Limits...
Evaluating the degree of conformity of papillary carcinoma and follicular carcinoma to the reported ultrasonographic findings of malignant thyroid tumor.

Jeh SK, Jung SL, Kim BS, Lee YS - Korean J Radiol (2007 May-Jun)

Bottom Line: We analyzed the ultrasonographic findings of these nodules based on the reported ultrasonographic findings of malignant thyroid tumor: hypoechogenicity, a taller than wide orientation, a microlobulated or irregular margin, a thick hypoechoic rim (halo sign), microcalcification and cystic change.Microcalcifications were demonstrated in 33.9% of the papillary carcinomas and in none of the cases of follicular carcinoma (p < 0.001).The previously reported ultrasonography findings of malignant thyroid tumor are in conformity with most of the papillary carcinomas, but not with follicular carcinomas.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, The Catholic Medial Center, Seoul, Korea.

ABSTRACT

Objective: We wanted to evaluate the degree of conformity of papillary carcinoma and follicular carcinoma to the reported ultrasonographic findings of malignant thyroid tumor.

Materials and methods: Between January 2003 and December 2004, fine needle aspiration biopsy was performed in 1,036 patients with palpable and nonpalpable thyroid lesions. We retrospectively reviewed the ultrasonographic findings of patients with papillary carcinomas (n = 127) and follicular carcinomas (n = 23) that were proven by operation or fine needle aspiration biopsy. We analyzed the ultrasonographic findings of these nodules based on the reported ultrasonographic findings of malignant thyroid tumor: hypoechogenicity, a taller than wide orientation, a microlobulated or irregular margin, a thick hypoechoic rim (halo sign), microcalcification and cystic change.

Results: The echogenicity was hypoechoic in 72.4% (92/127) of the papillary carcinomas, but it was isoechoic in 65.2% (15/23) of the follicular carcinomas (p < 0.001). The nodule shape was tall or round in 74.1% of the papillary carcinomas, but it was flat in 72.7% of the follicular carcinomas (p < 0.001). The tumor margin was microlobulated or irregular in 92.9% of the papillary carcinomas and in 60.9% of the follicular carcinomas (p < 0.001). A hypoechoic rim was seen in 26% of the papillary carcinomas (thin rim: 13.4%, thick rim: 12.6%) and in 86.6% of the follicular carcinomas (thin rim: 39.1%, thick rim: 47.8%, p < 0.001). Microcalcifications were demonstrated in 33.9% of the papillary carcinomas and in none of the cases of follicular carcinoma (p < 0.001). A solid mass without cystic change were seen in 98.4% of the papillary carcinomas and in 82.6% of the follicular carcinomas (p < 0.001).

Conclusion: The previously reported ultrasonography findings of malignant thyroid tumor are in conformity with most of the papillary carcinomas, but not with follicular carcinomas. The current ultrasonographic features for thyroid malignancy should be cautiously applied as the indication for needle aspiration biopsy so that follicular carcinomas are not missed by too narrow and strict biopsy criteria.

Show MeSH

Related in: MedlinePlus

Sonography of a 45-year-old male with the atypical findings of papillary carcinoma.The nodule of the thyroid gland shows the same iso-echogenicity as the normal thyroid gland without cystic change. An incomplete and irregular thick hypoechoic rim is seen in this nodule. Small foci without comet tail artifacts that are suggestive of microcalcifications are also seen.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2627417&req=5

Figure 4: Sonography of a 45-year-old male with the atypical findings of papillary carcinoma.The nodule of the thyroid gland shows the same iso-echogenicity as the normal thyroid gland without cystic change. An incomplete and irregular thick hypoechoic rim is seen in this nodule. Small foci without comet tail artifacts that are suggestive of microcalcifications are also seen.

Mentions: In conclusion, the previously reported sonographic findings of malignant thyroid nodule are in conformity with those of most papillary carcinomas, but these findings do not conform to those of the follicular carcinomas in the present study. This suggests that many follicular carcinomas might be initially analyzed as non-malignant lesions. As reported by Chan et al., about 10% of papillary carcinomas showed uncommon ultrasound features such as hyperechogenicity and few or no peripheral calcifications, like our cases in Figure 4 (5). Less than 40% of the papillary carcinomas in the present study showed different findings from the known malignant ultrasonographic findings. Therefore, these reported, known ultrasonographic criteria of malignant thyroid nodules should be cautiously applied as the indications for needle aspiration biopsy so that follicular carcinomas and some atypical papillary carcinomas are not missed according to overly narrow and strict biopsy criteria. Also, since follicular adenomas showed similar findings with follicular carcinomas, further studies are required for determining the sonographic findings of those two lesions.


