Aims and objectives
The percentage of malignant thyroid nodules have been almost tripled since last century [1,
2] and it had been explained by the increased usage of ultrasound examination.
More and more authors are discussing overdiagnosis and overtreatment of thyroid cancer and situation has been called “epidemic”.
The number of publications which advocate that active surveillance can be the first-line management of small papillary thyroid carcinomas [3,
5] is increasing.
In order to achieve a systematic evaluation of malignancy risk and reduce the number of biopsies,...
Methods and materials
This was retrospective descriptive and analytic research carried out at three medical institutions from November 2014 to October 2015.
795 thyroid nodules were categorized by TIRADS according to number of suspicious US features (marked hypoechogenicity,
microlobulated or irregular margins,
high stiffness with elastography,
metastatic lymph nodes).
Simply hypoechoic nodules without any signs of malignancy were classified as TIRADS 3.
TIRADS 2 group corresponded to benign nodule: simple cyst,
homogeneous hyperechoic nodules (“white knight”),
typical subacute thyroiditis and nodules with macrocalcification....
795 nodules were classified as TIRADS 2,
4B and 5 in 14.5,
5.7% of cases respectively.
Figure 1 shows cytology results and matched results of TIRADS categories.
Figure 2 shows TIRADS category 3 nodule echogenicity and cytology results.
Risk of malignancy were also calculated based on histology results.
For TIRADS categories 3 to 5 it was 17.7%,
58.3% and 76%,
TIRADS category 2 had too small nodule count and one of them was lymphoma,
therefore risk of malignancy...
Simple hypoechoic thyroid nodules TIRADS 3 did not show statistically significant relations to higher malignancy risk.
This sign significance and the role in biopsy assignation is distuted and every case needs to be evaluated separately.
American Association of Clinical Endocrinologists,
Associazione Medici Endocrinologi,
and European Thyroid Association Medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: executive summary of recommendations. Endocr Pract,
Trends in Thyroid Cancer Incidence and Mortality in the United States,
An observation trial without surgical treatment in patients with papillary microcarcinoma of the thyroid. Thyroid,