Mucosa associated lymphoid tissue lymphoma of the thyroid gland: a case report and literature review = MALT linfoma della tiroide: caso clinico e revisione della letteratura

Mucosa associated lymphoid tissue (MALT) lymphomas are low-grade, non-Hodgkin’s B cell lymphomas, mainly occurring in the gastrointestinal tract, but also in other tissues. We describe the management of a patient with hypothyroidism, tracheoesophageal compressive symptoms and chest tightness affected by a thyroid MALT lymphoma. The patient underwent debulking thyroidectomy and temporary tracheostomy in order to reduce dysphonia and dysphagia, followed by adjuvant chemotherapy and subsequently radiation therapy. A CT scan performed at the end of radiotherapy 6 months after surgery revealed remnants of residual tissue from the thyroidectomy without any pathological findings. I linfomi MALT sono dei linfomi non-Hodgkin a cellule B a basso grado che in genere insorgono a livello del tratto gastrointestinale, ma anche in altri tessuti. Descriviamo in questo articolo il management clinico-chirurgico di un paziente con ipotiroidismo, sintomi da compressione tracheo-esofagea e senso di oppressione toracica, affetto da linfoma MALT della tiroide. Il paziente è stato sottoposto a parziale asportazione della massa tiroidea e tracheostomia allo scopo di ridurre i sintomi compressivi ed in seguito a trattamento chemioterapico e radioterapico. L’esame TC effettuato una volta conclusa la radioterapia, circa 6 mesi dopo l’intervento, ha evidenziato gli esiti della tiroidectomia parziale in assenza di altri reperti patologici

Using Experimentally Validated Navier-Stokes CFD to Minimize Tidal Stream Turbine Power Losses Due to Wake/Turbine Interactions

Tidal stream turbines fixed on the seabed can harness the power of tides at locations where the bathymetry and/or coastal geography result in high kinetic energy levels of the flood and/or neap currents. In large turbine arrays, however, avoiding interactions between upstream turbine wakes and downstream turbine rotors may be hard or impossible, and, therefore, tidal array layouts have to be designed to minimize the power losses caused by these interactions. For the first time, using Navier-Stokes computational fluid dynamics simulations which model the turbines with generalized actuator disks, two sets of flume tank experiments of an isolated turbine and arrays of up to four turbines are analyzed in a thorough and comprehensive fashion to investigate these interactions and the power losses they induce. Very good agreement of simulations and experiments is found in most cases. The key novel finding of this study is the evidence that the flow acceleration between the wakes of two adjacent turbines can be exploited not only to increase the kinetic energy available to a turbine working further downstream in the accelerated flow corridor, but also to reduce the power losses of said turbine due to its rotor interaction with the wake produced by a fourth turbine further upstream. By making use of periodic array simulations, it is also found that there exists an optimal lateral spacing of the two adjacent turbines, which maximizes the power of the downstream turbine with respect to when the two adjacent turbines are absent or further apart. This is accomplished by trading off the amount of flow acceleration between the wakes of the lateral turbines, and the losses due to shear and mixing of the front turbine wake and the wakes of the two lateral turbines

Lung cancer epidemiology in North Sardinia, Italy

Background The aim of this study was to analyze and describe the epidemiological characteristics and trends of lung cancer in North Sardinia, Italy, in the period 1992–2010. Methods Data were obtained from the tumor registry of Sassari province which is a part of a wider registry web, coordinated today by the Italian Association for Tumor Registries. Results The overall number of lung cancer cases registered was 4,325. The male-to-female ratio was 4.6:1 and the mean age 68.1 years for males and 67 years for females. The standardized incidence rates were 73.1/100,000 and 13.5/100,000 and the standardized mortality rates 55.7/100,000 and 9.9/100,000 for males and females, respectively. An increasing trend in incidence of lung cancer in women was evidenced. Conversely, incidence was found to decrease in males. Relative survival at 5 years from diagnosis was low (8.8% for males and 14.9% for females). Furthermore, an increase in mortality rates was observed in both sexes in the period under investigation. Conclusions Our data show an increasing trend of lung cancer incidence in women in North Sardinia in the last decades. Conversely, a reduction of incidence rates was observed in males. Furthermore, a slightly increasing trend in mortality rates was observed in both sexes, suggesting the need to enhance smoking control strategies, consider adoption of effective surveillance policies, and improve diagnosis and treatment methods

