15 research outputs found
Fine needle aspiration biopsy of thyroid nodules: Cytohistological Correlation
OBJECTIVE: Fine-needle aspiration biopsy (FNAB) currently is the main procedure for distinguishing benign from malignant thyroid nodules. The aim of our study was to assess the accuracy of FNABs in our hospital by comparing the cytological and histological diagnosis.METHODS: We performed a prospective study including 321 patients with thyroid nodules admitted to "St. Marina" Hospital from January 2004 to December 2006. Clinical and US data, TSH, FT3, FT4, anti-TPO, cytological and histological findings were evaluated.RESULTS: FNABs were performed in all 321 cases, 290 of them were women and 31 men; mean age 52,9 years. Cytological evaluation considered 67,3% of FNABs as benign, 15,6% as suspicious, 4,7% as malignant and 12,4% as inadequate sample. 88 of the patients underwent thyroid surgery. The comparison between cytological and histological findings showed that 99,1% of cytologically benign nodules were histologically confirmed, as well as 100% of the malignant lesions. 89,5% of the cases classified as suspicious on FNAB turned out to be benign on histology and 10,5% were malignant. The discrepant cases were 2 false-negative results, which had a cytological diagnosis of nodular hyperplasia and turned out to be a medullary carcinoma. Our results showed a sensitivity of 88,2% and a specifity of 100%.CONCLUSION: Thyroid FNAB is an accurate and cost-effective preoperative tool for selection of patients who would benefit from surgery.Scripta Scientifica Medica 2008;40(1):39-4
Galectin-3 expression in thyroid tumors
Aim. To evaluate the expression of Galectin-3 in benign and malignant thyroid nodules and to assess its diagnostic value.Methods. Immunohistochemical analysis of Galectin-3 expression was performed on 64 surgically removed thyroid nodules, including 38 carcinomas (13 papillary, 2 tall cell variants, 4 lymph node metastases from papillary carcinoma,6 follicular variants of papillary carcinoma (FVPTC), 4 anaplastic, 5 follicular and 4 HΓΒΌrthle cell carcinomas), as well as 26 benign lesions (10 follicular adenomas, 5 HΓΒΌrthle cell adenomas, 11 nodular goiters with surrounding normal thyroid tissue).Results. We found strong and diffuse Galectin-3 expression in all malignant lesions except for one case of FVPTC and one follicular carcinoma. Normal thyrocytes and the majority of the benign lesions were negative for Galectin-3. This molecular marker was expressed in the cytoplasm as well as in the nuclei of follicular cells. Statistical analysis determined sensitivity 94.7%, specificity 69.2%, PPV 81.8%, NPV 90% and accuracy 83% of Galectin-3.Conclusion. Our findings suggest that immunohistochemical expression of Galectin-3 might contribute to differential diagnosis between malignant and benign thyroid nodules, including those with follicular architecture
