title: [Usefulness of thyroid and neck lymph node screening with carotid artery ultrasonography].
abstract: Ultrasonography of the carotid artery is routinely used to diagnose carotid artery stenosis and to screen the severity of atherosclerosis. During the performance of the ultrasonography, thyroid lesions or neck lymph node swelling are often observed. In this study, a total of 30,351 persons underwent carotid artery ultrasonography for thyroid and neck lesions as well as the carotid artery from 2008 to 2012. Criteria for further examination were either nodules with high echoic lesions indicating calcification, nodules 2cm or greater in diameter, malignant findings such as irregular shape, ill-defined border character, low and heterogeneous internal echoes, or diffuse swelling in the thyroid. Furthermore, neck lymph node swelling was also included in the criteria. Further examination was required in 650 (2.2%) of all 30,351 persons. In our hospital, 394 (60.6%) patients of the 650 were able to be examined with detailed ultrasonography and/or fine needle aspiration biopsy for thyroid and neck lesions. Finally, 73 patients (0.24%) were diagnosed as having malignant tumors consisting of 67 thyroid papillary carcinoma, two malignant lymphoma, one laryngeal carcinoma, one oropharyngeal carcinoma, one hypophryngeal carcinoma and one parathyroid carcinoma. Findings of the carotid artery ultrasonography for further examination were nodules with high echoic lesion in 370 (56.8%), nodules of 2cm or greater in diameter in 197 (30.2%), malignant findings in 120 (18.4%), diffuse swelling in 38 (5.8%) in the thyroid, and neck lymph node swelling in 38 (5.8%) of the 650 patients. The frequency of the malignant findings and neck lymph node swelling in the carotid artery ultrasonographic findings in thyroid carcinoma patients was significantly higher compared to those in patients with benign thyroid lesion. The tumors in 56 thyroid carcinoma patients which were detected with the carotid artery ultrasonography showed a significantly smaller and earlier stage in pT and pN compared to those in 21 thyroid carcinoma patients who consulted with subjective symptoms. These findings suggested that screening for thyroid and neck lesions in the performance of carotid artery ultrasonography is useful and needs to be widely adopted to reveal head and neck malignant tumors and early stage thyroid carcinomas.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Bandoh
authors.forename: Takashi
authors.initials: T
authors.lastname: Goto
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Harabuchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000473:pathology*; D013961:Thyroid Gland / Q000000981:diagnostic imaging*; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging*; D014463:Ultrasonography