Predictive value for malignancy in the finding of microcalcifications on ultrasonography of thyroid nodules

Chammas, Maria Cristina; Filho, Vergilius José Furtado de Araújo; Moysés, Raquel Ajub; Brescia, Marília D’Elboux Guimarães; Mulatti, Grace Carvajal; Brandão, Lenine Garcia; Cerri, Giovanni Guido; Ferraz, Alberto Rosseti

doi:10.1002/hed.20858

Cited by 32 publications

(24 citation statements)

References 17 publications

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“…However, only seven cases of malignancy were detected in that study and surprisingly only 4% in the second group presented these characteristics (9). In the present study using characteristics of high specificity (17)(18)(19)(20), although only 11.4% of the nodules presented these findings, the chance of malignancy in a second FNAC exam was approximately 17%. Although the FNAC was not repeated in the case of non-suspicious nodules considering this proportion of suspicious nodules, the frequency of malignancy in this group and an overall malignancy rate of approximately 2% upon repeat FNAC (3,4,6-9) it was concluded that specifically in these cases (non-suspicious nodules) malignancy should be negligible.…”

Section: Resultscontrasting

confidence: 60%

“…Although this imaging method alone does not define the etiology of the nodule it assists in the differentiation between benign and malignant nodules (10,(17)(18)(19)(20). This fact renders ultrasonography a highly attractive tool for the selection of candidates for repeat FNAC in the case of an initial benign cytological diagnosis, but its validation for this purpose is fundamental.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasonographic characteristics as a criterion for repeat cytology in benign thyroid nodules

Rosário

Purisch

2010

Arq Bras Endocrinol Metab

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OBJECTIVE: To report the results of repeat fine-needle aspiration cytology (FNAC) in thyroid nodules with an initial benign cytological diagnosis that grow during follow-up and/or present suspicious ultrasonographic characteristics. SUBJECTS AND METHODS: The sample consisted of 456 patients with 895 nodules. FNAC was repeated after 12 to 18 months in the case of nodules with suspicious ultrasonographic characteristics, irrespective of growth, and when the nodules showed significant growth. RESULTS: Among the 895 nodules examined, 102 (11.4%) presented suspicious ultrasonographic characteristics. The second FNAC revealed malignancy in 18 (17.6%) nodules, including 20% (2/10) of those showing growth and 17.4% (16/92) that did not. Seventy-six (9.6%) of 793 nodules without suspicious characteristics presented growth. Only one case (1.3%) of malignancy was diagnosed by repeat FNAC. CONCLUSIONS: The study suggests ultrasonographic characteristics rather than growth as a criterion for repeat FNAC in the case of nodules with an initial benign cytological diagnosis.

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Section: Resultscontrasting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Ultrasonographic characteristics as a criterion for repeat cytology in benign thyroid nodules

Rosário

Purisch

2010

Arq Bras Endocrinol Metab

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“…Although, microcalcifications are known to be strongly associated with malignant nodules, the association of macrocalcifications with malignancy is controversial (8)(9)(10)(11)(12)(13)(14)(15). Recent studies have revealed a relationship between macrocalcification and malignancy, particularly in papillary thyroid carcinomas (9,10,(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of cytopathological findings in thyroid nodules with macrocalcification: macrocalcification is not innocent as it seems

