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Background: Extrathyroid implantation or dissemination of thyroid tissue secondary to a thyroid procedure is rare. Most of these belonged to thyroid carcinoma with metastatic potential and uncommon for benign pathologies. Methods: We report the case of a 31‐year‐old female who was identified to have multiple subcutaneous implantation of thyroid tissue 5 years after transoral endoscopic thyroidectomy vestibular approach. A comprehensive literature search on implantation of thyroid tissue secondary to thyroid procedures was performed. Results: Accidental tearing of the capsule during previous surgery may lead to the subcutaneous implantation. Through literature review, a total 29 articles with 47 patients were identified. 33.3% were benign lesions, and implantation was mostly secondary to fine needle aspiration biopsy (46.5%). Conclusions: Subcutaneous or port site implantation after endoscopic thyroid surgery may occur in benign thyroid pathologies and therefore, oncologic principles must be strictly followed during surgery regardless of its histopathological nature. [ABSTRACT FROM AUTHOR]

Background. Violation of the principles of direct and negative feedback regulation of endocrine functions leads to nodular goiter. The structure and quantitative changes of thyroid gland can be assessed more informatively and accurately by polarization biomedical optics. The purpose was to substantiate the possibility of using polarization biomedical optic methods in the diagnosis of nodular thyroid goiter based on the application of an integrative pathophysiological approach of the principle of direct and negative feedback regulation of endocrine functions. Materials and methods. Two groups of patients were studied: control group 1 — healthy donors (n = 51), study group 2 — patients with nodular goiter (n = 51), who underwent a thyroid fine needle biopsy for diagnostic purposes. The fundamental idea of polarization biomedical optics is based on two analytical approaches: statistical and topographic (fractal). Instrumental laser methods were used such as polarization, interference, digital holographic, as well as computer and analytical methods: statistical and multifractal. The statistical parameters of polarization azimuth maps, polarization azimuth of phase and multifractal spectra of digital microscopic images of native histological sections of thyroid biopsy in patients with nodular goiter were determined quantitatively with calculation of the mean, dispersion, asymmetry and kurtosis. The significance of differences compared to the controls taken as 100 % was evaluated using the Student’s parametric test (p < 0.05). Results. There was a significant increase in the asymmetry and kurtosis of the polarization azimuth, a significant inhibition of the mean of polarization azimuth of phase digital microscopic images of native histological sections of thyroid biopsy in patients with nodular goiter, a significant increase in the asymmetry and kurtosis of digital microscopic images of native histological sections of thyroid biopsy in patients with nodular goiter. A significant increase in dispersion and a probable decrease in the asymmetry and kurtosis of multifractal spectra of polarization azimuth maps of digital microscopic images of native histological sections of thyroid biopsy in patients with nodular goiter were shown. Conclusions. There was a significant increase in the biophysical optical parameters of digital microscopic images of native histological sections of thyroid biopsy in patients with nodular goiter due to an increase in colloidal follicles and the growth of connective tissue around them. A probable inhibition of the average azimuth of polarization of phase digital microscopic images of native histological sections and a significant decrease in the asymmetry and kurtosis of multifractal spectra of polarization azimuth maps of digital microscopic images of native histological sections of thyroid biopsy in patients with nodular goiter are caused by the activation of thyrocytes as an amorphous component as a result of activation of the dysregulatory pathological process due to violations of the principle of direct and negative feedback regulation of endocrine functions. [ABSTRACT FROM AUTHOR]

Abstract Disturbances in the homeostasis of the elemental composition of thyroid tissue may have serious metabolic and health consequences. It is believed that the accumulation of some metals or the deficiency of others may even cause lethal tumours. Due to the fact that metallomics most often uses human serum to analyse macro and microelements as well as trace elements, it was decided to use material that is more difficult to obtain, but also adds credibility to the research – thyroid tissue samples biopsy. The experiments were conducted on 17 patients diagnosed with: nodular (10) and colloidal goitre (2), chronic thyroiditis (2), follicular adenoma (2) and papillary carcinoma (1). They were recruited by collecting a tumour fragment, control fragment and serum from each of them. The content of Ca, Cd, Co, Cr, Cu, Fe, Mg, Mn, Ni, Pb, Zn was examined using ICP-OES (Inductively Coupled Plasma - Optical Emission Spectrometers). Simultaneously, biochemical methods were used to determine the markers of inflammation, glycation and peroxidation: malondialdehyde, pentosidine, reactive free amine content, compounds with thiol groups and galectin 3 in the sera of the examined patients. Three statistically significant correlations were identified: Ca-Mg and Cu-Zn in control tissues (p

Disturbances in the homeostasis of the elemental composition of thyroid tissue may have serious metabolic and health consequences. It is believed that the accumulation of some metals or the deficiency of others may even cause lethal tumours. Due to the fact that metallomics most often uses human serum to analyse macro and microelements as well as trace elements, it was decided to use material that is more difficult to obtain, but also adds credibility to the research – thyroid tissue samples biopsy. The experiments were conducted on 17 patients diagnosed with: nodular (10) and colloidal goitre (2), chronic thyroiditis (2), follicular adenoma (2) and papillary carcinoma (1). They were recruited by collecting a tumour fragment, control fragment and serum from each of them. The content of Ca, Cd, Co, Cr, Cu, Fe, Mg, Mn, Ni, Pb, Zn was examined using ICP-OES (Inductively Coupled Plasma - Optical Emission Spectrometers). Simultaneously, biochemical methods were used to determine the markers of inflammation, glycation and peroxidation: malondialdehyde, pentosidine, reactive free amine content, compounds with thiol groups and galectin 3 in the sera of the examined patients. Three statistically significant correlations were identified: Ca-Mg and Cu-Zn in control tissues (p < 0.05) and Cr-Mn in pathological tissues (p < 0.05). A comparison of individual groups of patients shows that there are some potentail tendencies to increase or decrease in the concentration of certain elements or markers of inflammation and glycation, therefore we discuss potential relationships between a given parameter and a thyroid disorder. The pilot study is an introduction to a deeper analysis aimed at tracing the pathomechanism of the development of thyroid diseases, so that the risk of developing these diseases can be effectively minimized. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to study approaches to the intellectual processing of Russianlanguage textual medical information concerning the thyroid cytopathology description to solve the issues of their classification and generation of the text of the medical report, as well as augmentation of descriptions in their acute shortage. Over the past decade, the field of biomedicine has not undergone significant changes. Approaches to analyzing patients' problems are mostly based on manual processing and expert knowledge of doctors. The paper considers the creation of a machine-learning pipeline containing a full cycle of data preprocessing and model training in the field of thyroid nodules fine-needle aspiration classification according to the Bethesda thyroid cytopathology reporting system. Sequential and transformer neural networks were used to design the architecture of deep learning models. The paper proposes approaches for cleaning and preprocessing raw medical descriptions to the required type. The obtained results show that sequential neural networks have greater accuracy on small data sets, and transformation architectures are superior to others when generating cytopathological reports on large amounts of data. The solution obtained in the study can be used as an additional reference tool for thyroid cytologists. [ABSTRACT FROM AUTHOR]

