Evaluation of Ultrasonographic Characteristics and Cytopathological Results of Autonomous (Toxic) Thyroid Nodules

Year 2023, , 390 - 394, 20.10.2023

Mustafa Çalışkan

https://doi.org/10.18521/ktd.1342204

Abstract

Objective: Thyroid nodules are clinical conditions frequently encountered in the community and known to be associated with malignancy. In this study, it was aimed to determine the frequency of malignancy in patients diagnosed with autonomous (toxic) thyroid nodules (TTN). In addition, the effectiveness of ultrasonography (US) findings and fine needle aspiration (FNA) results in helping the diagnosis of malignancy were investigated.
Methods: Autonomous (Toxic) thyroid nodule was diagnosed by presence of nodule on US in the presence of subclinical or clinical hyperthyroidism, and detection of suppression in other parts of the gland with increased activity in scintigraphy performed with Tc‐99m pertechnetate. Fine-needle aspiration was performed on patients who were considered suspicious by ultrasonographic findings. The histopathology results of the patients who were found to need surgical resection were recorded.
Results: 125 patients with autonomous (toxic) thyroid nodules were included in the study. Of the patients, 82 (65.60%) were female and 43 (34.40%) were male, with a mean age of 63.55±11.13 years. Ultrasonography revealed that nodules were less frequently located in the isthmus and left upper pole. The presence of microcalcification was detected in 8 (6.4%) patients. Histopathologically, the nodules of 2 (1.6%) patients were found to be malignant. Both patients who were found to be malignant were male and their nodules were seen as hypoechoic on US.
Conclusions: Since it has been seen that autonomic (toxic) thyroid nodules may be related to malignancy, careful evaluation of male patients with a hypoechoic image on US was considered appropriate.

Keywords

Toxic Thyroid Nodule, Malignancy, Ultrasonography.

Supporting Institution

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Project Number

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Thanks

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Otonom (Toksik) Tiroid Nodüllerinin Ultrasonografik Özelliklerinin ve Sitopatolojik Sonuçlarının Degerlendirilmesi

Abstract

Amaç: Tiroid nodülleritoplumda sık karşılaşılan ve maligniteyle ilişkili olduğu bilinen klinik durumlardır. Bu çalışmada otonom (toksik) tiroid nodülleri (TTN) tanısı konulan hastalardaki malignite sıklığını belirlemek amaçlandı. Ayrıca ultrasonografi (US) bulguları ve ince iğne aspirasyonu (İİA) sonuçlarının malignite tanısına yardımcı olmadaki etkinliği araştırıldı.
Gereç ve Yöntem: Otonom (Toksik) tiroid nodülü tanısı, subklinik veya klinik hipertiroidi varlığında US’de nodül ve Tc‐99m perteknetat ile yapılan sintigrafide nodül veya nodüllere uyan alanlarda aktivite tutulumda artış ile birlikte bezin diğer kısımlarında supresyon saptanması ile kondu. Ultrasonografi bulguları ile şüpheli olarak değerlendirilen hastalara ince iğne aspirasyonu yapıldı. Cerrahi rezeksiyon gerekliliği saptanan hastaların histopatoloji sonuçları kaydedildi.
Bulgular: Çalışmaya otonom (toksik) tiroid nodülü saptanan 125 hasta dahil edilmiştir. Hastaların 82’si (%65,60) kadın, 43’ü (%34,40) erkek olup yaş ortalamaları 63,55±11,13 idi. Ultrasonografide nodüllerin isthmus ve sol üst polde daha az sıklıkla yerleştiği saptanmıştır. İzoekoik nodül görüntüsünün hipoekoik ve karışık eko görüntüden daha az olduğu görülmüştür (p<0,001). Mikrokalsifikasyon varlığı ise 8 (%6,4) hastada tespit edilmiştir. Histopatolojik olarak 2 (%1,6) hastanın nodülü malign olarak tespit edilmiştir. Malign olarak saptanan iki hasta da erkekti ve nodülleri US’de hipoekoik olarak görülmüştür.
Sonuç: Otonom (toksik) tiroid nodüllerinin malignite ile ilgili olabileceği görüldüğünden, US’de hipoekoik görüntüsü olan erkek hastalarda dikkatli değerlendirme yapılmasının uygun olduğu düşünülmüştür.

Keywords

Toksik Tiroid Nodulü, Malignite, Ultrasonografi.

Project Number

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