Incidentally discovered thyroid nodules and palpable neck masses present a common clinical problem. Further evaluation with neck ultrasound helps to characterize these lesions and stratify the risk of malignancy. Based on ultrasound characteristics, these lesions can be better defined using pathologic and other clinical data in order to determine the best management.
This practical handbook is a case compendium based on thyroid and neck ultrasonography patterns that are commonly encountered in clinical practice. A chapter will be designated for each of the major types of thyroid nodule ultrasound features, and additional chapters will be designated for other non-thyroid neck lesions. Beginning with imaging (photographic) examples of each of the ultrasound findings, clinical cases will be used to subdivide each feature and illustrate the differential diagnoses of the various types of thyroid and neck lesions. Associated cytology and histopathology images will be shown and described, as well as clinical data, including relevant history, physical exam, molecular marker results and clinical course. Chapters will include bulleted key points for quick reference as well as suggested readings for further investigation.
While several handbooks exist to educate readers about neck and thyroid ultrasonography and about cytopathology, this is a unique work that combines ultrasound and pathology data into a case-based, easy-to-read and concise format that fits in your pocket, adapting common terminology that is emerging for ultrasound, which will allow readers to employ a "standardized" approach to evaluating nodules, depending on the risk scoring system used.
Author(s): Leslie S. Eldeiry, Nora M. V. Laver, Gregory W. Randolph, Barry Sacks, Jeffrey R. Garber
Series: Contemporary Endocrinology
Publisher: Springer
Year: 2023
Language: English
Pages: 250
City: Cham
Preface
Series Editor Preface
Acknowledgments
Contents
Contributors
1: The Basics of Thyroid and Neck Ultrasound
Introduction
Basic Ultrasound Physics
Ultrasound Artifacts
Equipment
Transducer Selection
Patient Positioning and Scanning Techniques (Image 1.6)
Potential Scanning Pitfalls
Thyroid Anatomy (Image 1.7)
Normal Thyroid Texture (Image 1.8)
Textural Changes (Images 1.9, 1.10, and 1.11)
Anatomic Variants (Images 1.12 and 1.13)
Thyroglossal Duct Cyst
Thyroid Nodules
Simple Cysts (Image 1.14)
Spongiform Nodules (Uniformly Microcystic throughout) (Image 1.15)
Solid Nodules (Images 1.16, 1.17, 1.18, 1.19, and 1.20)
Lymph Node Assessment
Ultrasound Appearance of Lymph Nodes
Other Neck Masses
Parathyroid Glands
Salivary Glands (Image 1.26)
Branchial Cleft Cyst
Carotid Body Tumor
Further Reading
2: Ultrasound Scoring Systems, Clinical Risk Calculators, and Emerging Tools
Introduction
Risk Calculators Versus Clinical Practice Guidelines
Ultrasound Scoring Systems
AACE/ACE/AME
American Thyroid Association (ATA)
ACR TI-RADS and AI TI-RADS
EU-TIRADS
K-TIRADS
C-TIRADS
Comparison of Risk Stratification Tools
Risk Calculators
ACR TI-RADS and AI TI-RADS
Malignancy Risk Estimation of Lesions with AUS/ FLUS
The Brigham and Women’s Hospital (BWH) Thyroid Nodule Risk Estimator
Thyroid Nodule Malignancy Risk Calculator: Spain
Risk of Malignant Thyroid Nodules Based on Clinical, Biochemical, Ultrasound Characteristics, with or without Cytologic Features: Cleveland Clinic
The Thyroid Nodule App: TNAPP
Case Conclusion:
Further Reading
3: Thyroid Fine Needle Aspiration and Biopsy Techniques for Lesions in the Neck
Introduction
Equipment: Needles and Core Biopsy Devices
Solutions and Media
Thyroid Nodule Biopsy
Lymph Node
Biopsy Techniques
Preparation
Anesthesia
US Guidance Techniques (Fig. 3.9)
Thyroid Nodules
FNA Specimens
Molecular Markers
Thyroid Cyst Aspiration and Sclerosis
Procedure
Lymph Node Aspiration
FNA vs Core Biopsy
Parathyroid Adenomas
Salivary Gland and Other Miscellaneous Neck Masses
Further Reading
4: Overview of the Bethesda System for Reporting Thyroid Cytopathology
Introduction
Discussion
Nondiagnostic
Benign
Atypia of Undetermined Significance (AUS)/Follicular Lesion of Undetermined Significance (FLUS)
Follicular Neoplasm (FN)/Suspicious for a Follicular Neoplasm (SFN) (Specify if Oncocytic/Hürthle Cell Type)
Suspicious for Malignancy (SFM)
Malignant
Further Reading
5: Fine Needle Aspiration: Role of Molecular Testing
Introduction
Investigation of the Indeterminate Thyroid Nodule
Immunohistochemical Staining
Genetic Mutations in Thyroid Nodule Diagnosis
Genetic Translocations
Other Genetic Anomalies of Interest
Genetic Mutation Panels
MicroRNA (miRNA) Analysis
Mutation and miRNA (Multiplatform) Analysis Combined
Identification of Benign Nodule Characteristics
Genetic Testing and NIFTP Lesions
Initial Intervention Based on Molecular Results
Further Reading
6: Thyroid Gland Ultrasonography: Hashimoto’s, Graves’, Thyroiditis, Toxic Multinodular Goiter
Introduction
Discussion
Further Reading
7: Thyroid Nodule Composition
Discussion
Further Reading
8: Echogenicity of the Thyroid
Introduction
Discussion
Further Reading
9: Thyroid Nodule Ultrasonography: Margins and Shape
Introduction
Discussion
Further Reading
10: Calcification and Echogenic Foci of Thyroid Nodules
Introduction
Discussion
Further Reading
11: Vascularity of Thyroid Nodules
Introduction
Discussion
Further Reading
12: Parathyroid Imaging
Introduction
Parathyroid Embryology and Anatomy
Parathyroid Adenomas: Additional Examples
Atypical Appearance of Parathyroid Adenomas (Images 12.6, 12.7, and 12.8)
Ectopic Locations of Parathyroid Adenomas (Images 12.9, 12.10, 12.11, and 12.12)
Associated Thyroid Diseases Complicating Parathyroid Adenoma Localization (Images 12.13, 12.14, and 12.15)
4DCT
Discussion
Further Reading
13: Cervical Lymph Nodes
Introduction
Discussion
Further Reading
14: Anatomy and Selected Non-thyroid Neck Findings
Introduction
Normal Ultrasound Anatomy
Evaluation of Incidental Findings in the Neck
Discussion
Further Reading
Index
