Predicting malignancy in thyroid nodules: molecular advances

Over the last several years, a clearer understanding has developed of the genetic alterations underlying thyroid carcinogenesis. This knowledge can be used to tackle 1 of the challenges facing thyroidologists: management of the indeterminate thyroid nodule. Despite the accuracy of fine-needle aspiration cytology, many patients undergo surgery to diagnose malignancy and better diagnostic tools are required. A number of biomarkers have recently been studied and show promise in this setting. In particular, BRAF, RAS, PAX8-PPARγ, microRNAs, and loss of heterozygosity have each been demonstrated as useful molecular tools for predicting malignancy and can potentially guide decisions regarding surgical management of nodular thyroid disease. This review summarizes the current literature surrounding each of these markers, highlights our institution's prospective analysis of these markers, and describes the subsequent incorporation of molecular markers into a management algorithm for thyroid nodules.     

The great imposter: A case report of IgG4‐RD hypertrophic pachymeningitis with skull lytic lesion and pulmonary nodules

Immunoglobulin G4‐related disease (Ig4RD) is an inflammatory condition with unique clinical, serological, and pathological features. In this study, we report a challenging diagnostic clinical case of Ig4RD diagnosed based on histopathology. This unique imitating nature reinforces that it is crucial to consider the diagnosis of IgG4‐RD in those presenting with pachymeningitis.     

超声新技术在甲状腺结节中的一站式应用

近年来随着超声新技术的迅猛发展所带来的技术革新弥补了常规超声在鉴别诊断甲状腺结节方面的不足,超微血管成像技术以病灶内的低速微小血管检出提高了甲状腺结节良恶性的诊断率;超声造影可显示常规超声无法显示的微小血管,且可用于甲状腺结节的疗效评估;剪切波弹性成像可实时定性定量显示结节的软硬度信息。微波消融术治疗甲状腺结节的疗效好、术后并发症少、不影响患者美观度等优势,具有广阔的应用前景。这些新技术的应用,可使甲状腺结节从诊断到治疗上实现超声全程化诊治和管理。     

先天性色素痣伴增生性结节10例临床病理分析

目的:探讨先天性色素痣伴增生性结节的临床特点及组织病理特征。方法:收集第四军医大学西京皮肤医院2015—2019年经临床和病理确诊的10例先天性色素痣伴增生性结节患者的临床及病理资料,并进行回顾性分析。结果:10例患者年龄2~45岁（平均15岁）,9例增生性结节发生于婴儿,1例发生于成人。皮损位于四肢4例,头面部3例,...     

个性化扫描与常规扫描对≤1 cm肺小结节的CT成像价值比较

目的  比较个性化和常规两种扫描方案对≤1 cm肺小结节的CT成像效果,探索最佳扫描方案。方法  按照纳入及排除标准,选择2020年1月~2022年6月在我院行肺小结节CT成像的患者,按随机对照表以平衡对照法随机分为个性化组（n=67）和常规组（n=70）,个性化组进行严格的过度吸气训练、个性化体位、个性化扫描方向制定,获得的图像与常规扫描组进行图像质量比较。结果  个性化组的CT平扫、肺动脉期、肺静脉期图像质量均优于常规扫描组,差异有统计学意义（χ²=8.204,P=0.017;χ²= 6.625,P=0.036;χ²=7.139,P=0.028）;两组组内CT平扫、肺动脉期、肺静脉期图像质量比较,常规组组内CT平扫和肺静脉期图像质量差异有统计学意义（χ²=9.188,P=0.010）,常规组其余各期、个性化组组内比较图像质量差异均无统计学意义（P > 0.05）。结论  个性化扫描方案成像质量稳定,能提高≤1cm肺小结节CT成像的图像质量。