Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Ultrasonographic Findings of Papillary Thyroid Cancer with or without Hashimoto's Thyroiditis

하시모토 갑상선염의 동반 여부에 따른 갑상선 유두암의 초음파 소견

  • Park, Jun-Young (Department of Radiology, Korea Cancer Center Hospital) ;
  • Lee, Tae-Hyun (Department of Radiology, Korea Cancer Center Hospital) ;
  • Park, Dong-Hee (Department of Radiology, Korea Cancer Center Hospital)
  • 박준영 (원자력병원 영상의학과) ;
  • 이태현 (원자력병원 영상의학과) ;
  • 박동희 (원자력병원 영상의학과)
  • Received : 2010.02.05
  • Accepted : 2010.06.21
  • Published : 2010.08.01
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Abstract

Purpose: This study was designed to compare the ultrasonographic features of papillary thyroid carcinoma with and without Hashimoto's thyroiditis. Materials and Methods: This retrospective study included 190 patients with papillary thyroid carcinoma which was proven by neck surgery. The difference in the ultrasonographic findings between papillary thyroid carcinoma with Hashimoto's thyroiditis and papillary thyroid carcinoma without Hashimoto's thyroiditis were calculated statistically. Results: Hashimoto's thyroiditis was diagnosed in 61 of 190 patients following neck surgery. The incidence of coexisting papillary thyroid carcinoma with Hashimoto's thyroiditis was significantly higher in women (p=0.0026). In addition, the frequency of macrocalcification in patients with Hashimoto's thyroiditis was also significantly higher (p=0.0009). Conversely,other ultrasonographic findings including the shape, margin, echogenicity and calcifications, for patients with papillary thyroid carcinoma with Hashimoto's thyroiditis and papillary thyroid carcinoma without Hashimoto's thyroiditis, were not statistically significant. We also found that patients with Hashimoto's thyroiditis who showed no calcification on ultrasonography tended not to detect the papillary carcinoma at a higher frequency. Conclusion: On ultrasonography, macrocalcifications occurred more frequently in patients with Hashimoto's thyroiditis than those without Hashimoto's thyroiditis. Malignant thyroid nodules without calcifications in patients with Hashimoto's thyroiditis more often could not be detected. Therefore, it is important carefully examine patients with Hashimoto's thyroiditis.

목적: 하시모토 갑상선염을 동반한 환자와 동반하지 않은 환자에서 발생한 갑상선 유두암의 초음파 소견을 비교하고자 한다. 대상과 방법: 갑상선 결절로 수술을 시행한 후 갑상선 유두암으로 진단받은 190명을 후향적으로 분석하였다. 하시모토 갑상선염이 동반된 유두암 환자군과 동반되지 않은 유두암 환자군의 초음파 소견을 비교하였다. 결과: 190명의 환자 중에 61명이 수술 후 하시모토 갑상선염으로 진단되었다. 하시모토 갑상선염을 동반한 유두암 환자군은 남자 3명, 여자 58명으로 여성에서 발생 빈도가 높았다(p=0.0026). 초음파 소견상 하시모토 갑상선염을 동반한 갑상선 유두암에서 거대석회화의 발생 빈도가 유의하게 높았으며(p=0.0009), 침상 경계, 현저한 저에코, 그리고 불규칙한 모양 등은 두 집단간에 유의한 차이점이 없었다. 석회화가 없는 경우 하시모토 갑상선염이 동반된 환자에서 초음파상 유두암을 발견하지 못하는 빈도가 높았다. 결론: 하시모토 갑상선염을 동반한 갑상선 유두암은 갑상선염이 없을 때보다 거대석회화가 많이 발생하며, 초음파상 석회화가 없는 경우 악성 결절을 발견하지 못하는 경우가 있기 때문에 하시모토 갑상선염이 있는 경우 세심한 검사가 필요할 것으로 생각한다.

Keywords

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