Abstract
This chapter focuses on the significance of calcifications and echogenic foci in the ultrasonographic evaluation of thyroid nodules. Echogenic foci are hyperechoic foci within or surrounding a nodule. Calcifications are dense deposits of calcium and can be classified based on size and presence or absence of acoustic shadowing. Microcalcifications are punctate (1 mm or less in size) hyperechoic spots without acoustic shadowing that are associated with a higher likelihood of malignancy. Macrocalcifications are larger flecks of calcium (greater than 1 mm at longest diameter) accompanied by acoustic shadowing, with a nonspecific clinical significance and should be evaluated in combination with other suspicious ultrasound features. Correct identification of ultrasound features will help differentiate benign from malignant nodules and estimate the risk of malignancy to determine whether a biopsy is indicated.
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Further Reading
Haugen B, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1, 1):–133. https://doi.org/10.1089/thy.2015.0020.
Kobaly K, Kim CS, Langer JE, Mandel SJ. Macrocalcifications do not alter malignancy risk within the American Thyroid Association sonographic pattern system when present in non-high suspicion thyroid nodules. Thyroid. 2021:1542–8. https://doi.org/10.1089/thy.2021.0140.
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Malhi HS, Velez E, Kazmierski B, Gulati M, et al. Peripheral thyroid nodule calcifications on sonography: evaluation of malignant potential. Am J Roentgenol. 2019;213:672–5.
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Baldwin, C., Pessah-Pollack, R. (2023). Calcification and Echogenic Foci of Thyroid Nodules. In: Eldeiry, L.S., Laver, N.M.V., Randolph, G.W., Sacks, B., Garber, J.R. (eds) Handbook of Thyroid and Neck Ultrasonography. Contemporary Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-031-18448-2_10
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DOI: https://doi.org/10.1007/978-3-031-18448-2_10
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