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Background: Thyroid ultrasound (US) is a key in evaluation of thyroid nodules. Judicious use of thyroid US is helpful to choose the right nodules for further evaluation by Fine needle aspiration biopsy (FNAB) and to prevent unnecessary invasive procedures. Here are few features that have been found to be associated with higher risk of malignancy. Microcalcifications within the nodule, Solid structure, size, irregular margins, hypoechogenic, lobulated, infiltrative nodules with heterogenous echo charterers and the nodules that are taller than wide have all been found to have independent associations with increased risk of malignancy. A previous study (1) showed that nodules in the upper lobe of the thyroid had higher risk of malignancy compared to nodules in the lower lobe. In another study (2) nodules located in the mid pole and upper pole of the thyroid gland were found to be more likely to be malignant compared to the lower pole. Methods: We did a retrospective study looked at 50 consecutive nodules proven to be malignant by surgical histology at our clinic between 2011-2016. Subsequently we looked at the cohort of nodules found to be benign by FNAB in the same period of time and chose 50 cases that matched the age of the patient with malignancy and the sized of the malignant nodules. We reviewed the location of the nodules in the thyroid gland, Upper vs Lower to see if there is any associated between malignant nodules and location. Assignment of the nodules to the upper vs lower pole was done by comparing the distance between the superior and inferior poles of the nodules and the corresponding pole of the gland. Result: Out of the 50 malignant nodules, 34 were located in the upper lobe (68%) and 16 were located in the lower lobe (32%). Out of 50 benign nodules, 9 were located in the upper lobe (18%) and 41 were located in the lower lobe (82%). The odds of malignant nodules to be located in the upper lobe were 9.6 times more than the odds in the lower lobe. P = |
