J Korean Soc Radiol.  2015 Feb;72(2):92-100. 10.3348/jksr.2015.72.2.92.

Ultrasonographic Features of Metastatic Lymph Nodes in Papillary Thyroid Microcarcinomas and Macrocarcinomas

• Shin YG
• Kang H
• Joh YD
• Jeong KS
• Kim BS

• KMID: 2002804
• DOI: http://doi.org/10.3348/jksr.2015.72.2.92

Abstract

PURPOSE
To analyze ultrasonographic (US) features of metastatic lymph nodes (LNs) in papillary thyroid microcarcinomas (PTMC) and in papillary thyroid macrocarcinomas.
MATERIALS AND METHODS
The study reviewed US findings of 273 patients with pathologically confirmed papillary thyroid carcinoma (PTC) and metastatic LNs based on the US examination. Patients were divided into two groups: PTMC and papillary thyroid macrocarcinomas.
RESULTS
The 273 patients with PTC included 87 with PTMC and 186 with papillary thyroid macrocarcinoma. No significant difference of US features in patients with lateral neck node metastasis was found between PTMC (n = 96) and macrocarcinoma (n = 29). In central neck node metastasis, round shape was the most frequent findings in both groups (p < 0.001).
CONCLUSION
There was no significant difference in US features of metastatic LNs between PTMC and papillary thyroid macrocarcinomas. Therefore, careful evaluation of the whole neck should be made.

MeSH Terms

Humans
Lymph Nodes*
Neck
Neoplasm Metastasis
Thyroid Gland*
Thyroid Neoplasms

Figure

• 

  Fig. 1 Patient flow diagram. Flowchart shows the study population and included patients. Of 676 patients with pathologically confirmed papillary thyroid carcinoma, 186 patients from the papillary thyroid macrocarcinoma group and 87 patients from the PTMC group were selected because they were suspected of having metastatic lymph nodes based on the US examination. Note.-LN = lymph node, PTMC = papillary thyroid microcarcinoma, US = ultrasonographic

• 

  Fig. 2 Central neck node metastasis in 56-year-old man. A. Ultrasonographic image shows ill-defined hypoechoic papillary thyroid microcarcinoma with calcifications in the right thyroid gland. B. An oval shaped lymph node at left level VI shows focal hyperechogenicity (arrow) with loss of hilum in the left central neck on ultrasonography.

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  Fig. 3 Central neck node metastasis in 35-year-old woman. A. Ultrasonographic image shows a lobulated margin, marked hypoechoic papillary thyroid macrocarcinoma with extracapsular extension in the right thyroid gland. B. A round shaped lymph node (arrow) shows internal cystic change in the left central neck on ultrasonography.

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  Fig. 4 Lateral neck node metastasis in 56-year-old man. A. Ultrasonographic image shows a spiculated margin, marked hypoechoic papillary thyroid microcarcinoma in the right thyroid gland. B. An oval shaped lymph node (arrow) shows loss of hilum, hyperechogenicity, and microcalcification in the left lateral neck on ultrasonography.

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  Fig. 5 Lateral neck node metastasis in 61-year-old woman. A. Ultrasonographic image shows a spiculated margin, marked hypoechoic papillary thyroid macrocarcinoma with extracapsular extension in the right thyroid gland. B, C. The right level III (B) and level IV (C) metastatic lymph nodes show microcalcification (white arrow), loss of hilum, and hyperechogenicity (black arrow) on ultrasonography.

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