“…These findings are similar to those of Anil and colleagues wherein solid nodules on UTZ had the highest sensitivity (69-75%) for malignancy in comparison to cystic or spongiform appearance. 7 Cystic nodules were more likely benign (with only about 2% malignant), 8 similar to our findings. Solid nodules are a common ultrasound feature of papillary thyroid carcinoma in around 70% of cases, 4 anaplastic and medullary thyroid carcinoma also display this feature.…”
Section: Discussionsupporting
confidence: 88%
“…3 A number of studies have been published associating specific sonographic findings with thyroid malignancy. 1,2,[4][5][6][7][8][9] Many elucidate the role of nodule size and presence of microcalcifications. 2,[4][5][6][7][8][9] The ATA listed presence of disrupted rim calcifications with small extrusive hypoechoic soft tissue component, evidence of extrathyroidal extension, nodule shape and features as determinants of malignancy.…”
Objective: To determine the association of thyroid malignancy and the following ultrasonographic findings: presence of solid hypoechoic nodule, irregular margins (infiltrative, microlobulated, or speculated), microcalcifications or disrupted rim calcifications with small extrusive hypoechoic soft tissue component, taller than wide shape of the thyroid nodule, and evidence of extrathyroidal extension.
Methods:
Design: Cross-Sectional Study
Setting: Tertiary Government Training Hospital
Participants: Records of patients admitted to the Otorhinolaryngology- Head and Neck Surgery ward with a diagnosis of nodular non-toxic goiter, multinodular non-toxic goiter, and thyroid malignancy who underwent thyroid surgery between January 2017 and June 2018 were considered for inclusion.
Results: A total of 33 patients, 7 males and 26 females, were included in this study. Patients’ age ranged from 26 to 69 years with an average of 46 years. Thirteen (39.4%) had malignant while 20 (60.6%) had benign histopathologic results. There was a significant association between presence of solid hypoechoic nodule (Fisher exact, n = 33, p = .0047), irregular margins and microcalcifications with malignant histopathology results (X2 (df = 1, N = 33) = 8.57, p = .003). No significant difference was noted in the proportion of subjects with malignancy according to taller than wide nodules (Fisher exact, n = 33, p = 1.000) or presence of extrathyroidal extension nodules or presence of extrathyroidal extension (Fisher exact, n = 33, p = .276). On multivariate analysis using logistic regression, only microcalcification was found to be a significant predictor of malignancy (OR = 8.96, 95% CI: 1.02 – 87.19, p = .05).
Conclusion: There was a significant association between presence of solid hypoechoic nodule, margins and microcalcifications with thyroid carcinoma. Only microcalcification was found to be a significant predictor of thyroid malignancy on ultrasound, although our confidence interval was broad.
Keywords: calcifications; thyroid; thyroid carcinoma; thyroid nodule; ultrasonography
“…These findings are similar to those of Anil and colleagues wherein solid nodules on UTZ had the highest sensitivity (69-75%) for malignancy in comparison to cystic or spongiform appearance. 7 Cystic nodules were more likely benign (with only about 2% malignant), 8 similar to our findings. Solid nodules are a common ultrasound feature of papillary thyroid carcinoma in around 70% of cases, 4 anaplastic and medullary thyroid carcinoma also display this feature.…”
Section: Discussionsupporting
confidence: 88%
“…3 A number of studies have been published associating specific sonographic findings with thyroid malignancy. 1,2,[4][5][6][7][8][9] Many elucidate the role of nodule size and presence of microcalcifications. 2,[4][5][6][7][8][9] The ATA listed presence of disrupted rim calcifications with small extrusive hypoechoic soft tissue component, evidence of extrathyroidal extension, nodule shape and features as determinants of malignancy.…”
Objective: To determine the association of thyroid malignancy and the following ultrasonographic findings: presence of solid hypoechoic nodule, irregular margins (infiltrative, microlobulated, or speculated), microcalcifications or disrupted rim calcifications with small extrusive hypoechoic soft tissue component, taller than wide shape of the thyroid nodule, and evidence of extrathyroidal extension.
Methods:
Design: Cross-Sectional Study
Setting: Tertiary Government Training Hospital
Participants: Records of patients admitted to the Otorhinolaryngology- Head and Neck Surgery ward with a diagnosis of nodular non-toxic goiter, multinodular non-toxic goiter, and thyroid malignancy who underwent thyroid surgery between January 2017 and June 2018 were considered for inclusion.
