[Thyroid carcinoma diagnosed by pathology during surgery].
We describe the pathological diagnosis of 4 resected cases of thyroid carcinoma made during surgery in comparison to that for 6 benign thyroid tumors. Preoperative computed tomography scanning and ultrasonography revealed 1 case of simple nodules, 3 cases of multiple nodules, 3 cases of solid cystic nodules, and 3 cases of calcification. Cytological examination of fine needle aspirates revealed 1 case to be Class II and 3 cases to be Class III. The diagnosis, which was made during the operation procedure on the basis of the frozen section and final operative methods, was papillary adenocarcinoma in 2 cases (total thyroidectomy + D1 and subtotal thyroidectomy+D1) and suspected papillary adenocarcinoma in 2 cases (hemithyroidectomy+ D1 and lobectomy of the thyroid+D1). The final pathological diagnosis of the 4 cases was papillary adenocarcinoma (pStage I: 3 cases, pStage II: 1 case). In the 6 cases of benign thyroid tumor, preoperative examinations revealed variegated tumor findings, and cytological examination of fine needle aspirates revealed 1 case to be ClassII and 5 cases to be ClassIII. Pathological diagnosis of the frozen sections of the 6 benign samples indicated 1 case of suspected malignancy and 5 cases of benign tumor. In all 10 cases, the pathological diagnosis based on frozen sections (with a sensitivity of 4/4 and specificity of 5/6) was more accurate than that established with preoperative imaging and cytological examination, and is therefore effective for the decision-making process when selecting the operative method.
Dept. of Surgery, Tokyo Metropolitan Ohtsuka Hopital.
Haruya
H
Koshiishi
Takuya
T
Nakata
Ken
K
Imaizumi
Masaki
M
Kakimoto
Hiroyuki
H
Kato
Atsumi
A
Tamura
Hidemitsu
H
Tsutsui
Norihiko
N
Ikeda
D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy