Clinical Analysis of Macrocalcifications Accompanying a Thyroid Nodule: A Comparative Study with Microcalcifications / 대한내분비외과학회지

ABSTRACT

PURPOSE: The clinical value of macrocalcifications as an indicator that predicts malignancy of thyroid nodules is controversial. The purpose of this study was to investigate additional ultrasonographic findings accompanying macrocalcifications for predicting malignancies in thyroid nodules. METHODS: Between January 2005 and April 2008, 315 patients who had thyroid nodules with FNAB resulting in suspicious malignancies underwent thyroidectomy at the Wallace Memorial Baptist Hospital. Three hundred fifteen nodules, which were confirmed to be papillary thyroid carcinoma, and 192 nodules, which were confirmed to be benign, were reviewed retrospectively. We analyzed the malignancy rates according to calcification patterns and US findings of the associated solid nodules. RESULTS: Among the 165 papillary thyroid carcinomas with microcalcifications, 161 accompanied solid nodules, and 4 were found with microcalcifications, but without solid nodules. Of the 161 papillary thyroid carcinomas with microcalcifications and solid nodules, 85.7% showed signs suggestive of malignancy. The remaining 14.3%, where only microcalcifications were present, showed indications of predicting malignancy. When solid nodules were found with macrocalcifications, there were indicators of predicting malignancy (100%). Also, for situations in which benign nodules were accompanied by solid nodules, 29% had signs of predicting malignancy. For situations in which benign nodules did not accompany solid nodules, 21% showed suspicious signs of predicting malignancy, but were all confirmed as benign. CONCLUSION: CFor nodules that accompany microcalcifications, there can be indicators that predict malignant conditions separate from other opinions that accompany microcalcifications. However, for macrocalcifications, it would be more effective to set up future treatment plans based on ultrasonographic features of solid nodules accompanying calcifications rather than the calcification itself.