Relationship between patterns of calcification in thyroid nodules and histopathologic findings

• Published in: ENDOCRINE JOURNAL Vol. 60; no. 2; pp. 155 - 160
• Main Authors: Kim, Bu Kyung, Choi, Young Sik, Kwon, Hye Jung, Lee, Jun Seop, Heo, Jae Joon, Han, You Jin, Park, Yo-Han, Kim, Jeong Hoon
• Format: Journal Article
• Language: English
• Published: Japan The Japan Endocrine Society 2013
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Calcification; Calcinosis - pathology; Carcinoma - diagnostic imaging; Carcinoma - epidemiology; Carcinoma - pathology; Female; Hospitals, University; Humans; Incidence; Male; Medical Records; Middle Aged; Predictive Value of Tests; Republic of Korea - epidemiology; Retrospective Studies; Thyroid Gland - diagnostic imaging; Thyroid Gland - pathology; Thyroid Neoplasms - diagnostic imaging; Thyroid Neoplasms - epidemiology; Thyroid Neoplasms - pathology; Thyroid nodule; Thyroid Nodule - diagnostic imaging; Thyroid Nodule - epidemiology; Thyroid Nodule - pathology; Ultrasonography; Young Adult
• ISSN: 0918-8959; 1348-4540
• DOI: 10.1507/endocrj.EJ12-0294

Various patterns of calcification have been detected in benign and malignant thyroid nodules on ultrasonography (US). Microcalcification has been found to be highly associated with papillary thyroid carcinoma. However, other patterns of calcification have unclear clinical significance. The aim of this study was to evaluate which pattern of calcification could be predictive of malignancy. A total of 1,431 thyroid nodules of 1,078 patients who received preoperative ultrasound examinations and subsequently underwent thyroidectomy were retrospectively reviewed. The types of calcification were defined as follows: microcalcification, annular-like peripheral calcification, crescent-like peripheral calcification, intranodular coarse calcification, and calcified spot. Of these 1,431 nodules, 1,305 (91.1%) were thyroid carcinomas and 126 (8.9%) were benign nodules. Calcifications were detected in 38.6% (552/1,431) of all nodules. Calcifications were found in 40.2% (524/1,305) of malignant nodules and 22.2% (28/126) of benign nodules. Of the 524 malignant nodules with calcification, microcalcification was the most common pattern, occurring in 42.9% (225/524), and annular type was the least common pattern, occurring in 5.9% (31/524). Among the calcification types, only microcalcification and intranodular had a significant association with malignancy (p = 0.001, 0.035), with OR values of 3.5 (95% CI, 1.6-7.7) and 2.4 (95% CI, 1.1-5.6). Though using the patterns of calcification alone for predicting malignancy had limitation, microcalcification and intranodular calcification were significantly associated with malignancy.