Thyroid nodules with Bethesda System IV Cytology: Can Ultrasonography Differentiate Malignancy from Benign?.

Yoo,  Mi Ri; Son,  Eun Ju; Youk,  Ji Hyun; Kim,  Jeong A; Chung,  Sun Yang; Kim,  Hana; Gweon,  Hye Mi

Journal of Korean Society of Ultrasound in Medicine 2013;32(2): 120-127.

Mi Ri Yoo, Eun Ju Son, Ji Hyun Youk, Jeong A Kim, Sun Yang Chung, Hana Kim, Hye Mi Gweon

Department of Radiology and Research Institute of Radiological Science, Yonsei University Health System, Korea. ejsonrd@yuhs.ac

Published online: June 30, 2013.

ABSTRACT

PURPOSE: The purpose of this study is to identify clinical and imaging parameters that can be used in differentiation of benign versus malignancy of preoperative FNA diagnosis of Bethesda system IV nodules. MATERIALS AND METHODS: We analyzed clinical, ultrasonographic, and CT findings of 28 thyroid nodules with Bethesda system IV cytology on FNA, which were proven as follicular or Hurthle cell neoplasms on surgical pathology. RESULTS: No statistically significant differences according to age, sex, and ultrasonographic parameters, including echogenicity, margin, calcification, shape, cystic component, and degree of vascularity and enhancement on CT were observed between benign and malignant follicular neoplasms. Only the lesion size was significantly different (p<0.05). CONCLUSION: The size of follicular neoplasm is predictive of malignancy. If a thyroid nodule with the Bethesda IV cytology is larger than 24.5 mm, there will be a greater probability of malignancy.

Keywords: Thyroid; Follicular neoplasm; Bethesda system