Calcified Thyroid Research Articles

The correlation between thyroid nodular and thyroid calcification

Objective To explore the relation between thyroid nodular and thyroid calcification .Methods The clinical data of 430 cases with nodular goiter admitted from January 2011 to December 2013 were reviewed.All cases were performed ultrasonography and pathologic examination .Results Of 430 cases,there was thyroid carcinoma in 49 cases（11.4%）,including microcalcification in 30 cases（61.2%） and macrocalcification in 3 cases（6.1%）;benign lesion in 381 cases（88.6%）,including microcalcification in 24 cases（6.3%） and macrocalcification in 39 cases（10.2%）.The difference was remarkable （P=0.000）.There was remarkable difference in malignant calci-fied nodules ratio between the patients with microcalcification and macrocalcification （55.6%vs 7.1%,P=0.000）, between the patients aged 45 years below and above（48.8%vs 22.6%,P=0.007）,between the patients with solita-ry and multiple nodules（45.0%vs 16.7%,P=0.005）.But there was no statistic difference in malignant calcified nodules ratio between the male and female groups （24.2% vs.39.7%,P=0.130）.Conclusion Microcalcification is a highly specific sign to predict thyroid carcinoma in ultrasonography exam .Positive intervention will be performed immediately when calcification appears in thyroid nodules . Key words: Thyroid neoplasms; Goiter; Calcifying nanoparticles; Ultrasonography,doppler,color

Elastography Can Effectively Decrease the Number of Fine-Needle Aspiration Biopsies in Patients with Calcified Thyroid Nodules

When calcification, frequently found in both benign and malignant nodules, is present in thyroid nodules, non-invasive differentiation with ultrasound becomes challenging. The goal of this study was to evaluate the utility of elastography in differentiating calcified thyroid nodules. Consecutive patients (165 patients with 196 nodules) referred for fine-needle aspiration who had undergone both ultrasound elastography and B-mode examinations were analyzed retrospectively. Calcification was present in 45 benign and 20 malignant nodules. On 65 calcified nodules, elastography had 95% sensitivity, 51.1% specificity, 46.3% positive predictive value and 95.8% negative predictive value in detecting malignancy. Twenty-three of 45 benign calcified nodules were correctly diagnosed with elastography compared with 4 of 45 by B-mode ultrasound. Although it is difficult to differentiate benign and malignant calcified thyroid nodules solely with B-mode ultrasound, elastography has the potential to reduce the number of fine-needle aspiration biopsies performed on calcified nodules.

Ultrasonic surgical aspirator‐assisted phonosurgery: A novel technique for laryngeal cartilage dissection

INTRODUCTION Type I laryngoplasty has become the most dependable procedure for the management of anterior and midglottic incompetence since its classification by Isshiki in 1974. Many procedure variations have emerged, including the development of numerous techniques, implants, and prefabricated systems increasing the utilization of medialization laryngoplasty. Sharp dissection of the cartilage window becomes difficult with calcified thyroid cartilages, often encountered in older men. The surgical drill with a small cutting or diamond burr is used adjunctively to overcome this frequent anatomic variant. Halum et al. first described ultrasonic surgical system thyroplasty window creation in cadavers. The Sonopet ultrasonic surgical aspirator—developed by Synergetics USA, Inc. (O’Fallon, MO) and distributed by Stryker, Inc. (Kalamazoo, MI)—consists of a main control unit (Fig. 1), handpiece, ultrasonic tip, and foot control. This device produces ultrasonic vibrations that selectively grade rigid structures such as cartilage and bone while sparing adjacent soft tissue. The handpiece provides concurrent irrigation and suction (Fig. 2) while a piezoelectric element vibrates the tip at 25 kHz. The ultrasonic vibration moves in two planes, creating longitudinal and torsional forces without grabbing or kicking typical of rotary drill motion. This motion emulsifies tissue without excess heat production and requires minimal downward pressure. This ultrasonic surgical aspirator, initially created for neurosurgical applications, is now being used by a broader group of surgical subspecialties such as plastic surgery, ophthalmology, and oralmaxillofacial surgery. We now describe the first invivo series of the ultrasonic surgical aspirator for laryngeal framework surgery.

