Sonographic Appearance of Thyroid Cancer in Patients With Hashimoto Thyroiditis

• Published in: Journal of ultrasound in medicine Vol. 34; no. 4; pp. 697 - 704
• Main Authors: Durfee, Sara M., Benson, Carol B., Arthaud, Dylan M., Alexander, Erik K., Frates, Mary C.
• Format: Journal Article
• Language: English
• Published: England American Institute of Ultrasound in Medicine 01-04-2015
• Subjects: Adult; Aged; Aged, 80 and over; Female; Hashimoto Disease - complications; Hashimoto thyroiditis; head and neck ultrasound; Humans; Male; Middle Aged; Retrospective Studies; sonography; thyroid cancer; Thyroid Neoplasms - complications; Thyroid Neoplasms - diagnostic imaging; Ultrasonography; Young Adult; thyroid cancer; Hashimoto thyroiditis; head and neck ultrasound; sonography
• ISSN: 0278-4297; 1550-9613
• DOI: 10.7863/ultra.34.4.697

Objectives
To determine whether the sonographic appearance of thyroid cancer differs in patients with and without Hashimoto thyroiditis.
Methods
Patients with histologically proven thyroid cancer who had thyroid peroxidase (TPO) antibodies measured and sonography performed preoperatively were included. We evaluated each nodule for size, echogenicity, composition, margins, halo, and vascularity and evaluated the background heterogeneity of the gland.
Results
There were 162 thyroid cancers in 145 patients. Forty‐two patients (29.0%) had Hashimoto thyroiditis with positive TPO antibodies, and 103 patients (71.0%) had negative TPO antibodies. The background echogenicity was more often heterogeneous in TPO antibody–positive patients compared to those who had negative TPO antibodies (57.1% versus 26.2%; P= .0005). Comparing cancers in TPO antibody–positive to TPO antibody–negative patients, there was no significant difference in the size, echogenicity, composition, margins, halo presence, calcification presence and type, or vascularity of the cancerous nodule (P > .05). Among TPO antibody–positive patients, comparing thyroid cancerous nodules in patients with heterogeneous glands to those with homogeneous glands, there was no significant difference in any sonographic characteristic except the margin of the nodule, which was more often irregular or poorly defined in heterogeneous glands and more often smooth in homogeneous glands (P< .05).
Conclusions
Sonographic features of thyroid cancer are similar in patients with and without Hashimoto thyroiditis. Among patients with Hashimoto thyroiditis and thyroid cancer, the sonographic appearance of the cancerous nodule is similar, except that cancerous nodule margins are more likely to be irregular or poorly defined when the gland is heterogeneous.