Gallbladder adenomyomatosis mimicking carcinoma - a clinical case
Gallbladder adenomyomatosis is hyperplastic cholecystosis of the gallbladder. This is a relatively common and benign cause for diffuse or focal wall thickening.We present a case of a 48-year-old woman with complaints from 3 - 4 years of epigastric pain, abdominal swelling, occurring after eating, with a temporary effect after antispasmodics or antisecretors. There was a reduction in body weight. All laboratory tests were normal. An ultrasound examination revealed a diffusely thickened, stratified gallbladder wall and parenchymal mass in the lumen. Due to clinical suspicion of acalculous cholecystitis, antibacterial treatment was performed, which did not lead to relief of symptoms. The ultrasound picture also did not change. Magnetic resonance imaging showed an image of gallbladder adenomyomatosis. Given the differential diagnostic possibility of gallbladder cancer, a planned cholecystectomy was performed, which, together with histological examination, confirmed the benign nature of the disease. After the surgery, the patient's complaints completely disappeared.Gallbladder adenomyomatosis is a benign and degenerative condition characterized by mucosal proliferation and thickening of the muscle layer. Given the possible premalignant character, cholecystectomy remains the treatment of choice for patients with clinically manifested gallbladder adenomyomatosis.Β Β
Diagnostic value of fine needle aspiration biopsy of space - Occupying lesions of the parotid gland
ΠΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΡΠ²Π°Π½ΠΈΡΡΠ° Π½Π° ΡΠ»ΡΠ½ΡΠ΅Π½ΠΈΡΠ΅ ΠΆΠ»Π΅Π·ΠΈ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»ΡΠ²Π°Ρ 3% ΠΎΡ ΡΡΠΌΠΎΡΠΈΡΠ΅ Π² ΠΎΠ±Π»Π°ΡΡΡΠ° Π½Π° Π³Π»Π°Π²Π°ΡΠ° ΠΈ ΡΠΈΡΡΠ°. ΠΡΠΈΠ΅ΠΌΡΡΠ΅ΡΡΠ²Π΅Π½ΠΎ ΡΠ΅ Π·Π°ΡΡΠ³Π°Ρ ΠΏΠ°ΡΠΎΡΠΈΠ΄Π½Π°ΡΠ° ΠΆΠ»Π΅Π·Π°, ΠΊΠ°ΡΠΎ Π½ΡΠΌΠ° ΡΠ°ΠΌΠΎΡΡΠΎΡΡΠ΅Π»Π΅Π½ ΠΌΠ΅ΡΠΎΠ΄, ΠΊΠΎΠΉΡΠΎ Π΄Π° Π΅ Π΄ΠΎΡΡΠ°ΡΡΡΠ΅Π½ Π·Π° ΠΏΠΎΡΡΠ°Π²ΡΠ½Π΅ Π½Π° ΠΏΡΠ΅Π΄ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½Π° Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π°. Π‘ΡΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΈΡΠ΅ Π½Π°ΠΉ-ΡΠ΅ΡΡΠΎ ΠΏΡΠΈΠ»Π°Π³Π°Π½ΠΈ Π½Π΅Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ½ΠΈ ΡΠΏΠΎΡΠΎΠ±ΠΈ Π·Π° ΠΏΡΠ΅Π΄ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½Π° Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ° ΡΠ° ΠΎΠ±ΡΠ°Π·Π½ΠΈΡΠ΅ ΠΈΠ·ΡΠ»Π΅Π΄Π²Π°Π½ΠΈΡ ΠΈ ΡΡΠ½ΠΊΠΎΠΈΠ³Π»Π΅Π½Π°ΡΠ° Π°ΡΠΏΠΈΡΠ°ΡΠΈΠΎΠ½Π½Π° Π±ΠΈΠΎΠΏΡΠΈΡ (Π’ΠΠ). ΠΠ°ΡΡΠΎΡΡΠΎΡΠΎ ΠΏΡΠΎΡΡΠ²Π°Π½Π΅ ΠΈΠΌΠ° Π·Π° ΡΠ΅Π» Π΄Π° ΡΡΡΠ°Π½ΠΎΠ²ΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ½Π°ΡΠ° ΡΡΠΎΠΉΠ½ΠΎΡΡ Π½Π° Π’ΠΠ ΠΈ Π΄Π° Π΄Π΅ΡΠΈΠ½ΠΈΡΠ° ΠΌΡΡΡΠΎΡΠΎ ΠΈ Π² Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ½ΠΎ-Π»Π΅ΡΠ΅Π±Π½ΠΈΡ Π°Π»ΠΎΠ³ΠΎΡΠΈΡΡΠΌ. Π ΠΏΡΠΎΡΡΠ²Π°Π½Π΅ΡΠΎ ΡΠ° Π²ΠΊΠ»ΡΡΠ΅Π½ΠΈ 131 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ Ρ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅Π½ ΡΠΈΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅Π½ ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π», ΠΏΠΎΠ΄Π»ΠΎΠΆΠ΅Π½ΠΈ Π½Π° ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΠ΅, Π½Π° Π²ΡΠ·ΡΠ°ΡΡ ΠΌΠ΅ΠΆΠ΄Ρ 19 ΠΈ 94 Π³., 76 ΠΌΡΠΆΠ΅ ΠΈ 55 ΠΆΠ΅Π½ΠΈ. Π‘Π»Π΅Π΄ ΡΡΠΏΠΎΡΡΠ°Π²ΠΊΠ° Π½Π° ΡΠ΅Π·ΡΠ»ΡΠ°ΡΠΈΡΠ΅ ΠΎΡ Π’ΠΠ Ρ Ρ
ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ½ΠΈΡ ΠΎΡΠ³ΠΎΠ²ΠΎΡ Π½Π° ΡΠ΅Π·Π΅ΠΊΡΠ°ΡΠΈΡΠ΅ ΠΎΡ ΠΏΠ°ΡΠΎΡΠΈΠ΄Π½Π° ΠΆΠ»Π΅Π·Π° ΡΠ΅ ΡΡΡΠ°Π½ΠΎΠ²ΠΈ, ΡΠ΅ 77.9% ΠΎΡ ΠΎΠ±Π΅ΠΌΠ·Π°Π΅ΠΌΠ°ΡΠΈΡΠ΅ ΠΏΡΠΎΡΠ΅ΡΠΈ ΡΠ° Π±Π΅Π½ΠΈΠ³Π½Π΅Π½ΠΈ, ΠΊΠ°ΡΠΎ Π½Π°ΠΉ-ΡΠ΅ΡΡ ΡΡΠ΅Π΄ ΡΡΡ
Π΅ ΠΏΠ»Π΅ΠΎΠΌΠΎΡΡΠ½ΠΈΡΡ Π°Π΄Π΅Π½ΠΎΠΌ (44.7%), ΡΠ»Π΅Π΄Π²Π°Π½ ΠΎΡ ΠΊΠΈΡΡΠ°Π΄Π΅Π½ΠΎΠ»ΠΈΠΌΡΠΎΠΌΠ° (36.5%). ΠΡ ΠΌΠ°Π»ΠΈΠ³Π½Π΅Π½ΠΈΡΠ΅ ΡΡΠΌΠΎΡΠΈ ΠΏΡΠ΅ΠΎΠ±Π»Π°Π΄Π°Π²Π° ΠΌΡΠΊΠΎΠ΅ΠΏΠΈΠ΄Π΅ΡΠΌΠΎΠΈΠ΄Π½ΠΈΡΡ ΠΊΠ°ΡΡΠΈΠ½ΠΎΠΌ (24.1%), ΡΠ»Π΅Π΄Π²Π°Π½ ΠΎΡ ΠΊΠ°ΡΡΠΈΠ½ΠΎΠΌ Π² ΠΏΠ»Π΅ΠΎΠΌΠΎΡΡΠ΅Π½ Π°Π΄Π΅Π½ΠΎΠΌ (13.8%). ΠΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ½Π°ΡΠ° ΠΊΠ»Π°ΡΠΈΡΠΈΠΊΠ°ΡΠΈΡ Π·Π° ΠΎΡΠ΅Π½ΠΊΠ° Π½Π° Π’ΠΠ Π΅ ΠΈΠ·Π²ΡΡΡΠ΅Π½Π° Π² ΡΠ΅ΡΡ ΠΊΠ°ΡΠ΅Π³ΠΎΡΠΈΠΈ: 0 - Π½Π΅Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅Π½; I - Π΄Π΅ΡΠΈΠ½ΠΈΡΠΈΠ²Π½ΠΎ Π±Π΅Π½ΠΈΠ³Π½Π΅Π½; II - Π²Π΅ΡΠΎΡΡΠ½ΠΎ Π±Π΅Π½ΠΈΠ³Π½Π΅Π½; III - Π²ΡΠ·ΠΌΠΎΠΆΠ½ΠΎ ΠΌΠ°Π»ΠΈΠ³Π½Π΅Π½; IV - Π²Π΅ΡΠΎΡΡΠ½ΠΎ ΠΌΠ°Π»ΠΈΠ³Π½Π΅Π½; V - Π΄Π΅ΡΠΈΠ½ΠΈΡΠΈΠ²Π½ΠΎ ΠΌΠ°Π»ΠΈΠ³Π½Π΅Π½. ΠΡΠΎΡΡΠ°Π±ΡΠ»Π°ΡΠΈΡΡΠ° Π½Π° ΡΠ΅Π·ΡΠ»ΡΠ°ΡΠΈΡΠ΅ ΠΎΡ ΡΠΈΡΠΎΠ»ΠΎΠ³ΠΈΡΠ½ΠΈΡΠ΅ ΠΈ Ρ
ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ½ΠΈ ΡΠ΅Π·ΡΠ»ΡΠ°ΡΠΈ ΡΡΡΠ°Π½ΠΎΠ²ΠΈ, ΡΠ΅ Π’ΠΠ ΠΈΠΌΠ° ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»Π½ΠΎΡΡ 86.2%, ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡ 85.3% ΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ½Π° ΡΠΎΡΠ½ΠΎΡΡ 85.5%. ΠΡΠ΅Π΄ΡΡΠ°Π²Π΅Π½ΠΈΡΠ΅ Π΄Π°Π½Π½ΠΈ Π΄Π°Π²Π°Ρ ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠ΅ Π΄Π° ΡΠ΅ Π·Π°ΠΊΠ»ΡΡΠΈ, ΡΠ΅ ΡΡ Π΅ Π½Π°Π΄Π΅ΠΆΠ΄Π΅Π½ Π½Π°ΡΠΈΠ½ Π·Π° ΠΏΡΠ΅Π΄Π²Π°ΡΠΈΡΠ΅Π»Π½Π° ΠΏΡΠ΅Π΄ΠΎΠΏΠ΅ΡΡΠΈΠ²Π½Π° Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π°.Salivary gland tumours comprise 3% of all head and neck lesions; the parotid gland is most commonly affected. No single modality is suitable for preoperative diagnosis. The most common non-surgical means of obtaining preoperative information are imaging and needle aspiration cytology. The objective of the present study was to assess the diagnostic utility of fine needle aspiration biopsy (FNAB) and to define its place in the algorithm for diagnosis and treatment. Our study included 131 patients with adequate cytologic material, who underwent parotid gland surgery; the group included 76 men and 55 women, aged 19 to 94 years. Parotid masses were benign in 77.9% of the cases. Pleomorphic adenoma accounted