PAPILLON COURSE on THYROID ULTRASOUND

Section 2 The nodular goiter

Part 5 Borders of the nodule
Lectures

 

Table 3. Ill-defined borders

doi: 10.24390/thyrosite.ctu.2.5.lect.03.1

We give here some examples which might clarify the issue. However, to judge the degree of the blurred part of the borders always requires the analysis of the video.

Benign nodular goiter (cytology) - case 2104

Transverse scan

Longitudinal scan

The ventral part of the nodule is ill-defined on longitudinal scan. However, even in these images the degree of blur is below 50%. Moreover, the undefined margins are mainly caused by the identical echogenicity of the ventral part of the lobe (yellow arrow) and the neighboring strap muscle (red arrow). The small irregularities marked with green do not reach the extent of pathological degree.

   
Papillary carcinoma (histology) - case conp003
Transverse scan
Longitudinal scan

Three types of indistinct borders are presented in these images. Green arrows point to that part of the nodule which echogenicity is identical to the extrathyroidal strap muscle. The tumor has partly blurred (red arrows) and partly spiculated (yellow arrows) margins. The extent of blurred part of the border exceeds 50%.

   

Papillary carcinoma (histology) - case 2082

Transverse scan
Longitudinal scan

In this case almost the entire border of the nodule is ill-defined, moreover the lesion has lobulated (yellow arrows) and spiculated (red arrows) margins, as well.

   
Papillary carcinoma (histology) - case conp009
Transverse scan
Longitudinal scan

In this case more than 50% of the nodule' borders are ill-defined.

 
   

Benign lesion (cytology) - case 2069

Transverse scan
Longitudinal scan

The nodule has ill-defined borders in less than the third and more than the three-fourth of the circumference of the nodule, transverse scan and longitudinal view, respectively. (See the border between the red arrows.) The nodule also presents lobulation, the small irregularities marked with while arrow are not necessarily pathological, while those marked with yellow are abnormal findings.

   
Papillary carcinoma (histology) - case conp010
Transverse scan
Longitudinal scan

The borders of the nodule are both blurred and spiculated-lobulated.

 
   
Papillary carcinoma (histology) - case conp051
Transverse scan
Longitudinal scan

This is a typical example of ill-defined borders.

   
Benign lesion (cytology) - case 2142
Transverse scans
Longitudinal scans

There are two lesions in the right lobe, a ventral deeply hypoechogenic nodule and a dorsal minimally/moderately hypoechogenic area. Both have blurred borders, the ventral one has spiculated margins, as well.

   
Papillary carcinoma (histology) - case conp020
Transverse scan
Longitudinal scan
The dorsal and medial borders of the nodule are partly ill-defined, partly lobulated.
 
   
Papillary carcinoma (histology) - case conp032
Transverse scan
Longitudinal scan

The dorsal part of the nodule is ill-defined.

 
 

Papillary carcinoma (middle) and benign hyperplastic nodule (lower) (histology) - case conp034

Transverse scan
Longitudinal scan

The middle, malignant nodule has partly blurred (yellow arrows), partly lobulated margins (white arrows) while the lower, benign nodule presents blurred borders (yellow arrows) and spiculated margins (red arrows), as well. The small irregularities marked with green arrow cannot be judged as pathognomonic for lobulated margins.

   
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