Thyroid

2021 ◽  
pp. 1-122
Author(s):  
Mark Vanderpump
Keyword(s):  
Thyroid Hormone ◽  
Genetic Disorders ◽  
Needle Aspiration ◽  
Anatomy And Physiology ◽  
Thyroid Hormone Metabolism ◽  
Positron Emission ◽  
Molecular Action ◽  
Laboratory Investigations ◽  
Needle Aspiration Cytology

This chapter covers the anatomy and physiology of the thyroid, and the molecular action of the thyroid hormone. It explains tests of hormone concentration and homeostatic control, and rare genetic disorders associated with thyroid hormone metabolism. It covers antibody screens and screening for thyroid disease, ultrasound scanning, fine needle aspiration cytology, computed tomography, positron emission tomography, and other laboratory investigations. It then covers various thyroid-associated diseases, their treatment (medical and surgical when necessary), and any follow-up management programmes.

scholarly journals Inflammatory pseudotumors of the liver: Importance of a multimodal approach with the insistance of needle biopsy

2019 ◽  
Vol 11 (04) ◽  
pp. 361-368
Author(s):  
Neha Nigam ◽  
Shikha Singh Rajani ◽  
Archana Rastogi ◽  
Anupama Patil ◽  
Nikhil Agrawal ◽  
...  
Keyword(s):  
Needle Biopsy ◽  
Serum Alkaline Phosphatase ◽  
Complete Recovery ◽  
Needle Aspiration ◽  
Intermittent Fever ◽  
Inflammatory Pseudotumors ◽  
Laboratory Investigations ◽  
Needle Aspiration Cytology ◽  
Upper Abdominal

Abstract CONTEXT: Inflammatory pseudotumor (IPT) of the liver is a rare, tumor-like lesion that is considered to be biologically benign but often mimics malignancy. AIMS: The aim of the study was construe clinicopathological features, imaging findings, differential diagnosis, management, and follow-up of IPT involving the liver. SETTINGS AND DESIGN: It is a retrospective study. SUBJECTS AND METHODS: Cases included were of IPT, diagnosed on histopathology, at our center from June 2009 to December 2016. Details studied were clinical presentation, imaging studies, laboratory investigations, pathological features, treatment, and follow-up of the cases and compared with reports in the literature. RESULTS: A total of cases of IPT included were 17. The age of the patients ranged from 21 to 62 years. Common presenting features were intermittent fever, upper abdominal pain, and weight loss. Radiological diagnosis varied from neoplastic (13) to infectious etiologies (4), with hepatocellular carcinoma being the most common differential (7/17). Laboratory investigations revealed leukocytosis, hyperbilirubinemia, raised transaminases, and raised serum alkaline phosphatase. Core biopsy of a tumor conceded increased fibrosis along with mixed inflammatory cell infiltrates. Eleven cases were managed conservatively and showed regression or complete recovery. Six patients underwent surgical resection. None of these had any recurrence in median follow-up of 22 months. CONCLUSIONS: IPT of the liver can masquerade as a fatality, either primary or metastatic. It will be well managed with conservative modalities and can avoid redundant hepatectomy, reserved for complicated cases. For this intent, accurate preoperative diagnosis is the requisite, and needle biopsy with or without fine-needle aspiration cytology plays as a significant rescuer in this field.

The FUSION iENA Study: Comparison of I-124-PET/US Fusion Imaging with Conventional Diagnostics for the Functional Assessment of Thyroid Nodules by Multiple Observers

2019 ◽  
Vol 58 (06) ◽  
pp. 434-442 ◽  
Author(s):  
Thomas Winkens ◽  
Philipp Seifert ◽  
Christian Hollenbach ◽  
Christian Kühnel ◽  
Falk Gühne ◽  
...  
Keyword(s):  
Functional Assessment ◽  
Thyroid Nodules ◽  
Radioiodine Therapy ◽  
Fusion Imaging ◽  
Needle Aspiration ◽  
Patient Case ◽  
Positron Emission ◽  
Thyroid Medication ◽  
Case Files

