US Features of thyroid malignancy: pearls and pitfalls.


Journal Article (Review)

Thyroid nodules are common and occur in up to 50% of the adult population; however, less than 7% of thyroid nodules are malignant. High-resolution ultrasonography (US) is commonly used to evaluate the thyroid gland, but US is frequently misperceived as unhelpful for identifying features that distinguish benign from malignant nodules. Microcalcifications are one of the most specific US findings of a thyroid malignancy. Other useful US features include a marked hypoechogenicity, irregular margins, and the absence of a hypoechoic halo around the nodule. Lymphadenopathy and local invasion of adjacent structures are highly specific features of thyroid malignancy but are less commonly seen. The number, size, and interval growth of nodules are nonspecific characteristics. Suspicious US features may be useful for selecting patients for fine-needle aspiration biopsy when incidental nodules are discovered and when multiple nodules are present. Common interpretative pitfalls that may lead to failure to recognize a malignancy include mistaking cystic or calcified nodal metastases for nodules in a multinodular thyroid, mistaking diffusely infiltrative thyroid carcinomas and multifocal carcinomas for benign disease, and failing to recognize microcalcifications in papillary thyroid cancer.

Full Text

Cited Authors

  • Hoang, JK; Lee, WK; Lee, M; Johnson, D; Farrell, S

Published Date

  • May 2007

Published In

Volume / Issue

  • 27 / 3

Start / End Page

  • 847 - 860

PubMed ID

  • 17495296

Pubmed Central ID

  • 17495296

Electronic International Standard Serial Number (EISSN)

  • 1527-1323

International Standard Serial Number (ISSN)

  • 0271-5333

Digital Object Identifier (DOI)

  • 10.1148/rg.273065038


  • eng