Common and uncommon sonographic features of papillary thyroid carcinoma

Abstract

Objective: To determine the relative frequency of various sonographic findings in papillary carcinoma of the thyroid.

Methods: We retrospectively analyzed the sonographic features in 55 patients with proven papillary carcinoma of the thyroid. Sonographic features analyzed were echo texture, cystic change, margin, contour, presence of a peripheral halo, vascularity, and calcification pattern. Features were classified as common (> or = 35% of cases) or uncommon (< 10% of cases). Combinations of features were also analyzed.

Results: Common sonographic features of papillary carcinoma included hypoechoic texture (86%), microcalcifications (42%) or no calcifications (47%), well-defined margins (47%), and intrinsic hypervascularity (69%). Uncommon features included hyperechoic or mixed echo texture, cystic elements, irregular margins, hypovascularity, and coarse or peripheral calcifications. Of the 29 lesions that had calcifications, 20 (69%) had microcalcifications; 5 (17%) had coarse calcifications; and 1 had peripheral calcifications. In total, 54% of cases had at least 1 uncommon feature, and 11% had 2 or more uncommon features. Cystic carcinomas were rare and accounted for only 6% of lesions; all had hypervascular solid components. No carcinomas in our series were completely avascular.

Conclusions: There is a broad spectrum of sonographic findings in papillary carcinoma of the thyroid. Half of the lesions in this series had at least 1 uncommon sonographic feature.