Abstract

Diseases of the thyroid gland are manifested by either increase in gland size, alterations in hormonal secretion, or both. Changes in gland size and weight are associated with toxic or nontoxic goiter, adenomas, thyroiditis, or malignancies. Most of thyroid disease are manifested by mass, local compression in the neck and symptoms arising from disturbances in hormonogenesis resulting in hypothyroidism or hyperthyroidism. Also thyroid cancer has nodule and therefore is easily confused as to how to differenciate from other thyroid disease. So that, the thyroid cancer is one of the most debated of all neoplasms in terms of biology, the course and growth, precancerous lesions, surgical treatment and prognosis related to histopathological type. Multiple reports can be found to support almost any thyroid diseases related to malignancy, frequency, etiological factors, age distribution, prognosis and surgical treatment, etc. There are several reports on thyroid disease including cancer among Koreans based on clinical and statistical aspects, but there is no report of thyroid disease based on histopathological aspects in Korea. The present studies have surveyed the records of patients with thyroid disorders seen at Severance Hospital from 1960 to 1971. The incidence and pathological classification of all thyroid diseases among Koreans were investigated, and comparison with pathological diagnosis and clinical diagnosis, the incidence of malignancy in cold nodules of scanning, relationship between the malignancy and lymphocytic infiltration and calcification were observed. Materials and Methods ; The materials used in this study consist of surgically resected thyroid tissues for 12 years from 1960 to 1971. All specimens were fixed in 10% formalin. Grossly, the location and size of the tumor were examined. For histologic examinations, paraffin embedded blocks were cut in 5-6u thickness and sections were stained by hematoxylin eosin method. Histopathological studies on all thyroid diseases are performed as follows : 1. Histopathological classification of Thyroiditis by Hazard (1955). Goiter by Robbins (1967). Adenoma by Meissner and McManus (1953). Carcinoma by Hare and Salzman (1950). 2. Functional status. 3. Lymphocytic infiltration and calcification. For the all cases of thyroid diseases whose clinical records were available, sex, age, chief complaints, duration, location and size of lump, clinical diagnosis. type of treatment were reviewed.
Results
and Summary ; Clinical and histopathological studies were made on 446 surgically removed tissues of thyroid lesions, that were submitted to the department of pathology, Yonsei University College of Medicine, during the period of 12 years from 1960 to 1971. The following results were obtained. 1. Among 446 cases, 397 cases were female and the ratio of male and female thyroid disease was 1 : 8.1. In all cases observed, 199 cases (43.3%) adenoma, 130 cases (29.1%) goiter, 193 cases (20.9%) carcinoma, 24 cases (5.4%) thyroiditis were included. 2. The average age of adenoma was 34.2 year-old, nontoxic goiter 37.2, toxic goiter 37.8, carcinoma 41.2, thyroiditis 44.6. 3. The most common complaints of thyroid diseases was a mass(94.2%). The other clinical symptoms in order of frequency were palpitation, dyspnea and cough etc. 4. The average duration of chief complaint of thyroid carcinoma was 4.0 years, adenoma 3.5 years, goiter 1.9 years and thyroiditis 3. 1 years. 5. The comparison of the size of adenoma with that of carcinoma was not significantly different. The average size of adenoma was 4.6 cm and carcinoma 4.7 cm. 6. Among 28 cases of scanning, 18 cases (64.3%) were cold nodule in which 11 cases were adenoma in pathological diagnosis. 7. Some of clinical diagnosis was different from pathological diagnosis. Correct diagnosis of carcinoma was 35.1%, adenoma 31.9%, goiter 80.0% and thyroiditis 6.7%. 8. Histopathologically all of thyroiditis were chronic thyroiditis except one case that was acute suppurative thyroiditis. Hashimoto’s thyroiditis was 50% of all chronic thyroiditis. 9. Histopathologically nontoxic goiter comprises about 76.2% of all goiters. Nontoxic nodular goiter is 70.8% of all goiters. 10. Histologically follicular type comprises about 93% of adenoma. Most of follicular type consist of fetal type (37.8%) and colloid type (37.3%). 11. Histologically, papillary carcinoma is 60.2% of all carcinoma. There is no relation between type of thyroid carcinoma and lymphocytic infiltration. Among 76 cases with papillary growth carcinoma, calcification was observed in 38 cases (50%).