Displaying publications 21 - 40 of 126 in total

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  1. Fulltext Spectrum of thyroid lesions in hospital Universiti Sains Malaysia over 11years and a review of thyroid cancers in Malaysia
    Othman NH, Omar E, Naing NN
    Asian Pac J Cancer Prev, 2009;10(1):87-90.
    PMID: 19469631
    INTRODUCTION: Endemic goitre is a major concern in many nations including Malaysia. Seven states in the country have been identified by Ministry of Health of Malaysia to have high incidence of goitre and one of these is Kelantan.

    METHODS: This is a retrospective study over an 11-year period from 1994 to 2004 on all thyroid specimens submitted to the Pathology Department, Hospital Universiti Sains Malaysia (HUSM), in Kelantan. Epidemiological data were retrieved from the patients' records and pathology findings from the pathology reports.

    RESULTS: During this period, Department of Pathology HUSM received a total of 1,486 thyroid specimens. The female to male ratio was 6:1 and the median age was 40.0 years. The duration of goitre ranged from one to 15 years. Histopathological examination showed 71.9 percent were non-neoplastic and 28.1 percent neoplastic lesions. The hospital-based incidence of nodular hyperplasia was 9.9 per 100,000 admitted patients per year. The hospital-based incidence of all types of malignant thyroid cancers was 3.5 per 100,000. The most common malignancy was papillary carcinoma 76.6 percent. The majority of the cancers (59.5 percent) occurred in a background of nodular hyperplasia. Thyroid cancers made up 4.9 percent of all cancers seen in HUSM.

    CONCLUSION: This study suggests that malignant thyroid lesions arising from multi-nodular goitre are high in a population living in an iodine-deficiency area.
    Matched MeSH terms: Thyroid Neoplasms/epidemiology*
  2. Fine needle aspiration cytology of the thyroid--a review of experience in 1853 cases
    Jayaram G, Razak A, Gan SK, Alhady SF
    Malays J Pathol, 1999 Jun;21(1):17-27.
    PMID: 10879275
    1853 thyroid lesions subjected to cytological sampling (either by the fine needle aspiration or fine needle capillary sampling technique) from January 1992 to December 1997 at the University Hospital, Kuala Lumpur, were reviewed. Nodular goitre was the most common thyroid lesion needled (67.35%). Among the neoplastic lesions, follicular neoplasms predominated (64%), followed by papillary carcinoma (29.4%). In 325 cases, partial or total thyroidectomy had been done, providing material for histological review and cyto-histological correlation. Cytological diagnosis was found to have high sensitivity and specificity rates of over 75%. Besides, most non-neoplastic thyroid lesions could be diagnosed on cytology. The scope of cytology in the diagnosis of lymphomas, anaplastic and metastatic tumours rendered diagnostic biopsies (or thyroidectomy) unnecessary in these cases. Being a cost-effective technique and having the capacity to provide exact morphological diagnosis in a large variety of thyroid lesions, cytology is obviously the method of choice in the assessment of thyroid nodules.
    Matched MeSH terms: Thyroid Neoplasms/pathology
  3. Fulltext Radiation doses to patient's relatives following radioiodine therapy
    Sulaiman BT, Clarke SE
    Med J Malaysia, 1996 Mar;51(1):131-3.
    PMID: 10967992
    A total of 10 volunteers were monitored for radiation doses, whose spouses were given radio-iodine (131I) orally. Nine of the spouses were given radio-iodine for Graves' disease and one for thyroid carcinoma. It was found that the highest radiation dose received by the volunteer was only 13.5% of the annual dose limit for individual members of the public. Hence, patients treated with radio-iodine do not pose a significant radiation hazard to the public.
    Matched MeSH terms: Thyroid Neoplasms/radiotherapy*
  4. Fulltext Solitary thyroid nodule--experience in a district hospital
    Thambi Dorai CR
    Med J Malaysia, 1988 Mar;43(1):55-8.
