PAPILLON COURSE on THYROID ULTRASOUND

 

Case of the Month

January 2025 - case 3 (1177) - evaluation

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Summary and comments

46 colleagues sent me a reply.

1. How would you judge the discrete lesions in the RIGHT lobe?

Distribution of answers

5 There is at least one obvious pathological nodule.

3 There are more than one obvious pathological nodule.

32 There are no pathological nodules within.

6 I cannot give a clear answer to the question.

Expert comment

I agree with most colleagues: the discrete lesions within the right lobe do not correspond to pathological nodules, they are more active foci of the underlying thyroiditis.

2. How would you consider the echogenicity of the (largest) lesion in the LEFT lobe according to the 2023 ETA guideline?

Distribution of answers

9 This is iso/hyperechoic.

35 This is minimally/moderately hypoechoic.

2 This is very hypoechoic.

Expert comment

Although the nodule is a bit darker than the extranodular part, according to the 2023 EU guideline, we must compare the nodule to a healthy thyroid. As the insert at the end of the clip proved, the nodule is darker than a healthy thyroid, so this is minimally/moderately hypoechoic.

3. How do you classify the (largest) lesion in the left lobe according to the EU-TIRADS?

Distribution of answers

12 EU-TIRADS 3

31 EU-TIRADS 4

3 EU-TIRADS 5

Expert comment

A minimally/moderately hypoechoic nodule without suspicious findings should be considered as an EU-TIRADS 4 lesion. Considering the replies to the previous question, all but two colleagues have apllied the EU TIRADS rules correctly.

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