Lymph nodes metastatic of thyroid papillary carcinoma

Purpose: Ultrasonic diagnosis is the important first step in the practical management of patients with papillary thyroid carcinoma. Preoperative diagnosis of metastatic lymph nodes on ultrasonography images influences determination of the stage of the disease and the surgical procedure to be followed for those patients. It is, therefore, important to distinguish metastatic lymph nodes from reactive lymph nodes in ultrasonography diagnosis. The purpose of the present study was investigate the characteristic findings on ultrasonography images of metastatic lymph nodes of papillary thyroid carcinoma. Subjects & Methods: A total of 203 lymph nodes in 145 patients were included in this study. Ultrasonographic examinations were performed for primary patients with papillary thyroid carcinoma from October 2010 to February 2012 at the Kuma Hospital. The ultrasonogaphic findings, that is, shape, border, internal echo, cystic change, calcification, linear echogenic hilus, and Doppler signals of the hilus, were analyzed in the patients. Results: Pathological examinations found 161 metastatic lymph nodes and 42 reactive lymph nodes postoperatively. Irregular shape, heterogeneous and hyperechoic internal echo, calcification, absence of hilus, cystic change, and presence of Doppler signals on the extra-hilus region of lymph nodes on preoperative ultrasonography images were significantly correlated with the pathological diagnosis of lymph nodes metastasis. Conclusions: These ultasonographic findings of metastatic lymph nodes are considered to be useful for the practical management of patients with papillary thyroid carcinoma.