Experience Sharing of Ultrasonic and Pathologic Features of Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma (47 Cases Report)

Abstract

Objective: Discussing the ultrasonic and pathologic features of Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma (DSVPTC) in order to raise awareness of this disease. Methods:To collect ultrasonic and pathologic features of 47 cases of DSVPTC which confirmed pathologically referred to Department of Thyroid Surgery, the First Hospital of Jilin University from 2008 to 2015. Results: Diffuse hyper-echoic, coarse, heterogeneous echogenicity were visualized on ultrasonography in 43 patients. Scattered microcalcifications were found in the thyroid tissue without definite local lesions. Normal thyroid tissue was not seen on ultrasonography. 4 patient only has unilateral and the isthmus changes above. On color doppler sonography, abundant blood supply was visualized in the thyroids in all patients. Patients had bilateral cervical lymph node metastases with microcalcification, and 4 patient had ipsilateral cervical lymph node metastases. patients (including 1 patient with liver and lung metastasis) underwent bilateral total thyroidectomy and bilateral neck lymph node dissection, while 4 patient underwent bilateral total thyroidectomy and unilateral neck lymph node dissection. All were treated postoperatively by radioiodine and endocrine suppression. Conclusions: The ultrasonic features of diffuse thyroid carcinoma are characteristic. Ultrasonography plays an important role in the diagnosis of diffuse thyroid carcinoma. To prolong patients's survival time, diffuse thyroid carcinoma should be treated surgically as soon as possible, assisting I131 and endocrine suppression therapy after surgery.