Impact of Microcalcifications on Risk of Malignancy in Thyroid Nodules with Indeterminate or Benign Cytology
| Autor: | Matthew S. Murphy, Catherine Brophy, Patrick Sheahan, Neil O’Donovan, James Stewart, Julie McCarthy |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Thyroid nodules
medicine.medical_specialty Pathology 030209 endocrinology & metabolism Malignancy 03 medical and health sciences 0302 clinical medicine Calcinosis Risk Factors Cytology medicine Humans Thyroid Neoplasms Thyroid Nodule Retrospective Studies Ultrasonography medicine.diagnostic_test business.industry Nodule (medicine) medicine.disease Thyroid Diseases Fine-needle aspiration Otorhinolaryngology 030220 oncology & carcinogenesis Surgery Microcalcification Radiology medicine.symptom business Indeterminate |
| Zdroj: | Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery. 154(1) |
| ISSN: | 1097-6817 |
| Popis: | Adverse sonographic features such as microcalcification may predict increased likelihood of malignant cytology by fine-needle aspiration and, accordingly, increased risk of malignant histology. Our objective was to study the predictive value of microcalcifications and other sonographic features for malignancy among thyroid nodules with benign or indeterminate cytology.Case series with chart review.Academic teaching hospital.Patients (N = 769) with 858 thyroid nodules undergoing 1142 ultrasound fine-needle aspirations; 411 cases had surgical correlation.Sonographic features predictive of malignancy were correlated with malignancy as determined by histology. Incidental malignancies occurring outside the index nodule were discounted.Cytology was inadequate (87 cases), benign (518), indeterminate (210), and malignant (44). In 32 cases, initial benign cytology was upgraded to a higher-risk category after repeat ultrasound fine-needle aspiration. Microcalcification (P = .001) and irregular margins (P = .04) were significantly predictive of malignant cytology. Among surgical cases, microcalcification (P.001) and irregular margins (P = .04) were significantly predictive of malignant histology; 170 patients with initial benign cytology and 161 with indeterminate cytology underwent surgery. Microcalcification was significantly associated with malignancy among cases with indeterminate cytology (P = .04) but not among cases with benign cytology (P = .23); however, only 13 of 33 cases with benign cytology and microcalcifications underwent surgery.Presence of microcalcification increases the risk of malignancy in thyroid nodules with indeterminate cytology and may thus aid in selection of cases for surgery. |
| Databáze: | OpenAIRE |
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