Hashimoto thyroiditis: Part 2, sonographic analysis of benign and malignant nodules in patients with diffuse Hashimoto thyroiditis

Lauren Anderson, William D. Middleton, Sharlene A. Teefey, Carl C. Reading, Jill E. Langer, Terry Desser, Margaret M. Szabunio, Susan J. Mandel, Charles F. Hildebolt, John J. Cronan

Research output: Contribution to journalArticlepeer-review

54 Scopus citations

Abstract

OBJECTIVE. The purpose of this article is to compare sonographic features of benign and malignant nodules in patients with diffuse Hashimoto thyroiditis. SUBJECTS AND METHODS. As part of an ongoing multiinstitutional study, patients who underwent ultrasound and fine-needle aspiration of one or more thyroid nodules were analyzed for a variety of predetermined sonographic features. Patients with a sonographic appearance consistent with diffuse Hashimoto thyroiditis and with coexisting nodules that could be confirmed to be benign or malignant by fine-needle aspiration or surgical pathologic analysis were included in the study. RESULTS. Among nodules within diffuse Hashimoto thyroiditis, 84% (69/82) were benign (35 nodular Hashimoto thyroiditis, 32 nodular hyperplasia, and two follicular adenoma), and 16% (13/82) were malignant (12 papillary carcinoma and one lymphoma). Malignant nodules were more likely to be solid and hypoechoic (62% vs 19%). All types of calcifications were more prevalent among malignant nodules, including microcalcifications (39% vs 0%), nonspecific tiny bright reflectors (39% vs 6%), macrocalcifications (15% vs 3%), and eggshell (15% vs 2%). Benign nodules were more likely to be hyperechoic (46% vs 9%), to have a halo (39% vs 15%), and to lack calcifications (88% vs 23%). Benign nodules more often had ill-defined margins (36% vs 8%). CONCLUSION. Sonographic features of benign and malignant nodules within diffuse Hashimoto thyroiditis are generally similar to the features typical of benign and malignant nodules in the general population. If calcifications of any type are added to the list of malignant sonographic features, the decision to biopsy a nodule in patients with diffuse Hashimoto thyroiditis can be based on recommendations that have been published previously.

Original languageEnglish
Pages (from-to)216-222
Number of pages7
JournalAmerican Journal of Roentgenology
Volume195
Issue number1
DOIs
StatePublished - Jul 1 2010

Keywords

  • Thyroid
  • Thyroid biopsy
  • Thyroid cancer
  • Thyroid nodule
  • Thyroid ultrasound

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