Abstract
This study investigated a rare ultrasonographically detected thyroid petal-like calcification and its relationship with thyroid carcinoma and biological behavior. We described the clinical and ultrasonographical features of thyroid nodules with petal-like calcifications in 18 patients undergoing thyroid surgery and cervical lymph node dissection. All of the thyroid nodules with petal-like calcifications were papillary thyroid carcinomas (PTCs). Of the 18 patients, 13 (72.2%) had cervical central lymph node metastasis, and five (27.8%) had cervical lateral lymph node metastasis. Petal-like calcifications occurred in malignant thyroid nodules with a high incidence of lymph node metastasis, which may be a specific ultrasonographic feature associated with the aggressive biological behavior of PTC.
Highlights
Calcifications are commonly detected by ultrasonographic images in thyroid nodules and could be classified into various patterns [1,2,3,4,5,6]
Patients were staged according to the eighth edition of the American Joint Committee on Cancer (AJCC)/Tumor Lymph Node Metastasis (TNM) staging system [11,12,13]
The histopathologic result from all the patients was papillary thyroid carcinomas (PTCs), and 13 (72.2%) patients had cervical lymph node metastasis; previous studies have indicated that only 60–75% of thyroid nodules with microcalcification were PTC [4, 5], which indicates that petal-like calcifications in thyroid nodules are a fairly special sonographic characteristic of PTC and are highly associated with cervical lymph node metastasis
Summary
Calcifications are commonly detected by ultrasonographic images in thyroid nodules and could be classified into various patterns [1,2,3,4,5,6]. Kim et al further classified peripheral calcifications into annular-like peripheral calcifications and crescent-like peripheral calcifications [2, 3]. Among these subtypes, microcalcifications are known to be highly associated with papillary thyroid carcinoma (PTC) [4, 5]. Kobayashi et al reported that, out of 941 PTC patients, 32.0% patients had microcalcifications, and, out of 407 thyroid nodules with microcalcification, 301 (74.0%) were PTC [4]. To our knowledge, there are no studies on the ultrasonographic features of petal-like calcifications in thyroid nodules. We investigated the detection of petal-like calcifications by ultrasound and their relationship with thyroid carcinoma and biological behavior
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