Objective: Thyroid nodules are a common occurrence in adults. Although the majority of thyroid nodules are benign, a small percentage are cancerous. The combined phosphorylated histone H2AX (γ-H2AX) and p53-binding protein 1 (53BP1) assay was utilized to detect deoxyribonucleic acid (DNA) damage and DNA repair as biomarkers of the cellular stress response. Using the combined γ-H2AX and 53BP1 assay, we evaluated DNA damage, DNA repair capacity, and malignancy risk in peripheral blood mononuclear cells (PBMCs) of euthyroid individuals with nodular goiter. Materials and Methods: Peripheral blood samples were collected from 33 euthyroid patients with newly diagnosed nodular goiter and 30 healthy control participants. A fully automatic image analysis system was used for analyzing DNA damage (γ-H2AX), including DNA double-strand breaks (DSBs), and DNA repair (53BP1). Results: Euthyroid patients with nodular goiter exhibited a higher mean number of γ-H2AX foci per cell and a higher percentage of apoptotic cells compared to the control subjects (p=0.022 and p=0.005, respectively). Conclusion: This study found considerably higher DNA damage in euthyroid patients with nodular goiter than in control individuals. The increase in DNA damage occurs in the early stages of carcinogenesis. These patients were expected to exhibit compromised DNA repair along with enhanced DNA damage, increasing the risk of carcinogenesis. However, euthyroid patients with nodular goiter might be at a high risk of thyroid malignancy due to the high level of DNA damage. A long-term follow-up of these patients would provide better evidence of the relationship between DNA damage and the malignancy risk of thyroid. [ABSTRACT FROM AUTHOR]

Objective: Nodular goiter may increase the risk of thyroid cancer, but the genetic factors contributing to nodular goiter are not well understood. There is an overexpression of H19 lncRNA in goiter tissue and its target remains unknown. In this study, we attempted to identify a new target for H19 in the context of goiter development. Methods: Using interaction energy calculations, the interaction between NKX2-1 mRNA and H19 lncRNA was examined. Putative microRNAs were found at the H19 lncRNA target site with the highest affinity for NKX2-1. RNAseq data was analyzed to determine the tissue specificity of gene expression. Samples were taken from 18 goiter and 18 normal tissues during thyroidectomy. The expression of NKX2-1 was determined by RT-qPCR using specific primers. Results: The interaction between NKX2-1 and H19 was characterized by six local base-pairing connections, with a maximum energy of −20.56 kcal/moL. Specifically, the sequence that displayed the highest affinity for binding with H19 overlapped with the binding site of has-miR-1827 to NKX2-1. It was found that NKX2-1 is exclusively co-expressed with H19 in normal thyroid tissue. As compared to adjacent normal tissues, nodular goiter tissues have a significant overexpression of NKX2-1 (relative expression = 1.195, p = 0.038). Conclusion: NKX2-1 has been identified as the putative target of H19 lncRNA, which is overexpressed in nodular goiter tissues significantly. Level of Evidence: 4.

Objective: Few studies use all nodule burdens to specify the prognosis of multinodular goiter (MNG) following radiofrequency ablation (RFA), so this study addresses this question for MNG after completely ablating dominant nodules. Methods: The RFA indications for MNG include 2–5 benign nodules with over 50% normal tissue on ultrasound, 1–3 well-defined benign dominant nodules on cytology, largest diameter ≥20 mm and/or with clinical complaints, and patient refusal or unable to undergo surgery. A retrospective study of 185 MNG patients with completely ablated dominant nodules in a single-session RFA was conducted. The efficacy and complications were evaluated at 1, 6, 12 months, and yearly thereafter. Based on retreatment risks, progressive disease (PD), stable disease (SD), and complete relief (CR) were introduced to assess all nodule load changes. PD was clarified as having new/non-target nodules that newly appeared to ACR TI-RADS≥4, or new/enlarged non-target nodules ≥1 cm. Results: The initial ablation ratios of target nodules were 100% at one month. During a mean 22.38 ± 13.75 months (range, 12–60 months), the volume reduction rate of ablated nodules was 98.25% at 24 months without regrowth. Cosmetic and symptomatic scores decreased to 1 and 0, respectively, after 48 months. Of the patients, 9.7% (18/185) had PD and the retreatment rate was 2.2% (4/185). The complication rate was 2.7% (5/185). Conclusion: RFA provides cosmetic and symptomatic relief for an average of two years. RFA is a useful minimally invasive treatment modality for selected MNG patients.

Background The current report describes a unimodular thyroid goiter (TGo), identified unilaterally in a female cadaver, causing displacement or compression effects in the adjacent neck structures (common carotid artery (CCA) and internal jugular vein (IJV),). Methods Routine dissection of the neck of an 86-year-old female donated a Greek cadaver. Results A thyroid gland variant was identified coexisting with a TGo originating from the left thyroid lobe. The variant is a pyramidal lobe located on the left side of the isthmus. Owing to the presence of the TGo, the left CCA, along with the left IJV, deviated 50.6 mm ipsilaterally from the midline of the neck. The right CCA had a minor deviation of 30.8 mm, from the midline to the right side due to the proximity of the shifted trachea and esophagus with the CCA origin. The trachea and esophagus deviated contralaterally to the TGo, 24.4 mm from the midline. Conclusions CCA compression, stenosis, and angulation may cause dizziness, weakness, and hypomnesia. The potential outcomes were worse with IJV compression. Atherosclerosis tends to occur more often in arteries with inclined (angulated) parts.

Background Thyroid surgery for benign non-toxic nodular goitre is a common endocrine surgical procedure. It is not known whether thyroid hormone replacement therapy following surgery for benign thyroid disease influences mortality or morbidity rates. Methods A retrospective observational study was conducted using national registries in Sweden. Overall mortality and morbidity rates were compared for patients with or without thyroid hormone replacement therapy in patients operated on with hemithyroidectomy or total thyroidectomy for a diagnosis of benign non-toxic nodular goitre. Results Between 1 July 2006 and 31 December 2017, 5573 patients were included, 1644 (29.5%) patients were operated on with total thyroidectomy and 3929 patients with hemithyroidectomy. In the hemithyroidectomy group, 1369 (34.8%) patients were prescribed thyroid hormone replacement therapy in the follow-up. The patients who underwent hemithyroidectomy and did not use thyroid hormone replacement therapy in the follow-up had a standard mortality ratio of 1.31 (95% confidence interval, 1.09–1.54). The mortality ratio was not increased in patients who underwent total thyroidectomy or hemithyroidectomy and used thyroid hormone replacement therapy. The risk of death analysed by multivariable Cox regression for patients operated on with hemithyroidectomy without later thyroid hormone replacement therapy, adjusted for age and sex, showed an increased hazard ratio of 1.65 (1.19–2.30) compared with hemithyroidectomy with hormone replacement therapy. Conclusion Patients subjected to hemithyroidectomy without later hormone replacement therapy had a 30% higher risk of death compared with the normal Swedish population and a 65% increased risk of death compared with patients undergoing hemithyroidectomy with postoperative hormone replacement therapy. [ABSTRACT FROM AUTHOR]

Thyroid disorders are the most common endocrine disorder affecting the general population. Diseases of the thyroid glands present with either an alteration of hormone secretion or as an enlargement of the thyroid gland. They vary from non-neoplastic to neoplastic lesions. The prevalence and pattern of these disorders depend on the factors like age, sex and geographic patterns. The aim of the study is to determine the histomorphological features of thyroid lesions in thyroidectomy specimens in patients who underwent thyroidectomy in tertiary care hospital. This is a retrospective study, conducted in tertiary care centre attached to government hospital. All thyroidectomy specimens received in the Department of Pathology, from January 2021 to January 2023 were included in the study. The patients who underwent thyroidectomy in view of thyroid swelling, over a period of 2 years, were selected. Data was collected from histopathological examinations done on the thyroidectomy specimens. Different histomorphological patterns were observed on microscopy. The thyroid lesions were classified into Neoplastic and Non-neoplastic based on histomorphological features and the data was segregated according to this and analysed. There was a total of 194 specimens, of which 175 were from female and 19 were from male patients. Maximum number of thyroid lesions were seen in the age group of 30–50 years. Among 194 patients, 52 (26.8%) were found to have neoplastic lesions, of whom, 25 (12.8%) patients had benign and 27(14%) patients had malignant lesion. 141(72.7%) patients had non neoplastic conditions. One patient had lymphoproliferative disorder (0.5%). In Neoplastic lesions, Among Benign lesions, Follicular adenoma was found be present in 25 patients. In malignant lesions, Papillary carcinoma was the most commonly found lesion (25 cases, 12.9%). 141(73%) patients had Non neoplastic conditions. Most commonly occurring Non neoplastic lesions were Nodular goiter (50 cases, 25.8%) followed by Colloid goiter (34cases, 17.5%), Multinodular goiter (33 cases, 17%), Hashimoto's thyroiditis (5 cases, 2.6%). Followed by Chronic lymphocytic thyroiditis (4 cases, 2.1%). The frequency of carcinoma is more common in females amongst the total thyroid lesions. Papillary carcinoma was the most frequent malignancy (12.9%) among the thyroidectomy specimens. Papillary carcinoma was the commonest malignant lesion with female preponderance whereas, nodular goiter and colloid goiter were the commonest non neoplastic lesions with female preponderance. [ABSTRACT FROM AUTHOR]

