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PubMed1994

[Fine needle aspiration biopsy in the diagnosis of thyroid neoplasms].

The clinical value of fine needle aspiration biopsy cytology is discussed with reference to 4514 histologically verified cases. A good sensitivity and specificity, together with high accuracy, make this technique a method of choice in the preoperative diagnosis of thyroid disease.

Adenocarcinoma, Follicular↗
PubMed1991

Estrogen-receptor protein in thyroid neoplasms. An immunohistochemical analysis of papillary carcinoma, follicular carcinoma, and follicular adenoma.

Epidemiologic features of well-differentiated thyroid tumors and experimental evidence suggest that female sex hormones may exert effects on this gland and its neoplasms. This possibility was addressed by investigating the expression of estrogen-receptor protein in 80 thyroid neoplasms. Patients with papillary carcinomas, follicular carcinomas, and follicular adenomas were selected from each of the following groups: (1) postpubertal-premenopausal women (who are associated with the most favorable prognosis and greatest incidence of these neoplasms); (2) postmenopausal women; and (3) men of various ages. Sections from formalin-fixed paraffin-embedded tumors were stained with antiestrophilin antibody (clone H222) and the avidin-biotin-peroxidase complex method. In addition, other markers were included to distinguish thyroidal from other estrogen-receptor protein-reactive neoplasms; an anticytokeratin mixture, antithyroglobulin, and anti-gross cystic disease fluid protein-15 were applied in all cases. The expression of estrogen-receptor protein was detected in eight of 10, six of 10, and nine of 10 papillary carcinomas; four of eight, two of seven, and one of five follicular carcinomas; and none of 10, none of 10, and two of 10 follicular adenomas, in groups 1, 2, and 3, respectively. Nuclear staining was regional or multifocal in distribution. Cytokeratin and thyroglobulin were detected in all tumors. In contrast, none displayed anti-gross cystic disease fluid protein-15 immunoreactivity. These results indicate that the estrogen receptor may be detected immunohistochemically in thyroid neoplasms. However, no differences that could account for possible estrogen-related epidemiologic and prognostic variation in such tumors could be ascertained. Other discriminating immunostains, primarily including anti-gross cystic disease fluid protein-15 and thyroglobulin, are effective in distinguishing between thyroidal and extrathyroidal tumors that may express estrogen-receptor protein.

Adenocarcinoma↗
PubMed1995

Family with nonmedullary thyroid neoplasms.

This report concerns a family in which papillary thyroid carcinoma appeared in the father and two daughters and follicular adenoma in a granddaughter. The father died of systemic metastasis of papillary thyroid carcinoma. The two daughters and granddaughter felt well postoperatively. We speculate that some gene-related factors might play an important role in familial occurrence of papillary thyroid carcinoma and follicular thyroid adenoma in the family.

Adenoma↗
PubMed1983

Acute symptoms of the aerodigestive tract caused by rapidly enlarging thyroid neoplasms.

Two cases of rapidly enlarging tumors of the thyroid presenting with the sudden onset of symptoms referable to the aerodigestive tract are discussed. Although tumors of the thyroid are known to produce dysfunction of these structures, these cases are highly unusual, since in the vast majority of cases the onset and progression of these symptoms are insidious and rarely recognized by the patient or physician. The diagnostic workup and management of enlarging masses in this area is reviewed.

Adenoma↗
PubMed1985

DNA flow cytometry of thyroid neoplasms.

Mechanically dispersed cell suspensions from 23 thyroid lesions were studied by acridine orange flow cytometry. Eight of 14 carcinomas (three papillary, two medullary, two Hürthle cell, and one follicular) manifested abnormal DNA indices ranging from 0.6 to 2.0. Six carcinomas (four papillary and two medullary) were diploid. Four patients having papillary carcinomas with diploid DNA content were young women whose clinical course of disease was indolent. Three papillary carcinomas with abnormal DNA content were found in older men with clinically aggressive disease. One benign adenomatoid nodule displayed a small population with a low-degree hyperdiploid stemline (DNA index = 1.1) with low proliferative activity. Differentiation between clinically indolent and aggressive carcinomas may be possible by nuclear DNA determination, but further work is needed to determine the importance of proliferative activity in thyroid carcinoma.

