Ultrasonographic features and clinical characteristics of Warthin-like variant of papillary thyroid carcinoma

Kim, Ga Ram; Shin, Jung Hee; Hahn, Soo Yeon; Ko, Eun Young; Oh, Young Lyun

doi:10.1507/endocrj.ej15-0620

Cited by 8 publications

(11 citation statements)

References 24 publications

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“…This feature was the main suspicious indicator for FNA. In accordance with Kim et al findings [7], we found that taller-than-wide shape in our case series was not popular (18.2%). Besides, punctate echoic foci were detected in 9 cases only.…”

Section: Discussionsupporting

confidence: 92%

“…WVPTC is a rare subgroup of oncocytic variant [1] PTC, with about 162 cases reported in the English literature up to now [4,5,7,8]. Similar to previous reports, we found that WVPTC were more often seen in female patients (27/32，84.4%) with a relative high age (mean age, 51.0±10.8 years old).…”

Section: Discussionsupporting

confidence: 88%

“…Taller-than-wide shape, irregular/spicular margin, microcalcifications, extremely hypoechoic and solid composition are universally considered as the malignant indicators of thyroid cancers. The largest study about the US features of WVPTC was conducted by Kim et al in 2016 [7]. They concluded that WVPTCs did not sufficiently meet the typical suspicious findings mentioned above.…”

Section: Introductionmentioning

confidence: 99%

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Clinical and sonographic characteristics of Warthin-like variant papillary thyroid carcinomas

et al. 2019

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Aim: To summarize the clinical, ultrasonographic (US) and pathological characteristics of Warthin-like variant papillary thyroid carcinomas (WVPTC).Material and methods: Medical records and US images of 32 cases of WVPTCs diagnosed between December, 2006 and September, 2018 were reviewed. Clinical, pathological and US characteristics of these cases were collected and summarized. ACR TI-RADS was followed during the analysis of the US features of the lesions. Results: Totally, 32 patients with 33 WVPTC nodules were reviewed. WVPTC was more often seen in female patients (27/32,84.4%) with a relatively high age (mean age, 51.0±10.8 years old). Hyperthyroidism was observed in 14 patients; 2 patients were diagnosed as subclinical hyperthyroidism and 1 patient as subclinical hypothyroidism. Abnormal thyroglobulin antibody was detected in 22 patients. Mean size of the nodule was 1.2±0.5 cm (range, 0.5~2.99 cm) on US. Pathologically, tumor margin of 63.6% carcinomas were infiltrative but most (72.9%) of the enrolled carcinomas were intra-thyroidal. Lymphocytic thyroiditis was detected in 87.5% (28/32) patients. On US, most WVPTCs were solid or almost complete solid (32/33, 97.0%) and very hypoechoic (26/33, 78.8%). Taller-than-wide shape (6/33, 18.2%) and punctate echogenic foci (9/33, 27.3%) were not popular. All the nodules were scored higher than 5 points according to the ACR TI-RADS, including 9 nodules that were classified into TR4 and 24 nodules as TR5. Follow-up information was available in 31 patients and no recurrence or distal metastasis was detected.Conclusions: WVPTC is a rare variant of PTCs with favorable outcomes. Very hypoechoic echogenicity, solid or almost complete solid composition are the vital indicators for biopsy, even though the nodule may be wider-than-tall and have a lack of punctuate echoic foci.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

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Clinical and sonographic characteristics of Warthin-like variant papillary thyroid carcinomas

et al. 2019

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“…All cases are associated with heterogeneous parenchyma in the background [52]. Table 2 is summerized in the incidence and common US features of PTC variants.…”

Section: Favorable Variantsmentioning

confidence: 99%

Ultrasonographic imaging of papillary thyroid carcinoma variants

Shin

2017

Ultrasonography

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Ultrasonography (US) is routinely used to evaluate thyroid nodules. The US features of papillary thyroid carcinoma (PTC), the most common thyroid malignancy, include hypoechogenicity, spiculated/microlobulated margins, microcalcifications, and a nonparallel orientation. However, many PTC variants have been identified, some of which differ from the classic type of PTC in terms of biological behavior and clinical outcomes. This review describes the US features and clinical implications of the variants of PTC. With the introduction of active surveillance replacing immediate biopsy or surgical treatment of indolent, small PTCs, an understanding of the US characteristics of PTC variants will facilitate the individualized management of patients with PTC.

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“…According to previous studies [ 28 – 31 ], US features of malignant thyroid nodules are well established, and include hypoechogenicity, spiculated/microlobulated margin, microcalcifications, and non-parallel orientation. These suspicious US findings are relatively consistent regardless of histologic type or variant of thyroid cancer [ 18 , 32 – 34 ]. Moreover, several studies demonstrated that US characteristics of thyroid nodules might be highly reliable for predicting clinical outcomes and appropriate management of patients [ 19 , 21 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound and clinicopathological features of papillary thyroid carcinomas with BRAF and TERT promoter mutations

Hahn

Kim

et al. 2017

Oncotarget

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This study is to investigate if any relationship exists between the telomerase reverse transcriptase (TERT) promoter or proto-oncogene BRAF mutation and ultrasound (US) and clinicopathological features of papillary thyroid carcinomas (PTCs). The study included 150 patients with surgically confirmed PTC from October 1994 to December 2004. According to the existence of TERT promoter or BRAF mutations, we categorized patients into three groups (no mutation, BRAF mutation alone, or TERT+BRAF mutations) and analyzed the relationships between TERT promoter or BRAF mutation and US and clinicopathological features. The rate of recurrence or death according to mutation analysis was estimated. There were 35 (23.3%) cases with no mutation, 104 (69.3%) with BRAF mutation alone, and 11 (7.3%) with TERT+BRAF mutations. As the number of genetic mutations increased from no mutation to BRAF mutation alone to both BRAF and TERT mutations, the proportions of hypoechogenicity, non-parallel orientation, spiculated/microlobulated margin, microcalcifications, and high suspicion category increased. PTCs with TERT+BRAF mutations recurred more frequently than other groups (odd ratio = 17.921 and 31.468). The intervals to recurrence and overall survival were significantly shorter in the TERT+BRAF mutation group than in the other groups (Ps <.0001). PTCs with no mutation, with BRAF mutation alone, and with both TERT and BRAF mutations linearly increase in the probability of displaying malignant US features. In PTCs, the coexistence of BRAF with TERT mutations is more strongly correlated with recurrence and mortality than BRAF mutation alone.

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Ultrasonographic features and clinical characteristics of Warthin-like variant of papillary thyroid carcinoma

Cited by 8 publications

References 24 publications

Clinical and sonographic characteristics of Warthin-like variant papillary thyroid carcinomas

Clinical and sonographic characteristics of Warthin-like variant papillary thyroid carcinomas

Ultrasonographic imaging of papillary thyroid carcinoma variants

Ultrasound and clinicopathological features of papillary thyroid carcinomas with BRAF and TERT promoter mutations

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