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Ege Journal of Medicine
2017, Cilt 56, Sayı 3, Sayfa(lar) 115-123
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Follicular variant of papillary thyroid carcinoma: Gray-scale and Doppler sonographic features
Tülay Öztürk1, Süha Süreyya Özbek1, Gülgün Demirpolat Kavukçu1, Yeşim Ertan2, Müge Tunçyürek2, Ali Veral2, Deniz Nart2, Recep Gökhan İçöz3, Mehmet Mahir Akyıldız3, Özer Makay3
1Ege University Faculty of Medicine, Department of Radiology, İzmir, Turkey
2Ege University Faculty of Medicine, Department of Pathology, İzmir, Turkey
3Ege University Faculty of Medicine, Department of Surgery, İzmir, Turkey
Keywords: Thyroid carcinoma, papillary thyroid carcinoma, follicular variant, Doppler

Aim: The aim of this study was to present the sonographic characteristics of follicular variant of papillary thyroid carcinoma (FVPTC) related to different forms of the thyroid nodules, including those without a capsule. Another purpose was to analyze the color Doppler ultrasonography (CDUS) features of this unique tumor, which have not been intensively studied in previous works.

Materials and Methods: Twenty-two thyroid nodules (male/female: 17/5; mean age±SD: 42±16 years; range: 17-70) diagnosed with FVPTC were included in this study. The sonographic and Doppler features of the nodules were analyzed retrospectively. The intranodular pattern of vascularity was categorized with regard to the presence of perinodular and/or intranodular vascular signals, as well as a “spoke-and-wheel” appearance.

Results: The length of the nodules varied from 6 to 55 mm. Most of nodules were purely solid (77.3%), isoechoic (59.1%) or hypoechoic (31.8%) and had an oval shape (72.7%), well-defined margins (68.2%) and a peripheral hypoechoic halo (68.2%). Thirty-one percent of the nodules had a lobulated shape with microlobulated margins or an irregular configuration with ill-defined margins. Encapsulated FVPTCs had a peripheral hypoechoic halo and well-defined margins, whereas infiltrative cases exhibited the opposite characteristics. No calcification was observed in 72.7% of the nodules. Perinodular and predominantly peripheral intranodular hypervascularity was observed in 14 nodules (66.7%) and was the dominant pattern of vascularity in most of the encapsulated FVPTCs, unlike the infiltrative FVPTCs.

Conclusion: Diagnosis of FVPTC should always be considered when large thyroid nodules with predominantly solid echo-texture and other sonographic features that suggest benignity and nodular hypervascularity are observe.

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