Adenocarcinoma↗
PubMed1998

Analysis of TGF-B and TGF-B-RII in Thyroid Neoplasms from the United States, Japan, and China.

Transforming growth factor B (TGF-B) has an inhibitory effect on cell proliferation in various cells and tumors, so loss of TG-B-receptor (TGF-B-R) may lead to increase proliferative activity in these tumors. We compared the expression of TGF-B and TGF-B-Rll in a group of thyroid neoplasms from the United States, Japan, and China to determine if there were differences in the expression of this growth factor or its receptors in various tumor types from different countries. A total 108 neoplastic thyroids from the United States, 42 from Japan, and 46 from China were analyzed for TGF-B1, TGF-B3, and TGF-B-Rll by in situ hybridization with riboprobes. TGF-jB-RII expression was also examined by immunohistochemistry. TGF-B1 mRNA was expressed in all neoplastic thyroids from all three countries except for one anaplasti carcinoma (ACA). TGF-B3 expression was lowest in follicular carcinomas (FCA) from all three countries (30/42; 71%). TGF-B-RII was much lower in FCA from Japan (112; 50%) and China (6/11; 55%) compared to cases from the United States (26/29; 90%). TGF-B-RII expression in papillary carcinoma (PCA) was also lower in carcinomas from Japan (21/28; 75%) and China (23/30; 77%) compared to the United States (24/25; 96%). Most ACA from the United States (25/30; 83%) and from China (3/3; 100%) were positive for TGF-B-Rll. Immunohistochemical analysis for TGF-B-RII protein expression showed the highest levels in follicular adenomas (FA) (38/38; 100%) with decreased immunoreactivity in FCA (36142; 86%). PCA (66/83; 80%), and ACA (14/33; 42%). These findings suggest that loss of TGF-B--RII may be important in thyroid tumor progression and that environmental/geographic factors may play a role in the variable expression of TGF-B--RII in thyroid malignancy.

Journal Article↗
PubMed1977

[Treatment of thyroid neoplasms and proposed therapeutic plan].

Thirty-seven patients with thyroid cancer were treated at 1a Clinica Chirurgica of Parma between 1962 and 1970. Fourty-five per cent of tumors were papillary, 24 per cent follicular, 2 per cent medullary, 9 per cent anaplastic. Surgery combined with ormonal therapy formed the commonest treatment. Eighty-five per cent of the patients with papillary carcinoma 70 per cent with follicular and 33,3 per cent with anaplastic carcinoma survived for 10 years. This present series indicates that total thiroidectomy combined with ormonal therapy influences the survival time, confirms the prognostic value of histology and shows that papillary node metastases do not prejudice survival.

Adenocarcinoma↗
PubMed1991

[Echo-guided needle biopsy of the thyroid. An assessment of 52 thyroid neoplasms found in 1042 consecutive patients].

The authors report on a series of 1,043 fine-needle biopsies of the thyroid performed under US guidance; the patients had been selected for thyroid pathologic conditions. Fifty-two neoplasms were observed (46 papillary carcinomas, 1 medullary carcinoma, 2 follicular carcinomas, and 3 metastases), which had been detected by cytology and confirmed by histology or autopsy. The authors focus on 46 cases of papillary carcinoma: their US features were studied which, through a correlation of variables, allow a quick and "safe" recognition of the type of carcinoma (papillary carcinomas account for nearly 60% of thyroid neoplasms). Tumor echogenicity and outline, and the presence/absence of calcifications were evaluated: in most cases, papillary carcinomas presented as focal lesions (alone or associated with other goiter lesions), with irregular and blurred outline, no hypo/anechoic halo and, in about 1/3 of the cases, with calcifications and colliquative areas. In 17% of papillary neoplasms, metastases to loco-regional nodes were observable at US; in 3 cases the carcinoma did involve a loco-regional node but there were no US signs suggestive of it. The incidence of neoplasms on the total of fine-needle biopsies is 4.9%, while in a previous series of 3,038 fine-needle biopsies, without US guidance, on clinically detectable lesions, the figure was about 2%.