Evaluating the degree of conformity of papillary carcinoma and follicular carcinoma to the reported ultrasonographic findings of malignant thyroid tumor.

Jeh SK, Jung SL, Kim BS, Lee YS - Korean J Radiol (2007 May-Jun)

Sonography of a 45-year-old male with the atypical findings of papillary carcinoma.The nodule of the thyroid gland shows the same iso-echogenicity as the normal thyroid gland without cystic change. An incomplete and irregular thick hypoechoic rim is seen in this nodule. Small foci without comet tail artifacts that are suggestive of microcalcifications are also seen.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2627417&req=5

Figure 4: Sonography of a 45-year-old male with the atypical findings of papillary carcinoma.The nodule of the thyroid gland shows the same iso-echogenicity as the normal thyroid gland without cystic change. An incomplete and irregular thick hypoechoic rim is seen in this nodule. Small foci without comet tail artifacts that are suggestive of microcalcifications are also seen.
Mentions: In conclusion, the previously reported sonographic findings of malignant thyroid nodule are in conformity with those of most papillary carcinomas, but these findings do not conform to those of the follicular carcinomas in the present study. This suggests that many follicular carcinomas might be initially analyzed as non-malignant lesions. As reported by Chan et al., about 10% of papillary carcinomas showed uncommon ultrasound features such as hyperechogenicity and few or no peripheral calcifications, like our cases in Figure 4 (5). Less than 40% of the papillary carcinomas in the present study showed different findings from the known malignant ultrasonographic findings. Therefore, these reported, known ultrasonographic criteria of malignant thyroid nodules should be cautiously applied as the indications for needle aspiration biopsy so that follicular carcinomas and some atypical papillary carcinomas are not missed according to overly narrow and strict biopsy criteria. Also, since follicular adenomas showed similar findings with follicular carcinomas, further studies are required for determining the sonographic findings of those two lesions.

Bottom Line: We analyzed the ultrasonographic findings of these nodules based on the reported ultrasonographic findings of malignant thyroid tumor: hypoechogenicity, a taller than wide orientation, a microlobulated or irregular margin, a thick hypoechoic rim (halo sign), microcalcification and cystic change.Microcalcifications were demonstrated in 33.9% of the papillary carcinomas and in none of the cases of follicular carcinoma (p < 0.001).The previously reported ultrasonography findings of malignant thyroid tumor are in conformity with most of the papillary carcinomas, but not with follicular carcinomas.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, The Catholic Medial Center, Seoul, Korea.

ABSTRACT

Objective: We wanted to evaluate the degree of conformity of papillary carcinoma and follicular carcinoma to the reported ultrasonographic findings of malignant thyroid tumor.

Materials and methods: Between January 2003 and December 2004, fine needle aspiration biopsy was performed in 1,036 patients with palpable and nonpalpable thyroid lesions. We retrospectively reviewed the ultrasonographic findings of patients with papillary carcinomas (n = 127) and follicular carcinomas (n = 23) that were proven by operation or fine needle aspiration biopsy. We analyzed the ultrasonographic findings of these nodules based on the reported ultrasonographic findings of malignant thyroid tumor: hypoechogenicity, a taller than wide orientation, a microlobulated or irregular margin, a thick hypoechoic rim (halo sign), microcalcification and cystic change.

Results: The echogenicity was hypoechoic in 72.4% (92/127) of the papillary carcinomas, but it was isoechoic in 65.2% (15/23) of the follicular carcinomas (p < 0.001). The nodule shape was tall or round in 74.1% of the papillary carcinomas, but it was flat in 72.7% of the follicular carcinomas (p < 0.001). The tumor margin was microlobulated or irregular in 92.9% of the papillary carcinomas and in 60.9% of the follicular carcinomas (p < 0.001). A hypoechoic rim was seen in 26% of the papillary carcinomas (thin rim: 13.4%, thick rim: 12.6%) and in 86.6% of the follicular carcinomas (thin rim: 39.1%, thick rim: 47.8%, p < 0.001). Microcalcifications were demonstrated in 33.9% of the papillary carcinomas and in none of the cases of follicular carcinoma (p < 0.001). A solid mass without cystic change were seen in 98.4% of the papillary carcinomas and in 82.6% of the follicular carcinomas (p < 0.001).

Conclusion: The previously reported ultrasonography findings of malignant thyroid tumor are in conformity with most of the papillary carcinomas, but not with follicular carcinomas. The current ultrasonographic features for thyroid malignancy should be cautiously applied as the indication for needle aspiration biopsy so that follicular carcinomas are not missed by too narrow and strict biopsy criteria.

Show MeSH
Related in: MedlinePlus