- Tumor growth rate does not predict malignancy in surgically resected thyroid nodules classified as Bethesda category III with architectural atypia. [Journal Article]
- TThyroid 2018 Nov 13
- CONCLUSIONS: The size of thyroid nodules classified as AUS-A increased linearly, regardless whether these nodules were benign or malignant. These results suggest that growth kinetics on serial preoperative neck US cannot predict malignancy in the AUS-A subcategory.
- [Endocrinology: What are the most important practically relevant advances over the last ten years?] [Review]
- MFMMW Fortschr Med 2018; 160(Suppl 3):54-58
- Performance of a Multigene Genomic Classifier in Thyroid Nodules With Indeterminate Cytology: A Prospective Blinded Multicenter Study. [Journal Article]
- JOJAMA Oncol 2018 Nov 08
- CONCLUSIONS: In this prospective, blinded, multicenter study, the multigene GC test demonstrated a high sensitivity/NPV and reasonably high specificity/PPV, which may obviate diagnostic surgery in up to 61% of patients with Bethesda III to IV indeterminate nodules, and up to 82% of all benign nodules with indeterminate cytology. Information on specific genetic alterations obtained from FNA may help inform individualized treatment of patients with a positive test result.
- Gender-specific correlation of intranodular chronic lymphocytic thyroiditis with thyroid nodule size, echogenicity, and histologically-verified cytological class of malignancy risk. [Journal Article]
- JCJ Clin Transl Endocrinol 2018; 14:39-45
- No data are available on the cytologically and histologically demonstrated presence of intranodular chronic lymphocytic thyroiditis (ICLT) and on the ICLT relationship with thyroid nodule characteris...
No data are available on the cytologically and histologically demonstrated presence of intranodular chronic lymphocytic thyroiditis (ICLT) and on the ICLT relationship with thyroid nodule characteristics such as size, echotexture and nature (benign or malignant). We wished to fill this gap by analyzing data in a gender-specific fashion. We studied 408 thyroid nodules from 408 consecutive persons (325 females and 83 males). Nodules were isoechoic (n = 268) or hypoechoic (n = 140), ICLT +ve (n = 113 [27.7%]) or ICLT -ve (n = 295), cytologically low-risk (n = 197) or high-risk (n = 211), histologically benign (n = 263) or malignant (n = 145). ICLT prevailed in females (97/113) and in hypoechoic nodules (58/140 [41.4%] vs 55/268 [20.5%], P < 0.0001). Compared to males, females had (i) smaller nodules (18.5 ± 9.4 vs 23.3 ± 13.4 mm, P = 0.0002), a difference due to the isoechoic nodules (21.1 ± 9.8 vs 26.6 ± 14.1 mm, P = 0.0006), (ii) lower rates of high-risk nodules (161/325 [49.5%] vs 50/83 [60.2%], P = 0.082) and malignant nodules (110/325 [33.8%] vs 35/83 [42.2%] P = 0.16). ICLT +ve nodules were smaller than the ICLT -ve ones (15.4 ± 6.9 vs 20.9 ± 11.2 mm, P < 0.0001), a difference due to the isoechoic nodules (17.5 ± 6.5 vs 23.6 ± 11.7 mm, P = 0.0003). The smallest nodules were hypoechoic, cancerous and ICLT +ve nodules in males (9.5 ± 4.0 mm); the largest were isoechoic, cytologically risky and ICLT -ve in males (29.1 ± 13.2 mm). Compared to ICLT -ve nodules, malignancy prevailed in ICLT +ve nodules (55/113 [48.7%] vs 90/295 [30.5%], P = 0.0006), both in hypoechoic (37/58 [63.8%] vs 41/82 [50.0%]) and isoechoic nodules (18/55 [32.7%] vs 49/213 [23.0%]). ICLT +ve hypoechoic nodules of females and ICLT -ve hypoechoic nodules of males had the greatest rate of malignancy (67% both), while ICLT -ve isoechoic nodules of females had the lowest (19%). In conclusion, presence/absence of ICLT is associated with some sexually dimorphic characteristics of thyroid nodules. Adding the specification of ICLT positivity/negativity in cytological reports may help improving the risk of malignancy at least in some groups of thyroid nodules.
- A Rare Case of Heterozygous Gain of Function Thyrotropin Receptor Mutation Associated with Development of Thyroid Follicular Carcinoma. [Journal Article]
- CRCase Rep Genet 2018; 2018:1381730
- Activating mutations in thyrotropin receptor (TSHR) have been previously described in the context of nonautoimmune hyperthyroidism and thyroid adenomas. We describe, for the first time, a mutation in...
Activating mutations in thyrotropin receptor (TSHR) have been previously described in the context of nonautoimmune hyperthyroidism and thyroid adenomas. We describe, for the first time, a mutation in TSHR contributing to follicular thyroid carcinoma (FTC) in an adolescent. A 12-year-old girl presented with a right-sided neck swelling, increasing in size over the previous four weeks. Clinical examination revealed a firm, nontender thyroid nodule. Ultrasound scan of the thyroid showed a heterogeneous highly vascular mass. Thyroid function tests showed suppressed TSH [<0.03mU/L], normal FT4 [10.1pmol/L, 9-19], and raised FT3 [9.1pmol/L, 3.6-6.4]. Thyroid [TPO and TRAB] antibodies were negative. A right hemithyroidectomy was performed and the histology of the sample revealed follicular carcinoma with mild to moderate nuclear pleomorphism and evidence of capsular and vascular invasion (pT1b). Sanger sequencing of DNA extracted from the tumour tissue revealed a missense somatic mutation (c.1703T>C, p.Ile568Thr) in TSHR. Papillary thyroid carcinomas constitute the most common thyroid malignancy in childhood, while FTC is rare. FTC due to TSHR mutation suggests an underlying, yet to be explored, molecular pathway leading to the development of malignancy. The case is also unique in that the clinical presentation of FTC as a toxic thyroid nodule has not been previously reported in children.
