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[Cystic thyroid masses: ultrasonographic and pathologic correlation].

T Hiromura, K Choji, M Shinohara

    Rinsho Hoshasen. Clinical Radiography
    |September 1, 1989
    PubMed
    Summary
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    This study on cystic thyroid masses found specific ultrasound features can predict benign conditions like adenomatous goiter. However, some lesions lack clear distinguishing features, necessitating needle biopsy for accurate diagnosis.

    Area of Science:

    • Radiology
    • Oncology
    • Pathology

    Background:

    • Cystic thyroid masses present a diagnostic challenge.
    • Accurate preoperative differentiation between benign and malignant cystic thyroid lesions is crucial for patient management.

    Observation:

    • A retrospective review of 63 cystic thyroid masses in 49 patients who underwent preoperative sonography was conducted.
    • Specific sonographic features were correlated with pathological findings.

    Findings:

    • Oval cystic lesions with solid components projecting into the lumen were consistently adenomatous goiters.
    • Irregular cystic structures with finger-like pedunculated masses (>2 cm) were indicative of papillary carcinoma.
    • Small oval cysts (≤1 cm) with strong echoes were diagnosed as colloid goiters.

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  • A significant proportion of other cystic thyroid masses (12-30%) showed indeterminate malignancy potential based on sonography alone.
  • Malignant cells in most lesions were found in the pericystic portion, not the cyst wall, except for papillary carcinoma's solid component.

    • Implications:

    • Sonography can identify specific cystic thyroid masses as benign (adenomatous goiter, colloid goiter).
    • Certain sonographic features require further investigation due to indeterminate malignancy risk.
    • Ultrasonically guided needle biopsy is recommended for pericystic portions and solid components to improve diagnostic accuracy for potentially malignant cystic thyroid lesions.