scholarly journals Prediction of Ipsilateral Lateral Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma: A Combined Dual-energy CT and Thyroid Functional Indicators Study

2020 ◽  
Author(s):  
Ying Zou ◽  
Huanlei Zhang ◽  
Wenfei Li ◽  
Yu Guo ◽  
Fang Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Lymph Node Metastasis ◽  
Thyroid Carcinoma ◽  
Cervical Lymph Node ◽  
Cervical Lymph Node Metastasis ◽  
Dual Energy ◽  
Papillary Thyroid ◽  
Node Metastasis

Abstract BackgroundThe prediction of ipsilateral lateral cervical lymph node metastasis (ipsi-LLNM) was crucial to the operation plan in patients with papillary thyroid carcinoma (PTC). This study aimed to investigate the risk factors for ipsi-LLNM using dual-energy computed tomography (DECT) and thyroid functional indicators in patients with PTC. MethodsThe medical records of 406 patients with a pathological diagnosis of PTC were retrospectively reviewed from Jan 2016 to Dec 2019. Demographic, clinical, pathological findings, and parameters from DECT were evaluated. Risk factors for ipsi-LLNM were explored by univariate and multivariate analyses. Receiver operating characteristic (ROC) curves were used to evaluate the cut-off value of each risk factor.ResultsTotally 406 patients with PTC were analyzed, including 128 with ipsi-LLNM and 278 without. There were statistical differences of parameters between the two groups (P < .0001), including serum Tg, Anti-Tg, Anti-TPO, the volume of the primary lesion, calcification, extrathyroidal extension (ETE), and iodine concentration (IC) in arterial and venous phases. Independent risk factors for ipsi-LLNM included serum Tg, Anti-Tg, ETE, and IC in arterial and venous phases (P < .05). Ipsi-LLNM was more likely to occur when the following conditions were met: with ETE, Tg > 100.01 ng/ml, Anti-Tg > 89.43 IU/ml, IC in arterial phase > 3.4 mg/ml and IC in venous phase > 3.1 mg/ml.ConclusionsApplication of DECT parameters and thyroid functional indicators can improve the diagnostic performance in the evaluation of ipsi-LLNM in patients with PTC.

UNILATERAL TNM T1 AND T2 PAPILLARY THYROID CARCINOMA WITH LATERAL CERVICAL LYMPH NODE METASTASIS: TOTAL THYROIDECTOMY OR LOBECTOMY?

2020 ◽  
Vol 26 (10) ◽  
pp. 1085-1092
Author(s):  
Zhihong Wang ◽  
Jingzhe Xiang ◽  
Zhiqiang Gui ◽  
Yuan Qin ◽  
Wei Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Lymph Node Metastasis ◽  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Cervical Lymph Node ◽  
Cervical Lymph Node Metastasis ◽  
Papillary Thyroid ◽  
Node Metastasis

Objective: The aim of this study was to explore the effect of total thyroidectomy (TT) and lobectomy (LT) on the prognosis of unilateral papillary thyroid carcinoma (PTC) with lateral cervical lymph node metastasis. Methods: Patients with PTC and lateral cervical lymph node metastasis who underwent lateral cervical lymph node dissection between January 2007 and December 2016 were retrospectively reviewed. To investigate the effect of surgical procedure on the prognosis of lymph node metastasis patients, other high-risk factors such as extrathyroidal invasion and large tumor size were excluded. All patients were in Tumor-Node-Metastasis (TNM) stage T1 and T2. Primary end point was recurrence-free survival (RFS). Results: Among 264 PTC patients, 104 (39.4%) patients received TT and 160 (60.6%) patients received LT. With a median follow-up of 50 months (interquartile range, 34 to 74 months), 7 patients (2.65%) experienced recurrence. The 5-year RFS in the TT and LT groups was 96.1% and 97.7%, respectively, and was not significantly different ( P = .765). Similar results were found when excluding patients who received radioiodine ablation, which were 97.7% and 97.4%, respectively ( P = .752). Age ≥55 years (hazard ratio, 7.368; P = .018) and multifocality in the ispi-lateral lobe (hazard ratio, 10.059; P =.006) were identified as independent risk factors of recurrence. Conclusion: For unilateral TNM T1 and T2 PTC patients with lateral lymph node metastasis, there was no significant difference in the effect of TT and LT for RFS in the absence of other risk factors during the follow-up period. Patient age ≥55 years with multifocality in the unilateral lobe might be independent risk factors for prognosis. Abbreviations: ATA = American Thyroid Association; CT = computed tomography; ETE = extrathyroidal extension; LT = lobectomy; L-T4 = levothyroxine; PTC = papillary thyroid carcinoma; RFS = recurrence-free survival; RIA = radioiodine ablation; TgAb = anti-thyroglobulin antibody; TT = total thyroidectomy; TNM = Tumor-Node-Metastasis

scholarly journals Cooccurrence of Metastatic Papillary Thyroid Carcinoma andSalmonellaInduced Neck Abscess in a Cervical Lymph Node

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Jae-Myung Kim ◽  
Ju-Yeon Kim ◽  
Eun Jung Jung ◽  
Eun Jin Song ◽  
Dong Chul Kim ◽  
...  
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Lymph Node Metastasis ◽  
Thyroid Carcinoma ◽  
Cervical Lymph Node ◽  
Cervical Lymph Node Metastasis ◽  
Salmonella Typhi ◽  
Cystic Mass ◽  
Papillary Thyroid ◽  
Node Metastasis

Cervical lymph node metastasis is common in patients with papillary thyroid carcinoma (PTC).Salmonellaspecies are rarely reported as causative agents in focal infections of the head and neck. The cooccurrence of lymph node metastasis from PTC and a bacterial infection is rare. This report describes a 76-year-old woman with a cervical lymph node metastasis from PTC andSalmonellainfection of the same lymph node. The patient presented with painful swelling in her left lateral neck region for 15 days, and neck ultrasonography and computed tomography showed a cystic mass along left levels II–IV. The cystic mass was suspected of being a metastatic lymph node; modified radical neck dissection was performed. Histopathological examination confirmed the presence of PTC in the resected node and laboratory examination of the combined abscess cavity confirmed the presence ofSalmonella Typhi. Following antibiotic sensitivity testing of the culturedSalmonella Typhi, she was treated with proper antibiotics. Cystic lesions in lymph nodes with metastatic cancer may indicate the presence of cooccurring bacterial infection. Thus, culturing of specimen can be option to make accurate diagnosis and to provide proper postoperative management.

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