Prevalence of Thyroid Nodules Detected by Ultrasonography in Adults for Health Check-Ups and Analysis of Fine Needle Aspiration Cytology

Won Jun Kim; Joo Hyong Kim; Dong Won Park; Chang Beom Lee; Yong Soo Park; Dong Sum Kim; Woong Hwan Choi; Tae Wha Kim; You Hern Ahn

doi:10.3803/jkes.2008.23.6.413

Journal List > J Korean Endocr Soc > v.23(6) > 1003467

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kim, Kim, Park, Lee, Park, Kim, Choi, Kim, and Ahn: Prevalence of Thyroid Nodules Detected by Ultrasonography in Adults for Health Check-Ups and Analysis of Fine Needle Aspiration Cytology

Original Article

Journal of Korean Endocrine Society

Journal of Korean Endocrine Society 2008; 23(6): 413-419.

Published online: 31 December 2008

DOI: https://doi.org/10.3803/jkes.2008.23.6.413

Prevalence of Thyroid Nodules Detected by Ultrasonography in Adults for Health Check-Ups and Analysis of Fine Needle Aspiration Cytology

Won Jun Kim, Joo Hyong Kim, Dong Won Park, Chang Beom Lee, Yong Soo Park, Dong Sum Kim, Woong Hwan Choi, Tae Wha Kim, You Hern Ahn

Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.

Received 4 August 2008 Accepted 19 October 2008

Abstract

Background

The purpose of this study was to assess the prevalence of thyroid nodules in healthy adults without a history of thyroid disease and the results of fine needle aspiration cytology (FNAC).

Methods

We retrospectively studied 4,832 adults (2,427 women, 2,405 men) over the age of 20 who had visited our health care center from January, 2005, to March, 2008. Subjects with previous thyroid disease were excluded. All were screened by thyroid ultrasonography and FNAC was performed on large or potentially malignant nodules.

Results

Thyroid nodules were present in 686 women (28.3%) and 396 men (16.5%), with a female predominance (odds ratio = 1.47, 95% CI = 1.35~1.60). The prevalence of a thyroid nodule was significantly correlated with age in both women and men (P < 0.001). Multinodularity also increased according to age in both groups. Ninety patients were tested with conventional FNAC and 195 underwent ultrasonography-guided FNAC. The rate of inadequate cytology by ultrasonographic guidance was lower than by freehand methods, and the total rate of malignant cytology per patient was 17.9%. Ultrasonographic characteristics that significantly correlated with histologically-confirmed papillary carcinoma included a solid component, hypoechogenecity, irregular margin, and the presence of microcalcification or macrocalcification.

Conclusion

The prevalence of thyroid nodules detected by ultrasonography was 28.3% in healthy women and 16.5% in healthy men population. The prevalence and multinodularity was significantly correlated with age in both groups. It's useful to examine thyroid by ultrasonography because of detecting more nodules, providing guidance of FNAC, achieving more adequate sampling and not missing small malignant nodules.

Keywords: fine needle aspiration, prevalence, thyroid nodule, ultrasonography

Figures and Tables

Table 1

Prevalance of ultrasonographically detected nodules by age and sex distribution

The proportion (%) of ultrasonographically detected nodule according to age and sex were displayed in parentheses, respectively. Significant linear trend was found between age and the prevalence of nodules in women and men (P < 0.001 for women, P < 0.001 for men).

Table 2

Multinodularity of nodules by age and sex distribution

Table 3

The size of nodules by age and sex

The proportion (%) of ultrasonographically detected nodule according to age and sex were displayed in parentheses, respectively. There exists no statistically significance between age and size of nodules in women and men (P = 0.732 for women, P = 0.401 for men).

Table 4

FNAC results by freehand or ultrasonographic guidance

The proportion (%) of cytologic classification in each mode and totality were displayed in parentheses. There exists statistical significance between methods (P = 0.017).

Table 5

Comparison of ultrasonographic findings between benign thyroid nodules and malignant histopathology

The proportion (%) of histopathologically malignant cases and cytologically benign cases were displayed in parentheses. NS denotes 'not significant'.

References

1. Vander JB, Gaston EA, Dawber TR. The significance of nontoxic thyroid nodules. Final report of a 15-year study of the incidence of thyroid malignancy. Ann Intern Med. 1968. 69:537–540.

2. Tan GH, Gharib H. Thyroid incidentalomas: management approaches to nonpalpable nodules discovered incidentally on thyroid imaging. Ann Intern Med. 1997. 126:226–231.

3. Knudsen N, Bols B, Bulow I, Jorgensen T, Peerild H, Ovesen L, Laurberq P. Validation of ultrasonography of the thyroid gland for epidemiological purposes. Thyroid. 1999. 9:1069–1074.

