Jeong Ja Kwak

Retrieval Rate and Accuracy of Ultrasound-Guided 14-G Semi-Automated Core Needle Biopsy of Breast Microcalcifications

Objective To evaluate the retrieval rate and accuracy of ultrasound (US)-guided 14-G semi-automated core needle biopsy (CNB) for microcalcifications in the breast. Materials and Methods US-guided 14-G semi-automated CNB procedures and specimen radiography were performed for 33 cases of suspicious microcalcifications apparent on sonography. The accuracy of 14-G semi-automated CNB and radiology-pathology concordance were analyzed and the microcalcification characteristics between groups with successful and failed retrieval were compared. Results Thirty lesions were successfully retrieved and the microcalcification retrieval rate was 90.9% (30/33). Thirty lesions were successfully retrieved. Twenty five were finally diagnosed as malignant (10 invasive ductal carcinoma, 15 ductal carcinoma in situ [DCIS]) and five as benign. After surgery and mammographic follow-up, the 25 malignant lesions comprised 12 invasive ductal carcinoma and 13 DCIS. Three lesions in the failed retrieval group (one DCIS and two benign) were finally diagnosed as two DCIS and one benign after surgery. The accuracy of 14-G semi-automated CNB was 90.9% (30/33) because of two DCIS underestimates and one false-negative diagnosis. The discordance rate was significantly higher in the failed retrieval group than in the successful retrieval group (66.7% vs. 6.7%; p < 0.05). Punctate calcifications were significantly more common in the failed retrieval group than in the successful retrieval group (66.7% vs. 3.7%; p < 0.05). Conclusion US-guided 14-G semi-automated CNB could be a useful procedure for suspicious microcalcifications in the breast those are apparent on sonography.

Metastasis of Colon Cancer to Medullary Thyroid Carcinoma: A Case Report

Metastasis to the primary thyroid carcinoma is extremely rare. We report here a case of colonic adenocarcinoma metastasis to medullary thyroid carcinoma in a 53-yr old man with a history of colon cancer. He showed a nodular lesion, suggesting malignancy in the thyroid gland, in a follow-up examination after colon cancer surgery. Fine needle aspiration biopsy (FNAB) of the thyroid gland showed tumor cell clusters, which was suspected to be medullary thyroid carcinoma (MTC). The patient underwent a total thyroidectomy. Using several specific immunohistochemical stains, the patient was diagnosed with colonic adenocarcinoma metastasis to MTC. To the best of our knowledge, the present patient is the first case of colonic adenocarcinoma metastasizing to MTC. Although tumor-tumor metastasis to primary thyroid carcinoma is very rare, we still should consider metastasis to the thyroid gland, when a patient with a history of other malignancy presents with a new thyroid finding. Graphical Abstract

Papillary Thyroid Carcinoma Arising Within a Follicular Adenoma: A Case Report, Ultrasound Features, and Considerations.

Papillary thyroid carcinoma (PTC) arising within a follicular adenoma is an exceptionally rare histopathological subtype that shows the nuclear features of PTC within a benign-appearing, circumscribed follicular adenoma. Although it is clinically significant because of its malignant nature, its ultrasonographic features have not been described previously. A 26-year-old man presented with a heterogeneous isoechoic solid nodule with a marked hypoechoic solid focus and a low echoic peripheral rim in the right thyroid gland on ultrasonography. On color Doppler images, markedly increased vascularity was seen in the hypoechoic solid component. An ultrasound-guided gun biopsy suggested a follicular neoplasm. In the evaluation of a hemithyroidectomy specimen, thyroid follicles and a thin fibrous capsule were seen, which favored a follicular adenoma with tumor cells in a focal area indicating papillary carcinoma. Here, we report a case of PTC arising within a follicular adenoma and discuss possible considerations in thyroid ultrasonographic examinations.

The Diffuse Sclerosing Variant of Papillary Thyroid Cancer Presenting as Innumerable Diffuse Microcalcifications in Underlying Adolescent Hashimoto's Thyroiditis: A Case Report.

AbstractHashimotos thyroiditis is the most common diffuse thyroid disease and is characterized by diffuse lymphocytic infiltration. However, the ultrasonographic findings of papillary thyroid carcinomas that arise from Hashimotos thyroiditis in the pediatric and adolescent population are not well known.We report a rare ultrasonographic finding in a 22-year-old woman diagnosed with the diffuse sclerosing variant of papillary thyroid carcinoma that arose from underlying Hashimotos thyroiditis: innumerable diffuse microcalcifications instead of a typical malignant-appearing nodule.

Papillary Thyroid Carcinoma Arising in Children and Adolescent Hashimoto’s Thyroiditis: Ultrasonographic and Pathologic Findings

Objectives. We compared the ultrasonography and pathology features of papillary thyroid carcinoma (PTC) in pediatric and adolescents with Hashimotos thyroiditis (HT) with those of non-HT patients. Materials and Methods. Eleven patients who were surgically confirmed to have pediatric or adolescent PTC from 2006 to 2014 were included in this study. We retrospectively analyzed the preoperative ultrasonography and pathology features of PTC arising in HT and non-HT patients. Results. On ultrasonography, thyroid gland was lobulated and enlarged, with many scattered microcalcifications in four of five HT patients. Four of six non-HT patients had suspicious masses with calcifications. The diffuse sclerosing variant of PTC (DSVPTC) was found in three of five HT patients, but none in non-HT patients. Macroscopic or microscopic extrathyroidal extension was evident in all of the HT patients and four of the non-HT patients. Neck lymph node metastases were in all HT patients and five of non-HT patients. Conclusions. Three of five PTCs in pediatric and adolescent HT patients were DSVPTC, whereas all PTCs of the non-HT patients were classic type. On ultrasonography, thyroid gland was diffusely enlarged with scattered microcalcifications in four of five HT patients. All five HT cases had aggressive disease, including extrathyroidal extension and cervical lymph node metastases.

Analysis of RAS mutation in thyroid nodular hyperplasia and follicular neoplasm in a Korean population

To investigate the difference in frequency of RAS mutations between nodular hyperplasia (NH), follicular thyroid adenomas (FTAs) and follicular thyroid carcinomas (FTCs) in a Korean population.

Endotracheal Leiomyoma Mimicking Malignancy on 18F-FDG PET/CT in a Patient With Papillary Thyroid Carcinoma

Endotracheal leiomyoma is a rare benign lesion, accounting for approximately 1% of tracheal tumors, and generally occurs in the lower respiratory tract. Because its growth causes airway obstruction symptom, surgical treatment is generally suggested after detection. We report a case with leiomyoma of the cervical endotracheal space showing intense FDG uptake on F-FDG PET/CT mimicking malignancy in a 79-year-old woman with papillary thyroid carcinoma.

Persistent Vocal Fold Granuloma Following Superficial PAAG Injection Laryngoplasty: A Case Report

The injection material polyacrylamide hydrogel (PAAG; Ferrosan, Søborg, Denmark) is often used as space filler for soft-tissue defects. PAAG is a suitable alternative to the materials used for injection laryngoplasty. Over the past decade, 427 patients have undergone injection laryngoplasty in our clinic using PAAG, and no major complications, such as material migration or foreign body granuloma, were identified. Here, we report the case of the first woman to undergo laryngomicrosurgery to remove a vocal fold granuloma that developed after a superficial injection laryngoplasty performed 4 years previously.