Adenocarcinoma↗
PubMed1990

Thyroid tumors: cytomorphology of medullary, clinically anaplastic, and miscellaneous thyroid neoplasms.

Of 2,012 fine-needle aspirations (FNAs) of the thyroid performed between the years 1984 and 1988, detailed cytomorphologic analysis of 95 cases diagnosed as neoplastic on histology and/or cytology and those that received an equivocal cytodiagnosis are presented in this article. Discussed are medullary thyroid carcinomas (nine cases), clinically anaplastic thyroid tumors (CATT; eight cases), two cases of non-Hodgkin's lymphoma (NHL), and one primary leiomyosarcoma of the thyroid, for a total of 20 cases. Included in the category of CATT are all the thyroid tumors presenting clinically with an anaplastic growth pattern. The cytomorphology of these tumors varied, but the giant- and spindle-cell pattern was predominant. An accurate cytodiagnosis was possible, as per cytohistologic correlation, in seven cases, while in one case histological material was not available for study. Medullary carcinoma of the thyroid (MCT) showed a mixed spindle-cell and round-cell population in eight cases and an entirely spindle-cell population in one case. All cases of MCT were correctly diagnosed on cytology, and amyloid could be demonstrated in the cytologic smears in three cases. The cases of NHL and leiomyosarcoma could also be correctly interpreted on cytology.

Adult↗
PubMed1983

Ultrastructural morphometry of thyroid neoplasms.

This paper presents the first comprehensive morphometry analysis of normal thyroid, adenomas, and follicular and papillary carcinomas. The mean nuclear volume and the mean nuclear surface increased, while the volume densities of rough endoplasmic reticulum and dense bodies decreased from normal thyroid through adenomas and follicular carcinomas to papillary carcinomas. The different amounts of cytoplasmic organelles probably are related to endocrine function rather than to malignant potential. Papillary carcinomas with a predominantly follicular growth pattern are related more closely to follicular carcinomas than to papillary carcinomas dominated by papillae. This probably indicates a more active endocrine function rather than a different degree of malignancy. Papillary carcinomas, where follicular structures dominate, are therefore expected to respond to radioiodine treatment more favorably than those mainly forming papillae. Papillary carcinomas with abundant ground glass nuclei do not seem to have a lower volume density of heterochromatin than tumors lacking this nuclear feature. In the individual problem case with a follicular tumor, electron microscopy and morphometry cannot even distinguish between an adenoma and a well-differentiated follicular carcinoma.

Adenocarcinoma↗
PubMedDate not supplied

[Hürthle-cell thyroid neoplasms: a clinical enigma].

Hürthle cell neoplasms represent a pathological entity whose diagnosis and therapy are still not defined. These neoplasms constitute from 1.5% to 10% of all thyroid tumors. Hürthle cell nodule is clinically indistinguishable from other nodular thyroid diseases and histologic features of the tumors do not always allow us to distinguish benign nodules from malignant ones. The authors, analyzing a segment of their own experience (335 surgical thyroid diseases), observed nine cases of Hürthle cell adenomas (0.03%). Because of concomitant presence of heterolobar thyroid disease, seven cases were treated with a total thyroidectomy, and two cases were treated with a lobo-isthmectomy. In a long-term follow-up study, there were not signs of Hürthle cells neoplastic disease. The authors suggest that the treatment of choice for patients with "surely benign" Hürthle cell nodule is lobo-isthmectomy. For malignant Hürthle cell tumors, total thyroidectomy is the most rational treatment associated with cervical lymphadenectomy in presence of metastatic nodes. In all cases, a long-term periodical check-up proves to be the best solution, also for patients treated for benign pathological Hürthle cell.

Adenoma, Oxyphilic↗