Objective To analyze the clinicopathological features of multifocal papillary thyroid carcinoma (MPTC) and to explore its treatment strategy. Methods The clinical data of 601 patients with thyroid papillary carcinoma（PTC） who underwent the first thyroid surgery in Jiangsu Province Hospital of Chinese Medicine from July 2016 to October 2019 were analyzed retrospectively. The clinicopathological characteristics of MPTC and solitary papillary thyroid carcinoma (SPTC) were compared, and the risk factors for MPTC and central lymph node metastasis（CLNM） were analyzed. Results Among the 601 cases, there were 202 cases of MPTC, accounting for 33.6%, including 150 cases of bilateral thyroid cancer, accounting for 74.3% of MPTC. Among MPTC patients, the central and lateral neck lymph node metastasis rates were 60.9% (123/202) and 13.4% (27/202), respectively. The proportion of MPTC patients with body mass index (BMI)≥25 kg/m2, combined with Hashimotos thyroiditis (HT), tumor maximum diameter≥1 cm, thyroid capsule invasion, lymph node metastasis in central and lateral neck areas were higher than those in SPTC group (P＜0.05). The proportion of male, age＜55 years old, tumor maximum diameter≥1 cm, sum of tumor maximum diameter≥1 cm and thyroid capsule invasion of patients with CLNM in MPTC patients were higher than those of patients without CLNM (P＜0.05). The proportion of patients with nodular goiter in CLNM patients was lower than that in patients without CLNM (44.7% vs 62.0%, χ2=5.770，P＜0.05). Conclusion The rate of bilateral cancer is high in MPTC patients. PTC patients with BMI≥25 kg/m2, combined with HT and thyroid capsule invasion are more likely to have MPTC, and total thyroidectomy is recommended. The incidence of CLNM is higher in MPTC patients with male, age＜55 years old and thyroid capsule invasion, and bilateral central lymph node dissection is recommended.

Aim: Primary hyperparathyroidism and differentiated thyroid carcinoma are the most common endocrinological diseases. Since its first definition in the 1950s, nodular goiter and differentiated thyroid carcinoma in patients with primary hyperparathyroidism have been examined in many studies and an increase in cancer incidence has been found. In this study, we aimed to investigate the co-incidence of nodular goiter and differentiated thyroid cancer in patients with primary hyperparathyroidism. Material and Methods: One hundred seventy-two patients who underwent parathyroid surgery in our hospital between 2012 and 2015 were included in this study. Demographic, clinic, and surgical data of the patients were reviewed retrospectively. Results: The mean age of the patients was 54.3±11.3 years and 85.5% (n=147) of them were female. Nodular goiter was observed at a rate of 61.0% (n=105) in preoperative evaluation. Parathyroidectomy was performed in 125 (72.7%) and simultaneous total thyroidectomy was performed in 32 (18.6%) and lobectomy in 15 (8.7%) of the patients. Histopathologically, 94.8% (n=163) were interpreted as adenoma, 2.9% (n=5) as parathyroid hyperplasia, and 2.3% (n=4) as parathyroid carcinoma. Patients with papillary thyroid carcinoma (n=30) and benign (n=17) histopathologically were compared in terms of clinical and laboratory characteristics, and no significant difference was observed in any parameter. Conclusion: There was no significant increase in thyroid nodularity, but a significant increase was found in differentiated thyroid carcinoma incidence in patients with primary hyperparathyroidism in this study in accordance with the literature. This finding highlights the importance of preoperative thyroid evaluation in this patient group.

Aim:Autoimmune thyroid diseases are common in the general population. Thyroid cancer (TC) is the most common endocrine malignancy. The aim of this study was to evaluate the risk of thyroid carcinoma in patients with Basedow-Graves (BG) and Hashimoto’s thyroiditis (HT).Materials and Methods:1,668 patients underwent thyroid surgery at our institution. Of these, 138 patients were diagnosed with HT (126 women, 12 men) and 78 patients were diagnosed with BG (61 women, 17 men). HT and BG patients diagnosed with TC were identified.Results:TC was seen in 23.1% of BG patients, 52.2% of HT patients, and 38.7% of nodular goiter (NG) patients. In the comparison of BG patients with HT patients, TC was observed to be more common in HT patients (p

Abstract Background The intrapulmonary ectopic thyroid gland is exceedingly rare since the ectopic thyroid was discovered. Only eight cases have been reported in the worldwide literature. We present a case of multiple intrapulmonary ectopic thyroid glands with nodular goiter in a 10-year-old girl. Case presentation The girl was found with multiple intrapulmonary nodules in bilateral lungs during the treatment of nodular goiter. The intrapulmonary lesions were initially thought to be a high possibility of metastatic cancer. A computed tomography-guided percutaneous lung biopsy was performed, and the pathological examination confirmed that the diagnosis was ectopic intrapulmonary thyroid. Conclusion The ectopic intrapulmonary thyroid should be considered when children with nodular goiter presenting with suspected metastases in the lung.

As important drugs for the treatment of nodular goiter (NG), Prunella Spica preparations are widely used clinically, and have a significant effect on NG. Various active ingredients in the preparations intervene in the formation of NG by inhibiting the proliferation of thyroid follicular cells, promoting cell apoptosis, regulating immunity, improving the microcirculation of thyroid tissue and other mechanisms, and can reduce the postoperative recurrence of NG. [ABSTRACT FROM AUTHOR]

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Nodular goiter has become increasingly prevalent in recent years. Clinically, there has been a burgeoning interest in nodular goiter due to the risk of progression to thyroid cancer. This review aims to provide a comprehensive summary of the mechanisms underlying the therapeutic effect of Chinese medicine (CM) in nodular goiter. Articles were systematically retrieved from databases, including PubMed, Web of Science and China National Knowledge Infrastructure. New evidence showed that CM exhibited multi-pathway and multi-target characteristics in the treatment of nodular goiter, involving hypothalamus-pituitary-thyroid axis, oxidative stress, blood rheology, cell proliferation, apoptosis, and autophagy, especially inhibition of cell proliferation and promotion of cell apoptosis, involving multiple signal pathways and a variety of cytokines. This review provides a scientific basis for the therapeutic use of CM against nodular goiter. Nonetheless, future studies are warranted to identify more regulatory genes and pathways to provide new approaches for the treatment of nodular goiter. [ABSTRACT FROM AUTHOR]

