Unit 1- Malignant Lesions (93-111)

Thyroid CA has a low rate of……..

occurrence

The probability of Thyroid CA decreases with…..

multiple nodules

The probability of Thyroid CA increases when……

solitary lesion with same side lymphadenopathy

What percentage of solitary nodules may be malignant?

10-25%

What is the sonographic appearance of Thyroid CA?

-varies significantly

-50-80% have calcifications

-typically have increased vascularity

-usually hypoechoic

What are these images showing?

Thyroid CA

Thyroid CA Mets spreads to…..

-cervical lymph nodes

-lungs

-bones

-larynx

What is this image showing?

lymphadenopathy

What is the most common thyroid malignancy?

papillary cancer (60-85%)

Papillary CA occurs more in……

females

____ have calcifications; ________ have mets to cervical lymph nodes

25%, 20%

What is the sonographic appearance of papillary CA?

hypoechogenicity (90%)

microcalcifications

hypervascularity (90%)

cervical lymphadenopathy (20%)

What is this image showing?

papillary cancer

What is Medullary Carcinoma?

-enlargement of a portion of gland

-may involve entire gland

5-10%

What does MEN mean?

multiple endocrine neoplasia

What is the sonographic appearance of Medullary Carcinoma?

punctuated, bright echogenic foci (centrally)

deposits of calcium surrounded by amyloid

high association of lymphadenopathy

Follicular Carcinoma is more invasive than……

Papillary

Follicular Carcinoma (10-20%) is…..

aggressive

What does it look like when its minimally invasive?

-solitary mass

-well encapsulated

What does it look like when its widely invasive?

invasion of vessels/tissue

hematologic spread

What is the sonographic appearance of Follicular Carcinoma?

-irregular margins

-firm

-tortuous vessels within

What is this image showing?

follicular carcinoma

Medullary Carcinoma is _____ of thyroid CAs

5%

Medullary Carcinoma is……

-often familial (20%)

-high incidence of lymph node involvement

-appears similar to papillary

What are these images showing?

medullary Carcinoma

Anaplastic Carcinoma occurs in……

>50-year-olds

0-14% 5-year survival rate

Anaplastic Carcinoma (2%) is a……

-hard fixed mass

-rapid growth

-locally invasive

-death by asphyxiation

What is the sonographic appearance of Anaplastic Carcinoma?

-hypoechoic mass

-invasion of surrounding structures

What is this image showing?

Anaplastic Carcinoma

Lymphomas make up _____ of thyroid malignancies?

4%

Non-Hodgkin’s type

What is a Lymphoma?

mass with rapid growth

may are sequela of Hasimoto’s disease

What is the sonographic appearance of lymphomas?

hypoechoic mass- large- solid

lobulated

central necrosis may be present

often accompanied by thyroiditis