Predictive value for malignancy in the finding of microcalcifications on ultrasonography of thyroid nodules

The aim of this study was to determine the predictive value for malignancy of microcalcifications determined by ultrasonography in thyroid nodules.

One hundred seventy-seven nodules were prospectively studied by ultrasonography and compared with their fine-needle aspirative biopsy. The association between the presence and type of calcification and cytologic findings was verified through the chi-square test or likelihood ratio.

Thirty nodules showed calcification, of which 17 had fine calcifications, 3 had fine and gross calcifications, and 10 had only coarse calcification. Seven (41.18%) of 17 fine calcified nodules were malignant on cytology, 8 (47.06%) were benign, 1 (5.88%) was indeterminate, and 1 was suspect for malignancy. We found statistical significance between the presence of fine calcifications and malignancy (p = .001) and, in the 13 malignant nodule group, 8 (61.50%) had fine calcifications.

This study suggests that microcalcifications were highly specific for malignancy and were present in 61% of the malignant nodules.