Breast cancer incidence and mortality in North Sardinia in the period 1992–2010

The aim of this study was to analyze and describe the epidemiological characteristics and trends of breast cancer in Sassari province (Sardinia, Italy) in the period 1992 2010. Data were obtained from the local tumor registry which makes part of a wider registry web, coordinated today by the Italian Association for Tumor Registries. The overall number of breast cancer cases registered was 5,483 (46 males and 5,437 females). The mean age was 64.8 years for males and 60.4 years for females. The standardized incidence rates were 1/100,000 and 106.2/100,000 and the standardized mortality rates 0.3/100,000 and 23.2/100,000 for males and females respectively. An increasing trend in incidence and mortality rates of breast cancer in Sassari province was evidenced in the years under investigation. Relative survival at 5 years from diagnosis was 78.2% (73.1% for males and 78.3% for females

Warthin-like papillary carcinoma of the thyroid gland: case report and review of the literature

We present a case of Warthin-like papillary thyroid carcinoma in a 22-year-old woman and a review of the literature on the topic. The patient had the occasional discovery of a hypoechoic thyroid nodule of approximately 18 mm, characterized by irregular margins, hyperechoic spots, rich intra- and perilesional vascularization, and a suspicious enlarged right laterocervical lymph node. Fine-needle aspiration was performed for both lesions and the diagnosis of papillary thyroid carcinoma without lymph node involvement was made. The patient underwent thyroidectomy and central neck lymphadenectomy without complications. Histopathological examination suggested a Warthin-like papillary carcinoma of the thyroid gland, with all the removed lymph nodes being free of disease. The patient subsequently underwent iodine ablative therapy and she remains free of disease one year after surgery. Warthin-like papillary thyroid carcinoma is a recently described variant of papillary thyroid cancer that is frequently associated with lymphocytic thyroiditis. Morphologically, it resembles Warthin tumors of the salivary glands, with T and B lymphocytes infiltrating the stalks of papillae lined with oncocytic cells. Surgical and postoperative management is identical to that of classic differentiated thyroid cancer, while prognosis seems to be favourable

Management of thyroid Hurthle cell neoplasms: a single centre experience and literature review = Management delle neoplasie a cellule di Hurthle della tiroide: esperienza di un singolo centro e revisione della letteratura

Aim. We report our experience on the management of Hurthle cell neoplasms (HCNs) of the thyroid and a review of the literature in order to describe the most relevant clinical, diagnostic, biologic and therapeutic aspects. Materials and Methods. We retrospectively reviewed the clinical records of 15 consecutive patients with HCN. The male/female ratio was 1:4 and the mean age was 53.8 years. Fourteen patients underwent total thyroidectomy and one patient lobectomy. Two patients were lost to follow up. The mean follow up time was 54 months. Results. Eleven Hurthle cell adenomas and 4 carcinomas were found. At the time of initial surgical evaluation 9 patients (60%) were symptomatic, with hyperthyroidism and dysphagia being the most frequent manifestations. Only in 6 (40%) cases the diagnosis was obtained by preoperative fine needle aspiration biopsy. Among patients with Hurthle cell adenoma and carcinoma the mean age was 51 and 62 years respectively and the mean lesion size 1.6 and 3.8 cm respectively. No cases of death or recurrence were registered. Conclusions. Clinical manifestations are similar to those for other differentiated thyroid neoplasms. Patients with Hurthle cell carcinoma presented a mean age and a mean tumor size greater than those with Hurthle cell adenoma. Our data suggest that adenomas have not a malignant potential; nevertheless surgical resection is necessary to obtain a precise evaluation of eventual infiltrative events. Surgical resection is also the treatment of choice for the treatment of carcinomas with total thyroidectomy representing the best surgical option. Obiettivo. Riportiamo in questo articolo la nostra esperienza nel management delle neoplasie a cellule di Hurthle (HCNs) ed una revisione della letteratura allo scopo di sottolineare i più importanti aspetti clinici, diagnostici, biologici e terapeutici. Materiali e metodi. Abbiamo esaminato i dati clinici di 15 pazienti consecutivi con HCN. L’età media dei pazienti era di 53,8 anni e il rapporto maschi/femmine 1:4. Quattordici pazienti sono stati sottoposti a tiroidectomia totale ed uno a lobectomia. Due pazienti sono stati persi al follow up. Il tempo medio di follow up era di 54 mesi. Risultati. Undici pazienti sono stati trovati affetti da adenoma a cellule di Hurthle e 4 da carcinoma. Nove pazienti (60%) erano sintomatici, e solo in 6 (40%) casi la diagnosi è stata ottenuta tramite biopsia con ago aspirato. L’età media dei pazienti affetti da adenoma era 51 anni e di quelli con carcinoma 62. La dimensione media delle lesioni era superiore nei pazienti con carcinoma (3,8 cm verso 1,6 in quelli con adenoma). Non sono stati osservati decessi o recidive. Conclusioni. Abbiamo osservato una differenza di età e di dimensione delle lesioni tra i pazienti affetti da adenoma e quelli affetti da carcinoma. I nostri dati suggeriscono che gli adenomi a cellule di Hurthle non hanno potenziale maligno, tuttavia l’asportazione chirurgica è necessaria per la valutazione di eventuali eventi infiltrativi. Il trattamento chirurgico con tiroidectomia totale o resezioni più ampie ove necessario rappresenta il trattamento di scelta per i carcinomi

