Ultrasound Features of Suture Granulomas in the Thyroid Bed After Thyroidectomy for Papillary Thyroid Carcinoma with an Emphasis on Their Differentiation from Locally Recurrent Thyroid Carcinomas

Kim, Jeoung Hyun; Lee, Jeong Hyun; Shong, Young Kee; Hong, Suck Joon; Ko, Myung-Su; Lee, Deok Hee; Choi, Choong Gon; Kim, Sang Joon

doi:10.1016/j.ultrasmedbio.2009.04.009

« Previous Next »Ultrasound in Medicine and Biology
Volume 35, Issue 9 , Pages 1452-1457, September 2009

Ultrasound Features of Suture Granulomas in the Thyroid Bed After Thyroidectomy for Papillary Thyroid Carcinoma with an Emphasis on Their Differentiation from Locally Recurrent Thyroid Carcinomas

Jeoung Hyun Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
Jeong Hyun Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
- Address correspondence to: Jeong Hyun Lee, Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Poongnap-2dong, Songpa-gu, 138-736 Seoul, Korea.
Young Kee Shong
- Department of Endocrinology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
Suck Joon Hong
- Department of Breast and Endocrine Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
Myung-Su Ko
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
Deok Hee Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
Choong Gon Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
Sang Joon Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea

Received 28 November 2008; received in revised form 10 March 2009; accepted 14 April 2009. published online 21 July 2009.

Abstract

The purpose of our study was to evaluate the ultrasound features of suture granulomas at the thyroid bed after thyroidectomy for papillary thyroid carcinoma with an emphasis on their differentiation from locally recurrent thyroid carcinomas. We enrolled 14 suture granulomas in 10 patients and 20 locally recurrent carcinomas in 18 patients after thyroidectomy, confirmed by surgery (15 out of 20 recurrent carcinomas), or ultrasound-guided fine needle aspiration cytology (14 suture granulomas and 5 recurrent carcinomas). The ultrasound findings, including presence of internal echogenic foci suggesting calcification or suture material, were compared between the two groups. In the cases with internal echogenic foci, the size, number, distribution pattern, and the presence of a paired appearance were also evaluated. In result, most of the suture granulomas were irregular (n=13) and heterogeneous (n=9) (p<0.05). The incidence of internal echogenic foci was higher in suture granulomas (n=12) than in recurrent carcinomas (n=7) (p<0.05). The internal echogenic foci in all suture granulomas were clustered centrally or paracentrally, unlike those in recurrent carcinomas (p<0.05). Most of the echogenic foci in suture granulomas were larger than 1 mm in diameter (p<0.05) and had a paired appearance (p<0.05). Shape, heterogeneity, and the presence of central or paracentral internal echogenic foci are helpful criteria for differentiating suture granulomas from locally recurrent tumors in the thyroid bed. (E-mail: jeonghlee@hanmir.com)