KMID : 0986520020020010010
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Korean Journal of Endoscrine Surgery 2002 Volume.2 No. 1 p.10 ~ p.14
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Operative Indications for Hashimoto¡¯s Thyroiditis in Consideration of the Risk of Concurrent Thyroid Carcinoma
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Choi Sung-Lim
Yoo Bong-Ok Kim In-Soo Kin Yoon-Kyoo
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Abstract
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Purpose: This study was performed to further refine the indications for operative treatment of patients with Hashimoto¡¯s thyroiditis, and also to present the better histopathologic diagnosis method for Hashimoto¡¯s thyroiditis.
Methods: The authors evaluated retrospectively 130 patients with surgically proven Hashimoto¡¯s thyroiditis at presbyterian medical center in Chonju and Yonsei hospital in Masan from Jan. 1995 to Feb. 2002.
Results: The sensitivity of gun biopsy for the diagnosis of Hashimoto¡¯s thyroiditis was significantly higher than the one of fine needle aspiration (83.3% vs 46..2%, P£¼0.001). There were 26 cases (13.8%) of coexistent carcinoma of 130 patients. The incidence of carcinoma in men (6 in 9, 66.6%) was significantly higher than in women (20 in 121, 16.5%, P£¼0.05). The incidence of carcinoma in antithyroglobulin antibody negative group (8 in 10, 80%) was significantly higher than in antibody positive guoup (16 in 111, 14.4%, P£¼0.001). There was no significant difference in the incidence of carcinoma between positive and negative lymphadenopathy groups (22.6% vs 20.0%, P=0.681). As for ultrasonographic findings, patients with irregular-marginated dominant nodule or calcification had significantly higher incidence of carcinoma than those without so findings had (P£¼0.001). As for the distribution patterns of lymphocytes infiltration, the incidence of carcinoma in nodular or localized pattern groups is significantly higher than in diffuse group (24.5% vs 8.3%, P£¼0.05).
Conclusion: For histopathologic diagnosis of Hashimoto¡¯s thyroiditis, gun biopsy is more sensitive than fine needle aspiration. And the incidence of concurrent carcinoma in patients with Hashimoto¡¯s thyroiditis is increased under the circumstances as follows: men, negative antithyroglobulin antibody results on serologic test, ultrasonographic findings such as irregular-marginated dominant nodule, increased vascularity or calcification, and nodular or localized patterns of lymphocytes infiltration on histopathologic examination.
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KEYWORD
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Hashimoto¡¯s thyroiditis, Thyroid carcinoma, Operative indications
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