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A comparison of lymphocytic thyroiditis with papillary thyroid carcinoma showing suspicious ultrasonographic findings in a background of heterogeneous parenchyma.

Nam SY, Shin JH, Ko EY, Hahn SY - Ultrasonography (2014)

Bottom Line: We compared the benign and malignant nodules in terms of their clinical and radiological factors.A univariate analysis revealed that PTCs were more frequent in patients younger than 45 years and having microcalcifications than was LT.An independent predictor of PTC after adjustment was an age of <45 years.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea ; Department of Radiology, Gachon University Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea.

ABSTRACT

Purpose: The aim of this study was to compare ultrasonographic features in patients with lymphocytic thyroiditis (LT) and papillary thyroid carcinoma (PTC) having suspicious thyroid nodule(s) in a background of heterogeneous parenchyma and to determine the clinical and radiological predictors of malignancy.

Methods: We reviewed the cases of 100 patients who underwent ultrasonography between April 2011 and October 2012, and showed suspicious thyroid nodule(s) in a background of heterogeneous parenchyma. Eight patients who did not undergo ultrasonography-guided fineneedle aspiration cytology (FNAC) and 34 cases of follow-up ultrasonography after initial FNAC were excluded. We compared the benign and malignant nodules in terms of their clinical and radiological factors.

Results: For the 58 nodules including 31 LTs (53.4%) and 27 PTCs (46.6%), the mean tumor sizes of the two groups were 0.96 cm for LT and 0.97 cm for PTC. A univariate analysis revealed that PTCs were more frequent in patients younger than 45 years and having microcalcifications than was LT. An independent predictor of PTC after adjustment was an age of <45 years.

Conclusion: LT mimics malignancy in a background of heterogeneous parenchyma on ultrasonography. A young age of <45 years is the most important predictor of malignancy in this condition.

No MeSH data available.


Related in: MedlinePlus

A 63-year-old woman with lymphocytic thyroiditis (LT).Transverse (A) and longitudinal (B) ultrasonograms show a 2.0-cm mass with a taller-than-wide shape, irregular border, and marked hypoechogenicity with heterogeneous parenchyma in the left thyroid gland (arrows). Ultrasonography-guided fine-needle aspiration cytology revealed LT. The mass had disappeared on follow-up transverse (C) and longitudinal (D) ultrasonography after one year.
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f1-usg-14031: A 63-year-old woman with lymphocytic thyroiditis (LT).Transverse (A) and longitudinal (B) ultrasonograms show a 2.0-cm mass with a taller-than-wide shape, irregular border, and marked hypoechogenicity with heterogeneous parenchyma in the left thyroid gland (arrows). Ultrasonography-guided fine-needle aspiration cytology revealed LT. The mass had disappeared on follow-up transverse (C) and longitudinal (D) ultrasonography after one year.

Mentions: Thirty-one of the 58 nodules (53.4%) were finally diagnosed as LT (Fig. 1) and 27 (46.6%) as PTCs (Fig. 2). The clinical and imaging characteristics of LT and PTC are presented in Table 1. Patients with LT underwent surgery (n=3) because of contralateral cancer, follow-up ultrasonography-guided FNAC or CNB (n=14; interval decrease, 4; no change, 10), or follow-up ultrasonography (n=14; interval disappearance, 3; interval decrease, 2; no change, 9). Although in most patients the nodules decreased in size upon follow-up ultrasonography, four patients underwent follow-up ultrasonography-guided FNAC or CNB because of an unchanged, suspicious ultrasonographic feature of the nodule. There was no patient who was proven to have PTC on follow-up FNAC or CNB. Patients with PTC underwent surgery (n=24) or follow-up ultrasonography (n=3). The mean tumor sizes of the two groups were similar with 0.96 cm for LT and 0.97 cm for PTC (P=0.337). PTC showed a higher incidence in patients younger than 45 years and in those having microcalcifications than did LT (59.3% vs. 25.8%, respectively, P=0.009; 37.0% vs. 9.7%, respectively, P=0.031). Shape, nodule echogenicity, margin, multifocality, and thyroid functional status were not significantly different between the two groups. Of the 28 patients who underwent a color Doppler scan, 10 (35.7%) showed nodules with increased vascularity, whereas the remaining (64.3%) showed nodules with no vascularity. The vascularity of nodules was similar between the two groups.


