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Abstract
Purpose
This study was designed to compare the ultrasonographic features of papillary thyroid carcinoma with and without Hashimoto's thyroiditis.
Materials and Methods
This retrospective study included 190 patients with papillary thyroid carcinoma which was proven by neck surgery. The difference in the ultrasonographic findings between papillary thyroid carcinoma with Hashimoto's thyroiditis and papillary thyroid carcinoma without Hashimoto's thyroiditis were calculated statistically.
Results
Hashimoto's thyroiditis was diagnosed in 61 of 190 patients following neck surgery. The incidence of coexisting papillary thyroid carcinoma with Hashimoto's thyroiditis was significantly higher in women (p=0.0026). In addition, the frequency of macrocalcification in patients with Hashimoto's thyroiditis was also significantly higher (p=0.0009). Conversely,other ultrasonographic findings including the shape, margin, echogenicity and calcifications, for patients with papillary thyroid carcinoma with Hashimoto's thyroiditis and papillary thyroid carcinoma without Hashimoto's thyroiditis, were not statistically significant. We also found that patients with Hashimoto's thyroiditis who showed no calcification on ultrasonography tended not to detect the papillary carcinoma at a higher frequency.
Conclusion
On ultrasonography, macrocalcifications occurred more frequently in patients with Hashimoto's thyroiditis than those without Hashimoto's thyroiditis. Malignant thyroid nodules without calcifications in patients with Hashimoto's thyroiditis more often could not be detected. Therefore, it is important carefully examine patients with Hashimoto's thyroiditis.
Figures and Tables
Fig. 1
A photomicrograph of Hashimoto's thyroiditis shows lymphocytes infiltration with germinal center formation (H & E, ×40).
Fig. 2
US images of papillary thyroid carcinoma with Hashimoto's thyroiditis in a 55-year-old women.
A. Transverse US image shows ill defined multiple hypoechoic micronodules in thyroid gland.
B. A irregular shaped, and marked hypoechoic nodule with a macrocalcification (arrow).
Fig. 3
Longitudinal US image of papillary thyroid carcinoma without Hashimoto's thyroiditis in a 41-year-old women shows a speculated, irregular shaped, and marked hypoechoic nodule with microcalcifications (arrows).
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