Background: In this ongoing multicenter prospective cohort study on active surveillance (AS) in low-risk papillary thyroid microcarcinoma (PTMC), we aimed to compare the quality of life (QoL) of participants based on their choice of treatment, that is, AS or immediate surgery (OP). Methods: QoL of 203 participants who chose AS and 192 participants who underwent OP was evaluated using a thyroid-specific QoL questionnaire at diagnosis and during follow-up (median 8 months). Results: The mean ages of the participants in the AS and OP groups were 47.3 ± 11.7 and 45.6 ± 10.5 years ( p = 0.138), respectively, and the mean tumor sizes were 5.7 ± 1.6 and 6.5 ± 2.1 mm ( p = 0.065), respectively. At baseline, significantly better psychological health (7.1 ± 1.3 vs. 6.8 ± 1.6, p = 0.023) and overall health (6.8 ± 1.2 vs. 6.5 ± 1.3, p = 0.018) were observed in the AS group than in the OP group. During follow-up, significantly better physical (7.9 ± 1.1 vs. 7.4 ± 1.2, p < 0.001), psychological (7.4 ± 1.3 vs. 6.9 ± 1.6, p = 0.004), and overall health (6.9 ± 1.0 vs. 6.5 ± 1.1, p = 0.002) were observed in the AS group than in the OP group, whereas spiritual health was comparable between the two groups. Compared with the AS group, the OP group experienced more fatigue, changes in voice and appearance, less satisfaction, and low fear of recurrence. The self-assessed financial burden was similar at baseline and follow-up in both groups. Conclusion: The QoL of PTMC patients is different according to the type of treatment. Better psychological health at baseline and physical and psychological health at follow-up were observed in the AS group than in the OP group. However, studies with longer follow-up periods are needed.

Tuberculosis of the salivary gland is mostly a medically curable disease entity but early diagnosis is very important to ensure complete remission. In cases with a high index of suspicion, reliable diagnostic methods such as polymerase chain reaction (PCR) should always be considered before surgical intervention to enable differential diagnosis of a salivary gland tumor. To investigate the clinical characteristics of major salivary gland tuberculosis and to review the literature relating to its diagnosis. Eight patients diagnosed as having major salivary gland tuberculosis between 1994 and 2004 were treated at one of three tertiary referral centers. Medical records, including imaging findings and the results of microbiological tests, Mycobacterium tuberculosis PCR and histopathology, were retrospectively retrieved and the literature was reviewed. The parotid and submandibular glands were involved in 5 (62.5%) and 3 cases (37.5%), respectively. Neck CT demonstrated typical findings of salivary gland tuberculosis in 3 patients (37.5%). Fine-needle aspiration cytology revealed chronic inflammation in 6/7 patients (85.7%), 2 of whom (33.3%) showed caseous necrosis, strongly suggesting tuberculosis. Five of the 8 patients (62.5%) required resection of the affected gland and 3 (37.5%) received open biopsy. PCR was performed in half of the cases and was affirmative in every case. No significant differences were found between the surgically resected and non-resected groups in terms of treatment results or morbidity. All patients received anti-tuberculous chemotherapy for 8-12 months, with no disease recurrence.

BACKGROUND: “Atypia of undetermined significance” (AUS) in the Bethesda System for Reporting Thyroid Cytopathology is a heterogeneous category for cases that cannot be easily classified into benign, suspicious, or malignant. This study evaluated whether cytomorphology‐based subcategorization could better predict the malignancy risk in cases designated as AUS, and how the subcategories correlated with BRAF mutation status in thyroid fine‐needle aspirates (FNA).METHODS: Of 3589 cases of thyroid FNA diagnosed at the authors' institution in Seongnam, Korea, from January 2010 to December 2011, 331 cases of AUS were reviewed and subcategorized based on cytomorphological features, including nuclear atypia (NA), microfollicle formation (MF), Hürthle cell change (HC), and others (O). The malignancy rate of each subcategory was calculated using cases with histologic follow‐up. Pyrosequencing was conducted to detect BRAF mutations.RESULTS: Malignancy was histologically proven in 23.3% (77 of 331) of cases diagnosed as AUS. In cytomorphology‐based subcategories, the rate of malignancy was 30.8% (66 of 214) for AUS‐NA, 14.5% (8 of 55) for AUS‐O, 4.8% (2 of 42) for AUS‐MF, and 5% (1 of 20) for AUS‐HC. The BRAF V600E mutation was found in 40% (48 of 120) of AUS‐NA, 30.8% (4 of 13) of AUS‐HC, 6.7% (1 of 15) of AUS‐O, and 2.8% (1 of 35) of AUS‐MF.CONCLUSIONS: The AUS‐NA subcategory was associated with the highest risk of malignancy and the greatest frequency of BRAF V600E (substitution of valine to glutamic acid at position 600) mutation. These findings suggest that subcategorization of AUS by cytomorphology and BRAF V600E mutation status is important for predicting the risk of malignancy. Cancer (Cancer Cytopathol) 2014;122:512–520. © 2014 American Cancer Society.

Clinicopathologic implications of the miR-197/PD-L1 axis in oral squamous cell carcinoma Clinicopathologic implications of the miR-197/PD-L1 axis in oral squamous cell carcinoma

Moon JH, et al. Endocrinol Metab. 2018 Jun;33(2):278-286. https://doi.org/10.3803/EnM.2018.33.2.278