Abstract
The aim of the study is to prospectively investigate the common malignancy criteria of nodules with the inclusion of malignancy potential in palpable thyroid nodules by imaging scintigraphically and sonographically. The study was conducted on 55 patients with palpable thyroid nodules including the suspicions of malignancy. The evidences of the scintigraphic and ultrasonographic images were evaluated prospectively. The evidences were compared with histopathologic results after surgical intervention. The sensitivity and specificity of cold nodules to malignancy were found as100% and 82% respectively. In ultrasonography (USG), a comparison was performed between two groups of patients according to the dominant nodule diameter of each patient, and the diameter was significantly larger in the malignant group. The sensitivity to determine malignancy for the solid and complex structure of the nodule was 60% and 40% respectively. The specificity to determine malignancy was 26% for solid nodule and was 82% for the complex nodule. The patients with only one malignancy findings at USG were compared according to groups and a significant difference was not found. However, the patients with two or three malignancy findings at USG were compared according to groups and significant differences were found . The sensitivity and specificity for the patients with two malignancy findings at USG were found as 100% and 72% respectively. The combination of two or more of these USG findings may suggest an increased risk of thyroid cancer and fine needle aspiration biopsy is still the most important diagnostic method in the diagnosis of thyroid malignancies.
Highlights
After the patients had been evaluated according to their histopathological results, papillary carcinoma was found in four patients and papillary-follicular carcinoma was in one patient
Scintigraphy is recommended to be performed in patients with thyroid stimulating hormone (TSH) suppression [4, 10]
Considering the scintigraphic features, the hypoactive appearance of the nodule at scintigraphy is a reliable finding with a low grade in the detection of malignancy, the risk of malignancy is not high when this finding is detected
Summary
Most of these are clinically palpable nodules. It is reported that 4% of the American population has clinically a palpable thyroid nodule. Autopsy studies showed that 8% of the population had thyroid nodules. It has been reported that 15% of women over 50 years old have a single or multiple nodules in their thyroid [1]. Due to increased availability and sophisticated imaging techniques, increasing numbers of thyroid nodules are determined incidentally. There are palpable thyroid nodules in 1% of men and 5% of women, there are ultrasonically detectable thyroid nodules in 19% to 67% of unselected patients [2]. 5-15% of these nodules are thyroid cancers most of the thyroid nodules are benign [3]
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