Giovanni Guido Pompili MD, Presenter: Nothing to Disclose

Francesca Priolo, Abstract Co-Author: Nothing to Disclose

Silvia Tresoldi MD, Abstract Co-Author: Nothing to Disclose

Loredana De Pasquale, Abstract Co-Author: Nothing to Disclose

Amelia Bastagli, Abstract Co-Author: Nothing to Disclose

Gianpaolo Cornalba MD, Abstract Co-Author: Nothing to Disclose

To evaluate ultrasound characteristics of thyroid nodules with a known cytological diagnosis of follicular proliferation (FP) which could mean either follicular hyperplasia (FH) or follicular adenoma (FA) or follicular carcinoma (FC) and validate a malignity score of the nodule to limit surgery to selected cases.

Pre-operative US of 99 patients diagnosed with FP at cytology who successively underwent surgery have been reviewed (mean age 46 years, range 15-81 years). We assigned a score (0-8) resulting from the sum of single scores assigned to US features (1 point: hypoechoic, incomplete or absent halo, microcalcifications, mixed vascularization, size increased of more than 20% in 6 months; 2 points: single nodule, irregular margins and intralesional vascularization). We compared our results with final histology results ruling out 6 papillary microcarcinomas undetectable by US.

Results of histological exams were: 41 FH(41.4%), 46 FA(46.5%),12 FC(12.1%). Ninety-eight percent (40/41) of FH had a score of ≤3, 100% of FC had a score ≥4. In the population ≥4(n=33) there were 1FH(3%), 20 FA(61%), 12 FC(34%). In the population with score=3 (n=31) there were 16 FH (52%) and 15 FA (48%). In the population with score <3 (n=35) there were 24 FH (68.6%), 11 FA (31.4%) and no FC (0%)

We suggest a “second US look” to determine the malignity score in patients with a cytological diagnosis of FP. Surgery is advisable if the malignity score is ≥4; a US follow-up if =3; no action (benign nodule) if the score is <3.

A cytological diagnosis of follicular proliferation includes either benign and malignant nodules. A US second look enables to achieve a better diagnosis reserving surgery to selected cases

Pompili, G, Priolo, F, Tresoldi, S, De Pasquale, L, Bastagli, A, Cornalba, G, Management of Thyroid Follicular Proliferation: What To Do? A “Malignity Score” Help from Ultrasound (US).  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9007933.html