- Inter-observer Variability in the American College of Radiology Thyroid Imaging Reporting and Data System: In-Depth Analysis and Areas for Improvement. [Journal Article]
- UMUltrasound Med Biol 2018 Nov 08
- The American College of Radiology (ACR) introduced a new standardized system for management of thyroid nodules, the Thyroid Imaging Reporting and Data System (TI-RADS). The purpose of this retrospect...
The American College of Radiology (ACR) introduced a new standardized system for management of thyroid nodules, the Thyroid Imaging Reporting and Data System (TI-RADS). The purpose of this retrospective study is to evaluate the inter-observer variability in applying TI-RADS in clinical practice without prior dedicated training. We evaluated a total of 180 nodules constituting all consecutive thyroid aspirations performed in the radiology department between January 1, 2014 and June 30, 2014, with exclusion of histologically inadequate samples. Four radiologists, blinded to each other's evaluation and to final pathology results, evaluated all of the nodules based on the TI-RADS lexicon. TI-RADS score and management recommendations were then deduced from the inputted features. Statistical analysis was performed to determine inter-observer agreement among all readers, as well as between each two readers, in all TI-RADS sonographic features and for recommended management per TI-RADS score with multi-user Cohen's κ (Light's κ) and percentage agreement using R. There was fair-to-moderate inter-observer agreement in nodule composition (two-reader κ range: 0.327-0.533) and presence of calcifications (κ range: 0.229-0.527), but poor-to-fair agreement in echogenicity (κ range: 0.141-0.355), shape (κ range: 0.0729-0.513) and margins (κ range: 0.176-0.283). There was fair inter-observer agreement regarding management recommendations (κ range: 0.242-0.359).
- The association between the ultrasonography TIRADS classification system and surgical pathology among indeterminate thyroid nodules. [Journal Article]
- SSurgery 2018 Nov 08
- CONCLUSIONS: Among cytologically indeterminate and Afirma-suspicious nodules, the Thyroid Imaging and Reporting and Data System was a poor predictor of final surgical pathology. Additional prospective studies are needed to validate these findings.
- ID Proteins May Reduce Aggressiveness of Thyroid Tumors. [Journal Article]
- EPEndocr Pathol 2018 Nov 09
- ID genes have an important function in the cell cycle, and ID proteins may help identify aggressive tumors, besides being considered promising therapeutic targets. However, their role in thyroid tumo...
ID genes have an important function in the cell cycle, and ID proteins may help identify aggressive tumors, besides being considered promising therapeutic targets. However, their role in thyroid tumors is still poorly understood. We examined ID expression and their correlation with diagnostic and prognostic features aiming to find a clinical application in differentiated thyroid carcinoma (DTC) cases. mRNA levels of ID1, ID2, ID3, and ID4 genes were quantified and their expression was observed by immunohistochemistry in 194 thyroid samples including 68 goiters, 16 follicular adenomas, 75 classic papillary thyroid carcinomas, 18 follicular variants of papillary thyroid carcinoma, 5 follicular thyroid carcinomas, and 1 anaplastic thyroid cancer, besides 11 normal thyroid tissues. DTC patients were managed according to standard protocols and followed up for M = 28 ± 16 months. ID2, ID3, and ID4 mRNA levels were higher in benign (2.0 ± 1.9; 0.6 ± 0.6; and 0.7 ± 1.0 AU, respectively) than those in malignant nodules (0.30 ± 0.62; 0.3 ± 0.3; and 0.2 ± 0.3 AU, respectively, p < 0.0001 for all three genes) and were associated with no extra thyroid invasion or metastasis at diagnosis. ID3 nuclear protein expression was higher in benign than that in malignant cells (5.2 ± 0.9 vs 3.0 ± 1.8 AU; p < 0.0001). On the contrary, the cytoplasmic expression of ID3 was higher in malignant than that in benign lesions (5.7 ± 1.5 vs 4.0 ± 1.4 AU; p < 0.0001). Our data indicate that ID genes are involved in thyroid tumorigenesis and suggest these genes act impeding the evolution of more aggressive phenotypes. The different patterns of their tissue expression may help identify malignancy and characterize thyroid lesion aggressiveness.
- Correlation study of thyroid nodule cytopathology and histopathology at two institutions in Jordan. [Journal Article]
- CCytojournal 2018; 15:24
- CONCLUSIONS: Our results are comparable to those previously published figures. The rate of atypia of undetermined significance/follicular lesion of undetermined significance is higher than what is currently recommended in TBSRTC.
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- Radiofrequency ablation for benign thyroid nodules according to different US features: an Italian multicentre prospective study. [Journal Article]
- EJEur J Endocrinol 2018 Nov 01
- CONCLUSIONS: This multicentre study validated the efficacy and safety of RFA for treating BTN and showed a clear correlation between final shrinkage and some common US findings.