Core needle biopsy can minimise the non-diagnostic results and need for diagnostic surgery in patients with calcified thyroid nodules

To evaluate the role of core needle biopsy (CNB) for calcified thyroid nodules. Between October 2008 and July 2011, 264 patients underwent ultrasound-guided CNB for 272 calcified thyroid nodules at our institution. We retrospectively evaluated the incidence of technical failure, non-diagnostic readings, and the diagnostic performance of CNB, and analysed the relationship between the types of calcification and the CNB results. Finally, the incidence of diagnostic surgery was calculated. The incidence of technical failure was 1.1 % (3/275) and that of non-diagnostic results was 0.7 % (2/272). The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of CNB were 94.7 %, 89.5 %, 100 %, 100 %, and 90.2 %, respectively. There were no significant differences according to the calcification subtype for either the non-diagnostic results or the incidence of technical failure (P > 0.99 and P > 0.99). CNB could prevent diagnostic surgery for 92.9 % (13/14) of the patients who showed more than two non-diagnostic results in previous FNA. CNB can minimise the non-diagnostic results as well as diagnostic surgery in patients with calcified thyroid nodules. Therefore, CNB may be used as a first-line diagnostic tool for calcified thyroid nodules rather than FNA. CNB results show the low incidence of technical failure (1.1 %, 3/275). • CNB results show the low non-diagnostic rate (0.7 %, 2/272). There were no significant differences according to the calcification subtype. CNB can prevent unnecessary diagnostic surgery in 92.9 % (13/14).

Differential diagnostic value of contrast-enhanced ultrasound in calcified thyroid nodules

To evaluate the diagnostic value of contrast-enhanced ultrasound(CEUS) in calcified thyroid nodules. A total of 179 cases with calcified thyroid nodules between February 2009 and September 2012 underwent CEUS by injection of microbubbles via superficial vein was included in the study. Pathological diagnosis as a gold standard, the sensitivity, specificity, positive predictive, negative predictive and diagnostic coincidence rate of CEUS were evaluated. Among 110 cases of benign nodules, 62 cases were nodular goiter (46 cases with macrocalcification and 16 cases with microcalcification); 29 cases were adenoma (28 cases with macrocalcification and 1 case with microcalcification); 17 cases were Hashimoto's thyroid (13 cases with macrocalcification and 4 cases with microcalcification); and 2 cases were granuloma with microcalcification. Among 69 cases of malignant nodules (t = 14.33, P < 0.05), 68 cases were papillary carcinoma (60 cases with microcalcification and 8 cases with macrocalcification), and 1 case of medullary carcinoma with microcalcification. Malignant nodules mainly showed weak inhomogeneous enhancement, with the mean; peak intensity (51.38 ± 14.33)dB that was lower than that (92.37 ± 33.36)dB in benign nodules, and benign nodules showed isoenhancement or hyperenhancement, with significant differences compared to malignant nodules (t = 14.33, P < 0.05) , however, there were significant differences in the enhanced time and the time to peak between benign and malignant nodules. The sensitivity, specificity, positive predictive, negative predictive and diagnostic coincidence rate of CEUS for the diagnoses of thyroid nodules were 92.75%, 90.91%, 86.49%, 95.24% and 91.62%, respectively. CEUS has high value in differential diagnosis of benign and malignant calcified thyroid nodules.

Ossified Cartilago thyreoidea and its clinical insight: a cadaveric study.