Deciduoid mesothelioma of the thorax: A comprehensive review of the scientific literature.

AbstractObjectiveDeciduoid mesothelioma is a rare variant of malignant epithelioid mesothelioma. It often involves the peritoneum, but also thoracic cases have been reported. The aim of the present review is to describe the demographic, clinical, radiological, and pathological features of such a rare variant of thoracic mesothelioma, and the state of the art regarding the therapeutic approaches currently available.Data sourceEnglish‐language articles published from 1985 to June 2016, and related to thoracic deciduoid mesothelioma cases were retrieved using the Pubmed database.Study selectionThe search terms were "mesothelioma," "thoracic mesothelioma," "epithelial mesothelioma," "pleural mesothelioma," and "deciduoid mesothelioma."ResultsForty‐four cases included in 16 articles, published in the period under investigation, were analyzed in detail.ConclusionsThe mean age of the patients was 63 years, and the male to female ratio 1.7:1. Approximately 58% had exposure to asbestos, and 73% had a smoking history; familiarity was rarely reported. The most common anatomical site of origin was the right pleura, and the most frequent clinical manifestations were chest pain, dyspnea, cough, and weight loss. Thoracic X‐ray and computed tomography were the imaging techniques most employed for diagnosis and surgical planning. The pathological diagnosis was obtained by examination of surgical or biopsy specimens in most cases. The best treatment strategy of deciduoid mesothelioma is a matter of debate; nevertheless a multidisciplinary approach is currently the best option for the choice of the adequate therapeutic scheme

Epidemiology of thyroid cancer in an area of epidemic thyroid goiter

The aim of this study was to analyze and describe the epidemiological characteristics and trends of thyroid cancer in the province of Sassari (Sardinia, Italy), an area with epidemic thyroid goiter, in the period 1992–2010. Data were obtained from the local tumor registry whichmakes part of a wider registry web, coordinated today by the Italian Association for Tumor Registries. An increasing trend in the incidence of thyroid cancer in the province of Sassari was evidenced. This trend seems to follow the general worldwide trend and does not seem to be related to the high incidence of thyroid goiter in the area. The frequencies of the different histological subtypes were similar to those reported in numerous national and international reports.Women are affected earlier than men and, therefore, suffer greater professional, economic, and social impacts.Overallmortality is lowand a relative 5-year survival is excellent, especially in comparison to other malignancies

Rotor performance, blade loads, and wake resolution in Navier-Stokes CFD of tidal stream turbines

Reliably predicting turbine/wake interactions in arrays of tidal stream turbines is paramount to reducing losses of energy yield by optimizing array layout at the design stage. This study focuses on the analysis of turbine performance and rotor wakes based on Navier-Stokes computational fluid dynamics, discussing modeling aspects associated with the method used for incorporating turbine hydrodynamics and turbulent flow effects in simulations. Important factors considered herein are a) the impact of laminar-to-turbulent transition of the blade boundary layers on rotor performance, and b) the sensitivity of the computed wake evolution on the turbine modeling approach. For these analyses, the results of rotor resolved and generalized actuator disk solutions are compared to flume tank measured data of a model turbine performance and wake. The overall agreement of all computed solutions and measured data is good. In the presented Reynoldsaveraged Navier-Stokes analyses, the rotor-resolved analysis predicts the measured rotor wake up to about four rotor diameters behind the turbine well, and seemingly better than the actuator disk model, as expected; thereafter, however, the rotor resolved simulation dissipates the wake more slowly than observed in the experiment, whereas the wake recovery rate predicted by the actuator disk analysis is closer to measured data. The cross-comparison of the geometry resolved analyses and measured data indicate that the blade boundary layers are likely to be fully turbulent, which has a significant detrimental impact on the turbine power. It is also found that the time-averaged solution of the time-dependent analysis and that of the steady flow analysis of the turbine resolved flow field, differ negligibly, as noted in other recent studies