Sonographic appearance of focal thyroiditis

Area of Science:

• Radiology
• Endocrinology
• Pathology

Background:

• Thyroid nodules are common, and distinguishing between benign and malignant or inflammatory conditions is crucial.
• Lymphocytic thyroiditis can present as focal nodules, mimicking other thyroid pathologies on imaging.
• Accurate sonographic characterization is essential for guiding patient management.

Purpose of the Study:

• To describe the sonographic features of focal thyroid nodules that are histopathologically confirmed as lymphocytic thyroiditis.
• To evaluate the spectrum of imaging findings associated with focal lymphocytic thyroiditis.

Main Methods:

• Retrospective analysis of sonographic findings in patients with focal thyroid nodules.
• Correlation of sonographic appearance with fine-needle aspiration (FNA) biopsy results confirming lymphocytic thyroiditis.
• Assessment of nodule echogenicity, margins, calcification, cystic changes, and vascularity using Doppler techniques.

Main Results:

• Focal lymphocytic thyroiditis presented with diverse sonographic appearances.
• The most common presentation was a solid, hyperechoic nodule with ill-defined margins.
• Variable echogenicity, presence of calcifications, cystic areas, and diverse vascularity patterns were observed.

Conclusions:

• Focal thyroid nodules in lymphocytic thyroiditis exhibit a wide range of sonographic characteristics.
• No single sonographic feature reliably diagnoses lymphocytic thyroiditis or differentiates it from other nodular lesions.
• Fine-needle aspiration biopsy remains essential for the definitive diagnosis of these focal thyroid lesions.