    PMID: 3244321
    Matched MeSH terms: Thyroid Neoplasms/diagnosis
  5. Features of post-radioiodine whole body scan in non-invasive Follicular Thyroid Neoplasm with papillary-like nuclear features (NIFTP)
    Wong TH, Tan TH, Chin SC, Lee BN
    Med J Malaysia, 2018 06;73(3):181-182.
    PMID: 29962506
    Recently, encapsulated follicular variant of papillary thyroid carcinoma has been reclassified as non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) to emphasize the benign nature of this entity. In our institution, we have assessed 455 patients treated with radioiodine ablation for differentiated thyroid carcinoma and 20 of them were retrospectively found to fulfill the new NIFTP criteria. There was no evidence of metastasis on post radioiodine whole body scans for NIFTP cases and these patients were in remission subsequently. The benign features of these patients' whole body scans and good clinical outcome following treatment further support NIFTP as a low risk thyroid neoplasm.
    Matched MeSH terms: Thyroid Neoplasms/pathology
  6. Fulltext New-onset Thyroid Eye Disease after COVID-19 Vaccination in a Radioactive Iodine-Treated Graves' Disease Patient: A Case Report and Literature Review
    Im Teoh JH, Mustafa N, Wahab N
    J ASEAN Fed Endocr Soc, 2023;38(1):125-130.
    PMID: 37252417 DOI: 10.15605/jafes.038.01.19
    Autoimmunity associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been well-described as the mechanism of development of thyroid dysfunction following Coronavirus Disease 19 (COVID-19) infection and SARS-CoV-2 vaccination. However, the occurrence of thyroid eye disease (TED) after SARS-CoV-2 vaccination is scarcely described. The postulated mechanisms include immune reactivation, molecular mimicry and the autoimmune/inflammatory syndrome induced by adjuvants (ASIA). We report a case of new-onset TED after receiving the SARS-CoV-2 vaccine.
    Matched MeSH terms: Thyroid Neoplasms*
  7. Fulltext Primary lymphoma of the thyroid: diagnostic and therapeutic considerations
    Sarinah B, Hisham AN
    Asian J Surg, 2010 Jan;33(1):20-4.
    PMID: 20497878 DOI: 10.1016/S1015-9584(10)60004-8
    Primary thyroid lymphoma is uncommon and accounts for less than 2-5% of all thyroid malignancies. The aim of the present study was to review our experience and management of primary thyroid lymphoma and to discuss the diagnostic and therapeutic considerations.
    Matched MeSH terms: Thyroid Neoplasms/diagnosis*; Thyroid Neoplasms/pathology; Thyroid Neoplasms/therapy*
  8. Fulltext Carcinoma of thyroid--clinical presentation and outcome
    Sothy K, Mafauzy M, Mohamad WB, Mustaffa BE
    Med J Malaysia, 1991 Sep;46(3):212-7.
    PMID: 1839914
    The clinical, biochemical and pathological features of 31 patients with thyroid carcinoma managed at Hospital Universiti Sains Málaysia, Kubang Kerian from 1985 to 1989 were analyzed. There were 25 females and 6 males. The types of carcinoma were: papillary-17 cases; follicular-10 cases; medullary-2 cases and anaplastic-2 cases. For papillary carcinoma the mean age of the patients was 52.9 years. For follicular carcinoma the mean age was 48.3 years, for medullary carcinoma, 48.5 years and for anaplastic, 74.5 years. All patients had pre-existing goitre except for 2 and most presented with advanced disease. The mean duration of symptoms for papillary carcinoma was 3.7 years, follicular carcinoma 1.6 years, medullary carcinoma 13.5 years and anaplastic carcinoma 6 months. 12 patients presented with goitre of increasing size; 9 had compression symptoms; 4 presented with cervical lymph node enlargement and 6 presented with bony pains of whom 2 had paraplegia. None of the patients were ever thyrotoxic or hypothyroid. Treatment in general was unsatisfactory because of patients' non-acceptance of surgery and/or radioactive iodine.
    Matched MeSH terms: Thyroid Neoplasms/radiotherapy; Thyroid Neoplasms/surgery; Thyroid Neoplasms/therapy*
  9. The management of solitary thyroid nodules under local anaesthesia
    Cunningham IG, Lee YK
    Aust N Z J Surg, 1975 Aug;45(3):285-9.
