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Timofeeva L.A., Stepanov V.G., Kleverova L.S.
Ultrasound sign «calcification» of nodular thyroid neoplasms when using the TI-RADS system (case report)
Keywords: nodular formation of the thyroid gland, multiparametric ultrasound examination, calcifications, TI-RADS
The problem of improving the quality of early differential diagnosis of thyroid nodules remains relevant, since the number of patients with this pathology is steadily increasing. Obtaining reliable criteria for node malignancy is clinically significant for carrying out further therapeutic and diagnostic measures. In the case of detecting calcifications during ultrasound examination of the thyroid gland, the choice of tactics becomes more complicated, since today there is no unified understanding of the value of calcifications, and contradictions in their assessments persist. The aim is to demonstrate the complexity of differential diagnosis of nodular thyroid pathology using the clinical example. Results. The article presents a clinical case which is complex from a diagnostic point of view; it is a clinical case of nodular thyroid pathology in a patient aged 71 years. To make the diagnosis, a multiparametric ultrasound examination was performed in В-mode. Based on the results of multiparametric ultrasound examination, indications for a fine needle aspiration biopsy were determined and further management for the patient with nodular thyroid formation was determined. The results of the multiparametric ultrasound examination were ambiguous. In B-mode, the nodes were characterized by a hypoechogenic heterogeneous structure with multiple cystic cavities with intersections and microcalcifications. Taking into account these signs, the nodes were assessed as malignant (TI-RADS4). The patient underwent a fine needle aspiration biopsy, the results of which indicated goiter with signs of regressive changes (Bethesda II). The conclusion of the pathomorphological study indicated stromal calcinosis. Conclusions. Taking into account the ultrasound sign of "calicificates" made it possible to more accurately assess the nature of pathomorphological changes in the nodes in the right (TI-RADS4) and left (TI-RADS4) lobes of the thyroid gland, which was then confirmed by a pathomorphological study. Thus, multiparametric ultrasound remains the leading method in the diagnosis of nodular thyroid pathology.
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About authors
- Timofeeva Lyubov A.
- Doctor of Medical Sciences, Professor, Department of Propedaedeutics of Internal Diseases with Radio Diagnosis Course, Chuvash State University, Russia, Cheboksary (adabai@mail.ru; ORCID: https://orcid.org/0000-0002-4707-8214)
- Stepanov Vladimir G.
- Minister, Ministry of Health of the Chuvash Republic, Russia, Cheboksary (medicin_prm@cap.ru; )
- Kleverova Lyudmila S.
- Radiologist, Chief Freelance Specialist in Radiation Diagnostics, Republican Clinical Oncology Dispensary, Russia, Cheboksary (rkod@med.cap.ru; )
Article link
Timofeeva L.A., Stepanov V.G., Kleverova L.S. Ultrasound sign «calcification» of nodular thyroid neoplasms when using the TI-RADS system (case report) [Electronic resource] // Acta medica Eurasica. – 2023. – №4. P. 100-106. – URL: https://acta-medica-eurasica.ru/en/single/2023/4/10/. DOI: 10.47026/2413-4864-2023-4-100-106.