Korean J Radiol.  2010 Oct;11(5):579-582. 10.3348/kjr.2010.11.5.579.

Papillary Thyroid Carcinoma of a Diffuse Sclerosing Variant: Ultrasonographic Monitoring from a Normal Thyroid Gland to Mass Formation

• Kim HS
• Han BK
• Shin JH
• Ko EY
• Sung CO
• Oh YL
• Song SY

• KMID: 1102586
• DOI: http://doi.org/10.3348/kjr.2010.11.5.579

Abstract

A diffuse sclerosing variant of papillary thyroid carcinoma is uncommon and has a tendency for rapid growth and a higher incidence of cervical lymph node metastases. We experienced a case of a diffuse sclerosing variant of papillary thyroid carcinoma in a 48-year-old man. This case showed benign features on initial ultrasonography and positron emission tomography (PET) scan. A new nodule was detected on follow-up ultrasonography that showed rapid enlargement. This case was confirmed by surgical excision. We herein describe the initial and follow-up ultrasonographic findings of a diffuse sclerosing variant of papillary thyroid carcinoma.

Keyword

Papillary thyroid carcinoma; Diffuse sclerosing variant; Ultrasonography

MeSH Terms

Biopsy, Fine-Needle
Carcinoma, Papillary/pathology/surgery/*ultrasonography
Disease Progression
Humans
Lymphatic Metastasis
Male
Middle Aged
Neck Dissection
Neoplasm Invasiveness
Thyroid Neoplasms/pathology/surgery/*ultrasonography

Figure

• 

  Fig. 1 Diffuse sclerosing variant of papillary thyroid carcinoma in 48-year-old man. A, B. Initial thyroid ultrasonography (A) and PET scan (B) have normal appearance. C, D. Second-round screening examination was performed two years later. Ultrasonography (C) shows diffuse enlargement of left thyroid gland with heterogeneous echogenicity and formation of suspicious mass. It is regarded as pseudo-mass by heterogeneous parenchyma of left thyroid. PET scan (D) shows increased FDG uptake in both thyroid glands, especially in left lobe. These findings are regarded as benign thyroid disease and call for recommended follow-up examination. E, F. Follow-up examination was performed six months later. Ultrasonography shows well defined cystic and solid mass (arrows) measuring 16 mm at left thyroid gland (E, F). It also shows multiple internal microcalcifications within this mass and multiple high echoic dots suggesting microcalcifications (arrowheads in F). G. Lymph node of left level III shows nodular cortical thickening and microcalcifications. Metastasis was confirmed by surgery. H. Photomicrograph shows mass (arrows) with multiple internal psammoma bodies (arrowheads) (Hematoxylin and Eosin staining, ×20).

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