The Utility of Clinical Findings Including Serum TSH and Neck Ultrasonography for Predicting Thyroid Malignancy in Atypia of Undetermined Significance/Follicular Lesions of Undetermined Significance / 대한내분비외과학회지

PURPOSE: Neck ultrasonography (NUS) is one of the most commonly used methods for evaluating thyroid nodules and preoperative higher TSH levels are known to be associated with differentiated thyroid cancers. This study was conducted to assess whether serum TSH levels and neck ultrasonography are of value in predicting malignancy in patients with atypia of undetermined significance/follicular lesions of undetermined significance (AUS). METHODS: A total of 62 patients (7 men, 55 women; mean age 48.4±11.9 years) who had indeterminate cytologic results indicating AUS underwent thyroidectomy. Preoperative clinical data including serum TSH and the findings of NUS were analyzed retrospectively between malignant and non-malignant groups. RESULTS: The final pathologic results of malignancy were reported in 53 of 62 (85.5%) patients with AUS. There was no significant difference in the mean value of preoperative serum TSH between malignant and non-malignant groups (1.5±1.3 vs. 1.9±1.2, P=NS). In NUS, the patients diagnosed with malignancy in histology showed a higher proportion of calcification, taller-than-wide shape, hypoechoic texture and irregular margin (58.5% vs. 22.2%, P=0.044; 34% vs. 0%, P=0.038; 98.1% vs. 44.4%, P<0.01; 47.2% vs. 0%, P=0.008). CONCLUSION: Serum TSH was not related to malignancy in thyroid nodules showing AUS. However, ultrasonographic features including calcifications, taller-than-wide shape, hypoechoic pattern and irregular margin could be used to predict malignancy. Ultrasonography should be the first useful methods when making decisions regarding management of thyroid nodules showing indeterminate cytologic results as AUS.

Clinical Usefulness of Neck Ultrasonography in Peritonsillar Abscess / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Clinical differentiation of peritonsillar abscess (PTA) from peritonsillar cellulitis is sometimes difficult and physicians often rely on blind needle aspiration to locate abscess formation. According to previous studies, intraoral ultrasound is a useful, simple, and noninvasive technique that candifferentiate PTA from cellulitis in clinically equivocal cases, although it may cause some discomfort. The objective of this study was to establish a neck ultrasonographic technique that candifferentiate PTA from cellulitis in borderline cases and thereby to avoid unnecessary needle aspiraton. SUBJECTS AND METHOD: The study population included 44 patients (32 males and 12 females; age range 13 to 59 years) with clinically suspected PTA. These patientsunderwent neck ultrasonography examination before needle aspiration of abscess. RESULTS: On the basis of neck ultrasonography, 38 patients were considered as PTA and 6 as cellulitis. Neck ultrasonography was able to detect peritonsillar abscess in 94.7 per cent of the cases (sensitivity). The specificity of the test was 83.3 per cent, and accuracy was 79.1 per cent. CONCLUSION: Neck ultrasonography is a useful, simple, well-tolerated non-invasive technique that can be used to differentiate PTA from cellulitis in clinically equivocal cases.