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Benign Nodules (benign + nodule)
Selected AbstractsPost-thyroid FNA testing and treatment options: A synopsis of the National Cancer Institute Thyroid Fine Needle Aspiration State of the Science Conference,,DIAGNOSTIC CYTOPATHOLOGY, Issue 6 2008Lester J. Layfield M.D. Abstract The National Cancer Institute (NCI) sponsored the NCI Thyroid Fine Needle Aspiration (FNA) State of the Science Conference on October 22,23, 2007 in Bethesda, MD. The 2-day meeting was accompanied by a permanent informational Web site and several on-line discussion periods between May 1 and December 15, 2007 (http://thyroidfna.cancer.gov). This document addresses follow-up procedures and therapeutic options for suggested diagnostic categories. Follow-up options for "nondiagnostic" and "benign" thyroid aspirates are given. The value of ultrasound examination in the follow-up of "nondiagnostic" and "benign" thyroid aspirates is discussed. Ultrasound findings requiring reaspiration or surgical resection are described as are the timing and length of clinical and ultrasonographic surveillance for cytologically "benign" nodules. Options for surgical intervention are given for the diagnostic categories of "atypical/borderline," "follicular neoplasm," "suspicious for malignancy" and "malignant" (http://thyroidfna.cancer.gov/pages/info/agenda/). Diagn. Cytopathol. 2008;36:442,448. © 2008 Wiley-Liss, Inc. [source] Observer variability in the sonographic evaluation of thyroid nodulesJOURNAL OF CLINICAL ULTRASOUND, Issue 6 2010Chang Suk Park MD Abstract Objective. Inter- and intraobserver variabilities in the description and diagnostic categorization of sonographic (US) features of thyroid nodules were evaluated. Methods. The current study was conducted on 72 malignant nodules and 61 benign nodules. The US findings for each thyroid nodule were analyzed twice at a 6-week interval by five radiologists. The analyses were in accordance with the guidelines proposed bythe Thyroid Study Group of the Korean Society of Neuroradiology and Head and Neck Radiology (TSGKSNRHNR). Inter- and intraobserver variabilities were calculated using Cohen's kappa statistics. The sensitivity, specificity, positive-predictive value, and negative-predictive value in the assessment of the diagnostic accuracy using these guidelines were calculated. Result. The interobserver agreement was fair to substantial for US features and categorization. Of the US features of the thyroid nodules, internal content (solid versus cystic) showed substantial agreement (k= 0.64). There was moderate agreement with regard to shape, echogenicity, calcification, and diagnostic categories (k = 0.42, 0.57, 0.55, and 0.55, respectively). There was fair agreement for margin, echotexture, and capsule invasion (k = 0.34, 0.26, and 0.32, respectively). With regard to intraobserver agreement, there was moderate to substantial agreement for all US features except for echotexture and capsule invasion, which showed fair agreement. In particular, there was moderate to almost perfect agreement for the diagnostic category. The sensitivity, specificity, positive-predictive value, and negative-predictive value were 65.3%,81.9%, 60.7%,68.9%, 69.7%,73.8%, and 66.6%,75.5%, respectively. Conclusion. There were high degrees of inter- and intraobserver agreement using the "Guidelines for diagnostic thyroid ultrasonography," of the TSGKSNRHNR in the description and categorization of thyroid nodules. © 2010 Wiley Periodicals, Inc. J Clin Ultrasound, 2010 [source] Sonography of thyroid nodules with peripheral calcificationsJOURNAL OF CLINICAL ULTRASOUND, Issue 6 2009Minjung Park MD Abstract Purpose. This study was designed to assess the role of sonography (US) in the differentiation of benign from malignant thyroid nodules with peripheral calcifications. Methods. Sixty-four thyroid nodules with peripheral calcifications that were detected on US were included in the study. Nineteen nodules (30%) were benign, and 45 nodules (70%) were malignant. We retrospectively compared the US findings of the benign and malignant nodules, including interruption, thickening (,0.5 mm and over more than 50% of the circumference) of calcifications, internal echogenicity, margin, and presence of cystic change, size, and shape. Univariate and multivariate logistic regression analyses were performed. Results. Interruption of peripheral calcifications was more common in malignant nodules (84%) than in benign nodules (53%) (OR, 7.9; 95% CI, 1.3,48.4; p < 0.05). Thickening of the peripheral calcification was seen more frequently in malignant nodules (64%) than in benign nodules (11%) (OR, 14.7; 95% CI, 1.8,117.5; p < 0.05). For internal echogenicity, malignant nodules (58%) were more often hypoechoic than benign nodules (OR, 23.6; 95% CI, 2.2,256.3; p < 0.01). The mean tumor size was 1.1 cm for malignant nodules and 1.2 cm for benign nodules (p > 0.05). There were no significant differences for the presence or absence of cystic change, size, shape, and margin between malignant and benign nodules. Conclusion. Interruption and thickening of peripheral calcifications and decreased internal echogenicity of a thyroid nodule with peripheral calcifications are in favor of malignancy. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound 2009 [source] Minimal access thyroid surgery: technique and report of the first 25 casesANZ JOURNAL OF SURGERY, Issue 5 2004Jessica E. Gosnell Background: Minimal access thyroid surgery, using various techniques, is increasingly being reported. The present study reviews our experience with thyroid surgery using a lateral focused mini-incision approach, and assesses its safety and feasibility. Methods: The study group comprised all patients undergoing minimal access thyroid surgery (MATS) during the period May 2002,May 2003. Data were prospectively gathered, including patient demographics, indication for surgery, operation performed, nodule size, final pathology, and complications. Exclusion criteria for this procedure included: family history of thyroid cancer, previous neck irradiation or surgery, carcinoma on fine needle aspiration, presence of significant thyroiditis, multinodular goitre, and nodule size >3 cm. The operation was carried out through a 2.5-cm lateral incision placed directly over the nodule, with exposure gained by dissecting the plane between the sternomastoid muscle and the lateral edge of the strap muscles. Results: Twenty-five patients underwent MATS, 22 women and three men. Nineteen patients underwent hemithyroidectomy, five underwent isthmectomy, and one underwent local nodule excision. The average measured incision size was 2.63 cm at the end of the procedure. The average nodule size was 2.2 cm, and the average thyroid lobe resected measured 4.7 cm in maximal length. Final pathology revealed benign nodules in 21 patients and four thyroid cancers (two follicular and two papillary). There was one wound infection and two patients had temporary recurrent laryngeal nerve neuropraxia. Conclusion: Minimal access thyroid surgery is a safe and feasible alternative to open thyroid surgery in selected cases. [source] | ||||||||||