Microcalcifications,
cortical vascularity and cystic degeneration were associated with regional lymph node recurrence in univariate analyses (p<0.05).
The sensibility and specificity of microcalcifications were 47.3% and 85.7%,
of peripheral vascularity were 69.1% and 83.3%,
of cystic necrosis were 27.3% and 100%,
respectively.
We had 80 patients’ suspicious cervical lymph nodes,
with some ultrasonographic characteristic of lymph node recurrence thyroid cancer.
From these 80 patients with suspicious lymph nodes we had 22 patients with histologic confirmed recurrence.
Twenty two patients with thyroid cancer recurrence were identified: 14 women (63,6%) and 8 men (36.4%).
The mean age in this study among the recurrent patients was 46.8 years.
Among these patients (22 necks with recurrence),
17 patients had Papillary Cancer (77.3%),
4 patients Medullary Cancer (19%) and 1 patient Follicular Cancer (4.5%).
The rate of recurrence in cervical lymph nodes after thyroidectomy for thyroid cancer was 23.4%.
The most significant features on ultrasonography gray-scale on metastatic diseases were microcalcifications,
cystic necrosis and in Doppler ultrasound aspect was peripheral and irregular vascularization.
Compared to a similar study22,
in our assessment we get the same sensitivity in the detection of microcalcifications.
We observe that microcalcifications not always present posterior acoustic shadowing and may be sparse,
or grouped.
In the presence of cystic necrosis sensitivity of our study was 27.3%,
slightly higher compared to that study with a sensitivity of 11%.
Both showed a specificity of 100% for malignancy in the presence of cystic necrosis in the cervical lymph nodes.22
Summary of data acquired for 22 patients operated for lymph node recurrence of thyroid cancer and lymph nodes characteristics
Patient nₒ
|
Sex
|
Age
|
hist
|
US
|
FNAB
|
TG
|
RC
|
nₒ LYM
|
L+
|
microc
|
vasc
|
necr
|
1
|
1
|
44
|
1
|
+
|
+
|
0.9
|
+
|
57
|
8
|
pos
|
neg
|
neg
|
2
|
2
|
42
|
1
|
+
|
+
|
324
|
+
|
36
|
8
|
pos
|
pos
|
neg
|
3
|
2
|
33
|
3
|
+
|
+
|
0.9
|
+
|
52
|
5
|
neg
|
neg
|
neg
|
4
|
2
|
38
|
1
|
+
|
+
|
0.1
|
+
|
9
|
7
|
neg
|
neg
|
neg
|
5
|
2
|
65
|
3
|
+
|
+
|
0.3
|
+
|
10
|
2
|
neg
|
pos
|
pos
|
6
|
2
|
63
|
1
|
+
|
+
|
85.1
|
+
|
2
|
1
|
neg
|
neg
|
neg
|
7
|
2
|
35
|
1
|
+
|
+
|
0.1
|
+
|
1
|
1
|
neg
|
neg
|
neg
|
8
|
1
|
31
|
1
|
+
|
+
|
0.9
|
+
|
61
|
9
|
neg
|
pos
|
pos
|
9
|
2
|
30
|
1
|
+
|
+
|
0.4
|
+
|
17
|
2
|
pos
|
pos
|
neg
|
10
|
2
|
64
|
1
|
+
|
+
|
211.6
|
+
|
38
|
5
|
pos
|
pos
|
pos
|
11
|
2
|
61
|
1
|
+
|
+
|
13.5
|
+
|
20
|
1
|
neg
|
pos
|
pos
|
12
|
2
|
62
|
2
|
+
|
+
|
1.0
|
+
|
3
|
1
|
neg
|
neg
|
pos
|
13
|
2
|
26
|
3
|
+
|
+
|
211.0
|
+
|
34
|
5
|
pos
|
neg
|
neg
|
14
|
2
|
39
|
1
|
+
|
+
|
17.6
|
+
|
34
|
10
|
pos
|
pos
|
neg
|
15
|
1
|
71
|
1
|
+
|
+
|
0.1
|
+
|
20
|
4
|
pos
|
pos
|
neg
|
16
|
1
|
44
|
1
|
+
|
+
|
0.1
|
+
|
57
|
7
|
pos
|
neg
|
neg
|
17
|
1
|
24
|
1
|
+
|
+
|
0.2
|
+
|
167
|
23
|
neg
|
neg
|
neg
|
18
|
2
|
63
|
1
|
+
|
+
|
0.1
|
+
|
31
|
1
|
neg
|
neg
|
pos
|
19
|
1
|
65
|
1
|
+
|
+
|
6777
|
+
|
4
|
4
|
neg
|
pos
|
pos
|
20
|
1
|
25
|
3
|
+
|
+
|
1.0
|
+
|
15
|
8
|
pos
|
pos
|
pos
|
21
|
1
|
70
|
1
|
+
|
+
|
25.0
|
+
|
36
|
1
|
neg
|
pos
|
pos
|
22
|
2
|
35
|
1
|
+
|
+
|
0.1
|
+
|
57
|
1
|
neg
|
neg
|
|
Histol: 1.
Papillary cancer; 2.Follicular cancer; 3.
Medullary cancer
TG: Serum Thyroglobulin; US +: ultrasound with suspected lymph nodes
FNAB: positivity at cytology; RC: recurrence confirmed;
nₒ LYM: number of cervical lymph nodes evaluated at histological examination
L+: number of cervical lymph nodes metastases in each patient
+: positive data
Micro: presence (pos) or absent (neg) of microcalcifications
Vasc: presence (pos) or absent (neg) of peripheral vascularity
Necr: presence (pos) or absent (neg) of necrosis