Purpose: Fine needle aspiration is a safe and relatively accurate procedure for distinguishing benign and malignant lesions. We determined the diagnostic value of ultrasoundguided fine needle aspiration using an extension tube and examination by an endocrine surgeon. Methods: We reviewed the medical records of 257 consecutive patients receiving surgery for thyroid nodules in the Department of Surgery, Jesus Hospital, from January, 2006, to August, 2008. All patients received ultrasound-guided fine needle aspiration with an extension tube. Results: The male to female ratio was 1：5.5. Definitive histopathological diagnosis revealed benign lesions in 120 cases (47%) and malignant lesions in 137 cases (53%). Benign lesions were composed of nodular goiter (102 cases), follicular adenoma (13 cases), and Hashimoto thyroiditis (5 cases). Malignant lesions were composed of papillary carcinoma (131 cases) and follicular carcinoma (6 cases). Fine needle aspiration cytology revealed benign lesions in 103 cases and malignant lesions in 126 cases. The Overall results of ultrasound-guided FNA were: sensitivity, 94.5%, specificity, 95.0%, positive predictive value, 96.0%, negative predictive value, 93.2%, accuracy rate, 94.7%, false negative, 5.4%, and false positive, 4.9%. Most specimens (96.4%) were amenable for diagnosis. Conclusion: Fine needle aspiration is a good method for the differential diagnosis of thyroid nodules. High resolution ultrasound-guided FNA with an extension tube is helpful for obtaining good specimens.

Purpose: High resolution ultrasonography has recently become a useful tool to differentiate malignant thyroid nodules from benign thyroid nodules. We performed this study in order to determine the usefulness of an ultrasonography examination that's performed by endocrinologic surgeons through the analysis of the sonographic characteristics. Methods: A retrospective review was undertaken for 312 patients who underwent surgery and a US examination by the operator before surgery due to thyroid nodules at Jesus Hospital from February 2006 to March 2008. The review consisted of the characteristics of the sonographic parameters, such as the margin, structure, shape, echogenicity, homogeneity, calcification, sponge sign and the width/height ratio. Results: On univariate analysis of the non-follicular neoplasm, the significant parameters were the margin, structure, shape, echogeneity, homogeneity, calcification and the width/height ratio. On the logistic regression analysis, the margin, structure, shape and echogenecity were significant parameters. On a univariateanalysis of the follicular neoplasm, the significant parameters were the shape, echogenecity, homogeneity and calcification. On the logistic regression analysis of the total thyroid nodules, the margin, structure, shape and echogenecity were significant parameters. Especially, hypoechoic and solid structures are the most potent malignant characteristics.

Purpose: Fine needle aspiration cytology (FNAC) is a very useful procedure for the diagnosis and management of thyroid disease. The use of FNAC has increased over the years. We determined the incidence of complications associated with ultrasound-guided FNAC using an extended tube for a thyroid mass and the factors that contribute to such complications. Methods: A retrospective chart review was conducted to identify patients who underwent FNAC. Two hundred fifty-four patients underwent 325 procedures between July and September 2009. Results: There were no major complications associated with ultrasound-guided FNAC using an extended tube for a thyroid mass. The most minor complication was neck pain, which occurred in 16.1% of the patients (41/254). Multiple FNACs, anti-coagulant medications, abnormal thyroid function tests, nature of the mass, and size of the mass did not contribute to the complications in this study. Conclusion: Using an extended tube during ultrasoundguided FNAC for a thyroid mass is safe and convenient. 2) 연구 방법(1) 세침 흡인 검사 방법: 환자를 누운 자세에서 어깨 밑

Purpose:The follicular variant of papillary thyroid carcinoma (FVPTC) is difficult to diagnose due to pathologic features. There is also debate on the optimal extent of surgery. We separated FVPTC into two groups and compared the clinical features in an attempt to apply the treatment. Methods: All 40 patients with FVPTC who were diagnosed between 1990 and 2009 were reviewed and separated into two groups, an encapsulated group and an infiltrative group, based on whether a capsule was formed or infiltration occurred. These two different subtypes of FVPTC were compared on the traits of sensitivity of diagnosis and clinicopathologic features. Results: After review by a pathologist, 21 of 40 patients (55%) were found to have encapsulated tumors, and 18 patients (45%) had infiltrative tumors. There was no difference in age, sex, or size. Patients with encapsulated FVPTC had a significantly lower rate of lymph node metastasis (4.5%), multicentric tumors (18.2%), and thyroid capsular invasion (9.1%) compared with the infiltrative tumor group (50%, 50% and 50%, P＜0.05). There was no difference in FNA sensitivity between the two groups, but the sensitivity to frozen biopsy was higher in the infiltrative group. There was no recurrence in the encapsulated group, but 4 patients (22.2%) experienced recurrence in the infiltrative group. Conclusion: FVPTC can be separated into two subgroups by histologic features, and there are some clinicopathologic differences between the two groups. Patients who had encapsulated FVPTC had a lower rate of lymph node metastasis, multicentric tumors, and thyroid capsular invasion. They also showed a lower rate of recurrence than the infiltrative group. It is suggested that the encapsulated group can be treated with limited surgery and the infiltrative group needs aggressive treatment. (Korean J Endocrine Surg 2011;11:256-261)

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