Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Department of Pathology, Haukeland University Hospital Bergen, Bergen, Norway
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Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
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Background: Preoperative predictors for the need of prophylactic lymph node dissection in the lateral neck have been studied in patients with medullary thyroid carcinoma (MTC). Objectives: To evaluate the ability of serum calcitonin to predict the extent of surgery needed in the lateral neck. Methods: This retrospective population-based cohort study includes data from 94 of 139 patients with MTC surgically treated in Norway from 2003 to 2016. Patients were identified in the 4 regional centers treating MTC and by the Cancer Registry of Norway, and grouped according to calcitonin levels. In 58 patients without distant metastases or disease progression to the next tumor level (NPNL), data were compared in prognostic groups (N0-NPNL), (N1a-NPNL), and (N1b-NPNL). Results: At calcitonin levels ≤500, 501–1,000, and >1,000 pmol/L, metastatic lymph nodes in the lateral neck were found in 16, 50, and 71% of the patients, respectively. In the prognostic groups, 19% of N0-NPNL patients had calcitonin >500 pmol/L and 17% of N1b-NPNL patients had calcitonin ≤500 pmol/L. In multivariate analysis, factors predicting biochemical cure and calcitonin level ≤500 pmol/L were no metastatic lymph nodes in the lateral neck (p = 0.030) and tumor diameter ≤20 mm (p < 0.001), respectively. Factors related to metastatic lymph nodes in the lateral neck were extrathyroidal extension (p = 0.007) and no biochemical cure (p = 0.028). Conclusions: Basal calcitonin cannot predict the need for prophylactic lateral lymph node dissection in patients with MTC. Further prospective, randomized studies are warranted.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Department of Pathology, Haukeland University Hospital Bergen, Bergen, Norway
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Department of Medical Genetics, St. Olavs University Hospital, Trondheim, Norway
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Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
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Background: Medullary thyroid carcinoma (MTC) is rare. Nationwide population-based studies are important to evaluate its clinical course. Objectives: To describe all patients with MTC in Norway during 1994–2016 and compare time-related trends in diagnostics and surgical treatment, including prognostic factors for biochemical cure and disease-specific survival (DSS). Methods: This retrospective population-based cohort study includes data for 228 out of 237 patients (96%) with MTC; 201 patients were surgically treated. Patients were identified in the 4 regional centers treating MTC and by the Cancer Registry of Norway. Data were collected from patients’ files. Trends were compared over 2 study periods. Results: MTC accounted for 4.2% of thyroid carcinomas. During the study periods, the incidence increased from 0.18 to 0.25: 100,000 per year, preoperative diagnostics improved with increased use of calcitonin, ultrasound, and fine-needle cytology (p = 0.010, p < 0,001, and p = 0.001), patients were diagnosed at an earlier tumor stage (p = 0.004), and more patients were cured (p = 0.002). Via multivariate analysis of patients with metastatic lymph nodes, independent prognostic factors for cure were: a low ratio of metastatic and total number of dissected lymph nodes (p = 0.021) and no extrathyroidal extension (p = 0.030). Independent prognostic factors for DSS were: no distant metastasis, a younger age, and a low ratio of metastatic and dissected lymph nodes (p = 0.005, p = 0.020, p = 0.022). Conclusions: Preoperative diagnostics have improved over time with increased therapeutic control. A low ratio of metastatic and dissected lymph nodes predicts better outcomes in patients with metastatic lymph nodes.
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the pathology result. The TG level at that point was elevated (132.7 ng/ml, range 3.5-77). Thyrotropin receptor antibodies were within the normal range (<1.58 U/l). During the 4-year follow-up the patient has remained euthyroid. The multinodular
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Pathology. a Schwannoma, thyroid and parathyroid tissue. b Hypercellular Antoni A pattern of schwannoma. c S-100 stain positive (brown, color in online version only). d Low proliferation index (Ki67). Discussion Primary nonepithelial
Nuclear Medicine, Radiology Department, San Francisco VA Medical Center, San Francisco, Calif., USA
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node metastasis is very unusual. We report a unique case of papillary thyroid carcinoma with pathology-proven metastasis to an inguinal lymph node. Case Presentation The patient, a 55-year-old man, had an X-ray because of a painful shoulder. The
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surgical procedure performed in most cases and depending on the final pathology and risk of recurrence classification, a second surgery may be necessary to complete total thyroidectomy. Preoperative molecular analyses are now available for suspicious
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FJ: Role of ultrasound-guided core biopsy in the evaluation of spleen pathology. APMIS 2006;114:492-499. 10.1111/j.1600-0463.2006.apm_378.x 16907854 16 Lopez JI, Fernández de Larrinoa A, Zabala R, Oleada L, del Cura JL, Bilbao FJ: Utilidad de
Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal
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Health Investigation and Innovation Institute (i3S), University of Porto, Porto, Portugal
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Health Investigation and Innovation Institute (i3S), University of Porto, Porto, Portugal
Public Health Unit, ACES Baixo Mondego, Coimbra, Portugal
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Department of Endocrinology, Hospital University Centre of São João, Porto, Portugal
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Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal
Health Investigation and Innovation Institute (i3S), University of Porto, Porto, Portugal
Department of Pathology, Faculty of Medicine of the University of Porto, Porto, Portugal
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Selenium in AITD a . Study Year Study type Sample Pathology Main conclusion Zuo et al. ( 16 ) 2021 Systematic review and meta-analysis 17 studies AITD Se-containing supplements greatly reduced the levels of FT3, FT4
INSERM 1086 ANTICIPE, Caen University, Caen, France
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using Roche Cobas 6000 Tg electrochemiluminescent immunoassays (Roche Diagnostics). The normal reference ranges are 12–22 pmol/L for FT4, 0.27–4.2 mIU/L for TSH, 0–34 IU/mL for TPOAb, and 0–115 IU/mL for TgAb. Pathology All pathological slides
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and malignant thyroid lesions. Material and Method During 2012 and 2017, the archive of the Surgical Pathology Department of Shahid Rajaee and Faghihi Hospitals, affiliated to Shiraz University of Medical Sciences, Shiraz, Iran, was searched
