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Carcinoma
Soo Yeon Hahn1 Boo-Kyung Han Eun Young Ko Jung Hee Shin Eun Sook Ko
Hahn SY, Han BK, Ko EY, Shin
JOURNAL
Presented by : Meilani Sulaeman
1420221145
Supervisor : dr.Novita, Sp.Rad
Batas lobus:
esofagus
Trake
a
M.
sternocleidormastoideu
M.
s
sternohyoideus
M.
sternothytoideus
V.
Jugularis
interna
A. Corotis communis
N.
vagus
anterior
posteolatera
medial
Vascular Anatomy
Arteri thyroidea superior
Arteri thyroidea inferior
Arteri thyroidea IMA
Vena thyroidea superior
Vena thyroidea inferior
Vena thyroidea media
CARTILAGO THYREOIDEA
A. CAROTIS EXTERNA
CAROTIS INTERNA
1. A. THYREOIDEA SUPERIOR
CARTILAGO CRICOIDEA
A.
6/22/16 02:07:03 AM
ARCUS AORTAE
v. Thyroidea
suprior
v. Thyroidea
medialis
v.
Thyroidea
inferior
Structure
OBJECTIVE
According to previous reports, a small percentage of patients
present with masses confined to the isthmus, and the
incidence of papillary thyroid carcinoma (PTC) between 2.5%
and 9.2% [13]
However, PTCs arising in the isthmus are more likely to
invade adjacent tissues, such as the trachea and strap
muscles, than PTCs located in the other parts of the thyroid [1,
2, 4]
Therefore, the purpose of this study was to analyze the
ultrasound features and clinicopathologic characteristics
of PTCs originating in the isthmus and to evaluate how these
tumors differ from PTCs that originate in the lobes
Imaging Methods
Ultrasound and ultrasound-guided fine-needle aspiration
(FNA) were performed using a 7- to 15-MHz linear-array
transducer (HDI 5000, Philips Healthcare) or a 5- to 12MHz linear array transducer (IU22, Philips Healthcare)
by one of six board-certified radiologists who were
aware of the clinical findings.
All ultrasound-guided FNA there were not any
differences in ultrasound-guided FNA techniques for
isthmus-originating masses and lobe originating
masses.
Fig. 251-year-old woman with papillary thyroid carcinoma (PTC) originating in isthmus. A and B,
Transverse (A) and longitudinal (B) ultrasound images show 1.2-cm cystic mass with circumscribed margin,
wider-than-tall shape, broad abutment to anterior capsule (> 25%), and anterior capsular bulging. Analysis of
fine-needle aspiration cytologic examination result revealed PTC. After surgery, diagnosis was PTC arising in
isthmus without lymph node metastasis. According to pathologic report, no extrathyroidal extension was found
despite ultrasound finding suspicious for extrathyroidal extension
Results
The mean age at the time of
diagnosis of all 144 patients was 47.6
12.6 (SD) years (range, 2877
years).
The female-to-male ratio was 4.3:1.0
(81.3% vs 18.7%, respectively).
The mean tumor size was 1.2 0.7
cm (range, 0.33.7 cm).
RESULTS
According to the clinicopathologic analyses, the
incidence of extrathyroidal extension was
higher in the patients with a tumor originating
in the isthmus than in the control group (p =
0.026)
According to the imaging analyses, the tumors
originating in the isthmus more frequently had a
circumscribed margin (p = 0.030), a wider-thantall shape (p < 0.001), and the suspicion of
extrathyroidal extension (p < 0.001) than those
originating from the lobes.
CONCLUSION
The results of this study showed that PTCs
originating in the isthmus were more likely to
have extrathyroidal extension than those
originating from the lobes.
Therefore, careful ultrasound evaluation should
be performed on masses in the thyroid isthmus
even if ultrasound shows a circumscribed mass
with a wider-than-tall shape.
hypoechoge
nity
microcalcifica
tions
Poor
marginatio
n
isoechogen
ity
Smooth
margin
TERIMA KASIH
C. Borderline. Transverse US image of nodular hyperplasia in 60-yearold woman shows macrocalcification in peripheral portion of nodule.
Patient underwent right lobectomy of thyroid, despite benign cytology
upon US-guided fine-needle aspiration, for pathologic confirmation.
Lymphatics