Background. The problem of choosing the extent of surgeries on the thyroid gland for unilateral nodular goiter with compression syndrome is of concern for surgeons. In such cases, surgical treatment is absolutely indicated, and the possible variants of the extent of the operation are thyroidectomy and hemithyroidectomy. Thyroidectomy allows eliminating the focus of autoimmune aggression in the body, but in such cases, a patient should use thyroxine drugs for life. The purpose was to determine the indications for the choice of the extent of surgery in patients with unilateral nodular goiter and compression syndrome against the background of autoimmune thyroiditis (AIT) and to predict long-term results of surgical treatment. Materials and methods. The long-term outcomes of hemithyroidectomy were analyzed in 101 women aged 23 to 72 years with unilateral nodular goiter on the background of AIT and compression syndrome. We have analyzed the volume of the gland, echostructure variant, blood levels of thyroid-stimula­ting hormone (TSH), free thyroxine and triiodothyronine, thyroid peroxidase (TPO) antibodies, apoptosis and proliferation indicators before surgery in which treatment results were satisfactory and unsatisfactory. Results. Satisfactory result was revealed is 75 patients (group 1). According to the survey, they had no violations of the thyroid functional state 3 years after hemithyroidectomy, and, according to the ultrasound, in the parenchyma of the remaining lobe of the gland, the signs of AIT present before the surgery did not progress or progressed without hypothyroidism and changed ultrasound picture. The second group (unsatisfactory result) consisted of 26 patients who 3 years after hemithyroidectomy had an increase in the volume of the remaining thyroid gland and the progression of autoimmune process with the development of hypothyroidism on ultrasound. A satisfactory result of hemithyroidectomy in patients with unilateral nodular goiter on the background of AIT with compression syndrome can be expected in cases where at the time of surgery, the volume of the lobe is not more than 12.7 cm3, the echostructure is hypoechoic, heterogeneous and pseudomicronodu­lar, TSH is not more than 2.85 mIU/l, levels of free thyroxine and triiodothyronine are not lower than 16.7 and 5.3 pmol/l, respectively, TPO antibodies are not higher than 137 IU/ml. Conclusions. One of the possible options for surgical treatment of patients with unilateral nodular goiter on the background of AIT with compression syndrome may be hemithyroidectomy in conditions of preserved hormonal function of the gland with moderate processes of proliferation and apoptosis, structural changes in the parenchyma at the level of hypoechoic and heterogeneous, pseudomicronodular echostructural variants. We consider it contraindicated to use hemithyroidectomy in cases of pseudomacronodular and more severe variants of the echostructure of the thyroid parenchyma, regardless of the indicators of hormone-producing function, TPO antibodies, proliferation and apoptosis.

Thyroid scintigraphy is a method that formed more than 60 years ago and retains its importance for the diagnosis and assessment of the risk of nodular malignancy. The review examines the use of the scintigraphic method in functional and metabolic assessment of nodular goiter. Prerequisites for functional thyroid nodes screening with short-lived 99mTc-pertechnetate are outlined. Information is provided on the principles of its preparation and pharmacokinetics, as well as variants of the thyroid nodes functional activity, their possible malignant potential and indications for metabolic screening. The characteristic of metabolic activity allows to assess the risk of functionally “cold” thyroid nodes malignancy. The main stages of the use of nonspecific tumorotropic radiopharmaceuticals, the mechanism of their accumulation and metabolism in the thyroid tumors, the possibilities of the differential diagnosis of various types of nodular formations are presented. Modern views on the diagnostic capabilities of two-phase scintigraphy with 99mTс-methylisobutylisonitrile are reflected taking into account the relationship of radiopharmaceuticals accumulation with factors of proliferative activity and ultrastructural cell types, a variant of oncocytic pathology and multidrug-resistant protein expression.

Background: Reduced field‐of‐view diffusion‐weighted imaging (rFOV‐DWI) could be proved to quantitatively identify papillary thyroid carcinoma (PTC) and there is no literature regarding the use of T1 mapping to distinguish nodular goiter (NG) from PTC. Purpose: To compare T1 mapping with rFOV‐DWI in differentiating NG and PTC. Study Type: Prospective study. Populations: Ninety‐five hospitalized patients with thyroid nodules were included in the research. Sequence: All subjects underwent T1‐weighted imaging, T2‐weighted imaging, rFOV‐DWI and T1‐mapping sequences. Assessment: The apparent diffusion coefficient (ADC) and T1 values of each thyroid nodule were measured, respectively. According to pathological results, the thyroid nodules were divided into two groups: Group 1 (NG) and Group 2 (PTC). Statistical Tests: An independent sample t test was used to evaluate the differences of ADC and T1 between the two groups. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficiency of T1, ADC, Thyroid Imaging Reporting and Data System (TI‐RADS) and T1 and ADC. Results: The T1 and ADC values of nodular goiter were both higher than those of PTC (p < 0.05). The area under the ROC curve (AUC) values of T1 and ADC were significantly higher than that of T1 or ADC alone (p < 0.05). The AUC value of T1 and ADC was as same as that of TI‐RADS. Conclusion: The combination of T1 mapping and rFOV‐DWI could effectively differentiate NG from PTC. And it has at least the same diagnostic value as the ultrasound‐based TI‐RADS classification. [ABSTRACT FROM AUTHOR]

Aim: Primary hyperparathyroidism and differentiated thyroid carcinoma are the most common endocrinological diseases. Since its first definition in the 1950s, nodular goiter and differentiated thyroid carcinoma in patients with primary hyperparathyroidism have been examined in many studies and an increase in cancer incidence has been found. In this study, we aimed to investigate the co-incidence of nodular goiter and differentiated thyroid cancer in patients with primary hyperparathyroidism. Material and Methods: One hundred seventy-two patients who underwent parathyroid surgery in our hospital between 2012 and 2015 were included in this study. Demographic, clinic, and surgical data of the patients were reviewed retrospectively. Results: The mean age of the patients was 54.3±11.3 years and 85.5% (n=147) of them were female. Nodular goiter was observed at a rate of 61.0% (n=105) in preoperative evaluation. Parathyroidectomy was performed in 125 (72.7%) and simultaneous total thyroidectomy was performed in 32 (18.6%) and lobectomy in 15 (8.7%) of the patients. Histopathologically, 94.8% (n=163) were interpreted as adenoma, 2.9% (n=5) as parathyroid hyperplasia, and 2.3% (n=4) as parathyroid carcinoma. Patients with papillary thyroid carcinoma (n=30) and benign (n=17) histopathologically were compared in terms of clinical and laboratory characteristics, and no significant difference was observed in any parameter. Conclusion: There was no significant increase in thyroid nodularity, but a significant increase was found in differentiated thyroid carcinoma incidence in patients with primary hyperparathyroidism in this study in accordance with the literature. This finding highlights the importance of preoperative thyroid evaluation in this patient group. [ABSTRACT FROM AUTHOR]

Background: The intrapulmonary ectopic thyroid gland is exceedingly rare since the ectopic thyroid was discovered. Only eight cases have been reported in the worldwide literature. We present a case of multiple intrapulmonary ectopic thyroid glands with nodular goiter in a 10-year-old girl. Case presentation: The girl was found with multiple intrapulmonary nodules in bilateral lungs during the treatment of nodular goiter. The intrapulmonary lesions were initially thought to be a high possibility of metastatic cancer. A computed tomography-guided percutaneous lung biopsy was performed, and the pathological examination confirmed that the diagnosis was ectopic intrapulmonary thyroid. Conclusion: The ectopic intrapulmonary thyroid should be considered when children with nodular goiter presenting with suspected metastases in the lung. [ABSTRACT FROM AUTHOR]

