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© 2009 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 28:1685-1692 • 0278-4297

Sonographic Features of Follicular Variant Papillary Thyroid Carcinomas in Comparison With Conventional Papillary Thyroid Carcinomas

Dae Sik Kim, MD, Ji-hoon Kim, MD, Dong Gyu Na, MD, Sung-Hye Park, MD, Eunhee Kim, MD, Kee-Hyun Chang, MD, Chul-Ho Sohn, MD and Young Ho Choi, MD

Departments of Radiology (D.S.K., J.-h.K., D.G.N., E.K., K.-H.C., C.-H.S.) and Pathology (S.-H.P.), Seoul National University College of Medicine, Seoul, Korea; Human Medical Imaging and Intervention Center, Seoul, Korea (D.G.N.); and Department of Radiology, Seoul Municipal Boramae Hospital (Affiliated With Seoul National University Hospital), Seoul, Korea (Y.H.C.).

Address correspondence to Ji-hoon Kim, MD, Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea. E-mail: jhnkim{at}radiol.snu.ac.kr

Objective. The purpose of this study was to compare the sonographic features as well as the results of fine-needle aspiration biopsy (FNAB) of follicular variant papillary thyroid carcinoma (FVPTCs) and conventional papillary thyroid carcinoma (PTCs). Methods. Forty patients with 44 FVPTCs and 59 patients with 74 conventional PTCs were enrolled in this study. The sonographic features, sonographic gradings, and FNAB results were compared between the two groups. Results. The mean nodule size of FVPTCs was larger than that of conventional PTCs (17.70 versus 10.53 mm; P < .001). Sonographic features of an ovoid-to-round shape (95% versus 73%), isoechogenicity (52% versus 8%), and a hypoechoic halo (25% versus 3%) were more frequent in FVPTCs than conventional PTCs (P < .001). Sonographic features of a taller-than-wide shape (5% versus 22%), a spiculated margin (7% versus 32%), marked hypoechogenicity (5% versus 38%), and microcalcification (7% versus 24%) were rarer in FVPTCs than conventional PTCs (P < .05). The incidence of a sonographically malignant grade was also lower in FVPTCs (48%) than conventional PTCs (81%; P < .001). A diagnosis of PTC on FNAB of FVPTCs was less common than that of conventional PTCs (28% versus 56%; P = .0393); however, a diagnosis of an indeterminate cytologic type such as atypical cells or follicular lesions in FVPTCs was higher than that in conventional PTCs (46% versus 19%; P = .0418). Conclusions. Follicular variant papillary thyroid carcinomas show a relatively larger size, more benign sonographic features, a lower incidence of a sonographically malignant grade, and a lower diagnostic rate of PTC on FNAB compared with conventional PTCs.

Key Words: papillary carcinoma • sonography • thyroid neoplasm

Abbreviations: FNAB, fine-needle aspiration biopsy • FVPTC, follicular variant papillary thyroid carcinoma • PTC, conventional papillary thyroid carcinoma

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Copyright © 2009 by the American Institute of Ultrasound in Medicine.