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Diagnosis of thyroid carcinoma by ultrasonic examination: Comparison with that by fine needle aspiration cytology
246 DIAGNOSIS OF THYROID CONPARISON EXAMINATION: ASPIRATION CYTOLOGY. Makot" Division Kurnshiki,
KnTACIRI, of
Tanekazu
Endocrine Japan
CARCINONA WITH THAT
BY BY
HARADA. Tokuhik”
Surgery,
Kawasaki
ULTRASONIC FINE NEEDLE
THE INCIDENCE DISEASES.
KIMONO
T. KIYONO, T. Harada
Eledical
School.
ulcroson~c exaninatinn and fine r.eedle At present, cytology (FNAC) are the m”sf popular aspiration modalities for the diagnosis of thyroid carcinoma in Japan. In this paper, “e describe the diagnostic value examination for thyroid carcinoma. of ultrasonic comparing it with that of FNAC, and introduce a newly devised diagnostic system using a fuzzy inference t" make the diagnosis clearer and simpler. Ultrasonic examination was performed on 120 patients undergoing surgery, consisting of 56 cases of carcinoma and 64 cases of benign nodule. FNAC was performed on 109 cases "I these patients before surgery. Fifty cases of 64 benign nodules and 46 cases of 56 carcinomas were diagnosed correctly with ultrasonic examination. The sensitivity for cancer diagnosis was 0.84. specificity was 0.78 and accuracy was 0.81. On the other hand, with ““I: diagnostic tool "sing a fuzzy inference, sensitivity "as 0.79, specificity was 0.71 and accuracy was 0.i6. Ultr”s”nic findings of distorted shape, rough margin. UllCl.2aK boundary, heterogeneous internal echoes and the presence of hyperechoic sp”ts were important for the diagnosis of carcinoma. In contrast, 35 cases of 49 carcinomas were diagnosed as Glass IV or V with FNAC, an" 5U cases of 60 benign nodules were diagnosed as Class I or II. The sensitivity for c”nc”r diagnosis was 0.71, specificity was 0.83 and accucacy was 0.78. Ultrasonic examination is a non-invasive and painless method and has high diagnostic accuracy. Furthermore, a non-palpable nodule in the thyroid can also be detected and punctured exactly with ultrasonic We conclude that ultrasonic examination as a guidance. supplementary diagnostic tool for thyroid carcinoma is clinically a very useful method.
Division Kurashiki,
OF
El. Katagiri,
of
GROUND
T.
GLASS
Otawa,
Endocrine Surgery, 701-01, Japan
NUCLEI
IN
K. Yoshikawa.
Kawasaki
Medical
THYROID
K. Ota,
School,
Ground glass nuclei are an important finding in the diagnosis of papillary carcinoma of the thyroid. They appear only in formalin-fixed histologic sections, and are not seen in frozen sections or cytology specimens. We histologically examined the incidence of ground glass nuclei in thyoid diseases in various I" routinely conditions. prepared hisr"l"gical sece1ons, ground glass nuclei were seen in 44(88%, ~~0.01) of 50 cases of papillary carcinoma, and 1(4X) of 25 cases of adenomatous goiter. No ground glass nuclei were present in 20 cases of Graves's disease or 5 cases of follicular carcinoma. There was no diflerence in the incidence oi the ground glass nuclei of papillary carcinoma fixed with various fixntives, such as various concentrations of formalin, phosphate brlffered formalin, 2.5% glutaraldehyde, D-5 fixative, bouin fixative, acetone, 99.5% ethanol "f Carnoy flxacive. We compared the incidence in routinely prepared histologic sections with that in specimens fixed in 20% formalin for five years, but no duration of iixation influenced the incidence of ground glass We belleve nuclei in 16 cases of papillary carcinoma. that ground glass nuclei appear with no relation t" the duration of the iixative or the kind of fixation. Therefore, they are a reliable histologic finding in papillary carcinoma of the thyroid, as Hapke and Dehner insisted in their paper.
KnTACIRI, of
Tanekazu
Endocrine Japan
CARCINONA WITH THAT
BY BY
HARADA. Tokuhik”
Surgery,
Kawasaki
ULTRASONIC FINE NEEDLE
THE INCIDENCE DISEASES.
KIMONO
T. KIYONO, T. Harada
Eledical
School.
ulcroson~c exaninatinn and fine r.eedle At present, cytology (FNAC) are the m”sf popular aspiration modalities for the diagnosis of thyroid carcinoma in Japan. In this paper, “e describe the diagnostic value examination for thyroid carcinoma. of ultrasonic comparing it with that of FNAC, and introduce a newly devised diagnostic system using a fuzzy inference t" make the diagnosis clearer and simpler. Ultrasonic examination was performed on 120 patients undergoing surgery, consisting of 56 cases of carcinoma and 64 cases of benign nodule. FNAC was performed on 109 cases "I these patients before surgery. Fifty cases of 64 benign nodules and 46 cases of 56 carcinomas were diagnosed correctly with ultrasonic examination. The sensitivity for cancer diagnosis was 0.84. specificity was 0.78 and accuracy was 0.81. On the other hand, with ““I: diagnostic tool "sing a fuzzy inference, sensitivity "as 0.79, specificity was 0.71 and accuracy was 0.i6. Ultr”s”nic findings of distorted shape, rough margin. UllCl.2aK boundary, heterogeneous internal echoes and the presence of hyperechoic sp”ts were important for the diagnosis of carcinoma. In contrast, 35 cases of 49 carcinomas were diagnosed as Glass IV or V with FNAC, an" 5U cases of 60 benign nodules were diagnosed as Class I or II. The sensitivity for c”nc”r diagnosis was 0.71, specificity was 0.83 and accucacy was 0.78. Ultrasonic examination is a non-invasive and painless method and has high diagnostic accuracy. Furthermore, a non-palpable nodule in the thyroid can also be detected and punctured exactly with ultrasonic We conclude that ultrasonic examination as a guidance. supplementary diagnostic tool for thyroid carcinoma is clinically a very useful method.
Division Kurashiki,
OF
El. Katagiri,
of
GROUND
T.
GLASS
Otawa,
Endocrine Surgery, 701-01, Japan
NUCLEI
IN
K. Yoshikawa.
Kawasaki
Medical
THYROID
K. Ota,
School,
Ground glass nuclei are an important finding in the diagnosis of papillary carcinoma of the thyroid. They appear only in formalin-fixed histologic sections, and are not seen in frozen sections or cytology specimens. We histologically examined the incidence of ground glass nuclei in thyoid diseases in various I" routinely conditions. prepared hisr"l"gical sece1ons, ground glass nuclei were seen in 44(88%, ~~0.01) of 50 cases of papillary carcinoma, and 1(4X) of 25 cases of adenomatous goiter. No ground glass nuclei were present in 20 cases of Graves's disease or 5 cases of follicular carcinoma. There was no diflerence in the incidence oi the ground glass nuclei of papillary carcinoma fixed with various fixntives, such as various concentrations of formalin, phosphate brlffered formalin, 2.5% glutaraldehyde, D-5 fixative, bouin fixative, acetone, 99.5% ethanol "f Carnoy flxacive. We compared the incidence in routinely prepared histologic sections with that in specimens fixed in 20% formalin for five years, but no duration of iixation influenced the incidence of ground glass We belleve nuclei in 16 cases of papillary carcinoma. that ground glass nuclei appear with no relation t" the duration of the iixative or the kind of fixation. Therefore, they are a reliable histologic finding in papillary carcinoma of the thyroid, as Hapke and Dehner insisted in their paper.