Abstract Aim To investigate the value of I-124 positron emission tomography (PET) / ultrasound (US) fusion imaging in comparison to conventional diagnostics (CD) of Thyroid nodules (TN) by multiple observers. Methods Digital patient case files (PCF) of patients that received CD and I-124-PET/US in clinical routine were prepared containing cine-loops of the examinations. All physicians with nuclear medicine specialty from Germany, Austria, and Switzerland were invited to participate. 106 acquired observers completed 7.2 ± 1.8 (median: 8, range: 4–14) randomly assigned PCF (CD only or CD+PET/US). They assessed the TN function, stated their confidence in functional assessment, and suggested a treatment course for each TN. Results 68 PCF of 34 patients comprising 66 TN ≥ 1 cm (= 1.94 TN/patient) were created. A total of 748 (11.2/TN), and 751 ratings (11.4/TN) were recorded for CD only, and CD+PET/US, respectively. The functional assessment revealed more hyper- or hypofunctioning (524 vs. 320, p < 0.0001) and less indifferent or not rateable (209 vs. 428, p < 0.0001) TN in CD+PET/US vs. CD only. The observers’ confidence in functional assessment was superior in CD+PET/US (p < 0.0001). Furthermore, the ratings were carried out more homogeneous in CD+PET/US (p < 0.0001). Fewer suggestion of follow up (p < 0.0001), and more (p < 0.0001) suggestion of invasive treatments (fine-needle aspiration & surgery) was observed in CD+PET/US. Radioiodine therapy was more often (p = 0.0036), and thyroid medication less often (p = 0.0167) advised in CD+PET/US. Conclusion Functional assessment of equivocal TN shows frequent failures in CD, underestimating the incidence of hyper- and hypofunctioning lesions. Confidence in functional assessment significantly increases with additional PET/US. This influences the proposed treatment course.

Case of cholestatic jaundice associated with papillary carcinoma of thyroid: a multidisciplinary challenge

2021 ◽  
Vol 14 (2) ◽  
pp. e236372 ◽  
Author(s):  
Sanchit Sharma ◽  
Anoop Saraya ◽  
Prasenjit Das ◽  
Deepak Gunjan
Keyword(s):  
Papillary Carcinoma ◽  
Primary Tumour ◽  
Symptomatic Treatment ◽  
Liver Function Tests ◽  
Needle Aspiration ◽  
Cholestatic Jaundice ◽  
Drug Induced ◽  
Post Surgery ◽  
Positron Emission ◽  
Needle Aspiration Cytology

The report describes a patient with cholestatic jaundice who had incidentally detected parathyroid hormone-independent hypercalcaemia. The differential diagnosis for this presentation includes systemic granulomatous and infiltrative disorders, drug-induced liver injury and malignancy. As the initial investigations were non-contributory towards the aetiology, she was given steroids and later plasma exchange for symptomatic treatment. The differentials were revised again in view of no clinical and biochemical response. A repeat fine-needle aspiration cytology of the thyroid nodule (seen on positron emission tomography/CT) revealed papillary carcinoma of the thyroid. The patient underwent total thyroidectomy. There was a complete normalisation of liver function tests and serum calcium, and resolution of pruritus 3 months post surgery. She was retrospectively diagnosed as a case of papillary carcinoma of the thyroid with paraneoplastic manifestations—hypercalcaemia and cholestatic jaundice—which got resolved with treatment of the primary tumour.

scholarly journals What is New on Thyroid Cancer Biomarkers

2008 ◽  
Vol 3 ◽  
pp. BMI.S669 ◽  
Author(s):  
Rosaria M. Ruggeri ◽  
Alfredo Campennì ◽  
Sergio Baldari ◽  
Francesco Trimarchi ◽  
Maria Trovato
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Follicular Epithelium ◽  
Routine Practice ◽  
Appropriate Treatment ◽  
Follicular Lesions ◽  
Needle Aspiration Cytology ◽  
Well Differentiated

Thyroid cancer harbours in about 5% of thyroid nodules. The majority of them are well-differentiated cancers originating from the follicular epithelium, and are subdivided into papillary and follicular carcinomas. Undifferentiated carcinomas and medullary thyroid carcinomas arising from C cells are less common. Although most thyroid nodules are benign, distinguishing thyroid cancer from benign lesions is crucial for an appropriate treatment and follow-up. The fine needle aspiration cytology (FNAC) allows the diagnosis of nature of thyroid nodules in the majority of cases. However, FNAC has some limitations, particularly in the presence of follicular lesions which can appear dubious in rare instances even at histology. In an effort to improve diagnostic accuracy and offer new prognostic criteria, several immunohistochemical and molecular markers have been proposed. However, most of them have to be validated on large series before being used in routine practice.

scholarly journals Extra-laryngeal branching of recurrent laryngeal nerve: a possibility thyroid surgeons need to keep in mind to prevent inadvertent nerve injury

2019 ◽  
Vol 12 (11) ◽  
pp. e231305
Author(s):  
Gokul Gopi ◽  
Saurav Sarkar ◽  
Anindya Nayak
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nerve Injury ◽  
Preoperative Assessment ◽  
Central Compartment ◽  
Needle Aspiration ◽  
Laryngeal Nerve ◽  
Aspiration Cytology ◽  
Left Recurrent Laryngeal Nerve ◽  
Needle Aspiration Cytology

