Follicular thyroid cancer echocardiography or ultrasound: Difference between revisions
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* A nodule taller than it is wide is suspicious for malignancy. | * A nodule taller than it is wide is suspicious for malignancy. | ||
* Irregular margins are suspicious for malignancy | * Irregular margins are suspicious for malignancy | ||
===Lymphnode=== | ====Lymphnode==== | ||
* Enlarged regional lymph nodes are suspicious for thyroid malignancy | * Enlarged regional lymph nodes are suspicious for thyroid malignancy | ||
* Microcalcifications in regional lymph nodes are highly suspicious | * Microcalcifications in regional lymph nodes are highly suspicious | ||
Revision as of 14:37, 3 November 2015
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Follicular thyroid cancer Microchapters |
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Differentiating Follicular thyroid cancer from other Diseases |
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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 follicular thyroid cancer.
Ultrasound
Key Ultrasound Findings in Thyroid Cancer
- Large size, microcalcifications, and hypoechogenicity are suspicious feature[1]
- Lymphadenopathy is a suspicious feature
- Microcalcifications is the most specific finding associated with malignancy (~95%)
- Coarse calcifications can also be seen in malignant nodules
- Peripheral rim calcification can be seen in malignant nodules
- 25 % of follicular and medullary cancer are isoechoic solid nodule.
- There is 5% chance of a hyperechoic nodule being malignant.
- Invasion of local structures favors anaplastic thyroid carcinoma and thyroid lymphoma
- A nodule taller than it is wide is suspicious for malignancy.
- Irregular margins are suspicious for malignancy
Lymphnode
- Enlarged regional lymph nodes are suspicious for thyroid malignancy
- Microcalcifications in regional lymph nodes are highly suspicious
- Lymph nodes with cystic change are highly suspicious
- Loss of normal fatty hilum, irregular node appearance
- Increased colour Doppler flow is suspicious
- Low threshold criteria for lymph node biopsy
- Biopsy if suspicious features
- Consider biopsy if >8 mm
Sonographic Features Favouring a Malignant Nodule
- Hypoechoic solid
- Presence of microcalcifications: almost always warrants a FNA
- Local invasion of surrounding structures
- Taller than it is wide
- Large size: the cut off is often taken as 10 mm to warrant a FNA
- Suspicious neck lymph nodes suggesting metastatic disease
- Intranodular blood flow