for 44.7% of the benign tumors, followed by Warthin`s tumor (36.5%). Mucoepidermoid carcinoma and carcinoma ex pleomorphic adenoma represented, respectively, 24.1% and 13.8% of the malignancies. FNAB results were classified in six diagnostic categories: nondiagnostic, definitely benign, probably benign, possibly malignant, probably malignant, definitely malignant. Sensitivity of malignancy was 86.2%; specificity 85.3%; diagnostic accuracy 85.5%. The present data suggest that fine needle aspiration biopsy is a reliable tool for preoperative diagnosis
Baseline viral load - a predictor of treatment response in advanced hepatitis C
PURPOSE: The stage of liver disease and genotype of hepatitis C virus (HCV) are well-defined predictors for therapeutic success in chronic hepatitis C. This study aimed at assessing the prognostic role of baseline viral load for response to antiviral therapy in genotype 1 infected patients.MATERIAL AND METHODS: The study covered a total of 163 patients with hepatitis C, 93 of them with absent, mild or septal fibrosis (F0-F2) and 70 cases with bridging fibrosis (F3) or cirrhosis (F4). Viral load (HCV RNA) was determined with a sensitive RT-PCR technique. A high baseline viraemia was defined if HCV RNA exceeded 600000 IU/mL. All the patients were treated with peginterferon alfa and ribavirin for 24 to 48 weeks. They achieved a sustained viral response (SVR) if HCV RNA was undetectable six month after therapy cessation.RESULTS: SVR was registered in 80.6% of the patients with F0-F2 fibrosis stage, in 51.4% of those with F3-F4 fibrosis and in only 25% of 12 patients with early Child B cirrhosis or with present esophageal varices. Baseline viral load was not a prognostic factor for therapeutic effectiveness in early hepatitis C stage. However, in the advanced fibrosis stage, patients who achieved viral eradication had a significantly lower level of HCV RNA (440000 IU/mL) then those with relapse or non-response to therapy (997000 IU/mL).CONCLUSION: The most difficult-to-treat patients with HCV genotype 1 and advanced liver disease may successfully receive a standard treatment. The SVR rate is 51.4%, reaching the results of current triple therapy for F3-F4 stage. The viral eradication is associated with a low baseline viral load.Scripta Scientifica Medica 2013; 45(3): 53-57
Cervix carcinoma and incidental finding of medullary thyroid carcinoma by 18F-FDG PET/CT β clinical case
