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Necessity of Ultrasonography Guided Fine-Needle Aspiration or Core Biopsy for Benign-Looking Malignant Thyroid Nodules

건양의대학술지 2008년 8권 1호 p.15 ~ 19
유현미, 황철목, 김금원, 박용성,
소속 상세정보
유현미 ( Yoo Hyeun-Mi ) - 건양대학교 의과대학 영상의학교실
황철목 ( Hwang Cheol-Mog ) - 건국대학교 의과대학 영상의학교실
김금원 ( Kim Keum-Won ) - 건양대학교 의과대학 영상의학교실
박용성 ( Park Yong-Sung ) - 건양대학교 의과대학 영상의학교실

Abstract


Purpose: To analyze the frequency of benign-looking malignant thyroid nodules and to evaluate the usefulness of
ultrasonography guided fine-needle aspiration and core biopsy.

Materials and Methods : Two radiologists retrospectively analyzed in consensus the sonographic features of pathologically proven 392 malignant thyroid nodules of 378 patients. The patients underwent ultrasonography guided fine-needle aspiration biopsy, ultrasonography guided core biopsy, or surgery. We analyzed the following five sonographic features of thyroid nodule; internal content, margin, echogenicity, shape, and microcalcification based on previous reports. We determined thyroid nodules as benign-looking malignant nodules in cases that they showed no ultrasonographic malignant feature or below two ultrasonographic malignant features. We calculated the frequency of the benign-looking malignant nodule.

Results: The benign-looking malignant nodules of pathologically proven 392 malignant nodules were 169 (43%)
nodules. They include 12 (50%) of 24 cases of follicular carcinoma and 157 (44%) of 358 cases of papillary carcinoma.
Of 12 follicular carcinoma, 2 malignant features were found in 5 nodules, 1 malignant feature in 3 nodules, no malignant
feature in 4 nodules. Of 157 papillary carcinoma, 2 malignant features in 76 nodules, 1 malignant feature in 37 nodules,
no malignant feature in 44 nodules. Every medullary carcinoma and anaplastic carcinoma showed malignant features.

Conclusion: Our results showed that malignant thyroid nodules could be appear as benign or not definitely malignant nodules when we apply the reported sonographic criteria of malignant nodules. Ultrasonography guided fine-needle aspiration or core biopsy may be the valuable tool for sonographically benign-looking thyroid nodules for early diagnosis and treatment.

키워드

Thyroid;Neoplasm;Ultasonograpy;Fine-needle aspiration biopsy

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