Tiroid papiller karsinom folliküler varyantı: Gri-skala ve Doppler sonografik özellikleri

Abstract

Aim: The aim of this study was to present the sonographic characteristics of follicular variant of papillary thyroid carcinoma (FVPTC) related to different forms of the thyroid nodules, including those without a capsule. Another purpose was to analyze the color Doppler ultrasonography (CDUS) features of this unique tumor, which have not been intensively studied in previous works.Materials and Methods: Twenty-two thyroid nodules (male/female: 17/5; mean age±SD: 42±16 years; range: 17-70) diagnosed with FVPTC were included in this study. The sonographic and Doppler features of the nodules were analyzed retrospectively. The intranodular pattern of vascularity was categorized with regard to the presence of perinodular and/or intranodular vascular signals, as well as a “spoke-and-wheel” appearance.Results: The length of the nodules varied from 6 to 55 mm. Most of nodules were purely solid (77.3%), isoechoic (59.1%) or hypoechoic (31.8%) and had an oval shape (72.7%), well-defined margins (68.2%) and a peripheral hypoechoic halo (68.2%). Thirty-one percent of the nodules had a lobulated shape with microlobulated margins or an irregular configuration with ill-defined margins. Encapsulated FVPTCs had a peripheral hypoechoic halo and well-defined margins, whereas infiltrative cases exhibited the opposite characteristics. No calcification was observed in 72.7% of the nodules. Perinodular and predominantly peripheral intranodular hypervascularity was observed in 14 nodules (66.7%) and was the dominant pattern of vascularity in most of the encapsulated FVPTCs, unlike the infiltrative FVPTCs.Conclusion: Diagnosis of FVPTC should always be considered when large thyroid nodules with predominantly solid echo-texture and other sonographic features that suggest benignity and nodular hypervascularity are observe.