Yonsei Med J.  2013 Nov;54(6):1400-1406. 10.3349/ymj.2013.54.6.1400.

Anaplastic Thyroid Cancer: Ultrasonographic Findings and the Role of Ultrasonography-Guided Fine Needle Aspiration Biopsy

• Suh HJ
• Moon HJ
• Kwak JY
• Choi JS
• Kim EK

• KMID: 1798136
• DOI: http://doi.org/10.3349/ymj.2013.54.6.1400

Abstract

PURPOSE
To investigate the ultrasonographic (US) features of anaplastic thyroid cancer (ATC) and the diagnostic performance of US-guided fine needle aspiration biopsy (FNAB) therein.
MATERIALS AND METHODS
Eighteen cases of ATC diagnosed between January 2001 and May 2011 were included. FNAB was performed in all cases. Initial FNAB results were divided into three groups: 1) the cytological ATC group, cytological diagnosis of ATC; 2) the underestimated group, cytological diagnoses of malignancy other than ATC; and 3) the false negative group, cytological diagnoses of atypical, benign and non-diagnostic lesions. We retrospectively reviewed US findings and compared treatment modalities between each group.
RESULTS
Among the 18 patients, there were nine in the initially cytological ATC group, four in the underestimated group and five in the false negative group. The most common US features of ATC were a solid (64.7%) and irregular shaped (88.2%) mass with lymph node involvement (76.4%). However, except for lymph node involvement (p=0.003), US findings for each group were not statistically different. The initial cytological diagnostic accuracy of ATC was 50% (9/18). Surgery was performed less in the ATC group (11%) and the false negative group (20%) than the underestimated group (75%).
CONCLUSION
The US features of ATC were not especially different from other types of aggressive thyroid cancer. A correct diagnosis of ATC by initial US-FNAB was made in 50% of the patients, which is significant in that therapeutic surgery can be undertaken in lower numbers if correctly diagnosed.

Keyword

Anaplastic thyroid cancer; fine needle aspiration biopsy; ultrasonography

MeSH Terms

Aged
Biopsy, Fine-Needle/*methods
Female
Humans
Male
Middle Aged
Thyroid Gland/pathology
Thyroid Neoplasms/diagnosis/*ultrasonography

Figure

• 

  Fig. 1 Preoperative diagnostic methods of 18 anaplastic ATC. Underestimated group: poorly differentiated cancer and suspicious papillary carcinoma. False negative group: atypia, benign and non-diagnostic. bx, biopsy; ATC, anaplastic thyroid cancer; FNAB, fine needle aspiration biopsy.

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