DIFFERENTIAL DIAGNOSIS OF FOLLICULAR TUMORS OF THE THYROID

 

Timofeeva L.A.1,2,3, Stepanov V.G.1,2,4, Alexandrov Yu.K.5,

Nasrullaev M.N. 3

 

1 - I.N. Ulianov Chuvash State University. Cheboksary, Russia.

2 - Republican clinical oncological dispensary. Cheboksary, Russia.

3 - Kazan State Medical Academy. Kazan, Russia.

4 - Ministry of Health of the Chuvash Republic. Cheboksary, Russia.

5 - Yaroslavl state medical University. Yaroslavl, Russia.

 

 

Purpose. To assess the value of the ultrasound sign "calcifications" in the diagnosis of identified calci-fied thyroid lesions.

Materials and methods. A retrospective study of preoperative ultrasound examination protocols of 665 patients with focal thyroid lesions with ultrasound and morphological verification of calcification of nodes has been carried out. US Neck organs was performed using ultrasound devices Aplio XG (Toshiba, Japan) and SonoScape in gray scale modes, color Doppler mapping (CDM).

According to ultrasound thyroid gland observations 449 patients (67%) had the signs of calcifi-cations. Pathomorphological study showed that benign non-tumor diseases in (Group 1) 120 cases - (27, 6 %), benign tumors (Group 2) – in 53 cases (11.8%) thyroid cancer ( group 3) – in 276 cases (61.5%) were established.

Results and discussion. Factor analysis showed that the ultrasound signs of calcification has a high level of reliability but a different “weight” in the diagnosis due to morphological structures of thyroid gland focal lesion.

Diagnosing benign non-tumor thyroid nodules (TI-RADS2) key and priority ultrasound signs were absent. The significant benign tumor group signs are “echogenicity”, “calcifications”, “borders”. The thyroid cancer group (TI-RADS5) had the highest factor thyroid nodules loading signs of “borders”. (0,807450), “echostructure” (0,798709), “calcifications”, “echogenicity” (0,721247) “shape” (0,755404).

Based on the analysis of variance using multiple comparisons (Multiple Comparisons), a differ-ent diagnostic value of ultrasound signs of "microcalcifications" and "macrocalcifications" was estab-lished. In a comparative assessment of ultrasound of benign and malignant tumors of the thyroid gland, it was found that the sign "microcalcifications" (diagnostic weight 7.63031 ranks) belongs to the group of the most significant signs. Microcalcifications are one of the most significant markers of ma-lignant tumors of the thyroid gland, primarily papillary and medullary thyroid cancer, which was also shown by the presented study.

Conclusion. During thyroid nodules’ examination the diagnostic value of the “calcifications” is ambiguous and it is interpreted quite widely. The presence of calcifications both in benign nodes and tumors in thyroid gland of varying degrees of malignancy makes a more balanced approach to the in-terpretation of this symptom.

 

Keywords: thyroid gland, calcification, ultrasound examination, medical statistics.

 

 

Corresponding author: Timofeeva L.A., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Timofeeva L.A., Stepanov V.G., Alexandrov Yu.K., Nasrullaev M.N. Differential diagnosis of follicular tumors of the thyroid. REJR 2023; 13(1):49-57. DOI: 10.21569/2222-7415-2023-13-1-49-57.

 

Received: 22.02.23

Accepted: 07.03.23