    PMID: 1058690
    A group of patients with solitary nodules of the thyroid were treated at the University of Malaya by surgery under local anaesthesia. This was done in order to expedite exploration of a potentially malignant condition. This group comprised 43 patients, and four cancers were found. The standard technique used was satisfactory from the viewpoint of both the patient and the surgeon. The pattern of this condition in a Malaysian population is documented, the technique used is described, and thyroidectomy under local aneaesthesia is discussed.
    Matched MeSH terms: Thyroid Neoplasms/epidemiology; Thyroid Neoplasms/pathology; Thyroid Neoplasms/surgery*
  10. Fulltext Follicular Thyroid Adenoma presented as Branchial cyst: Case report
    Abdul Halim Shibghatullah, Wan Shah Jihan Wan Din, Ramiza Ramza Ramli
    International Medical Journal Malaysia, 2008;7(1):1-5.
    MyJurnal
    Follicular adenoma defined as a well encapsulated benign neoplastic condition of thyroid follicles. We describe this interesting case of a boy presented with right sided neck swelling that was diagnosed as a branchial cyst but later after excision, the histopathology revealed follicular adenoma of the thyroid with hemorrhage and degenerative changes in the centre. To our knowledge, this is the first reported case of follicular thyroid adenoma presented as branchial cyst.
    Matched MeSH terms: Thyroid Neoplasms
  11. Fulltext Fine Needle Aspiration (FNA) Cytology of the Thyroid: A Cyto-Histopathological Study of 361 Cases in Hospital Universiti Kebangsaan Malaysia
    Nurismah, M.I., Sharifah, N.A., Usama, A.E., Rohaizak, M., Naqiyah, I., Jasmi, A.
    Medicine & Health, 2007;2(1):58-65.
    MyJurnal
    Thyroid nodules are common but thyroid malignancies are not. Fine needle aspiration (FNA) cytology is a diagnostic tool used to screen patients with thyroid nodules who require surgery. We study the diagnostic accuracy of FNA as the initial diagnostic modality in the clinical assessment of thyroid nodules. Between January 1995 until December 2000, 2131 FNA of thyroid nodules were performed. Four hundred and forty-one (20.7%) of these were unsatisfactory and 1690 (79.3%) cases were satisfactory for cytological evaluation. Histopathological diagnosis were available for 361 cases. Cyto-histopathological correlation was carried out  for these cases. Our results showed a diagnostic accuracy of 96.2% with sensitivity and specificity rates of 87.7% and 98.4% res- pectively. Our positive predictive value is  93.4% and our negative  predictive value is 96.8%.  From this study, we conclude that fine needle aspiration is an important initial screening diagnostic tool for the investigation of thyroid nodules.           
    Matched MeSH terms: Thyroid Neoplasms
  12. Papillary thyroid microcarcinoma diagnosed in a patient presenting with hyperthyroidism
    Surenthiran Ramanathan, Tong, Chin Voon
    International e-Journal of Science, Medicine & Education, 2017;11(3):30-31.
    MyJurnal
    Papillary thyroid microcarcinoma is not uncommon
    and constitutes almost one third of all differentiated
    thyroid carcinomas. It is generally regarded as low risk
    and usually an incidental finding from histopathology
    examination. Some areas of management of this entity
    remains uncertain and requires a multidisciplinary
    approach. We present a patient who initially came to
    us with symptoms of hyperthyroidism, later underwent
    thyroidectomy for a suspicious lesion but was found to
    have micropapillary thyroid carcinoma in another part
    of her thyroid gland.
    Matched MeSH terms: Thyroid Neoplasms
  13. Comparison of free hand versus ultrasound-guided fine needle aspiration of thyroid with histopathological correlation
    Krishnappa P, Ramakrishnappa S, Kulkarni MH
    J Environ Pathol Toxicol Oncol, 2013;32(2):149-55.
