RAS mutation and associated risk of malignancy in the thyroid gland: An FNA study with cytology‐histology correlation

2021 ◽  
Author(s):  
Syed M. Gilani ◽  
Rita Abi‐Raad ◽  
James Garritano ◽  
Guoping Cai ◽  
Manju L. Prasad ◽  
...  
2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Sabah Patel ◽  
Petra Krutilova ◽  
Janice L Gilden

Abstract Introduction: Congenital Thyroid hemi-agenesis is an uncommon clinical entity. We present a case highlighting the importance of awareness of this condition and the need to evaluate and manage co-existing hypothyroidism and risk of malignancy. Case: A 20 year old female known to have Hashimoto’s thyroiditis (non-adherent to levothyroxine), and hemi-agenesis of left lobe of thyroid gland, presented with right-sided thyroid enlargement. She was clinically euthyroid. Physical exam: enlarged right sided thyroid gland with palpable anterior cervical lymphadenopathy. Left lobe could not be palpated. TFTs were notable for TSH 4.98 uIU/ml (0.358-3.74) and Free T4 0.79 ng/dl (0.76-1.46) consistent with sub-clinical hypothyroidism while Anti TPO antibody was positive at 8332.8 U/mL (0 - 60). CBC negative for leukocytosis. US thyroid: left-sided thyroid agenesis with intact isthmus and enlargement of right lobe of the thyroid 7.7 cm x 1.6 cm x 2.6 cm with 2 sub-centimeter hypoechoic solid nodules and 2 enlarged lymph nodes 1.5 cm and 2.3 cm (not found in US thyroid 2 years ago) Levothyroxine was re-started. ENT evaluation determined that her lymphadenopathy was benign and consistent with Hashimoto’s thyroiditis. Subsequent TFTs improved. Discussion: Thyroid Gland embryogenesis occurs in the 4th week of fetal life. Subsequent abnormal bilobal differentiation of the thyroid gland is presumed to be the etiology of congenital hemi-agenesis. Its prevalence in several studies is estimated to be between 0.05-0.25%. It is symptomatic pre-dominantly in females and may have familial origin with vast majority of cases having left hemi-agenesis with intact isthmus. It is helpful to know that most symptomatic patients have compensatory hypertrophy of the remnant lobe. It is important to remember that compensatory enlargement of the remnant lobe in the setting of hypothyroidism may be a sign of insufficient endogenous thyroxine production and/or replacement. Although rarely symptomatic, hemi-thyroid remnant may need to be evaluated for co-existing hyperthyroidism, hypothyroidism, carcinoma and multinodular goiter among others, with hypothyroidism thought to be the most common. US thyroid is a useful modality to help guide the evaluation of patients with hemi-agenesis. Awareness of this congenital condition is key in preventing unnecessary evaluations and interventions. Non-resolving lymphadenopathy in Hashimoto’s thyroiditis must be evaluated for lymphoma, however, based on studies, no additional risk of malignancy was identified in patients with underlying thyroid hemi-agenesis. References: Y.H. Wu, R.O. Wein, B. Carter Thyroid hemiagenesis: a case series and review of the literature Am J Otolaryngol, 33 (3) (2012), pp. 299-302


2021 ◽  
Vol 46 (2) ◽  
pp. 93-102
Author(s):  
Aleksandar Aleksić ◽  
Vlada Mitov ◽  
Aleksandar Jolić ◽  
Vanja Antić ◽  
Nataša Savić

Nodules in the thyroid gland are very common and can be found in 50-68% of adults in the general population. Only about 5% of these nodules are malignant and require treatment. They usually do not give any discomfort. When they are discovered, they should be assessed on the basis of clinical, echosonographic and cytological findings, and if necessary, using additional diagnostic methods, and make a decision on the need for treatment. Based on the ultrasound characteristics of the nodule, it is decided whether further diagnosis is needed, in terms of aspiration puncture with a thin needle (FNA) and cytological examination, after which a decision is made on further procedure. Ultrasound is the initial diagnostic method for the detection of thyroid nodules. In addition to the presence of nodules, it accurately determines the size, location and number of nodules in the thyroid gland (thyroid). This noninvasive screening method is safe, harmless and can be repeated. FNA is a very important diagnostic method, but its performance must be selective, since systematic puncture of all nodes, regardless of size or appearance, is not recommended. It is important that the indications for FNA be based on clinical characteristics, as well as on echosonographic stratification of the risk of malignancy.


JAMA ◽  
1967 ◽  
Vol 200 (2) ◽  
pp. 178-179 ◽  
Author(s):  
G. D. Skalkeas
Keyword(s):  

2015 ◽  
Vol 122 (03) ◽  
Author(s):  
M Ehlers ◽  
S Allelein ◽  
A Kuebart ◽  
T Dringenberg ◽  
M Haase ◽  
...  
Keyword(s):  

1981 ◽  
Vol 20 (02) ◽  
pp. 72-75 ◽  
Author(s):  
R. Kocak ◽  
R.G. Herbert ◽  
C.R. Squire ◽  
T.M.D. Gimlette

Radioiodine in the thyroid gland after a therapy dose of 131I was measured serially in 7 patients without Carbimazole, and in 11 patients starting Carbimazole 60 mg daily fourteen days after the therapy dose. Effective half-life for radioiodine in the gland initially 5.53±1.08 days fell to 4.26±1.12 days (p < 0.01) during Carbimazole, and returned to 5.83±1.21 days (NS) after stopping the drug. The radiation dose to the thyroid from a given therapy dose of 131I followed by Carbimazole was calculated to be 97% of that without Carbimazole when the drug was started after 14 days, and 90% and 75% when the drug was started after 7 days and 1 day respectively.


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