Type:
Educational Exhibit
Keywords:
Thyroid / Parathyroids, Ultrasound, Puncture, Endocrine disorders
Authors:
M. J. García Sánchez, S. Caparrós Cánovas, M. D. Montero Rey, S. De Agueda Martín, A. Santiago Hernando, S. Morón Hodge, A. M. Rodríguez, C. Martín-Hervás; Madrid/ES
DOI:
10.1594/ecr2018/C-1866
Conclusion
Hashimoto's thyroiditis is a frequent pathology with a wide ultrasound spectrum of appearances that can simulate other thyroid diseases.
As a consequence,
this disease could be called "the great simulator".
Its sonographic patterns are very varied and it is not uncommon in our daily practice to find radiology reports of undetermined thyroid nodule or multinodular goiter which actually correspond to thyroiditis,
leading to perform unnecessary invasive tests.
The presence of uni or bilateral,
single or multiple adenopathies in the infrathyroid and Delphian node regions is the key to its correct diagnosis by imaging,
even in the presence of a normal or almost normal thyroid parenchyma.
Every radiologist should be aware of the numerous ultrasound patterns that Hashimoto´s disease can present,
in order to avoid unnecessary diagnostic errors and fine-needle aspiration (FNA),
especially in the echogenic focal nodular form,
the “giraffe” pattern or the hypoechoic geographic area.
The nodules that do not have these characteristics should undergo FNA to rule out malignancy.