Characterization of Thyroid Nodule by Sonographic Features

Abstract

Introduction: The thyroid is an endocrine gland situated in the infrahyoid compartment of neck in a space outlined by muscle, trachea, esophagus, carotid arteries and jugular veins. Though nodular thyroid disease is relatively common, thyroid cancer is rare and accounts for less than 1% of all malignancies indicating that overwhelming majority of thyroid nodules are benign. The purpose of this study was to assess the sonographic characteristics in a solitary thyroid nodule and predict risk of malignancy.Methods: This prospective study was conducted in a tertiary care hospital in Kathmandu.62 patients with palpable thyroid nodule were evaluated for sonographic characteristics .USG guided FNA for cytopathological examination was then performed.Results: Out of 66 patients, four were subsequently excluded because they didn’t fulfill the inclusion criteria. Of the 62 patients, 47 (75.8%) were females and 15 (24.2%) were males. Among 56 benign nodules, 45 (80.4%) were in females and 11(19.6) were in male. Among 6 malignant nodules, 4(66.7%) were in males and 2 (33.3%) were in females. Result shows 5 malignant nodules (83.3%) were solid where as 1 malignant nodule (16.7%) was complex with solid predominance. All 4 cystic nodules (7.1%) were benign. All complex nodules with predomint cystic components were also benign. One malignant nodule (16.7%) had snow storm type of microcalcification. None of the benign nodules had microcalcification. Nodule having microcalcification was malignant. Findings showed that all malignant nodules (100%) had increased internal vascularity whereas benign nodules were variable in internal vascularity.Conclusion: This study has shown that colloid goiter is the commonest benign diagnosis whereas papillary carcinoma is the commonest malignancy. Malignant nodules are solid or predominantly solid whereas cystic and predominantly cystic nodules are likely to be benign. Macrocalcification and internal vascularity are not reliable to differentiate benign from malignant nodule. However, snowstorm calcification makes a nodule likely to be malignant whereas egg shell calcification is characteristic for benign nodule.

Prevalence of thyroid nodules in patients undergoing thyroid ultrasonography at a tertiary care centre

“…In this study the prevalence of thyroid nodules was 88% out of 111 cases. Higher prevalence was seen in the study done by Khadka et al 10 In the study done by Ahmed et al 11 the prevalence was only 25.1%. The total benign cases in this study were 86 (87.7%) and malignant cases were 32 (32.65%).…”

“…The total benign cases in this study were 86 (87.7%) and malignant cases were 32 (32.65%). Among 66 patients in Khadka et al's study, 10 there were 56 benign nodules and only six malignant nodules were noted. The malignant cases were seen among females than males in this study and female gender was associated with presence of nodule.…”

Association of Ultrasonography and Ultrasound-guided Fine Needle Aspiration Cytology in the Diagnosis of Thyroid Nodules

“…Like Reading et al , we found that the echo pa ern method for thyroid nodules is highly sensi ve and specific to the presence of benignity. In previous studies, the malignant risk of mixed echogenic nodules ranged from 2.3% to 21,22 17.6%. Our malignant rate is within this range.…”

Role of the American College Of Radiology –Thyroid Imaging Reporting and Data System (ACR TI-RADS) in Differentiating Benign and Malignant Thyroid Nodules

“…[8,9,10] Higher malignancy rate (22.9 %) was found in our study while other studies showed a lower prevalence rate of malignant nodules of 9.2-13%. [11,12,13] The mean age of a patient with benign and malignant nodules was 52.37 years and 51.44 years respectively. There was no significant statistical relationship between age and sex of patient and malignancy.…”

“…The colloid nodule was the most common benign nodule and papillary carcinoma was the most common malignant nodule as found in another study. [12] Three patients with papillary carcinoma had nodal metastasis at presentation. Similar to a study by Ewid et…”