Objective: The prevalence of thyroid dysfunction is higher in patients with diabetes, and its diagnosis couldenable a beter diabeticmanagement. The purpose of the present study is to examine the impact of pathophysiological changes in patients with Type-2 diabetes on the frequency of thyroid dysfunction, thyroid autoimmunity, thyroid nodule, and thyroid cancer in Turkey. Method: The study was conducted on a total of 3.276 patients with Type-2 diabetes who underwent thyroid tests and thyroid ultrasonography (US). The demographic characteristics, biochemical and hormonal values, thyroid US reports, and histopathologic reports were collected from electronic records of the patients. Results: Thyroid autoimmunity positive TPOab 15.9% (n = 524) and/orpositive TGab 9.9% (n = 327), the rate of positivity of both antibodies (TPOab + TGab) in the same patient, and total thyroid autoimmunity was found to be 32.57% (n=1067) in Type-2 diabeticpatients. Thyroid dysfunction wasdetected in 18.3% (n = 602) of these patients. The distribution of thyroid dysfunction was 9.09% (n = 298) subclinical hypothyroidism, 4.1% (n = 135) clinical hypothyroidism, 3.1% (n = 102) subclinical hyperthyroidism, 2.0% (n = 67) clinical hyperthyroidism. Also, 67.9% (n = 2225) thyroid nodules, and 5% (n = 164) thyroid cancer cases were detected. Conclusion: Thyroid dysfunction was foundincreased in patients with Type-2 diabetes at significant levels. [ABSTRACT FROM AUTHOR]

Introduction. Puncture fine needle aspiration (FNA) is currently the “gold standard” for morphological verification of thyroid nodules, which determines the further tactics of patient management. Currently, there are no strict ultrasound criteria for the gradation of malignant neoplasms of the thyroid gland. However, in the modern world, the search for minimally invasive methods for verifying thyroid nodules continues. Purpose of the study. The study carried out a comparative analysis of the results of a preoperative cytological study using the Bethesda system in 2017 and the results of ultrasound studies using developed by the American College of Radiology the Thyroid image reporting and data system (TIRADS). Materials and methods. Thyroid cancer risk stratification system with histological studies of the operating material after 2 440 surgical interventions for nodular goiter, carried out on the basis of the center of endocrine surgery of the city clinical hospital named after. F.I. Inozemtsev in the period from 2018 to 2019 year. Results. The sensitivity of the TIRADS system for the TIRADS 5 thyroid malignancy risk score was 100%. The TIRADS 2 thyroid malignancy risk score was observed only in Bethesda II cytological category and does not occur in malignant histological findings. Grade TIRADS 3 occurs only in patients with a benign histological result, but is also seen in Bethesda II, Bethesda IV, and Bethesda V cytology categories. Conclusions. Based on the study, it can be concluded that FNA is inappropriate in patients with a TIRADS 2 thyroid cancer risk. If a TIRADS 5 cancer risk is detected, regardless of the results of a cytological study, the patient should be recommended surgical treatment. If the cancer risk level is TIRADS 3 and the size of the nodules is up to 2.5 cm, it is also possible to refrain from FNA.

ObjectiveTo examine the relationship between urinary copper (Cu), zinc (Zn) and arsenic (As) and the incidence of nodular goiter and to provide evidences for nodular goiter prevention and treatment. MethodsThe cases of the study were 373 pathologically diagnosed nodular goiter patients hospitalized in the Department of Head and Neck Surgery of Anhui Cancer Hospital from September 2016 through March 2019; while, the controls were 1 : 1 individually gender- and age (± 2 years)-matched healthy people selected from a cohort study conducted in Anhui province. Face-to-face questionnaire interviews and laboratory tests were carried out among the participants. ResultsSignificantly lower morning urinary Cu (median [µg/g]; 25th quartile, 75th quartile) was detected in the cases compared to that in the controls (6.13; 2.36, 11.00 vs. 10.36; 6.27, 16.95; Z = – 6.625; P < 0.001); while, no significant differences between the cases and the controls were detected in morning urinary Zn (312.16; 98.65, 500.19 vs. 340.40; 99.41, 580.54) and As (30.44; 4.36, 88.30 vs. 23.75; 3.67, 81.82) (both P > 0.05). After adjusting for confounding factors such as gender, age, marital status, smoking, passive smoking, alcohol consumption, daily sleep time, body mass index, fasting blood glucose, serum total cholesterol, serum triglyceride, serum high density lipoprotein cholesterol, urinary Zn and urinary As, the results of multivariate logistic regression analysis showed that higher urinary Cu was associated with a decreased risk of nodular goiter (the third quartile [Q3] – the highest quartile [Q4] vs. the lowest quartile [Q1]: odds ratio [OR] = 0.73, 95% confidence interval [95% CI]: 0.54 – 0.98; [Q4] vs. Q1: OR = 0.56, 95% CI: 0.39 – 0.81; and Q4 vs. Q1: OR = 0.42, 95% CI: 0.19 – 0.97 only for male participants); the analyses did not revealed significant correlations between urinary Zn and As and nodular goiter incidence (all P > 0.05). ConclusionUrinary Cu concentration may reversely associated with nodular goiter incidence in Chinese people.

Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy. However, it is very difficult to distinguish PTC from benign carcinoma. Thus, specific diagnostic biomarkers are actively pursued. Previous studies observed that Nrf2 was highly expressed in PTC. Based on this research, we hypothesized that Nrf2 may serve as a novel specific diagnostic biomarker. A single-center retrospective study, including 60 patients with PTC and 60 patients with nodular goiter, who underwent thyroidectomy at the Central Theater General Hospital from 2018 to July 2020, was conducted. The clinical data of the patients were collected. Nrf2, BRAF V600E, CK-19, and Gal-3 proteins were compared from paraffin samples of the patients. Through this study, we obtained the following results: i) Nrf2 exhibits high abundance expression in PTC, but not in adjacent to PTC and nodular goiter; increased Nrf2 expression could serve as a valuable biomarker for PTC diagnosis; the sensitivity and specificity for the diagnosis of PTC were 96.70% and 89.40%, respectively. ii) Nrf2 also shows higher expression in PTC with lymph node metastasis, but not adjacent to PTC and nodular goiter, thus the increased Nrf2 expression might serve as a valuable predictor for lymph node metastasis in PTC patients; the sensitivity and specificity for the prediction in lymph node metastasis were 96.00% and 88.57%, respectively; excellent diagnostic agreements were found between Nrf2 and other routine parameters including HO-1, NQO1 and BRAF V600E. iii) The downstream molecular expression of Nrf2 including HO-1 and NQO1 consistently increased. In conclusion, Nrf2 displays a high abundance expression in human PTC, which leads to the higher expression of downstream transcriptional proteins: HO-1 and NQO1. Moreover, Nrf2 can be used as an extra biomarker for differential diagnosis of PTC and a predictive biomarker for lymph node metastasis of PTC.

Thyroid nodules are common, occurring in 50-60% of healthy patients. Currently, there are no effective conservative treatment options for nodular goiter, and surgery can have limitations and potential complications. The purpose of this study was to evaluate the efficacy, tolerability, and long-term results of using sclerotherapy and laser-induced interstitial thermotherapy (LITT) to treat benign thyroid nodules. A retrospective analysis was conducted on 456 patients with benign nodular goiter who received LITT. The volume of the nodular goiter was measured at 1, 3, 6, and 12 months post-treatment, and a repeated fine needle aspiration (FNA) with the cytological examination was performed to verify the structure of the nodular goiter in the long term. The results showed that LITT was an effective method for treating nodular mass (nodules), as evidenced by a decrease in the volume of NG by 51-85% after 6-12 months. FNA results 2-3 years after LITT showed no thyrocytes, only connective tissue, indicating the efficacy of LITT for benign thyroid nodules. LITT is highly effective in most cases, often resulting in the disappearance or significant decrease in nodular formations. [ABSTRACT FROM AUTHOR]

