J Korean Soc Ultrasound Med.  2013 Jun;32(2):120-127.

Thyroid nodules with Bethesda System IV Cytology: Can Ultrasonography Differentiate Malignancy from Benign?

• Yoo MR
• Son EJ
• Youk JH
• Kim JA
• Chung SY
• Kim H
• Gweon HM

Abstract

PURPOSE
The purpose of this study is to identify clinical and imaging parameters that can be used in differentiation of benign versus malignancy of preoperative FNA diagnosis of Bethesda system IV nodules.
MATERIALS AND METHODS
We analyzed clinical, ultrasonographic, and CT findings of 28 thyroid nodules with Bethesda system IV cytology on FNA, which were proven as follicular or Hurthle cell neoplasms on surgical pathology.
RESULTS
No statistically significant differences according to age, sex, and ultrasonographic parameters, including echogenicity, margin, calcification, shape, cystic component, and degree of vascularity and enhancement on CT were observed between benign and malignant follicular neoplasms. Only the lesion size was significantly different (p<0.05).
CONCLUSION
The size of follicular neoplasm is predictive of malignancy. If a thyroid nodule with the Bethesda IV cytology is larger than 24.5 mm, there will be a greater probability of malignancy.

Keyword

Thyroid; Follicular neoplasm; Bethesda system

MeSH Terms

Thyroid Gland
Thyroid Nodule