The recent prevalence of ultrasonography (US) has facilitated the early detection and qualitative evaluation of thyroid nodules. Furthermore, novel technical developments are extending the application range of US for other thyroid diseases.
The use of US to differentiate between thyroid carcinoma and benign nodule, between a metastatic lymph node and a reactive node, between thyroid lymphoma and chronic thyroiditis, and between destruction-induced thyrotoxicosis and Graves’ disease is introduced.
Classification systems for thyroid nodule have shown high diagnostic accuracy for thyroid carcinomas except follicular carcinoma. US diagnosis of lymph node metastasis showed high specificity but low sensitivity. Patients who were suspected of thyroid lymphoma based on US findings should undergo incisional biopsy or thyroidectomy for diagnosis of the histologic type if fine-needle aspiration biopsy findings suggest lymphoma. Patients should be carefully followed even if they were diagnosed as negative based on cytologic findings. Measurement of thyroid blood flow is helpful for diagnosing destruction-induced thyrotoxicosis, such as painless thyroiditis, by distinguishing the lesion from Graves’ disease.
Ultrasonography is useful for diagnosing various thyroid diseases, including thyroid carcinoma. The remaining issue to be resolved is the diagnosis of follicular carcinoma. Trials using novel techniques to differentiate these lesions are expected.
KeywordsThyroid Carcinoma Positive Predictive Value Negative Predictive Value Thyroid Nodule Papillary Carcinoma
- 5.Natori H (1999) Diagnostic criteria for thyroid nodules. J Med Ultrasonics 26:149–150Google Scholar
- 16.Takebe K, Date M, Yamamoto Y et al (1994) Mass screening for thyroid cancer with ultrasonography. Karkinos 7:309–317 (in Japanese)Google Scholar
- 29.Ito Y, Higashiyama T, Takamura Y et al (2007) Risk factors for recurrence to the lymph node in papillary thyroid carcinoma patients without preoperatively detectable lateral node metastasis: validity of prophylactic modified radical neck dissection. World J Surg 31:2085–2091CrossRefPubMedGoogle Scholar
- 46.Kato I, Tajima K, Aozasa K et al (1985) Chronic thyroiditis as a risk factor of B-cell lymphoma in the thyroid gland. Jpn J Cancer Res 40:459–468Google Scholar
- 47.Aozasa K (1990) Hashimoto’s thyroiditis as a risk factor of thyroid lymphoma. Acta Pathol Jpn l40:459–468Google Scholar
- 61.Kamijo K (2003) TSH-receptor antibody measurement in patients with various thyrotoxicosis and Hashimoto’s thyroiditis: a comparison of two two-step assays, coated plate ELISA using porcine TSH-receptor and coated tube radioassay using human recombinant TSH-receptor. Endocr J 50:113–116CrossRefPubMedGoogle Scholar