Objective: Serum copper (Cu) is an essential trace element that plays a key role in thyroid hormone production. An inappropriate level of serum Cu might be related to development of both benign and malignant thyroid neoplasm. Nodular goiter and papillary thyroid carcinoma (PTC) are common benign and malignant tumors of the thyroid, respectively. This study aims to compare the serum Cu levels of healthy women with women with PTC or nodular goiter. Materials and Methods: A total of 205 Thai women were recruited for this cross-sectional study. The reference group was comprised of 100 healthy volunteers. There were 61 nodular goiter and 41 PTC patients that had been treated with surgery. Serum Cu was measured using an atomic absorption spectrophotometer and the three groups were compared. Results: The serum Cu levels of the PTC, nodular goiter and the reference group were 0.93 (0.85, 1.11) μg/ml, 1.03 (0.90, 1.14) μg/ml and 0.97 (0.80, 1.11) μg/ml, respectively. The results were not statistically different (P = 0.10). A post hoc subgroup analysis in the PTC group showed only serum Cu levels were significantly higher in the blood vessel invasion group (P = 0.02). Conclusion: The serum Cu levels of patients with PTC and nodular goiter were not different and did not differ significantly from the reference group. Despite related to with only one pattern of histopathologically aggressive PTC-Blood vessel invasion, serum Cu levels cannot be used as an assistive tool for diagnosis and the prognosis of PTC. [ABSTRACT FROM AUTHOR]

Background: The debate on whether or not there is a difference in the incidence of thyroid cancer between the patients with Solitary thyroid Nodule (STN) and Multinodular Goiter (MNG) has been constantly present for the last few decades. With newer studies yielding mixed results, it was imperative to systematically compile all available literature on the topic. Methods: PubMed/MEDLINE, Cochrane Central, ScienceDirect, GoogleScholar, International Clinical Trials registry, and reference lists of the included articles were systematically searched for article retrieval. No filter was applied in terms of time, study design, language or country of publication. Rigorous screening as per PRISMA guidelines was undertaken by 2 independent reviewers in order to identify the articles that were most relevant to the topic. Results: Twenty-two studies spanning from 1992 to 2018 were included in this analysis and encompassed 50,321 patients, 44.2% of which belonged to the STN subgroup and 55.37% to the MNG subgroup. MNG was found to be associated with a significantly lower risk of thyroid cancer (OR = 0.76; 95% CI 0.61–0.96) when compared with STN. Papillary carcinoma was the most frequently occurring carcinoma across both groups, followed by follicular and medullary carcinomas. A subgroup analysis was performed to assess the efficacy of the two most commonly employed diagnostic tools i.e. surgery and fine needle aspiration cytology (FNAC), however it yielded nonsignificant results, indicating a comparable usefulness of the two. Another subgroup analysis run on the basis of the presumed iodine status of the participants also yielded nonsignificant results. Conclusion: There is a higher incidence of thyroid cancer among patients of STN, however, given the low quality of existing evidence on the topic, it is crucial to conduct larger studies that can establish association with a greater precision. [ABSTRACT FROM AUTHOR]

Introduction. Nodular goiters are clinically recognizable enlargements of the thyroid gland characterized by structural and/or functional transformation of one or several areas within the normal thyroid tissue. In the absence of thyroid dysfunction, autoimmune thyroid disease, thyroiditis, and thyroid malignancy, they constitute an entity described as simple nodular goiter. The objective of the study was to determine the scope of surgery in patients with unilateral nodular goiter with autoimmune thyroiditis (NGAIT) with compression syndrome and predict the long-term results of surgical treatment, based on the study of proliferation of apoptosis and autoimmune disorders. Materials and methods. Long-term results of hemithyroidectomy were analysed in 101 women aged between 23-72 years, with unilateral NGAIT. We analysed the volume of the gland lobe and the echo structure variant before surgery, blood levels of thyroid-stimulating hormone (TSH), free thyroxine and triiodothyronine, thyroid peroxidase antibodies (TPOab), apoptosis and proliferation indicators showing satisfactory or unsatisfactory treatment results. Results. In 75 patients, three years after hemithyroidectomy, no thyroid dysfunction was detected. At ultrasound, in the remaining thyroid the signs of autoimmune thyroiditis (AIT) did not progress. Twenty-six patients showed an increase in the remaining thyroid gland and progression of the autoimmune disease, with hypothyroidism. Conclusions. Hemithyroidectomy can be performed in patients with NGAIT and compression syndrome in conditions of preserved gland function, activation of proliferation and apoptosis, and pseudo micronodular parenchymal echo structure.

Zhenyu Li, Haiming Zhang, Wenying Chen, Hengguo Li Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, 510630, People’s Republic of ChinaCorrespondence: Hengguo Li, Email lhgjnu@263.netBackground: Papillary thyroid carcinoma (PTC) and nodular goiter (NG) represent the most commonly malignant and benign diseases of thyroid nodules and are often confused in diagnosis. CT examination has a certain diagnostic value for the diagnosis of suspected malignant thyroid nodules. The application of machine learning to radiomics features provides a new diagnostic approach, which has been widely used in ultrasound examination of the thyroid, but there are few literatures on CT examination.Purpose: To explore the efficacy of a diagnostic model aided by machine learning for preoperative differentiation of nodular goiter and papillary thyroid carcinoma thyroid nodules on the basis of 3D arterial-phase contrast-enhanced computed tomography (CECT) features.Materials and Methods: We collected the data of 193 NG and 214 PTC thyroid nodules from 407 patients in CT examinations. Together with the pathologist findings and radiology diagnosis, we built a radiomics model using the 1218 features extracted from the arterial phase of CECT images. By comparing the diagnostic performance of the radiomics model with that of the clinical diagnosis, we assessed the performance of the radiomics model.Results: The radiomics model was developed based on multivariable logistic regression with the optimal 12 radiomics features after feature dimension reduction. The radiomics model performed well on the classification accuracy of the PTC and NG thyroid nodules in the training group and validation group.Conclusion: The radiomics model based on the 3D arterial phase of CECT features performed better than the group of experienced radiologists in differentiating NG and PTC thyroid nodules.Keywords: radiomics, computed tomography, CT, nodular goiter, papillary thyroid carcinoma, differential diagnosis

Ectopic thyroid is a rare clinical disease, with the majority of the patient presented with hypo-functional thyroid tissue and absence of orthotopic thyroid gland. During embryogenesis, the thyroid gland descends from the foramen cecum to its normal position located below the larynx and hyoid bone, anterior to the 2nd, 3rd, and 4th tracheal cartilaginous rings. Any defect that occurs during this period will result in ectopic thyroid. Hence, ectopic thyroid is usually found along the course of the thyroglossal duct, laterally in submandibular glands and even in distant places such as mediastinum or very rarely in sub-diaphragmatic organs. However, the presence of an orthotoptic thyroid may lead some difficulties in the diagnosis of this disease; hence, fine-needle aspiration is recommended to avoid unnecessary operation provided the patient is asymptomatic.

Highlights Patients with thyroid tumor have higher perchlorate exposure than control. Perchlorate can increase the risk of papillary thyroid carcinoma. Perchlorate can disturb the homeostasis of thyroid function. Perchlorate was positively correlated with thyroglobulin antibody.

Abstract Background There have been no reports of tracheal intubation for airway obstruction after acute thyroid swelling following fine-needle aspiration (FNA) of the thyroid gland. Case presentation A 58-year-old woman with a 22 mm × 13 mm right hypervascular thyroid nodule underwent FNA once with a 22G needle under ultrasonographic guidance. Shortly after the aspiration, ultrasound revealed hypoechoic swelling with a crack-like pattern. The patient was observed under bed rest in the Fowler position and received intravenous steroids. A computed tomography (CT) scan showed swelling not only of the thyroid but also of the retropharyngeal space, and the patient complained of difficulty swallowing saliva. Laryngeal fiberscopy revealed protrusion of the posterior pharyngeal wall, edematous changes in the mucosa of the pharynx and epiglottis, and retention of saliva. The patient was intubated awake and hydrocortisone was administered every 8 h. She was extubated 3 days after FNA and discharged without any complications. Conclusions When neck swelling is noticed after FNA, ultrasonographic findings are especially important to assess potential causes. If airway obstruction is suspected, CT findings and fiberscope observation of the pharynx provide particularly useful information.