Arpacı

Özdemır

Çuhacı

et al. 2014

Arq Bras Endocrinol Metab

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Objective: Microcalcification is strongly correlated with papillary thyroid cancer. It is not clear whether macrocalcification is associated with malignancy. In this study, we aimed to assess the result of fine needle aspiration biopsies (FNAB) of thyroid nodules with macrocalcifications. Subjects and methods: We retrospectively evaluated 269 patients (907 nodules). Macrocalcifications were classified as eggshell and parenchymal macrocalcification. FNAB results were divided into four groups: benign, malignant, suspicious for malignancy, and non-diagnostic. Results: There were 79.9% female and 20.1% male and mean age was 56.9 years. Macrocalcification was detected in 46.3% nodules and 53.7% nodules had no macrocalcification. Parenchymal and eggshell macrocalcification were observed in 40.5% and 5.8% nodules, respectively. Cytologically, malignant and suspicious for malignancy rates were higher in nodules with macrocalcification compared to nodules without macrocalcification (p = 0.004 and p = 0.003, respectively). Benign and non-diagnostic cytology results were similar in two groups (p > 0.05). Nodules with eggshell calcification had higher rate of suspicious for malignancy and nodules with parenchymal macrocalcification had higher rates of malignant and suspicious for malignancy compared to those without macrocalcification (p = 0.01, p = 0.003 and p = 0.007, respectively). Conclusions: Our findings suggest that macrocalcifications are not always benign and are not associated with increased nondiagnostic FNAB results. Macrocalcification, particularly the parenchymal type should be taken into consideration. Arq Bras Endocrinol Metab. 2014;58(9):939-45 Keywords Thyroid nodule; macrocalcification; malignancy; suspicious of malignancy RESUMO Objetivo: A microcalcificação está fortemente correlacionada com o câncer papilar de tiroide. Não está claro se a macrocalcificação também está associada com malignidade. Neste estudo, nosso objetivo foi avaliar o resultado da biópsia de aspiração por agulha fina (FNAB) de nó-dulos tiroidianos com macrocalcificações. Sujeitos e métodos: Avaliamos retrospectivamente 269 pacientes (907 nódulos). As macrocalcificações foram classificadas como periféricas (casca de ovo) ou parenquimatosas (interna). Os resultados da FNAB foram divididos em quatro grupos citológicos: benignos, com malignidade, suspeita de malignidade e não diagnósticos. Resultados: Das amostras, 79,9% foram coletadas de mulheres e 20,1% de homens, e a idade média foi de 56,9 anos. A macrocalcificação foi detectada em 46,3% dos nódulos, e em 53,7% dos nódulos não havia macrocalcificação. A macrocalcificação parenquimatosa e periférica foi observada em 40,5% e 5,8% dos nódulos, respectivamente. Em termos citológicos, a malignidade e suspeita de malignidade foram mais comuns em nódulos com macrocalcificação em comparação com nódulos sem macrocalcificação (p = 0,004 e p = 0,003, respectivamente). Resultados benignos e não diagnósticos da citologia foram similares em ambos os grupos (p > 0,05). Os nódulos com calci...

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“…When microcalcification is noted within a solitary thyroid nodule the risk of malignancy is very high. It is present in 61% of the malignant nodules [3]. Any suspicious thyroid lesion, even tiny lesions should be investigated by fine needle biopsy.…”

Section: Discussionmentioning

confidence: 99%

Can leopards change their spots?

Modayil

Jacob²,

Leslie³

2010

BJR

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A 63-year-old man presented with a right neck lump. It was very hard to the touch, non-tender and had been present for 2 months. There were no other symptoms and he was otherwise fit and well. A thorough ear nose and throat (ENT) examination including flexible nasolaryngoscopy did not reveal any other abnormality. Further evaluation of the lump with ultrasound ( Figure 1a) and then CT (Figure 1b) was performed. Case 2A 43-year-old woman presented with a 6 month history of an ill-defined left neck swelling. There were no other symptoms. ENT examination including flexible nasolaryngoscopy did not reveal any other abnormality. The mass was evaluated with ultrasound ( Figure 2a)

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Predictive value for malignancy in the finding of microcalcifications on ultrasonography of thyroid nodules

Abstract: This study suggests that microcalcifications were highly specific for malignancy and were present in 61% of the malignant nodules.

Cited by 32 publications

References 17 publications

Ultrasonographic characteristics as a criterion for repeat cytology in benign thyroid nodules

Ultrasonographic characteristics as a criterion for repeat cytology in benign thyroid nodules

Evaluation of cytopathological findings in thyroid nodules with macrocalcification: macrocalcification is not innocent as it seems

Can leopards change their spots?

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