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Intrathyroidal ectopic thymus tissue: a diagnostic challenge

  • HEAD, NECK AND DENTAL RADIOLOGY
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Abstract

Objectives

The prevalence of thyroid nodules in pediatric population is 0.2–2%, which is lower than adults. However, the probability of the nodule to be malignant is higher than adults (20–73%). Differential diagnosis of thyroid lesions in children includes intrathyroidal ectopic thymus tissue (ITT). ITT can present as a thyroid nodule, and be confused with malignancy with its hyperechoic pattern; this might cause unnecessary fine-needle aspiration biopsies and/or surgical interventions. In the current study, we mainly aim to define both US and color Doppler ultrasonography (CDUS) characteristics of ITT. We also aim to describe the most sensitive and most specific diagnostic parameters of ITT.

Methods

We have evaluated US examination reports of 56 children for whom differential diagnosis included ITT between February 2015 and August 2018. We have recorded sonographic characteristics of the lesions, CDUS data, and thyroid hormone levels.

Results

Study population consists of 56 patients (22 ITT, 34 other diagnoses). Median age of the population is 10 years. Age, sex, laboratory results, and follow-up change in lesion diameters do not show any significant difference between ITT and other diagnosis groups. Typical US appearance, fusiform lesion shape, and isovascular CDUS characteristics are higher in ITT group. The median value of the lesion’s highest diameter is smaller in ITT group. The most valuable criteria to predict ITT presence were the fusiform shape and the longest diameter of the lesion.

Conclusions

Fusiform shape and a maximum diameter of ≤ 9 mm are the most selective criteria to predict ITT diagnosis.

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Authors and Affiliations

  1. Department of Radiology, Dr. Sami Ulus Training and Research Hospital, 06340, Altındağ, Ankara, Turkey

    Sonay Aydin

  2. Department of Radiology, Erzincan University, Erzincan, Turkey

    Erdem Fatihoglu

  3. Department of Radiology, Ankara Training and Research Hospital, Ankara, Turkey

    Mahmut Kacar

Authors
  1. Sonay Aydin
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  2. Erdem Fatihoglu
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  3. Mahmut Kacar
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Corresponding author

Correspondence to Sonay Aydin.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Institutional review board approval was obtained, and the need for informed consent was waived for the current retrospective study.

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Aydin, S., Fatihoglu, E. & Kacar, M. Intrathyroidal ectopic thymus tissue: a diagnostic challenge. Radiol med 124, 505–509 (2019). https://doi.org/10.1007/s11547-019-00987-0

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  • DOI: https://doi.org/10.1007/s11547-019-00987-0

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