A comparison of lymphocytic thyroiditis with papillary thyroid carcinoma showing suspicious ultrasonographic findings in a background of heterogeneous parenchyma

다국어 초록 (Multilingual Abstract)

Purpose: The aim of this study was to compare ultrasonographic features in patients with lymphocytic thyroiditis (LT) and papillary thyroid carcinoma (PTC) having suspicious thyroidnodule(s) in a background of heterogeneous parenchyma and to determine the clinical and radiological predictors of malignancy.
Methods: We reviewed the cases of 100 patients who underwent ultrasonography between April 2011 and October 2012, and showed suspicious thyroid nodule(s) in a background ofheterogeneous parenchyma. Eight patients who did not undergo ultrasonography-guided fineneedle aspiration cytology (FNAC) and 34 cases of follow-up ultrasonography after initial FNACwere excluded. We compared the benign and malignant nodules in terms of their clinical and radiological factors.
Results: For the 58 nodules including 31 LTs (53.4%) and 27 PTCs (46.6%), the mean tumor sizes of the two groups were 0.96 cm for LT and 0.97 cm for PTC. A univariate analysis revealedthat PTCs were more frequent in patients younger than 45 years and having microcalcifications than was LT. An independent predictor of PTC after adjustment was an age of <45 years.
Conclusion: LT mimics malignancy in a background of heterogeneous parenchyma on ultrasonography. A young age of <45 years is the most important predictor of malignancy in thiscondition.

참고문헌 (Reference)

1 Gutekunst R, "Ultrasonography related to clinical and laboratory findings in lymphocytic thyroiditis" 121 : 129-135, 1989

2 Pearce EN, "Thyroiditis" 348 : 2646-2655, 2003

3 Marcocci C, "Thyroid ultrasonography helps to identify patients with diffuse lymphocytic thyroiditis who are prone to develop hypothyroidism" 72 : 209-213, 1991

4 Takashima S, "Thyroid nodules associated with Hashimoto thyroiditis: assessment with US" 185 : 125-130, 1992

5 Ott RA, "The incidence of thyroid carcinoma in Hashimoto's thyroiditis" 53 : 442-445, 1987

6 Matsubayashi S, "The correlation between papillary thyroid carcinoma and lymphocytic infiltration in the thyroid gland" 80 : 3421-3424, 1995

7 Thomas CG Jr, "Surgical intervention in chronic (Hashimoto's) thyroiditis" 193 : 769-776, 1981

8 Hayashi N, "Sonography of Hashimoto's thyroiditis" 14 : 123-126, 1986

9 Set PA, "Sonographic features of Hashimoto thyroiditis in childhood" 51 : 167-169, 1996

10 Langer JE, "Sonographic appearance of focal thyroiditis" 176 : 751-754, 2001

11 Papini E, "Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features" 87 : 1941-1946, 2002

12 Iannuccilli JD, "Risk for malignancy of thyroid nodules as assessed by sonographic criteria: the need for biopsy" 23 : 1455-1464, 2004

13 Takashima S, "Primary thyroid lymphoma: evaluation with CT" 168 : 765-768, 1988

14 Kim EK, "New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid" 178 : 687-691, 2002

15 Yeh HC, "Micronodulation: ultrasonographic sign of Hashimoto thyroiditis" 15 : 813-819, 1996

16 Frates MC, "Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement" 237 : 794-800, 2005

17 Moon HJ, "Lymphocytic thyroiditis on fine-needle aspiration biopsy of focal thyroid nodules: approach to management" 193 : W345-W349, 2009

18 Wang L, "Likelihood ratio-based differentiation of nodular Hashimoto thyroiditis and papillary thyroid carcinoma in patients with sonographically evident diffuse hashimoto thyroiditis: preliminary study" 31 : 1767-1775, 2012

19 Anderson L, "Hashimoto thyroiditis: Part 2, sonographic analysis of benign and malignant nodules in patients with diffuse Hashimoto thyroiditis" 195 : 216-222, 2010

20 Anderson L, "Hashimoto thyroiditis: Part 1, sonographic analysis of the nodular form of Hashimoto thyroiditis" 195 : 208-215, 2010

21 Cipolla C, "Hashimoto thyroiditis coexistent with papillary thyroid carcinoma" 71 : 874-878, 2005

22 Pisanu A, "Coexisting Hashimoto's thyroiditis with differentiated thyroid cancer and benign thyroid diseases: indications for thyroidectomy" 55 : 365-372, 2003

23 Moon WJ, "Benign and malignant thyroid nodules: US differentiation: multicenter retrospective study" 247 : 762-770, 2008