Ultrasound variants of autoimmune thyroiditis in children and adolescents and their clinical implication in relation to papillary thyroid carcinoma development
Ultrasound variants of autoimmune thyroiditis in children and adolescents and their clinical implication in relation to papillary thyroid carcinoma development
Ultrasound variants of autoimmune thyroiditis in children and adolescents and their clinical implication in relation to papillary thyroid carcinoma development
Background The prevalence of autoimmune thyroiditis
(AIT) and papillary thyroid carcinoma (PTC) is rising in
children and adolescents, and the coincidence of AIT and
PTC is as high as 6.3-43%.
Objective To investigate the ultrasound manifestation of
AIT in relation to PTC development in paediatric patients.
Patients 179 paediatric patients (133 females), mean (SD)
age: 13.9 (3.03) years diagnosed with AIT and referred for
ultrasound evaluation. Eight patients were diagnosed with
PTC (6 females).
Methods Retrospective analysis of thyroid ultrasound
scans of patients diagnosed with AIT. Thyroid and autoimmune
status was assessed based on TSH, fT4, fT3 and
increased aTPO and/or aTG and/or TRAB levels. In patients
with PTC, total thyroidectomy was performed.
Results Analysis of thyroid US scans revealed that the following
five ultrasound variants of AIT were observed in
179 patients: the most common in 35.2%-diffuse thyroiditis
with hypoechogenic background and normoechogenic
parenchyma, in 30.2%-diffuse thyroiditis with irregular background, in 18.9% nodular variant with normoechogenic
background, in 11.7%-micronodulations and in 3.9%-diffuse
hypoechogenic background. Eight cases of PTC were
diagnosed in nodular variant of AIT with normoechogenic
irregular background.
Conclusion Patients with AIT and nodular variant with
normoechogenic irregular background of the thyroid gland
on US scans are in the risk group of developing PTC and
should be followed up with regular neck US assessment.