Ultrasonography.
2016 Oct;35(4):327-334. 10.14366/usg.15082.
Malignant-looking thyroid nodules with size reduction: core needle biopsy results
- Affiliations
-
- 1Department of Radiology and the Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. radbaek@naver.com
- 2Department of Radiology, Inha University School of Medicine, Incheon, Korea.
- 3Department of Radiology, Ajou University School of Medicine, Suwon, Korea.
- 4Department of Health Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- 5Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- 6Department of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- KMID: 2354361
- DOI: http://doi.org/10.14366/usg.15082
Abstract
- PURPOSE
The aim of this study was to evaluate whether malignant-looking thyroid nodules with size reduction were malignant or not.
METHODS
From November 2010 to July 2011, we retrospectively enrolled 16 patients with 16 nodules (11 females and five males; mean age, 55 years) who underwent core needle biopsy (CNB), and whose thyroid nodules had malignant ultrasonographic (US) features, although they showed size reduction (>20% decrease in maximum diameter) during the follow-up period (mean, 37±27 months). The histologic findings of the CNB specimen were reviewed and correlated with the US findings. US studies were analyzed for their internal content, shape, margin, echogenicity, the presence of microcalcification and macrocalcification, inner isoechoic rim, and low-echoic halo.
RESULTS
All nodules were confirmed as benign by CNB. Pathologic analysis was available for 12 CNB specimens. US imaging showed central hypoechogenicity or marked hypoechogenicity in all cases and a peripheral isoechoic rim in 15 nodules. US-pathologic correlation showed that the central hypoechoic area was primarily composed of fibrosis (12/12) and hemorrhage (8/12) and that the isoechoic rim was composed of follicular cells.
CONCLUSION
In our study, the CNB results of all of the malignant-looking thyroid nodules with size reduction were benign and were primarily composed of internal fibrosis and hemorrhage. Understanding these US and pathologic features could prevent repeated fine-needle aspiration or unnecessary diagnostic surgery.
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