title: Ultrasonographic Characteristics of the Follicular Variant Papillary Thyroid Cancer According to the Tumor Size.
abstract: Follicular variant papillary thyroid cancer (FVPTC) is the second most common subtype after conventional PTC. We compared ultrasonographic (US) features of FVPTC to those of conventional PTC according to tumor size. We reviewed US findings, pathologic reports, and medical charts of 249 PTC patients with surgically proven disease (83 FVPTCs, 166 conventional PTCs) at our institution from January 2007 to December 2012. FVPTCs were divided into PTC-like and follicular neoplasm (FN)-like based on sonographic characteristics. PTC-like features were defined as having at least one malignant feature (taller-than-wide shape, infiltrative margin, marked hypoechogenicity, and micro-calcifications), whereas FN-like cancers showed oval solid features without malignant features. FVPTCs showed a higher rate of FN-like features than conventional PTCs. Of 166 conventional PTCs, 13 (7.8%) had FN-like features and 153 (92.2%) had PTC-like features, whereas of the 83 FVPTCs, 31 (37.3%) had FN-like features and 52 (62.7%) had PTC-like features. Macro-FVPTCs showed a higher rate of FN-like features than micro-FVPTCs (P < 0.001). Of 21 macro-FVPTCs, 18 (85.7%) had FN-like features and 3 (14.3%) had PTC-like features, whereas of the 62 micro-FVPTCs, 13 (21%) had FN-like features and 49 (79%) had PTC-like features. There were no differences in multifocality, extrathyroidal invasion, and lymph node metastasis between PTC-like FVPTCs and FN-like FVPTCs. FVPTCs showed fewer sonographic malignant features than conventional PTCs. In particular, FVPTCs larger than 1 cm had a more frequent benign sonographic appearance. Therefore, if fine-needle aspiration result is suspicious for PTC in a nodule larger than 1 cm with no suspicious US features, the possibility of FVPTC might be considered.
authors.affiliation: Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea .
authors.forename: Eon Ju
authors.identifier: 0000-0002-8858-5343
authors.initials: EJ
authors.lastname: Jeon
authors.affiliation: Department of Surgery, Catholic University of Daegu School of Medicine, Daegu, Korea .
authors.forename: Young Ju
authors.identifier: 0000-0002-7005-0850
authors.initials: YJ
authors.lastname: Jeong
authors.affiliation: Department of Surgery, Catholic University of Daegu School of Medicine, Daegu, Korea .
authors.forename: Sung Hwan
authors.identifier: 0000-0002-7225-1250
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Pathology, Catholic University of Daegu School of Medicine, Daegu, Korea .
authors.forename: Chang Ho
authors.identifier: 0000-0003-2708-6011
authors.initials: CH
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea .
authors.forename: Ho Sang
authors.identifier: 0000-0002-7443-9206
authors.initials: HS
authors.lastname: Shon
authors.affiliation: Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea .
authors.forename: Eui Dal
authors.identifier: 0000-0003-2905-5382
authors.initials: ED
authors.lastname: Jung
mesh_terms: D000328:Adult; D018265:Carcinoma, Papillary, Follicular / Q000000981:diagnostic imaging* / Q000473:pathology; D003710:Demography; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography
keywords: Follicular Variant; Papillary; Thyroid Neoplasms