Summary and comments
55 colleagues sent a response.Does the RIGHT lobe have pathological nodule?
Distribution of answers
| Choice | Percentage | No |
| Yes. | 50.9% |
28 |
| Probably yes. | 16.43% |
9 |
| No. | 5.5% |
3 |
| Probably no. | 27.3% |
15 |
Expert commentary
This lesion is very likely a true nodule on ultrasound appearance. The circumstances favoring this view are the size, the unifocality and the echogenicity of the lesion. Regarding the latter, the dorsal part of the lobe is usually a bit darker while this lesion is a bit lighter compared with the non-lesional parenchyma.
Histopathology disclosed hyperplastic nodule.
If you would consider the largest lesion in the RIGHT lobe as nodule, how would you classify this lesion according to EU-TIRADS?
Distribution of answers
| Choice | Percentage | No |
| EU-TIRADS 3 | 81.82 % |
45 |
| EU-TIRADS 4 | 7.27 % |
4 |
| EU-TIRADS 5 | 10.91 % |
6 |
Expert commentary
This is an iso/hyperechoic lesion without any suspicious signs. It means that the lesion should be regarded as EU-TIRADS 3.
Does the LEFT lobe have pathological nodule?
Distribution of answers
| Choice | Percentage | No |
| The RIGHT lobe has, the left lobe has not. | 5.45 % |
3 |
| The LEFT lobe has, right lobe has not. | 21.82 % |
12 |
| Both lobes have nodules. | 67.27 % |
37 |
| The thyroid does not have nodules. | 5.45 % |
3 |
Expert commentary
This is a much more difficult question. In contrast with the lesion in the right lobe, this one is not a single one, not large. We cannot exclude the possibility that this would be a true nodule. I raise the attention for the careful wording, this lesion should not be described as an obvious nodule.
Indeed, histopathology disclosed only Hashimoto's thyroiditis in this lobe and no nodule was described here.
If you would consider the largest lesion in the LEFT lobe (pointed with yellow arrow) as nodule, how would you classify this lesion according to EU-TIRADS?
Distribution of answers
| Choice | Percentage | No |
| EU-TIRADS 3 | 5.45 % |
3 |
| EU-TIRADS 4 | 50.91 % |
28 |
| EU-TIRADS 5 | 43.64 % |
24 |
Expert commentary
This is a moderately hypoechoic lesion which shows taller-than-wide shape. Therefore, we can describe this lesion as EU-TIRADS 5. However, note that the lesion is sandwtched between the trachea and the carotid artery, so it cannot grow sideway, only in the ventro-dorsal and upper-lower directions. Therefore, I would not consider as a pathological form of nonparallel orientation, so, I would consider the lesion as EU-TIRADS 4.
How to judge the lymph node above the right lobe?
Distribution of answers
| Choice | Percentage | No |
| This is probably a benign, reactive-type node. | 90.91 % |
50 |
| This is probably a metastatic lymph node. | 9.09 % |
5 |
Expert commentary
I agree with most of the colleagues, this node does not present any suspicious signs.
