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Association between neck ultrasonographic findings and clinico‐pathological features in the follicular variant of papillary thyroid carcinoma
Author(s) -
Jang Eun Kyung,
Kim Won Gu,
Choi Yun Mi,
Jeon Min Ji,
Kwon Hyemi,
Baek Jung Hwan,
Lee Jeong Hyun,
Kim Tae Yong,
Shong Young Kee,
Song Dong Eun,
Kim Won Bae
Publication year - 2015
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.12674
Subject(s) - pathological , medicine , thyroid carcinoma , papillary carcinoma , thyroid , endocrinology , follicular carcinoma , pathology , follicular phase , ultrasonography , radiology
Summary Objective The follicular variant of papillary thyroid carcinoma ( FVPTC ) has multiple histological subtypes. Clinical outcomes of FVPTC are variable depending on the subtypes. This study evaluated the association of pre‐operative ultrasonographic ( US ) findings and clinico‐pathological features of FVPTC . Patients This retrospective study enrolled patients with FVPTC ( n = 70), size‐matched classical variant of papillary thyroid carcinoma ( CPTC , n = 328), follicular carcinoma ( n = 85) and follicular adenoma ( FA , n = 120). We defined the histological subtypes of FVPTC as infiltrative (I‐ FVPTC ; n = 19) or encapsulated (E‐ FVPTC ; n = 51) according to the presence of a fibrous capsule. Pre‐operative US was reviewed using a US scoring system and classified into low US score ( n = 42) and high US score ( n = 28). Results The median US score for FVPTC was lower than CPTC (2 vs 7, P < 0·001), but higher than FA (2 vs 0, P < 0·001). The median US score for I‐ FVPTC was significantly higher than E‐ FVPTC (4 vs 2, P = 0·009). I‐ FVPTC was more likely to be diagnosed as a malignancy or suspicious for malignancy on cytology than E‐ FVPTC ( P = 0·002). The cumulative risks of cervical lymph node ( LN ) or distant metastasis according to tumour size were significantly higher in I‐ FVPTC than E‐ FVPTC (all P < 0·001). The cumulative risks for cervical LN metastasis or capsular invasion according to tumour size were significantly higher in FVPTC with high US score than FVPTC with low US score ( P = 0·005, P < 0·001, respectively). Conclusions Pre‐operative US findings of thyroid nodules were associated with not only histological subtypes, but also the clinical behaviour in FVPTC .