Thyroid nodules are encountered in clinical practice during the diagnostic procedures or patientsβ follow-up due to other diseases quite far from the thyroid gland with prevalence 4β50% in general population, depending on age, diagnostic method and race. The prevalence of thyroid nodules increases with age and their clarification should be done for their adequate treatment. An 18F-FDG PET/CT was done with a PET/CT scanner (Philips Gemini TF), consisting of dedicated lutetium orthosilicate full ring PET scanner and 16 slice CT. The PET/CT scan of the whole-body revealed on the CT portion a hypodense nodular lesion in the left lobe of the thyroid gland with increased uptake of 18F-FDG on the PET with SUVmax 10.3 and demonstrated a complete response to the induction therapy of the main oncological disease of the patient β squamous cell carcinoma. This clinical case demonstrates that whole-body 18F-FDG-PET/CT has an increasingly important role in the early evaluation of thyroid cancer as a second independent malignant localization. Focal thyroid lesion with high risk of thyroid malignancy was incidentally found on 18F-FDG PET/CT
18F-FDG PET/CT in the diagnosis of an extranodal relapse of diffuse large B-cell lymphoma (DLBCL): a clinical case with a literature review
Extranodal lymphoma, secondary to or accompanying nodal disease is uncommon, but not unusual finding. 18-Fluorodeoxyglucose positron emission tomography (18F-FDG PET/CT) imaging has an essential role in the staging of lymphoma, in treatment response monitoring, and in detection of recurrence. We present a case of a 52-year-old man with generalized diffuse large B-cell lymphoma (DLBCL) with multiple extranodal sites involvement detected by 18F-FDG PET/CT. With this clinical case we demonstrate that 18F-FDG PET-CT is a more effective technique than CE-CT for the evaluation of viable extranodal involvement of the diffuse large B-cell lymphoma (DLBCL) and should be combined in the monitoring of DLBCL
Correlation between serum TSH and malignancy potential of thyroid nodules
Π¦Π΅Π»: ΠΠΎΡΠ»Π΅Π΄Π½ΠΈ ΠΏΡΠΎΡΡΠ²Π°Π½ΠΈΡ ΠΏΠΎΠΊΠ°Π·Π²Π°Ρ, ΡΠ΅ ΠΏΠΎ-Π²ΠΈΡΠΎΠΊΠΈΡΠ΅ Π½ΠΈΠ²Π° Π½Π° ΡΠΈΡΠ΅ΠΎΡΡΠΈΠΌΡΠ»ΠΈΡΠ°Ρ Ρ
ΠΎΡΠΌΠΎΠ½ (Π’SH) ΡΠ΅ ΡΠ²ΡΡΠ·Π²Π°Ρ Ρ ΠΏΠΎΠ²ΠΈΡΠ΅Π½Π° ΡΠ΅ΡΡΠΎΡΠ° Π½Π° ΠΌΠ°Π»ΠΈΠ³Π½Π΅Π½ΠΎΡΡ ΡΡΠ΅Π΄ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ Ρ Π½ΠΎΠ΄ΠΎΠ·Π½Π° Π³ΡΡΠ°. Π‘Π΅ΡΡΠΌΠ½ΠΈΡΠ΅ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΠΈ Π½Π° TSH ΠΎΠ±Π°ΡΠ΅ ΡΠ΅ ΠΏΠΎΠ²Π»ΠΈΡΠ²Π°Ρ ΠΎΡ ΡΠ°Π·Π»ΠΈΡΠ½ΠΈ ΡΡΡΡΠΎΡΠ½ΠΈΡ. Π¦Π΅Π»ΡΠ° Π½Π° ΠΏΡΠΎΡΡΠ²Π°Π½Π΅ΡΠΎ Π±Π΅ Π΄Π° ΡΠ΅ ΠΊΠΎΡΠ΅Π»ΠΈΡΠ° Π½ΠΈΠ²ΠΎΡΠΎ Π½Π° TSH ΠΏΡΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ Ρ ΡΠΈΡΠ΅ΠΎΠΈΠ΄Π½ΠΈ Π²ΡΠ·Π»ΠΈ Ρ ΡΠΈΡΠΎΠ»ΠΎΠ³ΠΈΡΠ½ΠΈΡΠ΅ ΠΈ Ρ
ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ½ΠΈΡΠ΅ ΡΠ΅Π·ΡΠ»ΡΠ°ΡΠΈ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»ΠΈ ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈ: 1483 ΠΏΠΎΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»Π½ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ (1339 ΠΆΠ΅Π½ΠΈ ΠΈ 144 ΠΌΡΠΆΠ΅) Ρ Π²ΡΠ·Π»Π΅ΡΡΠ° ΡΡΡΡΠΌΠ° Π±ΡΡ
