Papillary thyroid cancer echocardiography or ultrasound: Difference between revisions

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Revision as of 21:39, 5 August 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]

Overview

Neck ultrasound may be performed to detect papillary thyroid cancer.

Ultrasound

Ultrasound imaging is useful in the diagnosis and management of thyroid cancer. It is used for:^[1]

Evaluation of thyroid nodule characteristics
Determination of nodule location during fine needle aspiration study
Assessment of adjacent lymph node for the purpose of staging the cancer
Post-surgical surveillance for early detection of tumor recurrence and/or nodal metastatic disease

In summary, ultrasound imaging findings suggestive of malignant thyroid nodule include:

Microcalcification
Peripheral, coarse calcification
Solid, hypoechoic nodule
Locally invaded nodule (more commonly seen in anaplastic thyroid cancer and primary thyroid lymphoma)
High anteroposterior/width ratio
Irregular nodular margin
Adjacent suspicious lymph node with a size greater than 2 cm
- Presence of posterior acoustic shadowing

Additionally, ultrasound imaging has been observed to be useful in the diagnosis of non-palpable lymph node metastasis when used preoperatively.^[2]

Key ultrasound Findings in papillary thyroid cancer include:
- Hypoechoic nodule in the majority of cases
- Microclacifications that are seen as tiny punctate echogenic foci within the nodule (most common finding)
- Posterior acoustic shadowing from the edges of the nodule
Ultrasound Examples of Papillary thyroid cancer

References

↑ Coquia, Stephanie F.; Chu, Linda C.; Hamper, Ulrike M. (2014). "The Role of Sonography in Thyroid Cancer". Radiologic Clinics of North America. 52 (6): 1283–1294. doi:10.1016/j.rcl.2014.07.007. ISSN 0033-8389.
↑ Stulak, John M. (2006). "Value of Preoperative Ultrasonography in the Surgical Management of Initial and Reoperative Papillary Thyroid Cancer". Archives of Surgery. 141 (5): 489. doi:10.1001/archsurg.141.5.489. ISSN 0004-0010.
↑ ^3.0 ^3.1 ^3.2 ^3.3 ^3.4 ^3.5 Image courtesy of Dr Garth Kruger. Radiopaedia (original file ‘’here’’.Creative Commons BY-SA-NC

Template:WikiDoc Sources

[CoquiaChu2014-1] Coquia, Stephanie F.; Chu, Linda C.; Hamper, Ulrike M. (2014). "The Role of Sonography in Thyroid Cancer". Radiologic Clinics of North America. 52 (6): 1283–1294. doi:10.1016/j.rcl.2014.07.007. ISSN 0033-8389.

[Stulak2006-2] Stulak, John M. (2006). "Value of Preoperative Ultrasonography in the Surgical Management of Initial and Reoperative Papillary Thyroid Cancer". Archives of Surgery. 141 (5): 489. doi:10.1001/archsurg.141.5.489. ISSN 0004-0010.

[radio-3] 3.0 ^3.1 ^3.2 ^3.3 ^3.4 ^3.5 Image courtesy of Dr Garth Kruger. Radiopaedia (original file ‘’here’’.Creative Commons BY-SA-NC

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@@ Line 24: / Line 24: @@
 **Microclacifications that are seen as tiny punctate echogenic foci within the nodule (most common finding)
 **Posterior acoustic shadowing from the edges of the nodule
-The ultrasound is a useful test to distinguish solid from cystic lesions and to identify calcifications.<ref>{{cite news|url=http://findarticles.com/p/articles/mi_qa3725/is_200607/ai_n16598095/|title=Papillary Thyroid Carcinoma: An Overview|date=|accessdate= 2010-07-15 | work=Archives of Pathology & Laboratory Medicine | year=2006}}</ref>
-* The thyroid ultrasound is also very effective to discover microcarcinomas, which refer to very small carcinomas (<1&nbsp;cm).Papillary carcinoma within the thyroid usually appears as a solitary mass usually with an irregular outline, located in the subcapsular region and demonstrating vascularity.<ref name="pmid15770036">{{cite journal| author=Lyshchik A, Drozd V, Demidchik Y, Reiners C| title=Diagnosis of thyroid cancer in children: value of gray-scale and power doppler US. | journal=Radiology | year= 2005 | volume= 235 | issue= 2 | pages= 604-13 | pmid=15770036 | doi=10.1148/radiol.2352031942 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15770036  }} </ref> Small punctate regions of echogenicity representing microcalcifications (psammoma bodies) may be present.<ref name="pmid17579175">{{cite journal| author=Kwak JY, Kim EK, Son EJ, Kim MJ, Oh KK, Kim JY et al.| title=Papillary thyroid carcinoma manifested solely as microcalcifications on sonography. | journal=AJR Am J Roentgenol | year= 2007 | volume= 189 | issue= 1 | pages= 227-31 | pmid=17579175 | doi=10.2214/AJR.06.0750 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17579175  }} </ref>
-* Lymph node metastases have a tendency to completely cavitate (40%), and although usually multiple, in a minority of cases (6%) a single completely cystic node may be present. They tend to have septations, mural nodules, and relatively thick walls.<ref name="pmid11856700">{{cite journal| author=Wunderbaldinger P, Harisinghani MG, Hahn PF, Daniels GH, Turetschek K, Simeone J et al.| title=Cystic lymph node metastases in papillary thyroid carcinoma. | journal=AJR Am J Roentgenol | year= 2002 | volume= 178 | issue= 3 | pages= 693-7 | pmid=11856700 | doi=10.2214/ajr.178.3.1780693 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11856700  }} </ref>
-* Very few radiologists would aspirate a lesion under 10 mm in diameter.
-* A lesion that enlarges with follow up is a relatively strong indication for FNA of the lesion. In patients with pathological cervical nodes on ultrasound, any thyroid lesion should likely be aspirated.
-* In every day ultrasound practice, papillary thyroid cancer most commonly has poorly defined margins and/or calcifications (which may be macrocalcifications). There is a poor correlation between blood flow and malignancy in practice. Aspiration of simple cysts of the thyroid lesions does not yield malignant cells and cysts can safely be followed up in the context of excluding malignancy.
 *Ultrasound Examples of Papillary thyroid cancer
 [[File:Papillary thyroid cancer ultrasound 06.jpeg|thumb|center|Papillary thyroid cancer ultrasound<ref name=radio> Image courtesy of  Dr Garth Kruger. [http://www.radiopaedia.org Radiopaedia] (original file [http://radiopaedia.org/articles/papillary-thyroid-cancer ‘’here’’].[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>]]

Papillary thyroid cancer echocardiography or ultrasound: Difference between revisions

Revision as of 21:39, 5 August 2019

Overview

Ultrasound

References

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