Aim: Standard treatment may not be sufficient in patients with metastatic papillary thyroid cancer (PTC), and it may be beneficial to add PD-1 agents to the treatment. Therefore, this study was conducted to compare and evaluate the expression of PD-L1 in patients with nodular goiter (NG) and Hashimoto's thyroiditis (HT) within the scope of PTC carcinoma. Material and Methods: Thirty-five patients from each group who underwent thyroidectomy for NG, HT, and PTC, between January 2011 and December 2017 were identified. Immunohistochemically, an anti-PD-L1 stain was applied by taking new sections from the tissue samples of 105 patients. The histological type, tumour diameter, capsule invasion (CI), and lymphovascular invasion (LVI) were evaluated. Results: Nine (25.7%) of the patients with PTC were defined as classic, 10 (28.6%) as follicular, 6 (17.1%) as oncocytic, 5 (14.3%) as encapsulated, 2 (5.7%) as solid, 1 (2.9%) tall cell, and 2 (5.7%) as Warthin-like. The expression of PD-L1 in the patients with PTC was significantly higher than in the patients with NG and HT (p

Aim: Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios (respectively, NLR and PLR) have been associated with poor prognosis in various cancers. This study was conducted to investigate PLR and NLR in patients with papillary thyroid cancer (PTC) and nodular goiter (NG). Materials and Methods: Patients who had undergone thyroidectomy at our center were reviewed and the demographic, clinical and histopathological characteristics of patients with PTC or NG were recorded. Hemogram (complete blood count) results were used to calculate NLR and PLR. Results: The groups were similar with respect to age, gender and thyroiditis characteristics. The NG group was found to have significantly larger gland size compared to the PTC group. NLR and PLR values were similar in the two groups (p=0.556 and p= 0.841 respectively). Conclusion: PLR and NLR appear to be exceedingly similar in PTC and NG, and therefore, they cannot be used to distinguish between PTC and NG. However, it may be valuable to conduct future studies that take into account lesion size when comparing these parameters in thyroid nodules. [ABSTRACT FROM AUTHOR]

There are data indicating the coexistence of papillary thyroid carcinoma and autoimmune thyroiditis (AIT) in children. The aim of the study was elastographic evaluation of thyroid nodules in children and adolescents with AIT and nodular goiter in relation to cytological and/or histopathological diagnosis. We examined 215 children (57 boys and 158 girls) with 261 thyroid nodules (143 non-AIT and 118 AIT). All study participants underwent a conventional ultrasound examination with elastography followed by fine needle aspiration biopsy (FNAB). Abnormal Strain Ratio (SR ≥ 5) was observed in 36 non-AIT nodules and 15 AIT nodules. Papillary thyroid carcinoma was diagnosed in 5 patients (2% of all investigated nodules). SR of malignant thyroid nodules was statistically higher in comparison to SR of benign nodules both in the group of non-AIT (6 ± 4 vs. 3.67 ± 2.62, p = 0.024) and AIT nodules (6.3 ± 0.01 vs. 2.92 ± 1.89, p = 0.047). Comparison of non-AIT and AIT benign nodules revealed that SR was higher in non-AIT nodules (3.67 ± 2.62 vs. 2.92 ± 1.89, p = 0.01). We observed a strong positive correlation (R = 1) between TSH concentration and SR ratio in the group of all malignant thyroid nodules. Autoimmune inflammatory process of the thyroid gland does not limit the use of elastography in the diagnosis of thyroid nodules in children. [ABSTRACT FROM AUTHOR]

Copyright of International Journal of Endocrinology / Mìžnarodnij Endokrinologìčnij Žurnal is the property of Zaslavsky O.Yu and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To investigate the clinical efficacy and influence on thyroid function of ultrasound-guided microwave ablation (UGMWA) in patients with nodular goiter., Methods: A retrospective analysis was conducted on the clinical data of 162 patients with nodular goiter admitted to Beijing United Family Hospital and Beijing Tiantan Hospital, Capital Medical University from January 2021 to December 2022. According to the surgical treatment plan, they were divided into the control group (conventional surgical methods, n=78) and the experimental group (UGMWA, n=84). Thyroid function indicators, surgical time, visual analog scale (VAS) pain scores, complications, and cosmetic effects were compared between the two groups., Results: All patients recovered and were discharged after treatment. Three months postoperatively, both groups showed lower levels of free triiodothyronine (FT3) and free thyroxine (FT4) compared to pre-surgery levels, while levels of thyroid-stimulating hormone (TSH) were higher. However, compared with the control group, the experimental group had higher FT3 and FT4 levels and lower TSH levels (all P < 0.05). Additionally, patients in the experimental group had shorter surgical time, less intraoperative blood loss, and lower VAS pain scores than those in the control group. Moreover, the postoperative cosmetic effect scores were higher in the experimental group than in the control group (all P < 0.05). Finally, there was no statistically significant difference in the incidence of complications between the two groups (P=0.523)., Conclusion: UGMWA for the treatment of nodular goiters can expedite surgical time, protect thyroid function, reduce postoperative pain scores, and improve cosmetic effects with certain safety., Competing Interests: None., (AJTR Copyright © 2024.)

Ectopic thyroid is a rare clinical disease, with the majority of the patient presented with hypo-functional thyroid tissue and absence of orthotopic thyroid gland. During embryogenesis, the thyroid gland descends from the foramen cecum to its normal position located below the larynx and hyoid bone, anterior to the 2nd, 3rd, and 4th tracheal cartilaginous rings. Any defect that occurs during this period will result in ectopic thyroid. Hence, ectopic thyroid is usually found along the course of the thyroglossal duct, laterally in submandibular glands and even in distant places such as mediastinum or very rarely in sub-diaphragmatic organs. However, the presence of an orthotoptic thyroid may lead some difficulties in the diagnosis of this disease; hence, fine-needle aspiration is recommended to avoid unnecessary operation provided the patient is asymptomatic. [ABSTRACT FROM AUTHOR]

Abstract Background The incidence of papillary thyroid carcinoma (PTC) has been steadily increasing over the past decades. Hashimoto’s thyroiditis (HT) is the most common autoimmune disease, and is related to the pathogenesis of PTC. Programmed death-1 (PD-1) is currently used for the treatment of PTC, but there are very few studies on the clinical value of PD-1 in the diagnosis and targeted therapy of PTC. Methods The expression of T, B, NK cells and PD-1 in the peripheral blood of 132 patients with PTC (PTC group), 48 patients with nodular goiter (NG group) and 63 healthy subjects (HP group) were detected by flow cytometry. The expression of plasma T3, T4, FT3, FT4, TSH, TGAb and TPO was detected by chemiluminescence immunoassay. Among 132 PTC, 49 PTC&HT and 83 PTC&noHT were included. Among 48 NG, 10 NG&HT and 38 NG&noHT were included. The expressions of programmed death- ligand1(PD-L1) in tumor tissues of PTC group and thyroid tissues of NG group, PD-1 and CD3 in tumor infiltration lymphocyte (TIL) were detected by immunohistochemistry. Results The expression of FT3, TGAb, CD3+PD-1+, CD3+CD4+PD-1+ and CD3+CD8+PD-1+ in PTC and NG was significantly higher than that in the HP group. Moreover, CD3+PD-1+, CD3+CD4+PD-1+ and CD3+CD8+PD-1+ expression had significant differences between the PTC group and the NG group. In addition, the expression of TGAb, TPO, CD3+PD-1+, CD3+CD4+PD-1+ and CD3+CD8+PD-1+ in PTC&HT group was significantly higher than that in the PTC&noHT group. While, the expression of B cells, CD3+PD-1+, CD3+CD4+PD-1+ and CD3+CD8+PD-1+ in PTC&HT group was higher than that in NG&HT group. PD-1 showed a significant correlation with PTC lymph node metastasis. CD3+PD-1+ and CD3+CD4+PD-1+ was higher in N1 stage than in N0 stage. Immunohistochemical results showed that the expression of PD-1, CD3 and PD-L1 in PTC was significantly higher than that in NG. Conclusions T cell exhaustion might act as a biomarker for the differential diagnosis of PTC and NG. Patients with PTC&HT have obvious T cell exhaustion and increased expression of PD-1, PD-L1.Targeting the PD-1/PD-L1 pathway could be a new approach to prevent malignant transformation from HT to PTC&HT in the future.

