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Papillary thyroid cancer
Papillary thyroid cancer or papillary thyroid carcinoma〔 is the most common type of thyroid cancer,〔Hu MI, Vassilopoulou-Sellin R, Lustig R, Lamont JP ("Thyroid and Parathyroid Cancers" ) in Pazdur R, Wagman LD, Camphausen KA, Hoskins WJ (Eds) (Cancer Management: A Multidisciplinary Approach ). 11 ed. 2008.〕 representing 75 percent to 85 percent of all thyroid cancer cases.〔Chapter 20 in: 8th edition.〕 It occurs more frequently in women and presents in the 20–55 year age group. It is also the predominant cancer type in children with thyroid cancer, and in patients with thyroid cancer who have had previous radiation to the head and neck.
==Diagnosis==
Papillary thyroid carcinoma is usually discovered on routine examination as an asymptomatic thyroid nodule that appears as a neck mass. In some instances, the mass may have produced local symptoms. This mass is normally referred to a fine needle aspiration biopsy (FNA) for investigation. FNA accuracy is very high and it is a process widely used in these cases. Other investigation methods include ultrasound imaging and nuclear scan. The ultrasound is a useful test to distinguish solid from cystic lesions and to identify calcifications. The thyroid ultrasound is also very effective to discover microcarcinomas, which refer to very small carcinomas (<1 cm).
Papillary thyroid carcinomas are also discovered when a hard nodule is found in multinodular goiter, when enlarged cervical lymph nodes are detected, or when there are unidentified metastatic lesions elsewhere in the body.〔 Expanding lesions found in the thyroid gland, especially if they are painful, should be examined as they may indicate the presence of papillary thyroid carcinoma. Other clinical signs that could indicate papillary thyroid are: fixation to the trachea, stony hardness, damage to recurrent laryngeal or cervical sympathetic nerves. Seventy five percent of the population will have these thyroid nodules, and the majority will always be benign.〔(【引用サイトリンク】 title=Papillary Carcinoma Prognosis )〕
Chest x rays are not commonly performed. In cases of metastasis, some other tests are run to obtain sufficient information before a surgery. Such tests include the ultrasound and MRI of the neck as well as the CAT scanning. Other options that have shown good results in identifying tumors or related outcomes are the use of thallium-201 chloride, which helps identify metastatic tumor; gallium scan, which is helpful to visualize lymphomas; I-metaiodobenzylguanidine (MIBG) which has proven useful in imaging MTC; Tc-MIBI, which has been effective in detecting deposits of metastatic thyroid cancer; PET scans, which are also helpful for the imaging of metastatic disease. Chia et al. report that TSHR mRNA measured with FNA enhances the preoperative detection of cancer in patients with thyroid nodules, reducing unnecessary surgeries, and immediate postoperative levels can predict residual/metastatic disease.〔 Suspected lung metastases and/or miliary aspects at x-ray or CT can be diagnosed by cytology on a bronchoalveolar lavage specimen.〔 ()〕
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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