The three major cartilages of the larynx - thyroid, cricoid, and arytenoids are all hyaline cartilage. They may undergo calcification or endochondral ossification (or both), such calcified or ossified cartilage may compress the neuro vascular structures around it. Accordingly the present study was undertaken to observe the incidence of the ossified thyroid cartilages (Cartilago Thyreoidea) in the human cadavers, discuss its clinical implications and to review the literature regarding these anatomical variations. This study was carried out on 54 human cadavers at Department of Anatomy-Santhiram Medical College Nandyal, Department of Anatomy-Melaka Manipal Medical College (MMMC)-Manipal and Department of Anatomy,Kasturba Medical College (KMC), Manipal Karnataka.Early ossified thyroid cartilages were detected in 4 female cadavers out of 54 human [27 male and 27 female] cadavers. To the best of our knowledge, early calcified thyroid cartilages observed in this study have not been cited in modern literature. Frequently, the partly ossified cartilages create a diagnostic problem for the radiologist examining for foreign bodies. Proper knowledge and diagnosis of such calcified or ossified thyroid cartilages assists the clinician in the appropriate management of the patient.

Computer-Assisted Analysis of Ultrasonographic Features of Calcified Thyroid Nodules

Brief Description of the Purpose of the Studyto determine computerized US features of calcified thyroid nodules that are useful in the differentiation between malignant and benign lesions.MethodsDigital US images of 99 pathologically-proven thyroid nodules with calcifications (malignant: benign = 78: 21) were evaluated. We designed and implemented a CAA scheme to quantitatively analyze the 24 US features of the calcified thyroid nodules based in two categories: morphology and calcification. We performed Student’s t-test and discriminant analysis and generated receiver operating characteristic (ROC) curves and the corresponding areas under the curve (AUC) in order to compare morphology, calcification and combined features.Main ResultsAmong the 24 analyzed features, 10/12 (83.3%) morphology and 7/12 (58.3%) calcification features showed significant differences between malignant and benign thyroid nodules (p < 0.05). The AUC values for morphology, calcification and combined features were 0.81 (95% CI, 0.75-0.86), 0.79 (95% CI, 0.73-0.84), and 0.86 (95% CI, 0.81-0.91), respectively. The combined features showed a significantly higher AUC value than morphology or calcification features alone (p < 0.05).Importance of the ConclusionsCombined morphology and calcification features from CAA had a significantly higher diagnostic performance in differentiating malignant from benign calcified thyroid nodules when compared to the use of morphology or calcification features alone. Brief Description of the Purpose of the Studyto determine computerized US features of calcified thyroid nodules that are useful in the differentiation between malignant and benign lesions. to determine computerized US features of calcified thyroid nodules that are useful in the differentiation between malignant and benign lesions. MethodsDigital US images of 99 pathologically-proven thyroid nodules with calcifications (malignant: benign = 78: 21) were evaluated. We designed and implemented a CAA scheme to quantitatively analyze the 24 US features of the calcified thyroid nodules based in two categories: morphology and calcification. We performed Student’s t-test and discriminant analysis and generated receiver operating characteristic (ROC) curves and the corresponding areas under the curve (AUC) in order to compare morphology, calcification and combined features. Digital US images of 99 pathologically-proven thyroid nodules with calcifications (malignant: benign = 78: 21) were evaluated. We designed and implemented a CAA scheme to quantitatively analyze the 24 US features of the calcified thyroid nodules based in two categories: morphology and calcification. We performed Student’s t-test and discriminant analysis and generated receiver operating characteristic (ROC) curves and the corresponding areas under the curve (AUC) in order to compare morphology, calcification and combined features. Main ResultsAmong the 24 analyzed features, 10/12 (83.3%) morphology and 7/12 (58.3%) calcification features showed significant differences between malignant and benign thyroid nodules (p < 0.05). The AUC values for morphology, calcification and combined features were 0.81 (95% CI, 0.75-0.86), 0.79 (95% CI, 0.73-0.84), and 0.86 (95% CI, 0.81-0.91), respectively. The combined features showed a significantly higher AUC value than morphology or calcification features alone (p < 0.05). Among the 24 analyzed features, 10/12 (83.3%) morphology and 7/12 (58.3%) calcification features showed significant differences between malignant and benign thyroid nodules (p < 0.05). The AUC values for morphology, calcification and combined features were 0.81 (95% CI, 0.75-0.86), 0.79 (95% CI, 0.73-0.84), and 0.86 (95% CI, 0.81-0.91), respectively. The combined features showed a significantly higher AUC value than morphology or calcification features alone (p < 0.05). Importance of the ConclusionsCombined morphology and calcification features from CAA had a significantly higher diagnostic performance in differentiating malignant from benign calcified thyroid nodules when compared to the use of morphology or calcification features alone. Combined morphology and calcification features from CAA had a significantly higher diagnostic performance in differentiating malignant from benign calcified thyroid nodules when compared to the use of morphology or calcification features alone.