Π° ΠΎΡΠ΅Π½Π΅Π½ΠΈ Ρ ΡΡΠ½ΠΊΠΎΠΈΠ³Π»Π΅Π½Π° Π°ΡΠΏΠΈΡΠ°ΡΠΈΠΎΠ½Π½Π° Π±ΠΈΠΎΠΏΡΠΈΡ (Π’ΠΠ) ΠΏΠΎΠ΄ Π£Π ΠΊΠΎΠ½ΡΡΠΎΠ» Ρ ΡΠΈΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅Π½ ΡΠ΅Π·ΡΠ»ΡΠ°Ρ, ΠΊΠ»Π°ΡΠΈΡΠΈΡΠΈΡΠ°Π½ ΠΊΠ°ΡΠΎ Π½Π΅Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅Π½, Π±Π΅Π½ΠΈΠ³Π½Π΅Π½, ΡΠΎΠ»ΠΈΠΊΡΠ»Π°ΡΠ½Π° Π»Π΅Π·ΠΈΡ, ΡΡΡΠΏΠ΅ΠΊΡΠ΅Π½ ΠΈΠ»ΠΈ ΠΌΠ°Π»ΠΈΠ³Π½Π΅Π½. Π‘Π΅ΡΡΠΌΠ½ΠΈΡΠ΅ Π½ΠΈΠ²Π° Π½Π° TSH ΡΠ° ΠΈΠ·ΡΠ»Π΅Π΄Π²Π°Π½ΠΈ ΠΏΠΎ Ρ
Π΅ΠΌΠΈΠ»ΡΠΌΠΈΠ½ΠΈΡΡΠ΅Π½ΡΠ½Π° ΠΈΠΌΡΠ½ΠΎΠ΅Π½Π·ΠΈΠΌΠ½Π° ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠ°. 390 ΠΎΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ ΡΠ° ΠΎΠΏΠ΅ΡΠΈΡΠ°Π½ΠΈ ΠΈ ΠΎΠΊΠΎΠ½ΡΠ°ΡΠ΅Π»Π½ΠΎΡΠΎ Ρ
ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ½ΠΎ ΠΈΠ·ΡΠ»Π΅Π΄Π²Π°Π½Π΅ ΠΏΠΎΡΠ²ΡΡΠ΄ΠΈ 83 ΠΊΠ°ΡΡΠΈΠ½ΠΎΠΌΠ°.Π Π΅Π·ΡΠ»ΡΠ°ΡΠΈ: Π§ΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»Π½ΠΎΡΡΡΠ° ΠΈ ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡΡΠ° Π½Π° Π’ΠΠ Π² ΠΏΡΠ΅Π΄ΡΠΊΠ°Π·Π²Π°Π½Π΅ΡΠΎ Π½Π° ΠΌΠ°Π»ΠΈΠ³Π½Π΅Π½ΠΎΡΡ Π±ΡΡ
Π° ΡΡΠΎΡΠ². 90,32% ΠΈ 81,11%. Π‘ΡΠ΅Π΄Π½ΠΎΡΠΎ Π½ΠΈΠ²ΠΎ Π½Π° ΡΠ΅ΡΡΠΌΠ½ΠΎ TSH ΠΏΡΠΈ ΡΠΈΡΠΎΠ»ΠΎΠ³ΠΈΡΠ½ΠΎ Π΄ΠΎΠ±ΡΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½ΠΈΡΠ΅ Π²ΡΠ·Π»ΠΈ Π±Π΅ 1,7032,569 mU/l, ΠΏΡΠΈ ΡΠΎΠ»ΠΈΠΊΡΠ»Π°ΡΠ½ΠΈΡΠ΅ Π»Π΅Π·ΠΈΠΈ 2,3934,119 mU/l, ΠΏΡΠΈ ΡΡΡΠΏΠ΅ΠΊΡΠ½ΠΈΡΠ΅ Π½ΠΎΠ΄ΡΠ»ΠΈ 2,3262,317 mU/l ΠΈ ΠΏΡΠΈ ΡΠΈΡΠΎΠ»ΠΎΠ³ΠΈΡΠ½ΠΎ ΠΌΠ°Π»ΠΈΠ³Π½Π΅Π½ΠΈΡΠ΅ Π²ΡΠ·Π»ΠΈ 3,0452,781 mU/l. ΠΠ°ΠΊΠ°Ρ ΠΈ Π² ΡΠ΅ΡΠ΅ΡΠ΅Π½ΡΠ½ΠΈ Π³ΡΠ°Π½ΠΈΡΠΈ Π’SH Π½ΠΈΠ²Π°ΡΠ° ΠΏΡΠΈ ΠΌΠ°Π»ΠΈΠ³Π½Π΅Π½ΠΈΡΠ΅ ΡΠΈΡΠΎΠ»ΠΎΠ³ΠΈΠΈ ΡΠ° Π·Π½Π°ΡΠΈΠΌΠΎ ΠΏΠΎ-Π²ΠΈΡΠΎΠΊΠΈ Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠ΅ Ρ Π±Π΅Π½ΠΈΠ³Π½Π΅Π½ΠΈΡΠ΅ ΡΠ»ΡΡΠ°ΠΈ (p<0,0001). Π’Π°Π·ΠΈ Π²ΡΡΠ·ΠΊΠ° Π±Π΅ ΠΏΠΎΡΠ²ΡΡΠ΄Π΅Π½Π° ΠΈ ΡΡΠ΅Π΄ ΠΎΠΏΠ΅ΡΠΈΡΠ°Π½ΠΈΡΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ, ΠΏΡΠΈ ΠΊΠΎΠΈΡΠΎ ΡΡΠ΅Π΄Π½ΠΎΡΠΎ ΠΏΡΠ΅Π΄ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΎ Π’SH Π΅ ΡΠΈΠ³Π½ΠΈΡΠΈΠΊΠ°Π½ΡΠ½ΠΎ ΠΏΠΎ-Π²ΠΈΡΠΎΠΊΠΎ ΠΏΡΠΈ Ρ
ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ½ΠΎ Π·Π»ΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½ΠΈΡΠ΅ Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠ΅ Ρ Π΄ΠΎΠ±ΡΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½ΠΈΡΠ΅ Π²ΡΠ·Π»ΠΈ (TSH 3,387 vs. 1,613 mU/l; p<0,0001). Π‘ ΡΠ΅Π» Π΄Π° ΠΈΠ·Π±Π΅Π³Π½Π΅ΠΌ ΡΠ°ΠΊΡΠΎΡΠΈ, Π²Π»ΠΈΡΠ΅ΡΠΈ Π½Π° Π’SH Π½ΠΈΠ²Π°ΡΠ°, ΠΈΠ·ΠΊΠ»ΡΡΠΈΡ
ΠΌΠ΅ Π²ΡΠΈΡΠΊΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ Ρ ΡΠΈΡΠ΅ΠΎΠΈΠ΄Π½Π° Π°Π²ΡΠΎΠ½ΠΎΠΌΠΈΡ, ΡΠΈΡΠ΅ΠΎΠΈΠ΄ΠΈΡ Π½Π° Π₯Π°ΡΠΈΠΌΠΎΡΠΎ (ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»Π½ΠΈ Π°Π½ΡΠΈΡΠ΅Π»Π°, Π£Π Π²ΠΈΠ΄, Π»ΠΈΠΌΡΠΎΡΠΈΡΠ½Π° ΠΈΠ½ΡΠΈΠ»ΡΡΠ°ΡΠΈΡ Π² Ρ
ΠΈΡΠΎΠ»ΠΎΠ³ΠΈΡΠ½ΠΈΡ ΠΏΡΠ΅ΠΏΠ°ΡΠ°Ρ), ΠΊΠ°ΠΊΡΠΎ ΠΈ ΡΠ΅Π·ΠΈ, ΠΏΡΠΈΠ΅ΠΌΠ°ΡΠΈ Π»Π΅Π²ΠΎΡΠΈΡΠΎΠΊΡΠΈΠ½ ΠΈΠ»ΠΈ ΡΠΈΡΠ΅ΠΎΡΡΠ°ΡΠΈΡΠΈ. Π‘ΡΠ΅Π΄ ΠΎΡΡΠ°Π²Π°ΡΠΈΡΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΡΡΠ΅Π΄Π½ΠΎΡΠΎ Π’SH ΠΎΡΡΠ°Π½Π° Π·Π½Π°ΡΠΈΠΌΠΎ ΠΏΠΎ-Π½ΠΈΡΠΊΠΎ ΠΏΡΠΈ Π΄ΠΎΠ±ΡΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½ΠΈΡΠ΅ Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠ΅ ΡΡΡ Π·Π»ΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½ΠΈΡΠ΅ ΡΠ»ΡΡΠ°ΠΈ (1,370 vs. 2,805 mU/l; p<0,0001).ΠΠ·Π²ΠΎΠ΄ΠΈ: Π Π΅Π·ΡΠ»ΡΠ°ΡΠΈΡΠ΅ Π½ΠΈ ΠΏΡΠ΅Π΄ΠΏΠΎΠ»Π°Π³Π°Ρ Π΄ΠΈΡΠ΅ΠΊΡΠ½Π° Π²ΡΡΠ·ΠΊΠ° ΠΌΠ΅ΠΆΠ΄Ρ ΡΠ΅ΡΡΠΌΠ½ΠΈΡ Π’SH ΠΈ ΡΠΈΡΠΊΠ° Π·Π° ΠΌΠ°Π»ΠΈΠ³Π½Π΅Π½ΠΎΡΡ ΠΏΡΠΈ ΡΠΈΡΠ΅ΠΎΠΈΠ΄Π½ΠΈΡΠ΅ Π½ΠΎΠ΄ΡΠ»ΠΈ ΠΊΠ°ΠΊΡΠΎ Π² ΡΠΈΡΠΎΠ»ΠΎΠ³ΠΈΡΠ½ΠΈ, ΡΠ°ΠΊΠ° ΠΈ Π² Ρ
ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ½ΠΈ ΡΠ΅ΡΠΈΠΈ ΡΠ»Π΅Π΄ ΠΈΠ·ΠΊΠ»ΡΡΠ²Π°Π½Π΅ Π½Π° Π²Π»ΠΈΡΠ½ΠΈΠ΅ΡΠΎ Π½Π° ΡΠ°Π·Π»ΠΈΡΠ½ΠΈ ΡΠΈΡΠΎΠ²ΠΈΠ΄Π½ΠΈ Π·Π°Π±ΠΎΠ»ΡΠ²Π°Π½ΠΈΡ ΠΈ ΠΌΠ΅Π΄ΠΈΠΊΠ°ΠΌΠ΅Π½ΡΠΈ.Objectives:Recent studies have reported that higher levels of TSH are associated with an increased incidence of thyroid malignancy in patients with nodular thyroid disease. However, different conditions may affect TSH concentration. The aim of our study was to correlate serum TSH levels in patients with thyroid nodules with cytological and histological results.Materialsandmethods:1483 consecutive patients (1339 women and 144 men) with nodular thyroid disease were evaluated by ultrasound-guided fine needle aspiration biopsy (FNAB) with cytological results classified as nondiagnostic, benign, follicular lesion, suspicious or malignant. Serum levels of TSHwere measured at presentation by chemiluminescent immunoassay. 390 of the patients were operated and final histology proved 83 carcinomas.Results:The overall sensitivity and specificity of FNAB in predicting malignancy were 90,32% and 81,11%, respectively. Mean TSH in cytologically benign nodules was 1,7032,569 mU/l, in follicular lesions 2,3934,119 mU/l, in suspicious nodules 2,3262,317 mU/l and in malignant on cytology nodules 3,0452,781 mU/l. Although in the reference range TSH levels in malignant cytologies were significantly higher that those in benign cases (p<0,0001). This relationship was confirmed among operated cases where mean preoperative TSH was significantly higher in histologically malignant than benign nodules (TSH 3,387 vs. 1,613 mU/l; p<0,0001). In order to eliminate the factors influencing TSH concentration, we excluded all patients with thyroid autonomy, Hashimoto`s thyroiditis (positive antibodies, US appearance, lymphocytic infiltration on histology) and those on levothyroxin or thyrostatic treatment. Among the rest of the patients, mean TSH value remained significantly lower in benign than malignant cases (1,370 vs. 2,805 mU/l; p<0,0001).Conclusion:Our results suggest a direct relationship between serum TSH and risk of malignancy in thyroid nodules both in cytological and histological series after excluding the influence of different thyroid diseases and medication
Diagnostic value of fine needle aspiration biopsy of space-occupying soft tissue lesions in the head and neck region
ΠΠ°Π±ΠΎΠ»ΡΠ²Π°Π½ΠΈΡΡΠ° Π½Π° ΠΌΠ΅ΠΊΠΈΡΠ΅ ΡΡΠΊΠ°Π½ΠΈ Π½Π° Π³Π»Π°Π²Π°ΡΠ° ΠΈ ΡΠΈΡΡΠ° ΡΠ° ΡΠ°Π·Π½ΠΎΠΎΠ±ΡΠ°Π·Π½ΠΈ ΠΏΠΎ ΡΠ²ΠΎΡ Ρ
