Korean J Endocr Surg. 2008 Dec;8(4):260-265. Korean.
Published online Dec 31, 2008.
Copyright © 2008 Korean Association of Thyroid and Endocrine Surgeons; KATES
Original Article

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

Hsu Chieh Wang, M.D.,1 Sun Mi Paik, M.D.,2,4 Yang Soo Lim, M.D.,1 Min Hee Jeong, M.D.,3 and Jin Gu Bong, M.D.5
    • 1Department of Surgery, Wallace Memorial Baptist Hospital, Busan, Korea.
    • 2Department of Radiology, Wallace Memorial Baptist Hospital, Busan, Korea.
    • 3Department of Pathology, Wallace Memorial Baptist Hospital, Busan, Korea.
    • 4Department of Radiology, Hanseo Hospital, Busan, Korea.
    • 5Department of Department of Surgery, Deagu Catholic University College of Medicine, Deagu, Korea.
Accepted November 25, 2008.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords
Thyroid nodule; Macrocalcification; Papillary thyroid carcinoma; Ultrasonography


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