Follicular thyroid cancer echocardiography or ultrasound

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]

Neck ultrasound may be performed to detect follicular thyroid cancer.

• Key ultrasound findings in thyroid cancer are:

• Large size, microcalcifications, and hypoechogenicity^[1]
• Lymphadenopathy
• Microcalcifications- most specific finding associated with malignancy (~95%)
• Coarse calcifications
• Peripheral rim calcification
• Isoechoic solid nodule
• A nodule taller than it is wide
• Irregular margins

• The lymph node findings are:

• Enlarged regional lymph nodes are suspicious for thyroid malignancy
• Microcalcifications in regional lymph nodes are highly suspicious
• Lymph nodes with cystic change are highly suspicious
• Loss of normal fatty hilum, irregular node appearance
• Increased colour Doppler flow is suspicious
• Low threshold criteria for lymph node biopsy
• Biopsy if suspicious features
• Consider biopsy if >8 mm