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

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)

100th Anniversary of Shandong University Cheeloo Colledge of Medicine


Deen professor Kong

Deen professor Kong

100th Anniversary Shandong University Cheeloo Colledge of Medicine
100th Anniversary Shandong University Cheeloo Colledge of Medicine
                    On 19th of December 2017, 100th Anniverssary of Shandon University, Cheeloo Colledge of Medicine was heald in Jinan, China.  Congratulations on 100 year anniversary for the Shandon University.

Sandon University and Wakayama Medical University have a long history of communication, student exchange, faculty exchange and academic communications under a friendship agreement.  Wakayama Medical University had a good experience with Shandon University in many fields.  All of your faculty members who visited at Wakayama Medical University gave us strong impressions.  All of them worked very hard with us and developed research collaborations. Our faculty members visited at Jinan more than 20 times under the friendship agreement.  It is amazing for us that you could continuously develop this extraordinary university to an excellence of China. I am sure that Shandon University and Wakayama Medical University, together deepen our mutual relationship continuously in the next century. I am sure that Shandon University will lead us developing our friendship communication between the 2 universities, Shandong University and Wakayama Medical University, and between China and Japan, in the next 100 years.


Heartfelt congratulations and best wishes for your continuous success. We wish you have another 100 years of good accomplishments, developments and success.


Kennichi Kakudo, MD, PhD


category: Others comment: (0)

Differences of Clinical Managements between Asia and Western Countries.


Education in medical school should be the same among countries and medical science should be the same in any countries. However, medical practice is not the same among countries due to different economic condition and different ratial back ground. I found one more important factor impacts on clinical managements of patients, and it was different logic and way of thinking among us. I wrote how it was different between Asian countries’ practice and western countries’ practice in the following two publications. I believe these differences count very much for patients. They are free access and please visit them if you are interested in.
  1. Kakudo K, Higuchi M, Horokawa M et al.: Thyroid FNA cytology in Asian practice – Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas. Cytopathology 2017; Nov 2. doi: 10.1111/cyt.12491. [Epub ahead of print]

  2. Kakudo K: How to handle borderline/precursor thyroid tumors in management of patients with thyroid nodules. Gland Surg 2017. doi: 10.21037/gs.2017.08.02

category: Others , To Patient comment: (0)