    PMID: 24099428
    Fine-needle aspiration (FNA) cytology of the thyroid is usually performed on an outpatient basis. The results of FNA are operator dependent and may be affected by the lesion characteristics and the aspiration technique. In current practice ultrasound (US) is widely used to guide the needle for aspiration of nondominant nodules. Our study aimed to compare the free-hand FNA with US-guided FNA in the evaluation of thyroid nodules. A total of 91 cases of thyroid lesions were studied at the Department of Pathology, Karnataka Institute of Medical Sciences, Hubli, India. All the cases underwent free-hand and US-guided FNA. The cytological samples from both procedures were analyzed for adequacy, cytological features, and possible diagnosis. The results were correlated with histopathological diagnosis whenever possible. Of 91 aspirates, 89 were satisfactory and 2 were unsatisfactory on US-guided FNA, whereas 85 were satisfactory and 6 were unsatisfactory in free-hand FNA. Of 91 cases 68 (74.7%) were nonneoplastic lesions and 21 (23.1%) were neoplastic lesions in US-guided FNA, whereas 67 cases (73.6%) were nonneoplastic and 18 cases (19.8%) were neoplastic in free-hand FNA. Histopathological study was possible in 25 patients, among whom 15 lesions were nonneoplastic and 10 were neoplastic. Sensitivity and specificity of US-guided FNA to detect neoplastic lesions were 81.81% and 92.85%, respectively, compared with free-hand FNA, for which the sensitivity and specificity were 54.54% and 92.85%, respectively. The diagnostic accuracy of guided FNA was 88% against the 76% accuracy rate of free-hand FNA. US-guided FNA provides a better representative sample and has a higher diagnostic rate in the evaluation of thyroid lesions.
    Matched MeSH terms: Thyroid Neoplasms/pathology; Thyroid Neoplasms/surgery; Thyroid Neoplasms/ultrasonography
  14. Fulltext Energy and macronutrient intake and risk of differentiated thyroid carcinoma in the European Prospective Investigation into Cancer and Nutrition study
    Zamora-Ros R, Rinaldi S, Tsilidis KK, Weiderpass E, Boutron-Ruault MC, Rostgaard-Hansen AL, et al.
    Int J Cancer, 2016 Jan 01;138(1):65-73.
    PMID: 26190646 DOI: 10.1002/ijc.29693
    Incidence rates of differentiated thyroid carcinoma (TC) have increased in many countries. Adiposity and dietary risk factors may play a role, but little is known on the influence of energy intake and macronutrient composition. The aim of this study was to investigate the associations between TC and the intake of energy, macronutrients, glycemic index (GI) and glycemic load in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The study included 477,274 middle-age participants (70.2% women) from ten European countries. Dietary data were collected using country-specific validated dietary questionnaires. Total carbohydrates, proteins, fats, saturated, monounsaturated and polyunsaturated fats (PUFA), starch, sugar, and fiber were computed as g/1,000 kcal. Multivariable Cox regression was used to calculate multivariable adjusted hazard ratios (HR) and 95% confidence interval (CI) by intake quartile (Q). After a mean follow-up time of 11 years, differentiated TC was diagnosed in 556 participants (90% women). Overall, we found significant associations only with total energy (HRQ4 vs .Q1 , 1.29; 95% CI, 1.00-1.68) and PUFA intakes (HRQ4 vs .Q1 , 0.74; 95% CI, 0.57-0.95). However, the associations with starch and sugar intake and GI were significantly heterogeneous across body mass index (BMI) groups, i.e., positive associations with starch and GI were found in participants with a BMI ≥ 25 and with sugar intake in those with BMI 
    Matched MeSH terms: Thyroid Neoplasms/etiology*; Thyroid Neoplasms/epidemiology*; Thyroid Neoplasms/pathology
  15. Wavelet energy-guided level set-based active contour: a segmentation method to segment highly similar regions
    Achuthan A, Rajeswari M, Ramachandram D, Aziz ME, Shuaib IL
    Comput Biol Med, 2010 Jul;40(7):608-20.
