SFEBES2018 Poster Presentations Thyroid (27 abstracts)
Clinico-pathological correlation of U3 thyroid nodules: A retrospective review
Mostafa Ellatif 1 , Oluwagbemiga Idowu 1 , Neelam Khalid 1 , Daniel Darko 1 , Ravi Lingam 1 , Tan Tran 1 , Neil Tolley 2 , Pushpa Khatri 1 & Koteshwara Muralidhara 3
1London North West Healthcare NHS Trust, London, UK; 2Imperial College Healthcare NHS Trust, London, UK; 3London North West Healthcare NHS Trust, London, UK.
Background: The incidence of thyroid cancer is increasing globally mainly due to increased detection of papillary microcarcinoma. The British Thyroid Association (BTA) guideline (2014) recommends the use of U1-U5 classification on ultrasound to assess thyroid cancer risk. U3 nodules have low, but indeterminate risk and therefore need FNAC. This retrospective review analyses the outcome of U3 nodules in an outer London hospital.
Methods: Thyroid ultrasound performed between 2016 and 2017 were searched and those with reported U3 nodules were selected (n=104) for this retrospective review. The static images were interrogated against the BTA guideline for U3 characteristics, corresponding cytology and histology. People with overt hypo or hyperthyroidism were excluded.
Results: Nearly 81% (n=84) were female (mean age 48 years). Multiple nodules were noted in 54% (n=56) of which only 5% (n=2) were larger than 4 cm compared to 19% (n=9) among solitary nodules. The nodules were mainly heterogeneous (87%) and mixed vascularity was the most common reported U3 characteristic (94.5%) followed by isoechoic nodules (55.5%); other features were reported less frequently (<30%). FNA was done at least once in 86% (n=89). In those with multiple nodules, 86% had THY2 cytology and 9% had THY3a/f whereas 26% with solitary nodule had THY3a (n=11), 7% THY3f and 5% THY5 (n=2). Nineteen patients (18%) had thyroid surgery, which included four total thyroidectomies (two THY5, two large goitre). Both THY5 total thyroidectomy patients had papillary cancer (pT1a pN1a) and were treated with radioiodine. None of the fifteen who had hemithyroidectomy needed any further procedure. This included 7 of the 22 who had THY1 on first FNA.
Conclusion: In summary, this review showed a bias towards mixed vascularity in reporting U3 nodule, negligible indeterminate cytology rate in multiple nodules and a reassuringly low rate of clinically significant papillary cancer risk (<3%).
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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