Results: A total of 33 patients, 7 males and 26 females, were included in this study. Patients’ age ranged from 26 to 69 years with an average of 46 years. Thirteen (39.4%) had malignant while 20 (60.6%) had benign histopathologic results. There was a significant association between presence of solid hypoechoic nodule (Fisher exact, n = 33, p = .0047), irregular margins and microcalcifications with malignant histopathology results (X2 (df = 1, N = 33) = 8.57, p = .003). No significant difference was noted in the proportion of subjects with malignancy according to taller than wide nodules (Fisher exact, n = 33, p = 1.000) or presence of extrathyroidal extension nodules or presence of extrathyroidal extension (Fisher exact, n = 33, p = .276). On multivariate analysis using logistic regression, only microcalcification was found to be a significant predictor of malignancy (OR = 8.96, 95% CI: 1.02 – 87.19, p = .05).
Conclusion: There was a significant association between presence of solid hypoechoic nodule, margins and microcalcifications with thyroid carcinoma. Only microcalcification was found to be a significant predictor of thyroid malignancy on ultrasound, although our confidence interval was broad.
Keywords: calcifications; thyroid; thyroid carcinoma; thyroid nodule; ultrasonography
“…More serious presentation can be neck pain due to internal hemorrhage or even its rupture which can be threatening. Spontaneous infection in the cyst is unexpected but any cyst can be infected if underwent needle aspiration [1 , 7 , 9] . Fig.…”
Thyroid isthmus lesions are generally small sized and can be solid or cystic. Discerning isthmic origin of a large nodule, especially if purely cystic, can become a diagnostic challenge because of thin thyroid tissue in it. We report a case of a 68-year-old male patient who had 6 weeks history of non- inflammatory central neck swelling associated with recent dysphagia, for which he underwent ultrasound and computed tomography (CT) scan examinations. Colloid nodules usually do not require further attention. Despite being commonest and benign thyroid nodules, they may require treatment if causing pressure symptoms. Its imaging characteristics can be variable, but they usually exhibit comet tail artifacts on ultrasound. In equivocal cases, claw sign on CT scan is diagnostic to confirm the site. Radiologists have a principle role to rule out other differentials of cystic neck lesions by careful examination of imaging features. In our case, CT scan allowed to rule out primary differential of thyroglossal cyst and guided clinicians for specific management plan.
“…Özellikle 1 cm'den büyük boyutlu nodüllerin tanısında ultrasonografi (USG) oldukça yararlı olup, toplumun 1/3'inde ultrasonografi ile nodül saptanabilmektedir (2,3) . Tiroid nodülleri sık görülmekle birlikte, %5-15 kadarında da tiroid kanseri gelişmektedir (4) . Tiroid nodülleri, ultrasonografik özelliklerine göre farklı sınıflamalar ile değerlendirilmekte ve kanser gelişimi açısından yüksek riskli nodüller belirlenebilmektedir.…”
Objective: Thyroid nodule is the most common disease of the thyroid gland and is closely associated with thyroid cancer. The gold standard method in diagnosis is Fine Needle Aspiration Biopsy (FNAB). Although the relationship between nodules containing microcalcification and malignancy is well known, there is no consensus on the relation of nodules with macrocalcification to malignancy and the adequacy of FNAB. In this study, it was aimed to compare the results of FNAB of nodules with and without macrocalcification in US examination. Methods: In this retrospective study, 466 nodules undergoing FNAB of 450 patients who applied for biopsy were included in the study. The demographic characteristics of the patients, US features of the nodules and cytopathology results of FNAB in the Bethesda classification were recorded. Nodules were divided into two main groups as calcified and non-calcified. US features and cytopathology results of the groups were compared. Results: Transverse sizes of calcified nodules were found to be larger than non-calcified ones (p = 0.003). In addition, solid composition, hypoechoic and prominent hypoechoic echogenicity, and irregular border feature were found with a higher rate in the calcified group (p <0.001). No significant difference was found between insufficient sample/non-diagnostic cytology (Bethesda-1) ratios in both groups (19.2% and 14.7%). Cytopathologically, number of malignant and suspected malignant nodules (Bethesda 5 and 6) were found to be higher in the calcified group (p=0.05). Conclusion: According to the results of this study, detection of macrocalcification in thyroid nodules in US examination does not cause a significant increase in insufficient FNAB results. However, the presence of macrocalcification increases the risk of malignancy of the thyroid nodule.
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