Korean J Radiol.  2012 Oct;13(5):530-535. 10.3348/kjr.2012.13.5.530.

Partially Cystic Thyroid Nodules: Ultrasound Findings of Malignancy

• Park JM
• Choi Y
• Kwag HJ

• KMID: 1392929
• DOI: http://doi.org/10.3348/kjr.2012.13.5.530

Abstract

OBJECTIVE
To seek for the ultrasound (US) findings of partially cystic thyroid nodules that are associated with malignancy.
MATERIALS AND METHODS
We reviewed the US characteristics of 22 surgically confirmed partially cystic papillary carcinomas, and compared them with those of 80 benign partially cystic nodules. The review cases were selected in a random order from a total of 1029 partially cystic nodules that were diagnosed with an US-guided fine needle aspiration biopsy over a period of 8 years (June 2003 to October 2010) at our institution.
RESULTS
In partially cystic thyroid nodules, a taller-than-wide shape (100%, p < 0.001) and spiculated or microlobulated margin (58.3%, p = 0.003) were significantly associated with malignancy. In terms of internal solid portion of the nodule, eccentric configuration (68.0%, p < 0.001), non-smooth margin (81.3%, p < 0.001), hypoechogenecity (30.0%, p < 0.042), and microcalcification (89.5%, p < 0.001) were more frequently demonstrated in malignant nodules than benign ones.
CONCLUSION
In partially cystic thyroid nodules, understanding the characteristics of US findings is important to make a precise diagnosis of malignant nodules.

Keyword

Partially cystic nodule; Partially cystic papillary carcinoma; Cystic papillary carcinoma; Thyroid nodule; Ultrasound

MeSH Terms

Adolescent
Adult
Aged
Biopsy, Fine-Needle
Carcinoma, Papillary/pathology/surgery/*ultrasonography
Case-Control Studies
Chi-Square Distribution
Cysts/pathology/surgery/*ultrasonography
Female
Humans
Male
Middle Aged
Statistics, Nonparametric
Thyroid Neoplasms/pathology/surgery/*ultrasonography
Thyroid Nodule/pathology/surgery/*ultrasonography

Figure

• 

  Fig. 1 Longitudinal ultrasound image of papillary thyroid carcinoma in 53-year-old woman shows predominantly cystic nodule. Entire nodule has smooth margin. Internal protruding eccentric solid position contains multiple punctuate round echogenic foci suggesting microcalcifications.

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  Fig. 2 Example of non-eccentric configuration of internal solid portion. Transverse (A) and longitudinal (B) US images show partially cystic nodule with isoechoic internal solid portion in 57-year-old woman. Entire nodule has ill-defined margin (arrows). Nodular hyperplasia was diagnosed by US-guided fine needle aspiration. US = ultrasound

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  Fig. 3 Transverse ultrasound image of predominantly cystic nodule in 69-year-old woman. Eccentric solid position protruded internally and contained multiple microcalcifications. Note difference between smooth margin of entire nodule (arrows) and non-smooth margin of internal solid portion (arrowheads). Papillary thyroid carcinoma was diagnosed by fine needle aspiration and surgery.

• 

  Fig. 4 Longitudinal ultrasound image of predominantly cystic nodule in 66-year-old woman shows eccentric configuration. Note difference between smooth margin of entire nodule (arrows) and non-smooth margin of internal solid portion (arrowheads). This lesion was surgically confirmed as papillary thyroid carcinoma despite substantial cystic portion.

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  Fig. 5 Transverse ultrasound image of predominantly cystic nodule in 63-year-old woman shows eccentric configuration of internal solid portion with multiple microcalcifications. Note non-smooth margin of internal solid portion (arrows). This lesion was surgically confirmed as papillary thyroid carcinoma despite substantial cystic portion.

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