TIRADS - Table 4 (large) EU-TIRADS 4 category

 

Minimally hypoechoic nodules without any suspicious signs are included in this subgroup. The issue here again relates to hypoechoic thyroid. In such cases, the 'normal reference' tissue is not evident on which we can differentiate between hypoechoic and non-hypoechoic nodules. The other problem is the lack of clear definition on heterogeneous nodules..

Benign lesion (cytology) - case 723

Transverse scan
Longitudinal scan

The nodule is brighter than the strap muscle while darker than the extranodular tissue and does not show any suspicious sign. This is an EU-TIRADS 4 lesion.

Papillary carcinoma (histology) - case 2111

Transverse scan
Longitudinal scan

The nodule is a dominantly iso/hyperechoic lesion with a minimally hypoechoic minority part. According to the rules of the EU-TIRADS, this should be regarded as a TIRADS 4 nodule.

Papillary carcinoma (histology) - case 2018

Transverse scan
Longitudinal scan

The lesion should be regarded as a TIRADS 4 nodule because the echogenicity was minimally/moderately hypoechoic and the nodule did not show any suspicious findings. The undulation at the lower-medial part of the lobe simply follows the arch of the trachea, therefore this is not a pathological form of irregular borders.

Benign lesion (cytology) - case 2127
Transverse scan
Longitudinal scan

The nodule is a dominantly iso/hyperechoic lesion with a minimally hypoechoic minority part. According to the rules of the EU-TIRADS, this should be regarded as a TIRADS 4 nodule.

Benign cystic-colloid goiter (cytology) - case 2123

Transverse scan
Longitudinal scan

This is again a dominantly iso/hyperechoic lesion with a minimally hypoechoic minority part. According to the rules of the EU-TIRADS, this should be regarded as a TIRADS 4 nodule. The intranodular echogenic figures are related to ventral cystic areas, therefore, these should be regarded as microcalcifications. These are back wall figures caused by posterior enhancement