KMID : 0986520100100020088
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Korean Journal of Endoscrine Surgery 2010 Volume.10 No. 2 p.88 ~ p.92
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Analysis of Postoperative Pathological Findings of Graves¡¯ Disease
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Heo Dong-Sik
Bae Ja-Seong Sung Ki-Young Kim Jeong-Soo Park Woo-Chan
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Abstract
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Purpose: The diagnosis of Graves¡¯ disease can be clinically made by the findings of hyperthyroidism combined with eye signs or a diffusely enlarged goiter. The pathological findings of Graves¡¯ disease are hypertrophy and hyperplasia of the thyroid follicles. Surgical treatment for Graves¡¯ disease is indicated for patients with a suspicion of cancer, a large goiter, medical failure, patient preference or severe ophthalmopathy. The aim of this study is to determine the diagnostic accuracy of clinically diagnosed Graves¡¯ disease on the basis of the postoperative pathologic findings.
Methods: We performed a retrospective analysis of the medical records of the patients who were diagnosed as having Graves¡¯ disease since Jan 2000 at St. Mary¡¯s Hospital, The Catholic University of Korea. To confirm the pathological findings in this study, the patients who underwent surgical treatment were enrolled, and their preoperative diagnostic tests were also reviewed.
Results: A total of 57 patients with Graves¡¯ disease underwent surgery due to medical failure in 45 (78.9%), ophthalmopathy in 25 (43.8%), huge goiter in 4 (7%), suspicion of cancer in 4 (7%), and others in 4 (7%). Thirty nine (68.4%) patients were female and total thyroidectomies were performed in 52 (91.2%) patients. The pathological reports of the thyroid specimens showed diffuse hyperplasia in 53 (92.9%), nodular hyperplasia in 2 (3.5%), Lymphocytic thyroiditis in 1 (1.8%) and Hashimoto¡¯s thyroiditis in 1 (1.8%). The diagnostic accuracy of preoperative antimicrosomal Ab, anti-TSHR Ab and a technetium 99m thyroid scan was 73.8%, 86.0% and 69.7%, respectively. Papillary carcinoma was identified in 6 patients (10.5%).
Conclusion: The microscopic findings of 5 patients (7.0%) who were diagnosed clinically as having Graves¡¯ disease were not compatible with the criteria for a pathological diagnosis. Surgical treatment and confirmation of the exact pathology should be performed for the appropriate treatment.
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KEYWORD
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Diagnosis, Graves¡¯ disease, Pathology
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