    PMID: 20541182 DOI: 10.1016/j.compbiomed.2010.04.005
    This paper introduces an approach to perform segmentation of regions in computed tomography (CT) images that exhibit intra-region intensity variations and at the same time have similar intensity distributions with surrounding/adjacent regions. In this work, we adapt a feature computed from wavelet transform called wavelet energy to represent the region information. The wavelet energy is embedded into a level set model to formulate the segmentation model called wavelet energy-guided level set-based active contour (WELSAC). The WELSAC model is evaluated using several synthetic and CT images focusing on tumour cases, which contain regions demonstrating the characteristics of intra-region intensity variations and having high similarity in intensity distributions with the adjacent regions. The obtained results show that the proposed WELSAC model is able to segment regions of interest in close correspondence with the manual delineation provided by the medical experts and to provide a solution for tumour detection.
    Matched MeSH terms: Thyroid Neoplasms/pathology; Thyroid Neoplasms/radiography
  16. Follicular thyroid carcinoma with direct tumour extension into the great cervical veins and right atrium: is transcervical thrombectomy a safe option?
    Taib NA, Hisham AN
    Asian J Surg, 2007 Jul;30(3):216-9.
    PMID: 17638642
    Direct tumour extension into the internal jugular veins (IJV) and right atrium in thyroid cancer is extremely uncommon. We report three cases of advanced thyroid cancer invading into the IJV and right atrium. All three patients had well-differentiated thyroid cancer and presented with typical clinical picture of the superior cava syndrome coupled with significant compressive symptoms. Two patients had obvious tumour thrombus extending to the superior vena cava (SVC) and right atrium, whilst in one patient, the thrombus extended to the SVC close to the edge of the right atrium. In all three patients, the intraluminal tumour thrombus was clinically palpable. Involvement of the IJV, SVC and right atrium was confirmed with computed tomography (CT) scan and echocardiography. The decision to extract the thrombus transcervically was made on the basis of the positive "ring sign", which is a thin rim of contrast surrounding the tumour thrombus documented on CT. All three patients underwent total thyroidectomy with segmental resection and ligation of the IJV. The tumour thrombus was successfully extracted transcervically. The histopathology report confirmed follicular carcinoma in all three patients. Two patients had radioiodine ablation therapy postoperatively, and were well 18 months after operation. One patient who had lung metastases documented on chest CT succumbed to the disease due to massive haemoptysis 3 weeks after operation.
    Matched MeSH terms: Thyroid Neoplasms/pathology*; Thyroid Neoplasms/surgery
  17. Fulltext Large fungating thyroid cancers: a unique surgical challenge
    Harjit KD, Hisham AN
    Asian J Surg, 2005 Jan;28(1):48-51.
    PMID: 15691799
    Large goitres are common in the developing world, particularly in Asia and Africa. Nonetheless, large fungating goitres are extremely rare and represent a unique challenge to surgeons. Surgery should always be considered, when the general condition of the patient permits, to provide a better quality of life as it offers the only hope of long-term survival. The potential gain with surgery is that it allows maximum benefit for more effective radioactive iodine ablation and radiotherapy treatment. We report two cases of large fungating thyroid cancers complicated by anaemia and foul-smelling discharge.
    Matched MeSH terms: Thyroid Neoplasms/pathology; Thyroid Neoplasms/surgery*
  18. MicroRNAs and Lymph Node Metastasis in Papillary Thyroid Cancers
    Mutalib NS, Yusof AM, Mokhtar NM, Harun R, Muhammad R, Jamal R
    Asian Pac J Cancer Prev, 2016;17(1):25-35.
    PMID: 26838219
    Lymph node metastasis (LNM) in papillary thyroid cancer (PTC) has been shown to be associated with increased risk of locoregional recurrence, poor prognosis and decreased survival, especially in older patients. Hence, there is a need for a reliable biomarker for the prediction of LNM in this cancer. MicroRNAs (miRNAs) are small noncoding RNAs that regulate gene translation or degradation and play key roles in numerous cellular functions including cell-cycle regulation, differentiation, apoptosis, invasion and migration. Various studies have demonstrated deregulation of miRNA levels in many diseases including cancers. While a large number of miRNAs have been identified from PTCs using various means, association of miRNAs with LNM in such cases is still controversial. Furthermore, studies linking most of the identified miRNAs to the mechanism of LNM have not been well documented. The aim of this review is to update readers on the current knowledge of miRNAs in relation to LNM in PTC.
