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Sonographic Findings Predictive of Central Lymph Node Metastasis in Patients With Papillary Thyroid Carcinoma: Influence of Associated Chronic Lymphocytic Thyroiditis on the Diagnostic Performance of Sonography

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Title: Sonographic Findings Predictive of Central Lymph Node Metastasis in Patients With Papillary Thyroid Carcinoma: Influence of Associated Chronic Lymphocytic Thyroiditis on the Diagnostic Performance of Sonography
Authors: Eun Ju Son, Cheong Soo Park, Eun Kyung Kim, Yeon Hwa Yoo, Jeong-Ah Kim, Jin Young Kwak, Ji Hyun Youk
Contributors: Yeon Hwa Yoo, Jeong-Ah Kim, Eun Ju Son, Ji Hyun Youk, Jin Young Kwak, Eun-Kyung Kim, Cheong Soo Park, Kwak, Jin Young, Kim, Eun Kyung, Kim, Jeong Ah, Park, Cheong Soo, Son, Eun Ju, Youk, Ji Hyun, Kim, Eun-Kyung
Source: Journal of Ultrasound in Medicine. 32:2145-2151
Publisher Information: Wiley, 2013.
Publication Year: 2013
Subject Terms: Adult, Male, Thyroiditis, Ultrasonography/statistics & numerical data, Papillary, Thyroid Neoplasms/epidemiology, Thyroid Neoplasms/diagnostic imaging, Comorbidity, Carcinoma/secondary, Sensitivity and Specificity, Lymph Nodes/diagnostic imaging, Young Adult, 03 medical and health sciences, chronic lymphocytic thyroiditis, 0302 clinical medicine, Risk Factors, Republic of Korea, Humans, Thyroid Neoplasms, Carcinoma/epidemiology, Aged, Ultrasonography, sonography, Carcinoma/diagnostic imaging, Thyroiditis/diagnostic imaging, Incidence, Carcinoma, Reproducibility of Results, Middle Aged, Carcinoma, Papillary, 3. Good health, central lymph node metastasis, Thyroid Neoplasms/secondary, Thyroid Cancer, Papillary, Thyroiditis/epidemiology, Lymphatic Metastasis, papillary thyroid carcinoma, Female, Republic of Korea/epidemiology, Lymph Nodes
Description: ObjectivesTo analyze sonographic findings suggesting central lymph node metastasis of papillary thyroid carcinoma and to evaluate the influence of associated chronic lymphocytic thyroiditis on the diagnostic performance of sonography for predicting central lymph node metastasis.MethodsA total of 124 patients (101 female and 23 male; mean age, 47.5 years; range, 21–74 years) underwent sonographically guided fine‐needle aspiration in central lymph nodes from January 2008 to July 2011. Sonographic features of size, shape, margin, thickening of the cortex, cortical echogenicity, presence of a hilum, cystic changes, calcification, and vascularity of enlarged lymph nodes were analyzed before fine‐needle aspiration and classified into 2 categories (probably benign and suspicious). Sonographic findings were correlated with the pathologic diagnosis and associated chronic lymphocytic thyroiditis. Receiver operating characteristic curve analysis was performed to assess the diagnostic performance of sonography for predicting central lymph node metastasis according to the associated thyroiditis.ResultsFifty‐one lymph nodes (39.5%) were malignant, and 73 (60.5%) were benign. On univariate analysis, size, shape, margin, cortical thickening, cortical echogenicity, cystic changes, calcification, and vascularity were significantly different between the benign and metastatic nodes (P < .05). On multivariate analysis, eccentric cortical thickening (odds ratio, 26.59; 95% confidence interval [CI], 3.26–216.66) and hyper echogenicity of the cortex (odds ratio, 18.46; 95% CI, 2.44–139.64) were significantly associated with malignant nodes (P < .05). The area under the curve values for sonography for predicting metastasis were 0.756 (95% CI, 0.618–0.894) in chronic lymphocytic thyroiditis–positive patients and 0.971 (95% CI, 0.938–1.000) in negative patients.ConclusionsEccentric cortical thickening and cortical hyperechogenicity were the sonographic findings predictive of central lymph node metastasis from papillary thyroid carcinoma. The diagnostic performance of sonography for predicting metastasis was superior in chronic lymphocytic thyroiditis–negative patients than in positive patients.
Document Type: Article
Language: English
ISSN: 1550-9613
0278-4297
DOI: 10.7863/ultra.32.12.2145
Access URL: https://pubmed.ncbi.nlm.nih.gov/24277897
https://ir.ymlib.yonsei.ac.kr/handle/22282913/88658
https://yonsei.pure.elsevier.com/en/publications/sonographic-findings-predictive-of-central-lymph-node-metastasis-
http://www.jultrasoundmed.org/content/32/12/2145.full.pdf
https://pubmed.ncbi.nlm.nih.gov/24277897/
https://www.onlinelibrary.wiley.com/doi/pdf/10.7863/ultra.32.12.2145
https://www.ncbi.nlm.nih.gov/pubmed/24277897
Rights: Wiley Online Library User Agreement
CC BY NC ND
Accession Number: edsair.doi.dedup.....1fa753c6e30ca4b20a29869b46c8418e
Database: OpenAIRE
Description
ISSN:15509613
02784297
DOI:10.7863/ultra.32.12.2145