Diagnostic value of contrast-enhanced ultrasound in calcified thyroid nodules

Objective To evaluate the diagnostic value of conventional ultrasound and contrastenhanced ultrasound(CEUS) in calcified thyroid nodules.Methods 122 cases of calcified thyroid nodules confirmed by pathology were underwent conventional ultrasound and CEUS.The sensitivity,specificity,positive predictive,negative predictive and diagnostic coincidence rate of conventional ultrasound and CEUS were evaluated.Receiver operating characteristic (ROC) curve was constructed to assess the differential diagnosis value of conventional ultrasound and CEUS in calcified thyroid nodules.Results There were 73 benign and 49 malignant nodules among 122 calcified thyroid nodules.The sensitivity,specificity,positive predictive,negative predictive and diagnostic coincidence rate of conventional ultrasound were 49.98％,76.71％,58.54％,69.14％ and 65.57％,while for CEUS were 89.80％,91.78％,88.00％,93.06％ and 90.98％,respectively.There was statistical difference for each index between the two methods (all P ＜0.05).The area under ROC curve of CEUS was 0.908,which was bigger than conventional ultrasound.Conclusions Compared with conventional ultrasound,CEUS has higher value in differential diagnosis of benign and malignant calcified thyroid nodules. Key words: Ultrasonography; Microbubbles ; Thyroid nodule ; Calcification

Contribution of theBRAFMutation Analysis in Calcified Thyroid Nodules

The aim of this study was to evaluate the diagnostic contribution of BRAF(V600E) mutation analysis from the fine-needle aspiration (FNA) specimens of calcified thyroid nodules. From January 2008 to December 2008, 139 patients with 139 calcified thyroid nodules prospectively underwent BRAF(V600E) mutation analysis and ultrasound-guided FNA. At ultrasound, the patterns of calcification were classified into microcalcification, macrocalcification, and rim calcification. The performance of FNA alone then FNA plus BRAF(V600E) mutation analysis for the diagnosis of calcified thyroid nodules was compared on the basis of surgery, repeated FNA, or imaging follow-up for at least 1 year. Of 139 calcified nodules, 92 (66%) malignancies were detected, which included 91 papillary thyroid carcinomas and one follicular thyroid carcinoma. The malignant rates based on calcification type were 80% (63 of 79) for microcalcifications, 59% (19 of 32) for macrocalcifications, and 36% (10 of 28) for rim calcifications. The BRAF(V600E) mutation was identified in 50% of all nodules and in five (25%) of 20 nodules with indeterminate or nondiagnostic cytology. Adding BRAF(V600E) mutation analysis to FNA compared with FNA alone improved the negative predictive value of 83.9 to 92.2% (p = 0.034) but not the sensitivity, specificity, positive predictive value, and accuracy. The BRAF(V600E) mutation analysis from FNA specimens for calcified thyroid nodules may be performed for a greater negative predictive value and unveil the malignancy in 25% of indeterminate or nondiagnostic cytology.