Π°ΡΠ°ΠΊΡΠ΅Ρ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡ - Π±Π΅Π½ΠΈΠ³Π½Π΅Π½ΠΈ ΠΈ ΠΌΠ°Π»ΠΈΠ³Π½Π΅Π½ΠΈ ΡΡΠΌΠΎΡΠΈ, ΠΊΠΈΡΡΠΎΠ·Π½ΠΈ ΠΎΠ±ΡΠ°Π·ΡΠ²Π°Π½ΠΈΡ, Π²ΡΠ·ΠΏΠ°Π»ΠΈΡΠ΅Π»Π½ΠΈ ΠΏΡΠΎΡΠ΅ΡΠΈ. ΠΠΎΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ½ΠΎΡΠΎ ΠΈΠΌ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠΈΡΠ°Π½Π΅ ΠΎΠΏΡΠ΅Π΄Π΅Π»Ρ ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ½ΠΈΡ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄. ΠΠ΅ΡΠ½ΠΎ ΠΏΡΠΈΠ»ΠΎΠΆΠΈΠΌ ΠΈ Ρ Π½Π°ΠΉ-ΠΌΠ°Π»ΠΊΠΎ ΡΡΡΠ°Π½ΠΈΡΠ½ΠΈ Π΅ΡΠ΅ΠΊΡΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡeΠ½ ΠΌΠ΅ΡΠΎΠ΄ Π΅ ΡΡΠ½ΠΊΠΎΠΈΠ³Π»Π΅Π½Π°ΡΠ° Π°ΡΠΏΠΈΡΠ°ΡΠΈΠΎΠ½Π½Π° Π±ΠΈΠΎΠΏΡΠΈΡ (Π’ΠΠ), ΡΡΡΠ΅ΡΠ°Π½Π° Ρ, ΠΈΠ»ΠΈ ΠΏΡΠ΅Π΄ΡΠ΅ΡΡΠ²Π°Π½Π° ΠΎΡ ΠΎΠ±ΡΠ°Π·Π½ΠΈ ΠΈΠ·ΡΠ»Π΅Π΄Π²Π°Π½ΠΈΡ. Π Π½Π°ΡΡΠΎΡΡΠΎΡΠΎ ΠΏΡΠΎΡΡΠ²Π°Π½Π΅ ΡΠ° ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π΅Π½ΠΈ 69 ΡΠ»ΡΡΠ°Ρ Π½Π° Π’ΠΠ ΠΎΡ ΠΎΠ±Π΅ΠΌΠ·Π°Π΅ΠΌΠ°ΡΠΈ ΠΏΡΠΎΡΠ΅ΡΠΈ Π½Π° ΠΌΠ΅ΠΊΠΈΡΠ΅ ΡΡΠΊΠ°Π½ΠΈ Π² ΠΎΠ±Π»Π°ΡΡΡΠ° Π½Π° Π³Π»Π°Π²Π°ΡΠ° ΠΈ ΡΠΈΡΡΠ°. Π‘ΡΠΏΠΎΡΡΠ°Π²ΠΊΠ°ΡΠ° Π½Π° ΡΠΈΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅Π½ ΠΈ Ρ
ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅Π½ ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π», ΠΏΠΎΠΊΠ°Π·Π²Π° Π²ΠΈΡΠΎΠΊ ΠΏΡΠΎΡΠ΅Π½Ρ Π½Π° ΡΡΠ²ΠΏΠ°Π΄Π΅Π½ΠΈΠ΅. Π’ΠΠ Π΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΠ° Π²ΠΈΡΠΎΠΊΠ° ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»Π½ΠΎΡΡ - 100%, ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡ - 88.52% ΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ½Π° ΡΠΎΡΠ½ΠΎΡΡ - 89.96% Π²ΡΠ² Π²ΡΠΈΡΠΊΠΈ ΡΠ»ΡΡΠ°ΠΈ.Soft tissue pathology in the head and neck region includes benign and malignant tumors, cystic lesions, inflammatory conditions. Fine needle aspiration biopsy (FNAB) is easy to perform and minimally invasive diagnostic procedure, especially in combination with diagnostic imaging. The present study represents 69 cases of FNAB obtained from space-occupying soft tissue lesions in the head and neck. Excisional biopsy confirmed the high diagnostic value. FNAB showed high sensitivity - 100%, specificity - 88.52% and diagnostic accuracy - 89.96%
Therapeutical approach in patients with cutaneous pseudolymphomas
Cutaneous pseudolymphomas are reactive lymphocytic proliferations that appear in the skin and resemble a malignant lymphoma. Most of the pseudolymphomas are caused by infections with B. Burgdorferi, others include tattoo reactions, immunizations or allergens desensibilization injections and infection with herpes simplex and zoster. The most common clinical man if estations include a single large nodule or solitary and multiple lesions. They are sharply bordered, soft, reddish, dome- shaped and covered by thinned skin. The sites of predilection include the ear lobes, nape, nipple and areola, axillae, scrotum and the dorsum of the foot. Scripta Scientifica Medica 2011;V.43(1):23-2