Korean J Otolaryngol-Head Neck Surg.  2007 May;50(5):420-425.

Clinical Manifestation and Differential Diagnosis of Thyroid Follicular Neoplasm

Affiliations
  • 1Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Korea. kytae@hanyang.ac.kr
  • 2Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Korea.
  • 3Department of Radiology, College of Medicine, Hanyang University, Seoul, Korea.

Abstract

BACKGROUND AND OBJECTIVES: A preoperative differential diagnosis between follicular adenoma and follicular carcinoma of thyroid is very difficult, and the standard basis for distinction is the presence of capsular and/or vascular invasion. In this study, we analyzed the findings of preoperative tests and clinical features to facilitate the differential diagnosis and treatment of the follicular neoplasm.
SUBJECTS AND METHOD
A retrospective review of medical records was carried out on 104 patients who had undergone thyroid surgery and had been diagnosed with thyroid follicular adenoma or carcinoma from 1995 through 2004. The final pathologic diagnosis was compared to the various clinical data including the result of fine needle aspiration cytology (FNAC) and ultrasonographic findings.
RESULTS
Of total 104 cases, 82 were follicular adenoma and 22 were follicular carcinoma. The incidence of carcinoma was significantly higher in male than in female. The result of FNAC were divided into 6 cytodiagnostic groups, namely, inadequate, colloid nodule without atypia, colloid nodule with atypia, follicular neoplasm without atypia, follicular neoplasm with atypia, or highly suspicious malignancy. The incidence of carcinoma was significantly higher in the groups with atypia such as colloid nodule with atypia, follicular neoplasm with atypia, and highly suspicious malignancy than in the groups without atypia. The incidence of follicular carcinoma was significantly higher in ill-defined marginal cases. Calcification on ultrasonography also indicated the possibility of malignancy.
CONCLUSION
The incidence of follicular carcinoma was significantly high in male patients, atypia in FNAC, and ill-defined margin and calcification on ultrasonography.

Keyword

Thyroid neoplasm; Follicular adenoma; Follicular carcinoma

MeSH Terms

Adenoma
Biopsy, Fine-Needle
Colloids
Diagnosis
Diagnosis, Differential*
Female
Humans
Incidence
Male
Medical Records
Retrospective Studies
Thyroid Gland*
Thyroid Neoplasms
Ultrasonography
Colloids
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