Value of Echogenic Foci in Diagnosing Papillary Thyroid Carcinoma and Predicting Aggressive Biological Behavior

Wang, Guojuan; Nie, Fang; Wang, Yanfang; Wang, Peihua; Wang, Lan; Xiao, Fan; Ma, Zhenxian

doi:10.1002/jum.15815

Cited by 5 publications

(3 citation statements)

References 26 publications

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“…Similar to CLNM, multiple microcalcifications at the primary site independently increased the risk of occult carcinoma. This implies that a greater number and distribution of punctate echogenic foci could be linked to PTC’s aggressive biological behavior, [ 36 ] warranting further research.…”

Section: Discussionmentioning

confidence: 99%

Incidence and risk factors for occult lesions in low-risk papillary thyroid microcarcinoma patients with tumor characteristics appropriate for thermal ablation: A retrospective study

Jin,

Zhu,

et al. 2023

Medicine

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In recent years, thermal ablation has been increasingly employed for the treatment of low-risk papillary thyroid microcarcinoma (PTMC) across various institutions. Its use as a standard or initial treatment continues to be a subject of debate. Retrospective analyses of the surgical pathology in post-ablation patients have indicated that occult lesions are not uncommon. This retrospective study aimed to examine the incidence and risk factors of occult lesions via postoperative pathology in low-risk PTMC patients who fulfilled the criteria for thermal ablation therapy. We examined the medical records of patients who underwent thyroid surgery and had a Bethesda classification V or VI based on fine needle aspiration cytology between November 22, 2020, and December 31, 2022. A total of 413 patients with preoperative tumor characteristics appropriate for thermal ablation were included in this study. Occult lesions, encompassing ipsilateral or contralateral occult carcinoma or central lymph node metastases may have occurred in 34.7% of patients. Male gender (OR: 2.526, 95% CI: 1.521–4.195, P = .000), tumor location in the lower pole (OR: 1.969, 95% CI: 1.186–3.267, P = .009), multiple microcalcifications (OR: 5.620, 95% CI: 2.837–11.134, P = .000), and Hashimoto’s thyroiditis (OR: 2.245, 95% CI: 1.292–3.899, P = .004) were independent risk factors for the presence of occult lesions. In low-risk PTMC patients exhibiting tumor characteristics amenable to thermal ablation, over one-third of the patients may present with occult lesions. Meticulous evaluation of the presence of additional lesions is necessary before performing thermal ablation, particularly in patients exhibiting high-risk factors for occult lesions.

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Section: Discussionmentioning

confidence: 99%

Incidence and risk factors for occult lesions in low-risk papillary thyroid microcarcinoma patients with tumor characteristics appropriate for thermal ablation: A retrospective study

Jin,

Zhu,

et al. 2023

Medicine

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“…Middleton et al. ( 36 ) reported that the risk of malignancy was 29.8%–40.5% in solid nodules and 5.9%–15.1% in nodules mixed with PEF. PEF in thyroid nodules is considered as predictor of malignant thyroid cancer in children and adolescents ( 35 , 37 , 38 ).…”

Section: Discussionmentioning

confidence: 99%

Ultrasonographic, clinical, and pathological features of papillary thyroid carcinoma in children and adolescents with or without Hashimoto’s thyroiditis

Ruan

Luo

et al. 2023

Front. Oncol.

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ObjectiveTo compare the ultrasonographic, clinical, and pathological features of children and adolescents with papillary thyroid carcinoma (PTC) with and without Hashimoto’s thyroiditis (HT)Materials and methodsA total of 52 children and adolescent patients surgically diagnosed with PTC between 2017 and 2022 were included; 14 children and adolescent patients with PTC were diagnosed with HT via pathological examination. The preoperative ultrasonographic, postoperative histological, and molecular and clinical characteristics were retrospectively analyzed.ResultsThe prevalence rate of PTC in patients with HT was 27%. Papillary thyroid microcarcinomas were found in 11 of 38 patients without HT, but none in patients with HT (p = 0.023). Extrathyroidal extension, capsular invasion, and lymph node metastases were more frequent in patients with PTC and HT than in patients with PTC alone (p < 0.05 for both). The ultrasonographic features of nodule composition, echogenicity, shape, margin, Thyroid Imaging Reporting and Data System categories, and total points were similar. The patterns of echogenic foci were more prominent in the nodules of patients with HT than in those of patients without HT (p = 0.016).ConclusionThe frequency of papillary thyroid microcarcinomas in patients with PTC and HT was less, whereas that of extrathyroidal extension, capsular invasion, and lymph node metastasis was significantly higher in patients with PTC and HT than in those with PTC alone. The patterns of echogenic foci on ultrasonography may represent a risk for PTC.

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To the Editor: We have read with great interest the article by Wang et al, titled "Value of echogenic foci in diagnosing papillary thyroid carcinoma and predicting aggressive biological behavior." 1 The aim of this retrospective study was to classify the echogenic foci viewed in thyroid nodules, establish association with papillary carcinoma, and to correlate biological aggressiveness by the presence of cervical lymph node metastasis. Hence, this work is of vast significance for our diagnostic center to evaluate echogenic foci, however, we have some thoughts and questions about the study.The authors interestingly found that punctate and mixed echogenic foci are associated with higher malignancy risk and those nodules with comet-tail artifacts and with peripheral rim were protective factors for papillary carcinoma with PPV of 84.6 and 85.7%, respectively.

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confidence: 99%