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A focal marked hypoechogenicity within an isoechoic thyroid nodule: is it a focal malignancy or not?

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dc.contributor.authorHa, EJ-
dc.contributor.authorBaek, JH-
dc.contributor.authorLee, JH-
dc.contributor.authorLee, HY-
dc.contributor.authorSong, DE-
dc.contributor.authorKim, JK-
dc.contributor.authorShong, YK-
dc.contributor.authorHong, SJ-
dc.date.accessioned2017-04-04T10:11:30Z-
dc.date.available2017-04-04T10:11:30Z-
dc.date.issued2015-
dc.identifier.issn0284-1851-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/13774-
dc.description.abstractBACKGROUND: A marked hypoechogenicity is a reliable criterion for a malignant nodule, whereas isoechogenicity is considered to be a benign ultrasonographic (US) finding. However, there have been no reports to demonstrate whether a focal marked hypoechogenicity within an isoechoic nodule is a focal malignancy.

PURPOSE: To evaluate whether a focal marked hypoechogenicity within an isoechoic nodule on US examination is a focal malignancy and to correlate US histologic findings using surgical or core needle biopsy (CNB) specimens.

MATERIAL AND METHODS: From January 2010 to August 2011, 28 consecutive patients (25 women, 3 men; mean age, 52.2 years) with 29 thyroid nodules, which showed a focal marked hypoechogenicity within an isoechoic nodule on US, underwent US-guided CNB for a suspicion of a focal malignancy. All nodules were confirmed by surgery (n = 6) or more than two consecutive US-guided biopsies (n = 23). We evaluated the risk of malignancy, and analyzed histological components which correlated with a focal marked hypoechogenic area within an isoechoic nodule on US. Statistical analysis was performed using the Mann-Whitney U test and Fisher's exact test.

RESULTS: Of the 29 nodules, 25 were benign (86.2%) and four were malignant (13.8%). The peripheral location of focal marked hypoechogenicity within an isoechoic nodule was the only significant US finding that suggested malignancy (P = 0.03). All benign focal marked hypoechogenicities were histologically composed of severe fibrosis with a few follicular cells with varying frequencies of hemosiderin, calcification, infarction, and granulation tissue.

CONCLUSION: Although a focal marked hypoechogenicity within an isoechoic nodule is usually benign, the peripheral location of a focal marked hypoechogenicity may be a malignancy. The histologic information obtained by CNB specimen may reduce the needs for repetitive fine needle aspirations or diagnostic surgery.
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dc.language.isoen-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHBiopsy, Large-Core Needle-
dc.subject.MESHDiagnosis, Differential-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHObserver Variation-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHThyroid Diseases-
dc.subject.MESHThyroid Neoplasms-
dc.subject.MESHThyroid Nodule-
dc.subject.MESHUltrasonography-
dc.titleA focal marked hypoechogenicity within an isoechoic thyroid nodule: is it a focal malignancy or not?-
dc.typeArticle-
dc.identifier.pmid24938659-
dc.identifier.urlhttp://journals.sagepub.com/doi/abs/10.1177/0284185114539322?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed-
dc.contributor.affiliatedAuthor하, 은주-
dc.type.localJournal Papers-
dc.identifier.doi10.1177/0284185114539322-
dc.citation.titleActa radiologica (Stockholm, Sweden : 1987)-
dc.citation.volume56-
dc.citation.number7-
dc.citation.date2015-
dc.citation.startPage814-
dc.citation.endPage819-
dc.identifier.bibliographicCitationActa radiologica (Stockholm, Sweden : 1987), 56(7). : 814-819, 2015-
dc.identifier.eissn1600-0455-
dc.relation.journalidJ002841851-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Radiology
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