Yonsei Med J.  2006 Oct;47(5):748-751. 10.3349/ymj.2006.47.5.748.

Suture Granuloma Mimicking Recurrent Thyroid Carcinoma on Ultrasonography

• Chung YE
• Kim EK
• Kim MJ
• Yun M
• Hong SW

• KMID: 1381259
• DOI: http://doi.org/10.3349/ymj.2006.47.5.748

Abstract

Although high resolution ultrasonography (US) is helpful in the differentiation of suture granulomas from recurrent thyroid cancer in most cases, a definite diagnosis cannot always be made. We report a case that mimicked recurrent thyroid cancer on US and 2-[fluorine-18] fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET), but diagnosis of a suture granuloma was confirmed by a US-guided fine needle aspiration biopsy (FNAB). In order to avoid unnecessary operations, the differential diagnosis between postoperative suture granulomas and recurrent cancer is important.

Keyword

Thyroid; ultrasonography; foreign bodies; granuloma

MeSH Terms

Thyroidectomy/*adverse effects
Thyroid Neoplasms/diagnosis/pathology/ultrasonography
Sutures/*adverse effects
Positron-Emission Tomography
Neoplasm Recurrence, Local/diagnosis/pathology/ultrasonography
Humans
Granuloma, Foreign-Body/*diagnosis/etiology/ultrasonography
Female
Diagnosis, Differential
Biopsy, Fine-Needle
Adult

Figure

• 

  Fig. 1 Longitudinal US shows a 1.4 × 1.5 cm-sized ill-defined hypoechic nodule with microcalcification at the right thyroid gland. It was confirmed to be a papillary carcinoma by surgery.

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  Fig. 2 A, B. Transverse (A) and longitudinal (B) US shows an irregular shaped hypoechic nodule (arrows) in the right thyroidectomy bed.

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  Fig. 3 A, B. Coronal (A) and Axial view (B). A few foci of mildly increased FDG uptake are seen in the right thyroidectomy area.

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  Fig. 4 (A) A multinucleated giant cell engulfs several acute inflammatory cells in the background of the fibrohistiocytic and neutrophilic cells (Papanicolaou × 400). (B) A large central irregular foreign material is surrounded by granulomatous inflammatory aggregates in the background of variable inflammatory cells and frequent scattered giant cells (Diff-Quick stain × 100).

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