Purpose or Case Report: After reviewing the exhibit, participants will be able to recognize suspicious and non-suspicious ultrasound (US) features of pediatric thyroid nodules which will help to triage nodules that need a biopsy.
Methods & Materials: The exhibit will illustrate the imaging findings of benign nodules such as adenomatoid/ hyperplastic nodule, colloid nodule, chronic lymphocytic thyroiditis and follicular adenoma as well as malignant lesions such as papillary carcinoma, follicular carcinoma, medullary carcinoma, lymphoma and metastasis. The role of thyroid elastography to differentiate benign from malignant thyroid nodules will be briefly discussed.
Recently published management guidelines for children with thyroid nodules and differentiated thyroid cancer by the American Thyroid Association Guidelines Task Force will be briefly discussed.
Results: US features suggestive of a benign nodule include nodule with a uniform halo, predominantly cystic composition, and avascularity.
US features highly suspicious for malignancy include micro-calcifications, extension beyond the thyroid margin, taller-than-wide shape in the transverse plane, marked hypoechogenicity and associated enlarged cervical lymph nodes.
Less specific US features that may raise suspicion include lack of a halo, ill-defined or irregular margin, solid composition and increased central vascularity.
Conclusions: Although relatively rare in children, radiologists are likely to encounter thyroid nodules in routine clinical practice, whether incidentally or during imaging workup for a palpable nodule or abnormal thyroid function test. It is often challenging to determine which nodules are malignant. This presentation will help the radiologist identify suspicious and non-suspicious US features of pediatric thyroid nodules helping to appropriately triage nodules that need biopsy.