By Masayoshi Akisada M.D., Yoshihide Fujimoto M.D. (auth.)
The perform of medication alterations constantly, as technology publications the surgeon to the accomplishment of his target, the remedy of the sufferer. examine of the heritage of medication exhibits that frequently a therapy of a ailment was once came upon sooner than the reason for the sickness was once identified. frequently the therapy used to be unnecessarily complex, but if the reason for the difficulty was once came across, the medication grew to become uncomplicated and secure. it truly is with the higher less than status of the genuine nature of thyroid affliction that this e-book is anxious. those that learn it is going to be capable of make their remedies of sufferers with ailments of the thyroid extra basic and extra secure. Dr. MASAYOSHI AKISADA and Dr. YOSHIHIDE FUJIMOTO have given to thyroidologists a brand new means of spotting cancers of the thyroid. making the most of the truth that many cancers of the thyroid comprise minute components of calcification referred to as psammoma our bodies, they've got built a strategy of roentgenographic exam of the thyroid that's delicate adequate to teach those tiny opacities and to warn the internist and the health care provider that melanoma is perhaps current. there isn't any query that this delicate diagnostic try out will end up to be of worth reminiscent of that of mammography.
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Additional info for Soft Tissue Roentgenography in Diagnosis of Thyroid Cancer: Detection of Psammoma Bodies by Spot-Tangential Projection
0(;:) of adenomas in HOSHI'S study, and only 2 of 98 benign nodules in our series. I t should be kept in mind that the incidences of psammoma bodies cited above are all derived from histological studies. The soft: tissue roentgenography of parafIin block specimens gavf' us a similar incidencf' of psammomatous calcification. But, as will be stated in the following chapter, psammoma bodies present in about half of the cancer cases and in almost all the cases of benign nodule are small in amount, scattered and non-conglomerated, so that eVf'n with the optimal technique now available they are unable to be demonstrated on rocntgcnograms of the neck.
It is strongly recommended that the physician marks the skin indicating the center of the nodule, so that the technician can achieve the proper proj ection. Spot-tangential projection is obtained in one of the following positionings, d epending on the location, size and shape of the thyroid nodule. (a) The patient lies on the roentgenographic table in the semiprone position with the desired side up and with her head and neck on an obliquely placed pillow. A prepacked film is inserted between the neck and the pillow.
Invasion of the trachea is best demonstrated on tomograms. In cases where there are signs and symptoms suggesting the presence of esophageal invasion, examination by barium swallow is also indicated. 54 Chapter VI Clinical Application and Results Since January 1, 1970, soft tissue roentgenography of the neck has been applied as one of the routine examinations for patients with clinical evidence of nodular disorders of the thyroid. The experience with this technique during the 23-month period until November 30, 1971 indicates that it is a promising method for detecting thyroid carcinoma.