<p><strong>Objective: </strong>To evaluate the validity of sonoelastography of cold thyroid nodule in diagnosis of malignant nodule with fine needle aspiration cytology analysis as the reference standard.</p><p><strong>Patients and Methods: </strong>This cross sectional study was conducted in the Institute of Nuclear Medicine & Allied Sciences (INMAS), Sir Salimullah Medical College (SMC) & Mitford Hospital campus, Dhaka, from July 2015 to June 2016 in 85 patients with solitary solid cold nodule. Eighty five nodules in these patients were examined by conventional ultrasound, ultrasound elastography and radionuclidescan. The final diagnosis was obtained from cytological findings. Tissue stiffness on ultrasound elastography was scored from 1 (low stiffness over the entire nodule) to 4 (high stiffness over the entire nodule).</p><p><strong>Results: </strong>The mean age was found 33.8±10.1 years with range from 12 to 58 years and male to female ratio was 1:5.1. The mean size of nodules was found 2.0±0.6 cm. Most (40.0%) of the patients were found in elastography score 2, 22(25.9%) score 1, 17(20.0%) score 4 and 12(14.1%) score 3. The validity of elastography scores had sensitivity 77.8%, specificity 86.2%, accuracy 83.5%, positive predictive values 72.4% and negative predictive values 89.3% for prediction of thyroid nodule.</p><p><strong>Conclusion: </strong>Considering the validity parameter the elastography may be effective diagnostic modality for evaluation of thyroid nodule.</p><p>Bangladesh J. Nuclear Med. 19(2): 103-106, July 2016</p>
Papillary and follicular thyroid carcinomas, together known as differentiated thyroid carcinomas (DTC), are among the most curable of cancers. Distant metastases are rare events at the onset of DTC. Sites of metastases from follicular thyroid cancer (FTC) are usually osseous, and those from papillary thyroid cancer (PTC) metastasize to regional nodal basins and the lungs. Visceral metastases are rare, but the involvement of multiple sites has been reported so far. Liver metastases from differentiated thyroid carcinoma (LMDTC) are rare.We present the case of a patient with follicular variant of papillary thyroid carcinoma (FVPTC) unusually involving the liver.
Bangladesh J. Nuclear Med. 22(2): 146-149, Jul 2019
Thyroglossal duct cyst (TGDC) is the most common developmental anomaly of the thyroid gland, while TGDC carcinoma with local infiltration to the hyoid bone is extremely rare. The reported case of papillary thyroid carcinoma (PTC) was diagnosed in TGDC along with local infiltration to the hyoid bone and needed individualized management. A 70-year-old male patient presented with a history of PTC arising in TGDC and locally infiltrated to the hyoid bone followed by total thyroidectomy and radical sistrunk operations and was referred to National Institute of Nuclear Medicine and Allied Sciences (NINMAS) for radioactive iodine therapy (RAIT). His post-operative ultrasound of the neck revealed an irregular shaped, fungating, grossly non-homogenous mixed echogenic mass lesion invading the hyoid bone, measuring about 25 X 28 mm. Radioactive iodine(131I) of 150 mCi was administered because the residual hyoid bone mass was inoperable and he was on thyroxine suppression therapy. The post-therapy 131I scan (RxWBS) showed two intense foci of radiotracer concentration (RTC) in the upper area (above the thyroid bed) and an intense focal RTC in the fundal region of the stomach. The activity in the stomach region was evaluated by ultrasound imaging, which revealed a soft tissue mass or thickening of the mid-region of the posterior wall of the stomach (3.3 cm X 1.6 cm). A CT scan of the chest was also performed to rule out metastasis, and it revealed multiple nodular lesions in both lung fields (most likely secondary) as well as tiny subcentric lymphnodes in the lower pre- and right paratracheal regions after nearly one month of RAIT when the patient was stable for examination. EBRT is still under consideration as adjuvant therapy. Tyrosine kinase inhibitors (TKI) may be considered in cases of refractoriness to radioiodine and disease progression.
Bangladesh J. Nuclear Med. 26(1): 67-70, 2023
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