A case of adult-onset Still’s disease (AOSD)-like manifestations abruptly developing during confirmation of a diagnosis of metastatic papillary thyroid carcinoma

A 68-year-old Japanese man was admitted to our hospital suffering from abrupt onset of high fever accompanied by arthralgia, myalgia, sore throat, macular eruption, and liver dysfunction. Six months before the onset of these manifestations, (18)F-fluoro-deoxy-glucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) had detected, unexpectedly, three calcified thyroid lesions without (18)F-FDG uptake. Two months before the onset of the present manifestations, ultrasonography-guided fine-needle aspiration had led to a diagnosis of papillary thyroid carcinoma (PTC). Soon after the occurrence of the rheumatic manifestations, a subsequent (18)F-FDG PET/CT scan showed not only the three thyroid lesions, the same as those in the previous scan, but also (18)F-FDG uptake in the thyroid lesion. A diagnosis of adult-onset Still's disease (AOSD)-like manifestations associated with PTC was made, and treatment with 40 mg/day of prednisolone (PSL) resolved the symptoms promptly. PSL was gradually tapered, without recurrence of the (AOSD)-like manifestations. Five months after the initiation of treatment with PSL, total thyroidectomy, followed by (131)I thyroid ablation treatment, was performed while the patient was on a PSL dose of 18 mg/day. Seven months after the thyroidectomy, the dose of PSL was tapered to 2 mg/day, and neither the AOSD-like manifestations nor the PTC relapsed. On confirming a diagnosis of AOSD, it may be necessary to consider the presence of an associated malignancy, including solid tumors such as PTC.

Prevalence of Thyroid Cancer in Thyroid Nodules with Dense Calcification

목적: 갑상선 결절은 흔하게 발견되며 약 5%에서 갑상선 암으로 진단되므로 악성 결절과 양성 결절을 구분하는 것이 중요하다. 최근 고해상도 갑상선 초음파의 발달로 악성을 시사하는 초음파 소견을 예측하고자 다양한 연구가 진행되었고, 미세석회화와 악성화의 연관성이 확립된 반면, 거대석회화와 갑상선암의 연관성에 대한 논란이 있어 다수를 대상으로 후향적 연구를 시행하였다. 방법: 5년 동안 갑상선 결절로 인하여 화순전남대병원을 방문하여 갑상선 초음파를 시행하였던 환자들 중에서 갑상선적출술을 받았거나, 갑상선암의 위험인자로 잘 알려진 미세석회화를 동반하는 경우를 제외하고, 거대석회화 유무에 따라 두 군으로 구분하여 갑상선 초음파, 미세침흡인세포 검사 결과 및 수술을 통한 병리 결과를 확인하였다. 결과: 거대석회화를 동반하는 군에서 악성의 빈도는 22.7% (37/163)로 석회화가 불분명하거나 없는 군의 악성 결절의 빈도가 13.4% (271/2,021)인 것과 비교하여 통계학적으로 유의하게 높았고(p < 0.01), 비정형 및 악성의심 결절의 빈도도 유의하게 높았다(p < 0.01). 거친석회화 군에서 변연부석회 화군에 비해 통계학적 의의는 없었지만 악성의 빈도가 높았다(30.1% vs. 16.2%). 결론: 거대석회화를 동반한 갑상선 결절은 악성의 빈도가 높으며, 부적절한 검체를 얻을 확률이 높으므로 주의 깊은 미세침흡인세포검사 및 추적검사가 필요하다.

Calcifications in thyroid nodules identified on preoperative computed tomography: Patterns and clinical significance