4. Kang HW, No JH, Chung JH, Min YK, Lee MS, Lee MK, Yang JH, Kim KW. Prevalence, clinical and ultrasonographic characteristics of thyroid incidentalomas. Thyroid. 2004. 14:29–33.

5. Tomimori E, Pedrinola F, Cavaliere H, Knobel M, Medeiros-Neto G. Prevalence of incidental thyroid disease in a relatively low iodine intake area. Thyroid. 1995. 5:273–276.

6. Brander A, Viikinkoski P, Nickels J, Kivisaari L. Thyroid gland: US screening in a random adult population. Radiology. 1991. 181:683–687.

7. Ezzat S, Sarti DA, Cain DR, Braunstein GD. Thyroid incidentalomas. Prevalence by palpation and ultrasonography. Arch Intern Med. 1994. 154:1838–1840.

8. Nam-Goong IS, KIM HY, Gong G, Lee HK, Hong SJ, Kim WB, Shong YK. Ultrasonography-guided fine needle aspiration of thyroid incidentaloma:correlation with pathological findings. Clin Endocrinol. 2004. 60:21–28.

9. Papini E, Guglielmi R, Bianchini A, Crescenzi A, Taccogna S, Nardi F, Paunzi C, Rinaldi R, Toscano V, Pacella CM. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab. 2002. 87:1941–1946.

10. Suk JH, Kim TY, Kim MK, Kim WB, Kim HK, Jeon SH, Shong YK. Prevalence of ultrasonographically detected thyroid nodules in adults without previous history of thyroid disease. J Kor Soc Endocrinol. 2006. 21:389–393.

11. Chung WY, Chang HS, Kim EK, Park CS. Ultrasonographic mass screening for thyroid carcinoma: a study in women scheduled to undergo a breast examination. Surgery Today. 2001. 31:763–767.

12. Yim CH, Oh HJ, Chung HY, Han KO, Jang HC, Yoon HK, Han IK, Han BH, Lee KS, Cho BJ. Prevalence of thyroid nodules detected by ultrasonography in womens attending health check-ups. J Kor Soc Endocrinol. 2002. 17:183–188.

13. Kim JH, Park SJ, Kim SE, Lee KH, Cho IK, Jang SI, Lee JK, S KS, Kwon HP, Chung SC. Prevalence of thyroid nodules detected by ultrasonography in adult men attending health check-ups. J Kor Soc Endocrinol. 2007. 22:112–117.

14. Miki H, Oshimo K, Inoue H, Morimoto T, Monden Y. Sex hormone receptors in human thyroid tissues. Cancer. 1990. 66:1759–1762.

15. Kim WB, Kim TY, Kwon HS, Moon WJ, Lee JB, Choi YS, Kim SK, Kim SW, Chung KW, Baek JH, Kim BI, Park DJ, Na DG, Choe JH, Chung JH, Jung HS, Kim JH, Nam KH, Chang IS, Chung WY, Hong SW, Hong SH, Lee JH, Yi KH, Jo YS, Kang HC, Shong MH, Park JW, Yoon JH, Kang SJ, Lee KW. Management guidelines for patients with thyroid nodules and thyroid cancer. J Kor Soc Endocrinol. 2007. 22:157–187.

16. Kim DL, Song KH, Kim SK. High prevalence of carcinoma in ultrasonography-guided fine needle aspiration cytology of thyroid nodules. Endocr J. 2008. 55:135–142.

17. Gharib H. Fine-needle aspiration cytology of thyroid: an appraisal. Ann Intern Med. 1994. 118:282–289.

18. Izquierdo R, Arekat MR, Knudson PE, Kartun KF, Khurana K, Kort K, Numann PJ. Comparison of palpation-guided versus ultrasound-guided fine-needle aspiration biopsies of thyroid nodules in an outpatient endocrinology practice. Endocr Pract. 2006. 12:609–614.

19. Yim CH, Chung H-K, Kim WB, Park DJ, Kim SY, Cho BY, Lee HK. Prevalence of thyroid cancer in patients with cold thyroid nodules in relation to sex, age, and multinodularity. J Kor Soc Endocrinol. 1998. 13:366–372.

20. Akslen LA, Myking AO, Salvesen H, Varhaug JE. Prognostic importance of various clinicopathological features in papillary thyroid carcinoma. Eur J CancerA. 1992. 29A:44–51.

21. Chan JK. Strict criteria should be applied in the diagnosis of encapsulated follicular variant of papillary thyroid carcinoma. Am J Surg Pathol. 2002. 22:602–606.

TOOLS

Similar articles