Follicular thyroid cancer echocardiography and ultrasound

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2] Ammu Susheela, M.D. [3]

Overview

Neck ultrasound may be performed to detect follicular thyroid cancer. Follicular thyroid adenoma/carcinoma may appear as a hypoechoic nodule with thin hypoechoic halos or central linear hypoechoic striations or areas in the thyroid ultrasound imaging.

Ultrasound

• Ultrasound imaging is useful in the diagnosis and management of thyroid cancer. It is used for:
  • 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.
• Possible ultrasound findings in follicular adenoma/carcinoma include:
  • Solid, well-marginated, hypoechoic nodules with thin hypoechoic halos
  • Central linear hypoechoic striations or areas