The purpose of this study was to evaluate the patterns and clinical importance of calcifications in thyroid nodules identified on preoperative computed tomography (CT). CT of 383 patients undergoing thyroid operations were reevaluated to identify thyroid calcification. A novel classification for thyroid calcifications on CT images was applied. The prevalence and patterns of calcification were classified, analyzed, and correlated with clinical and histopathologic findings. Of the 383 patients, 135 (35.2%) had intrathyroidal calcifications identified on CT. Among these 135 patients, 65 (48%) were found to have thyroid cancer on definitive histopathology. Theincidence of cancer was greater in calcified nodules (48%) than in noncalcified nodules (20%; P< .001). According to the calcification patterns, 2 of 9 (22%) nodules with peripheral calcification, 11 of 52 (21%) nodules with coarse calcification, 18 of 31 (58%) nodules with a single punctate calcification, and 34 of 43 (79%) nodules with multiple punctate calcifications were malignant. In the subset of 42 patients who presented with a solitary calcified nodule, 35 (83%) were found to have cancer. In addition, the incidence of lymph node metastases is greater in malignant nodules with calcification than in those without (48% vs 25%; P = .01). Thyroid calcification found on preoperative CT may represent an increased risk for thyroid malignancy. When the pattern shows multiple punctate calcification or the calcification is noted within a solitary nodule, the risk of malignancy is high in this study.

Thyroid Calcifications: What Is Suspicious or Not on Ultrasound?

Thyroid Calcifications: What Is Suspicious or Not on Ultrasound?

Contribution of the BRAF Mutation Analysis in Calcified Thyroid Nodules

891 stacle to obtaining adequate cytologic specimens because of technical difficulty or lack of a cellular component. Nam et al. [7] reported that the application of the BRAFV600E mutation analysis from FNA specimens is more effective for thyroid nodules with malignant ultrasound features than for nodules without malignant ultrasound features. On the basis of these data, we hypothesized that BRAFV600E mutation testing of FNA specimens is likely to increase the diagnostic accuracy in calcified nodules. The aim of this study was to evaluate the diagnostic contribution of BRAFV600E mutation analysis from the FNA specimens of calcified thyroid nodules.

Comparative Study of US Features, US-guided Fine Needle Aspiration Cytology, and Pathology Results for Eggshell Calcified Thyroid Nodules

Comparative Study of US Features, US-guided Fine Needle Aspiration Cytology, and Pathology Results for Eggshell Calcified Thyroid Nodules

Calcification-related absorption in thyroid scintigraphy

The enhanced absorption of X-rays in calcified structures is a basic prerequisite for performing conventional bone radiography. On the other hand, nothing has been reported on possible absorption effects of 'calcifications' as frequent findings in thyroid nodules or in the sternal bone / sternoclavicular joints. This may be caused by the general opinion, that the high energy of 99mTc-photons (140 keV) do not make visible absorptions effects very likely. To prove possible absorption effects of calcifications on thyroid scintigraphy experimentally, effects of calcium absorbers were tested on a technetium flood phantom. Furthermore, absorption effects of various calcifications (discs of calcium sulphate and calcium carbonate with varying thickness) on normal thyroid tissue and autonomous nodules were simulated in a thyroid phantom. CT 130 kV-images of 46 consecutive patients were checked for presence of retrosternal or retroclavicular growth of the thyroid gland and to measure the extent and density of the sternal bone and calcified intrathyroidal nodules. In addition, clinical cases are presented in which a possible absorption by calcifications seems to be likely. Bony structures in front of the thyroid gland or calcified intrathyroidal nodules could be seen on CT in 24/46 patients. The mean averaged density was 219 Houndsfield units (SD: 89 HU). The quantitative measurements using a 99mTc-flood source showed a mean absorption of 4.9%. In a thyroid phantom, absorption effects were visible only in 3/20 positions of the calcium discs over the thyroid phantom. Focal effects could be better detected in situations of only moderate uptake of the surrounding tissue. A dependence of absorption and chemistry (sulphate, carbonate) could not be found. Visible absorption effects caused by sternal bone or thyroid calcifications are seldom but potentially able to diminish the visible uptake and should be taken into account when interpreting thyroid scintigrams.