Sufang Zhang,1,* Liyan Huang,1,* Qingshan Huang,2,* Weili Wei,1 Lijun Xie,1 Jinshu Zeng,1 Qiuyang Gu,1 Ling Chen,1 Shuqiang Chen1 1Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People’s Republic of China; 2Musculoskeletal Tumor Center, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shuqiang ChenDepartment of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People’s Republic of ChinaTel/Fax +86-591-87981961Email chenshu0518@163.comPurpose: Ultrasonography as the first choice for thyroid nodules is still difficult to distinguish between solid follicular thyroid neoplasm (FTN) and solid nodular goiter (NG). We tried to investigate the value of relative size (M/S, M: the maximum diameter of target nodule, S: the maximum diameter of the largest of the remaining nodules) that may help to differentiate FTN from NG.Methods: T test and chi-square test were used to retrospectively analyze the differences of the clinical and ultrasonographic characteristics between FTN and NG in 422 cases in our hospital. T test was used to analyze the difference of M/S value in the two kinds of nodules. ROC was used to evaluate the accuracy of M/S value in distinguishing the two.Results: There were statistically significant differences in age, echogenicity, calcification, peripheral halo and blood supply between the two. The M/S value is not only significantly different in the two kinds of nodules but also can be used as a quantitative indicator to guide ultrasound diagnosis. ROC analysis showed that the cutoff point and AUC of M/S value were 1.94 and 0.709, respectively.Conclusion: In the ultrasound diagnosis of multiple thyroid nodules, the M/S value can better distinguish FTN and NG. We need to be aware of FTN when the M/S value of the nodule is greater than 2.Keywords: follicular thyroid neoplasm, nodular goiter, size, ultrasonography

ABSTRACT Objective: Percutaneous ethanol injection (PEI) is an alternative to surgery for the treatment of thyroid nodules (TNs). However, size reductions of treated (TTNs) and untreated TN (UTNs) have not been compared. Volumetric reductions in TTNs with PEI were evaluated by comparing TTNs and UTNs in the same patient, and independent variables predicting good post-PEI outcomes were analyzed. Materials and methods: Overall, 282 patients with multinodular goiters were selected. Two nodules located in different lobes were compared for common disease behaviors. Overall, 150 nodules were selected from 75 patients (6 M: 69 F) with a mean age of 50.1 ± 17.4 years. This prospective nonrandomized intervention study prioritized treating TNs of greater volume or single hyperfunctioning TNs. A single observer experienced in PEI and an ultrasound specialist performed the interventions. Results and discussion: TTNs (mean volume: 14.8 ± 16.2 mL) were reduced by 72.6 ± 27.3% of their initial volume, while UTNs increased by a mean of 365.7 ± 1.403.8% (p < 0.00001). The patients underwent a mean of 4.0 ± 3.1 outpatient PEI sessions without relevant complications. Logistic regression analysis showed that the magnitude of the PEI induced reduction was associated with the number of treatment sessions (p = 0.03, CI [1.1-38.2]) and not with ultrasonographic characteristics of the nodules. Each PEI session increased the rate of TN reduction by a factor of 6.7. Conclusions: PEI is a well-tolerated outpatient procedure that effectively reduces the volume of TNs and is noticeably superior to conservative treatment for all ultrasonographic classifications.

Objective To improve the understanding of papillary thyroid carcinoma(PTC) by analyze the clinicopathological features and postoperative recurrence risk of four groups including PTC and PTC with Hashimoto's thyroiditis (HT),PTC with Nodular goiter (NG),PTC with Thyroid adenoma(TA) respectively. Methods A total of 657 patients with PTC were selected to compare and analyze the differences in clinicopathology and prognosis among the four groups of pure PTC (the control group),HT+PTC (group 1),NG+ PTC (group 2),TA+PTC (group 3).Results (1) Gender,age and pathological characteristics:the age of onset in group 2 and group 3 was older than that in the control group;group 1 and group 2 had more female cases than the control group;the incidence of multifocal carcinoma was higher in group 3 than that in the control group ;group 2 was less likely to have lymph node metastasis than the control group.(2) Thyroid function: TSH levels in group 3 was lower than that in the control group;FT3 levels in group 1 and group 2 were lower than those in the control group;and TGAB and TPOAB levels in group 1 were higher than those in the control group.(3)TNM staging and AJCC staging:group 2 had a larger proportion of N0 patients than the control group;group 3 had a smaller proportion of stage 1 patients and a larger proportion of stage 2 patients than the control group.(4)Recurrence risk stratification and MACIS prognostic score:groups 2 and group 3 accounted for a larger proportion of low-risk patients than the control group;group 3 had a lower 20-year survival rate than the control group.The above results were statistically significant(P <0.05).Conclusion The clinical and pathological characteristics of patients with PTC combined with other benign diseases are significantly different from pure PTC patients,suggesting that the treatment plan needs to be customized.Patients with benign thyroid disease should be closely followed up.Early diagnosis and timely and appropriate surgical treatment are the keys to improving survival and prognosis. [ABSTRACT FROM AUTHOR]

Copyright of Pamukkale Medical Journal is the property of Pamukkale Journal of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: To report the results of a multicenter retrospective evaluation of the clinical outcomes of thermal ablation (TA) in a large series of autonomously functioning thyroid nodules (AFTN) with a follow-up protracted up to 3 years. Methods: Patients treated with single TA for an AFTN in Italy were included. Changes in nodule volume, TSH values, and ongoing anti-thyroid therapy were assessed at the 2-, 6-, 12-, 24-, and 36-month follow-up controls. Complications and need of any additional therapy after TA were also registered. Results: A total of 361 patients (244 females, 117 males, median age 58 years, IQR 46–70 years) were included. Nodule volume was significantly reduced at all time points (p < 0.001) (median volume reduction 58% at 6-month and 60% at 12-month). Serum TSH values increased significantly at all time points. After TA, anti-thyroid therapy was withdrawn in 32.5% of patients at 2 months, in 38.9% at 6 months, and in 41.3% at 12 months. A significant difference in the rate of patients who withdrawn medical therapy at 12 months was registered between small (< 10 mL) (74%), medium (49%), or large (> 30 mL) nodules (19%). A single major complication occurred (0.25%). Additional treatments were needed in 34/361 (9.4%) of cases including 4 (1.1%) surgical treatment. Conclusions: Image-guided thermal ablation offers a further safe and effective therapeutic option in patients with AFTN. Clinical outcomes are significantly more favorable in small than in large size AFTN. Key Points: • Thermal ablations (TA) can be safely and effectively used in patients with autonomously functioning thyroid nodules (AFTN). • TA results in a clinically significant nodule volume reduction that is paralleled by TSH level normalization and anti-thyroid drug therapy discontinuation (after TA anti-thyroid therapy was withdrawn in 41.3% at 12 months). • Clinical outcomes after TA are more favorable in small nodules, and when a large amount of thyroid nodule tissue is ablated. [ABSTRACT FROM AUTHOR]