A comparison of lymphocytic thyroiditis with papillary thyroid carcinoma showing suspicious ultrasonographic findings in a background of heterogeneous parenchyma.

Nam SY, Shin JH, Ko EY, Hahn SY - Ultrasonography (2014)

A 63-year-old woman with lymphocytic thyroiditis (LT).Transverse (A) and longitudinal (B) ultrasonograms show a 2.0-cm mass with a taller-than-wide shape, irregular border, and marked hypoechogenicity with heterogeneous parenchyma in the left thyroid gland (arrows). Ultrasonography-guided fine-needle aspiration cytology revealed LT. The mass had disappeared on follow-up transverse (C) and longitudinal (D) ultrasonography after one year.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4282222&req=5

f1-usg-14031: A 63-year-old woman with lymphocytic thyroiditis (LT).Transverse (A) and longitudinal (B) ultrasonograms show a 2.0-cm mass with a taller-than-wide shape, irregular border, and marked hypoechogenicity with heterogeneous parenchyma in the left thyroid gland (arrows). Ultrasonography-guided fine-needle aspiration cytology revealed LT. The mass had disappeared on follow-up transverse (C) and longitudinal (D) ultrasonography after one year.
Mentions: Thirty-one of the 58 nodules (53.4%) were finally diagnosed as LT (Fig. 1) and 27 (46.6%) as PTCs (Fig. 2). The clinical and imaging characteristics of LT and PTC are presented in Table 1. Patients with LT underwent surgery (n=3) because of contralateral cancer, follow-up ultrasonography-guided FNAC or CNB (n=14; interval decrease, 4; no change, 10), or follow-up ultrasonography (n=14; interval disappearance, 3; interval decrease, 2; no change, 9). Although in most patients the nodules decreased in size upon follow-up ultrasonography, four patients underwent follow-up ultrasonography-guided FNAC or CNB because of an unchanged, suspicious ultrasonographic feature of the nodule. There was no patient who was proven to have PTC on follow-up FNAC or CNB. Patients with PTC underwent surgery (n=24) or follow-up ultrasonography (n=3). The mean tumor sizes of the two groups were similar with 0.96 cm for LT and 0.97 cm for PTC (P=0.337). PTC showed a higher incidence in patients younger than 45 years and in those having microcalcifications than did LT (59.3% vs. 25.8%, respectively, P=0.009; 37.0% vs. 9.7%, respectively, P=0.031). Shape, nodule echogenicity, margin, multifocality, and thyroid functional status were not significantly different between the two groups. Of the 28 patients who underwent a color Doppler scan, 10 (35.7%) showed nodules with increased vascularity, whereas the remaining (64.3%) showed nodules with no vascularity. The vascularity of nodules was similar between the two groups.

Bottom Line: We compared the benign and malignant nodules in terms of their clinical and radiological factors.A univariate analysis revealed that PTCs were more frequent in patients younger than 45 years and having microcalcifications than was LT.An independent predictor of PTC after adjustment was an age of <45 years.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea ; Department of Radiology, Gachon University Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea.

ABSTRACT

Purpose: The aim of this study was to compare ultrasonographic features in patients with lymphocytic thyroiditis (LT) and papillary thyroid carcinoma (PTC) having suspicious thyroid nodule(s) in a background of heterogeneous parenchyma and to determine the clinical and radiological predictors of malignancy.

Methods: We reviewed the cases of 100 patients who underwent ultrasonography between April 2011 and October 2012, and showed suspicious thyroid nodule(s) in a background of heterogeneous parenchyma. Eight patients who did not undergo ultrasonography-guided fineneedle aspiration cytology (FNAC) and 34 cases of follow-up ultrasonography after initial FNAC were excluded. We compared the benign and malignant nodules in terms of their clinical and radiological factors.

Results: For the 58 nodules including 31 LTs (53.4%) and 27 PTCs (46.6%), the mean tumor sizes of the two groups were 0.96 cm for LT and 0.97 cm for PTC. A univariate analysis revealed that PTCs were more frequent in patients younger than 45 years and having microcalcifications than was LT. An independent predictor of PTC after adjustment was an age of <45 years.

Conclusion: LT mimics malignancy in a background of heterogeneous parenchyma on ultrasonography. A young age of <45 years is the most important predictor of malignancy in this condition.

No MeSH data available.


Related in: MedlinePlus