    Matched MeSH terms: Thyroid Neoplasms/genetics*; Thyroid Neoplasms/pathology*
  19. Follicular adenoma with squamous metaplasia and cystic change: report of a case with fine needle aspiration cytological and histological features
    Jayaram G, Jayalakshmi P
    Malays J Pathol, 1999 Dec;21(2):101-4.
    PMID: 11068414
    Squamous metaplasia (SM) of thyroid follicular epithelium is known to occur in a variety of non-neoplastic lesions as well in thyroid neoplasms, notably papillary carcinoma (PC). In follicular thyroid tumors, on the other hand, SM is very rare. This case describes cytological and pathological findings in a follicular adenoma (FA) that presented as a cystic lesion with extensive SM. The fine needle aspiration (FNA) cytology sample in this case yielded only necrotic material from the cystic area and squamous cells, which being mostly of immature type, were not recognised as squamous in the cytological smears. The needle missed the solid (neoplastic) component of the lesion and on the whole the cytological picture was considered to be equivocal. FA can now be added to the spectrum of thyroid lesions that can show SM. Awareness of this will enable cytopathologists to consider non-papillary lesions in the differential diagnosis of thyroid nodules that yield squamous cells.
    Matched MeSH terms: Thyroid Neoplasms/pathology*; Thyroid Neoplasms/surgery
  20. CD56 expression in benign and malignant thyroid lesions
    Muthusamy S, Azhar Sha S, Abdullah Suhaimi SN, Kassim N, Mahasin M, Mohd Saleh MF, et al.
    Malays J Pathol, 2018 Aug;40(2):111-119.
    PMID: 30173227 MyJurnal
    INTRODUCTION: Thyroid cancer is the most common endocrine malignancy with more than 95% originating from follicular epithelial cells. Diagnostic dilemma may arise in occasional cases such as when an encapsulated nodule with a follicular growth pattern exhibits clear nuclei with grooves making it difficult to distinguish a follicular adenoma from encapsulated follicular variant papillary thyroid carcinoma. This study aimed to evaluate the diagnostic utility of an immunohistochemical marker, CD56, to distinguish between benign and malignant thyroid lesions.

    MATERIALS AND METHODS: We retrospectively studied CD56 expression in 54 benign and 54 malignant thyroid lesions using archival formalin fixed paraffin-embedded tissue blocks for the study period from January 2010 to December 2015, diagnosed in a tertiary hospital.

    RESULTS: CD56 was expressed in 52/54 (96.3%) of benign specimens and only 24/54 (44.4%) of malignant ones. The malignant specimens comprised 31 (57.4%) papillary thyroid carcinomas (PTC), 11 (20.3%) follicular carcinomas (FC), seven (13%) medullary thyroid carcinomas (MC), one (1.9%) poorly differentiated carcinoma (PC) and four (7.4%) anaplastic carcinomas (AC). CD56 was not expressed in 28/31 (90.3%) of the PTCs, 1/11 (9.1%) FCs, 1/4 (25%) of ACs while all MCs and the PD were positive. The benign group comprised nodular hyperplasias (29/54), lymphocytic thyroiditis (10/54), follicular adenomas (FA) (14/54) and one hyalinising trabecular tumour. CD56 was expressed in all the benign cases except one FA and one nodular hyperplasia. Thirteen of the 14 FAs were CD56 positive. The difference in expression between benign and malignant tumours was statistically significant as the p value was <0.01.

    CONCLUSION: CD56 is a potentially good immunohistochemical marker for differentiating papillary thyroid carcinoma from other benign follicular lesions of the thyroid especially in differentiating follicular variant PTC from FA in equivocal cases.

    Matched MeSH terms: Thyroid Neoplasms/diagnosis; Thyroid Neoplasms/pathology*
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