytic nodules seem to carry a higher rate of malignancy both cytologically and histopathologically. Suspicous US features except hypoechoic pattern were not higher in malignant compared to benign exophytic nodules. © 2016, Tehran University of Medical Sciences and Iranian Society of Radiology Daha fazlası Daha az

The value of cytokeratin-19 immunohistochemistry in the differential diagnosis of papillary thyroid carcinomas

Barut F. | Bektaş S. | Bahadir B. | Onak Kandemir N. | Karadayi N. | Özdamar Ş.O.

Article | 2009 | Turkiye Klinikleri Journal of Medical Sciences29 ( 1 ) , pp.42 - 47

Objective: The gold standard for diagnosis of papillary thyroid carcinoma is conventional histology, which depends on the characteristic nuclear features, regardless of whether papillary architecture is present or not. This study was carried on to evaluate the utility of cytokeratin-19 in the diagnosis and differential diagnosis of papillary thyroid carcinoma. Material and Methods: Expression of cytokeratin-19 was tested on formalin-fixed, paraffin-embedded tissues from 380 surgically resected thyroid lesions including hyperplasic nodules (n= 243), granulomatous thyroiditis (n= 3), lymphocytic (n= 53) and Hashimoto's thyroiditis (n= . . . 11), follicular adenomas (n= 17), Hurthle cell adenomas (n= 4), well-differentiated thyroid tumor with follicular architecture of uncertain malignant potenti al (n= 1), papillary carcinomas (n= 45), follicular carcinoma (n= 1), insular carcinoma (n= 1), and medullary carcinoma (n= 1). The immunoreactivity was scored as negative, 1+, 2+, 3+, and 4+, based on the extent of the reaction regardless of previous diagnosis. Results: Positive reaction with cytokeratin-19 was denoted in all of the 45 cases of papillary carcino mas with scores of 4+, 3+ and 2+ and the ratios were 57.8% (26/45), 33.3% (15/45) and 8.9% (4/45), respectively. There seemed to be a strong diffuse cytoplasmic reactivity with cytokeratin-19 in papillary thyroid carcinomas. The sensitivity and specificity for cytokeratin-19 in papillary carcinomas among neoplastic thyroid lesions were 91.8% and 86.2%, respectively. Conclusion: In additi on to careful histological evaluation, cytokeratin-19 seems useful for the diagnosis of papillary thyroid carcinomas. Copyright © 2009 by Türkiye Klinikleri Daha fazlası Daha az

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