Retrospective Analysis of Thyroid Nodules by Clinical and Pathological Characteristics, and Ultrasonographically Detected Calcification Correlated to Thyroid Carcinoma in South China

Objective: To investigate the clinical and pathological characteristics of thyroid nodules, as well as to evaluate the significance of ultrasonographically detected thyroid calcification in the diagnosis of thyroid carcinomas. Methods: Retrospective data were studied from 1,051 consecutive patients who underwent a thyroidectomy in the Provincial Hospital of Fujian Medical University in South China between January 2003 and July 2006 for nodular thyroid disease. Complete sonographical information before surgery was only collected from 758 of the 1,051 patients. Results: Among the 1,051 patients, benign lesions were found in 857 (81.54%) patients, of whom 612 (71.41%) were nodular goiter; malignant lesions were found in 194 (18.46%) patients, in whom benign thyroid lesions were also found in 85 (43.81%) patients. A total of 48 patients suffered from microcarcinomas, of whom 37 patients had benign lesions; these 37 accounted for 43.53 and 77.08%, respectively, of the 85 malignant cases with benign lesions and the 48 cases with microcarcinomas. In the 758 patients who underwent thyroid ultrasonography before surgery, intrathyroidal calcifications were apparent in 243 patients (32.06%). The incidence of calcification was significantly higher in patients with thyroid carcinoma (54.17%) than in those with benign lesions (26.87%; p < 0.005). Detection of calcification in thyroid lesions by ultrasound had a sensitivity of 32.38% and a specificity of 87.35%, with an OR of 3.31 (95% CI, 2.24–4.63), positive likelihood ratio of 2.56, negative likelihood ratio of 0.77 and a κ value of 0.23. Conclusion: Thyroid carcinoma, especially microcarcinoma, often coexists with benign thyroid disease. Calcification detected by thyroid ultrasound represents a risk factor for malignancy, but is of limited use as a sole marker of malignancy.

The Relationship between the Feature of Thyroid Calcification and Thyroid Papillary Cancer

Backgraound and Objectives Thyroid calcification is widely known as a highly specific sign of malignancy. However, there are few studies on the correlation between the calcification and papillary thyroid cancer (PTC). The aim of this study was to describe the features of calcification in thyroid mass, and determine the relationship between thyroid calcification and PTC. Subjects and Methods Patients (116) who underwent surgery for thyroid mass during the period of March 2006 to December 2008 were reviewed retrospectively. Each patient underwent preoperative sonography (n=96) and computed tomography (CT)(n=110) to evaluate the thyroid lesion. We subdivided the calcification according to characteristic features and compared the pathologic results. The association between the type of calcification and PTC was verified through the Chi-square test or likelihood ratio. Results Of 96 patients who underwent sonography, 41 (42.7%) had calcification, of which 23 had microcalcificaiton, 15 had focal calcification, and three had rim calcification. Of 41 calcified lesions, 34 (82.9%) were PTC. Incidence of cancer from thyroid which had no calcified lesion was 30.9%. Three (6.7%) of 45 benign lesions had microcalcification, and 20 (39.2%) of 51 were PTC. We found statistically significant correlation between the presence of calcification, especially microcalcification, on sonography and PTC. Thirty of 110 patients (27.3%) who underwent neck CT had calcification, and among them, 20 patients (66.7%) were diagnosed as PTC. There was no statistical significance in relationship between calcification on CT and malignancy. Conclusion This study suggests that microcalcification which is shown by sonography were more specific for PTC than other calcified lesions.

Calcified thyroid nodule masquerading as foreign body: pitfall of lateral neck X ray

Accidental foreign body ingestion is one of the most common ENT emergencies. Fish bones comprise majority of ingested foreign bodies in south east asian population. Lateral neck radiography is an invaluable screening tool in assessment of patient presenting with throat discomfort following foreign body ingestion, A lateral neck X-ray can be helpful in confirming and localizing a radio-opaque foreign body when direct examination is unremarkable but can be misleading in certain cases of anatomical variations or migrated foreign bodies.

Anaplastic Thyroid Carcinoma Arising From a Calcified Thyroid Mass

Anaplastic Thyroid Carcinoma Arising From a Calcified Thyroid Mass