A 45-year-old woman presented with a neck swelling since the past 6 years. The swelling was painless but slowly and progressively increasing in size. On examination, a thyroid swelling of size approximately 6×4 cm was seen on the left side. Ultrasonography revealed the size to be 6×5 cm with microcalcifications. Fine needle aspiration cytology revealed the mass to be papillary carcinoma. She was planned for total thyroidectomy with central compartment clearance. Preoperative assessment including thyroid hormone profile was normal and the patient was taken for surgery after proper anaesthesia clearance. During the surgery, it was found that there was a branching of the left recurrent laryngeal nerve. The branching was confirmed with nerve monitor and careful dissection was done to prevent injuries. The surgery was completed successfully without any nerve damage and the postoperative period was uneventful. Follow-up assessments revealed no signs of nerve injury like hoarseness of voice. Possibility of abnormal branches and duplication of nerves though uncommon should not be underestimated and extra vigilance and caution must be exercised when operating near a nerve, even by an experienced surgeon familiar with the local anatomy. Any doubts arising during the surgery must be clarified immediately, and nerve monitors should be used to check suspected branching and duplications before proceeding further.

scholarly journals Primary retroperitoneal mullerian adenocarcinoma

Rare Tumors ◽  
2010 ◽  
Vol 2 (1) ◽  
pp. 16-19 ◽  
Author(s):  
Ayman Elnemr ◽  
Yutaka Yonemura ◽  
Masaya Shinbo ◽  
Eisei Nishino
Keyword(s):  
Abdominal Mass ◽  
Needle Aspiration ◽  
Cystic Mass ◽  
High Serum ◽  
Aspiration Cytology ◽  
Positron Emission ◽  
Pet Scanning ◽  
History Of ◽  
Needle Aspiration Cytology ◽  
Primary Retroperitoneal

Mullerian tumors are extremely rare malignancies in the retroperitoneum. We report a case of a 46-year old woman who presented with an eight year history of lower abdominal mass. Ultrasonography (US) and computed tomography (CT) demonstrated a 15×10 cm cystic mass in the left lower retroperitoneum. As serial percutaneous needle aspiration cytology was negative for malignancy, she was observed for seven years. Eleven months ago, the mass was excised. The histopathology was reported as mucinous adenocarcinoma of the retroperitoneum. Six cycles of intraperitoneal (IP) chemotherapy was administered during the last six months after diagnosis of recurrence by aspiration cytology and high serum tumor markers (CEA, CA19-9). A few days ago, positron emission tomographic (PET) scanning showed evidence of local recurrence and single vertebral metastasis, so she was admitted again for systemic chemotherapy. Meticulous revision of additional sections of the tumor revealed papillary, serous, mucinous, and endometrioid subtypes of the mullerian adenocarcinoma. To our knowledge, there has been no similar case described in the literature.

scholarly journals Arterial thrombosis as primary presentation of endogenous Cushing’s syndrome

2019 ◽  
Vol 12 (2) ◽  
pp. bcr-2018-227491
Author(s):  
Vijay Alexander ◽  
Maria Koshy ◽  
Riddhi Dasgupta ◽  
Ronald Albert Carey
Keyword(s):  
Cushing’S Syndrome ◽  
Arterial Thrombosis ◽  
Clinical Manifestations ◽  
Dynamic Mri ◽  
Cushing's Syndrome ◽  
Positron Emission ◽  
History Of ◽  
Laboratory Investigations ◽  
Primary Presentation

Cushing’s syndrome is known to present with a characteristic set of clinical manifestations and complications, well described in literature. However, hypercoagulability remains an under recognised entity in Cushing’s syndrome. A 31-year-old woman from Southern India presented with history of fever, left upper quadrant pain and progressive breathing difficulty for 3 weeks. Clinical examination revealed discriminatory features of Cushing’s syndrome. Laboratory investigations showed biochemical features of endogenous ACTH-dependent Cushing’s syndrome. Imaging of the abdomen revealed splenic collection, left-sided empyema and extensive arterial thrombosis. Gadolinium enhanced dynamic MRI of the pituitary gland revealed no evidence of an adenoma while a Ga-68 DOTATATE positron emission tomography CT scan ruled out an ectopic Cushing’s. A diagnosis of endogenous Cushing’s syndrome causing a prothrombotic state with extensive arterial thrombosis was made. She was initiated on oral anticoagulation and oral ketoconazole for medical adrenal suppression. She subsequently underwent bilateral adrenalectomy and was well at follow-up.

Sign in / Sign up

Export Citation Format

Share Document