This web site is conducted by Kennichi Kakudo, MD, PhD, professor emeritus of Wakayama Medical University and visiting professor of Kindai University, Faculty of Medicine, Japan. I am also a visiting professor of Shandon University and Taishan Medical University, China. It is designed for a personal communication with you to discuss one of the followings; 1) (to pathologists) about pathology and its future directions and case consultation, 2) (to patients) about your diagnosis and advises for your decision making, as a second opinion consultation and 3) (to physicians in the other fields), as consultation and quality control for your patients’pathology reports.
Although the most parts of this home page are written in Japanese, you may enjoy my English pages and my scientific publications written in English. Please send your comments and discussion to me at E-mail:

Second Opinion Consultation on Thyroid Diseases from Patients.
It is a well-known fact that there are severe observer disagreements in benign and malignant diagnosis of thyroid tumors (Hirokawa M, et al.: Observer variation of encapsulated follicular lesions of the thyroid gland. Am J Surg Pathol, 26:1508-1514, 2002 & Lloyd RV, et al.: Observer Variation in the Diagnosis of Follicular Variant of Papillary Thyroid Carcinoma. Am J Surg Pathol, 28(10):1336-1340, 2004). Although an accurate diagnosis is essential to ensure the most effective treatments, over-diagnoses and over-treatments are serious problems in some areas including thyroid tumors (Esserman LJ et al: Addressing overdiagnosis and overtreatment in cancer: a prescription for change. Lancet Oncol, 15:234-242, 2014.). Second opinion consultation will solve some of the problems and lead you to most proper treatments with confidence.

How to get a second opinion from Dr Kakudo.
Ask your doctor to obtain a second opinion from Dr Kakudo showing this HP ( ), and then your physician or hospital send me your histological slides and a case summary to the following address. As no official request form prepared in this HP, please includes followings in your request letter; 1) contact address, E-mail address and names where my second opinion diagnosis should be sent, 2) patient name, date of birth, and PDFs (copies) of pathology reports (first opinion) together with histological slides, 3) a case summary including clinical diagnosis and medical history of the patient, 4) questions and points where you (patient) most concern and 5) address the histological samples should be returned.
(Gross photos of resected specimens and image files such as ultrasound, CT or MRI are desirable but not must.)
Address where samples and request should be sent.
K. Kakudo, MD, PhD
Nishitomigaoka 3-11-2,
Nara-city, Nara, 631-0006 Japan.
Consultation Fee: $200.00(Two hundred US dollars).
Please transfer above sum to
The Bank of Tokyo-Mitsubishi UFJ, Ltd, Japan (bank code: 0005).
Account holder: Kakudo Kenichi
Account number: 5054926 and branch number: 458 (Kintetsu-Gakuenmae branch).
After confirmation of receipt, the samples will be returned to the address you indicated.

International Thyroid Cancer Symposium was held at the IRCAD in Taiwan on October 4, 2015.

Please find the following link for my presentation, and my title is “Classification of the thyroid follicular cell tumors – identification of borderline lesions-”.
Things usually move very slowly but sometimes the change may occur dramatically. Pathology is a very old science and usually stable and immutable, however we are facing to an epoch making drastic change in diagnosis of thyroid tumors. This is my history of diagnostic criteria for encapsulated follicular variant papillary carcinoma. The pathology diagnosis is no longer a gold standard for cancer diagnosis in thyroid tumors. You will find it in my lecture.

The 55th Annual Meeting of the Japan Thyroid Association

Centennial of Hashimoto Disease International Symposium I ”Future Perspective of Thyroid Autoimmunity”

2012.12.1 ACROS Fukuoka B2F Event Hall

[Session 5]

Yuji Nagayama (Nagasaki University Graduate School of Biomedical Sciences, Japan)
Wilmar M.Wiersinga (University of Amsterdam, The Netherlands)

3)IgG4 Thyroiditis and Fibrotic Variant of Hashimoto’s Disease
Kenich Kakudo, Yaqion Li
(Department of Medical Technology, Kobe Tokiwa University, Japan
Department of Human Pathology, Wakayama Medical University, Japan)


Recent Posts

2018 The 23rd Taiwan Joint Cancer Conference


Dr Giordano, Lai and Kakudo

Meuseum visit

Professor Giordano (University of Michigan) and I were invited to have 2 lectures each in the 23rd Taiwan Joint Cancer Conference, being held in Taipei on 6th of May, 2018. We enjoied beautiful seanry of Taiwan and deep histry of China (Figure). The conference PPT files are available at Lecture notes for my two lectures were published in the J Basic Clin Med ( .

category: To Clinician , To pathologist comment: (0)

Chinese version of our text book on thyroid FNA cytology was published.


Publication ceremony

Chinese version

Dr Liu and Kakudo

Chinese version was published.

Dr Liu worked hard, to which many Chinese authors joint, to translate the first edition of Thyroid FNA Cytology, differential diagnoses and Pitfalls into Chinese edition ( The Chinese version was published on 5th of May, 2018 and ceremony ( was held in the 2018 International Symposium on Thyroid Pathology, being held in ChangZhou, China (Figure 1). We are very happy about it (Figure 2).

category: To pathologist comment: (0)

The Second Symposium of the Working Group of Asian Thyroid FNA Cytology


2nd WG Asian Thyroid FNA Cytology

The 2nd WG Asian Thyroid FNA Cytology

The Second Symposium of the Working Group of Asian Thyroid FNA Cytology was held in Chiang Mai, Thailand on 19 January, 2018. Thanks to professor Rangdaeng, president of Thai Society of Cytology, for giving us this wonderful opprtunity. Abstracts are aveilable at . This WG had a productive year last year and published the following list of research articles and reviews. They were: Four papers in the special issue on NIFTP in J Basic Clinical Medicine, vol 6, 2017. (open access available on line from the journal website) Nine articles in the special issue on the current practices of thyroid FNA cytology in Asian countries in the J Pathol Translat Med, November issue, 2017. More original studies were published by our members in well-recognized international journals. They were;
1.Cho U, Mete O, Kim MH et al. Molecular correlates and rate of lymph node metastasis of non-invasive follicular thyroid neoplasm with papillary-like nuclear features and invasive follicular variant papillary thyroid carcinoma: the impact of rigid criteria to distinguish non-invasive follicular thyroid neoplasm with papillary-like nuclear features. Mod Pathol 2017; 30:810-25.
2.Bychkov A, Hirokawa M, Jung CK et al.: Low rate of noninvasive follicular thyroid neoplasm with papillary-like nuclear features in Asian practice. Thyroid 2017; 27:983-984.
3.Kakudo K, Higuchi M, Hirokawa M et al.: Thyroid FNA cytology in Asian practice – Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas. Cytopathology 2017; 28:455-466.
4.Bychkov A, Keelawat S, Agarwal S, et al. Impact of noninvasive follicular thyroid neoplasm with papillary-like nuclear features on risk of malignancy for the Bethesda categories: A multi-institutional study in five Asian countries. Pathology (in press).
5.Bychkov A, Jung CK, Liu Z, et al. Noninvasive follicular thyroid neoplasm with papillary-like nuclear features in Asian practice: A pathologist’s perspective.
In the 20th ICC Sydney, a companion meeting was accepted.  Please join us to activate Asian thyroid practive more.

category: To pathologist comment: (0)