Table of Contents Author Guidelines Submit a Manuscript
Journal of Thyroid Research
Volume 2014, Article ID 761653, 7 pages
http://dx.doi.org/10.1155/2014/761653
Research Article

Differential Profile of Ultrasound Findings Associated with Malignancy in Mixed and Solid Thyroid Nodules in an Elderly Female Population

1Department of Endocrinology and Metabolism, Dr. Cesar Milstein Hospital, 951 La Rioja Street, C1221ACI Buenos Aires, Argentina
2School of Pharmacy and Biochemistry, UBA, 954 Junín Street, C1113AAD Buenos Aires, Argentina
3Department of Cyto-Pathology, Dr. Cesar Milstein Hospital, 951 La Rioja Street, C1221ACI Buenos Aires, Argentina
4Department of Surgery, Dr. Cesar Milstein Hospital, 951 La Rioja Street, C1221ACI Buenos Aires, Argentina
5Department of Medical Imaging, Dr. Cesar Milstein Hospital, 951 La Rioja Street, C1221ACI Buenos Aires, Argentina

Received 13 March 2014; Revised 16 May 2014; Accepted 23 May 2014; Published 23 June 2014

Academic Editor: Carmen C. Solorzano

Copyright © 2014 María Inés Vera et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. Ultrasonographic characteristics are associated with thyroid malignancy. Our aim was to compare the diagnostic value of ultrasound features in the detection of thyroid malignancy in both solid and mixed nodules. Methods. We prospectively studied female patients (≥50 years) referred to ultrasound-guided fine needle aspiration biopsy. Ultrasound features considered suspicious were hypoechogenicity, microcalcifications, irregular margins, high anteroposterior (AP)/axial-ratio, and absent halo. Associations were separately assessed in mixed and solid nodules. Results. In a group of 504 elderly female patients (age =  years), the frequency of malignant cytology was 6%. Thirty-one percent of nodules were mixed and 60% were solid. The rate of malignant cytology was similar for mixed and solid nodules (7.4 versus 5.8%, : 0.56). While in mixed nodules none of the ultrasound characteristics were associated with malignant cytology, in solid nodules irregular margins and microcalcifications were significant (all ). The combination of irregular margins and/or microcalcifications significantly increased the association with malignant cytology only in solid nodules (OR: 2.76 (95% CI: 1.25–6.10), : 0.012). Conclusions. Ultrasound features were of poor diagnostic value in mixed nodules, which harbored malignant lesions as often as solid nodules. Our findings challenge the recommended minimal size for ultrasound-guided fine needle aspiration biopsy in mixed nodules.