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Thyroid Nodule Ultrasonography: Margins and Shape

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Handbook of Thyroid and Neck Ultrasonography

Part of the book series: Contemporary Endocrinology ((COE))

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Abstract

The sonographic appearance of a thyroid nodule can help distinguish a benign from suspicious nodule. Smooth margins are often found in benign thyroid lesions. Infiltrative, irregular, and lobulated margins have been associated with malignancy and further evaluation with ultrasound-directed needle biopsy should be considered. Extrathyroidal extension of a nodule on ultrasound is also highly suggestive of malignancy as well as invasion of the nodule beyond the thyroid capsule. The shape of a thyroid nodule is determined by the ratio of the nodule’s antero-posterior diameter and transverse diameter, as measured in the transverse plane. A “taller than wide” nodule, in which the antero-posterior to transverse ratio is greater than 1, has also been found to be associated with malignancy. In this chapter, we review the sonographic features for the various types of thyroid nodule margins and shape and provide clinical examples of each.

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Change history

  • 14 June 2023

    Owing to an unfortunate oversight, the book was inadvertently published with errors in few author names and affiliations.

Further Reading

  • Chan BK, Desser TS, McDougall IR, Weigel RJ, Jeffrey RB Jr. Common and uncommon sonographic features of papillary thyroid carcinoma. Ultrasound Med. 2003;22(10):1083–90.

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  • Kim E-K, Park CS, Chung WY, Oh KK, Kim DI, Lee JT, Yoo HS. New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid. AJR Am J Roentgenol. 2002;178(3):687–91.

    Article  PubMed  Google Scholar 

  • Koike E, Noguchi S, Yamashita H, Murakami T, Ohshima A, Kawamoto H, Yamashita H. Ultrasonographic characteristics of thyroid nodules: prediction of malignancy. Arch Surg. 2001;136(3):334–7.

    Article  CAS  PubMed  Google Scholar 

  • Leenhardt L, Menegaux F, Franc B, Delbot T, Mansour G, Hoang C, Guillausseau C, Aurengo H, Le Guillouzic D, Turpin G, Aurengo A, Chigot JP, Hejblum G. Selection of patients with solitary thyroid nodules for operation. Eur J Surg. 2002;168(4):236–41.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA

    Michael D. Otremba

  2. Harvard Vanguard Medical Associates, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA

    Chia A. Haddad

  3. Massachusetts Eye and Ear Infirmary, Boston, MA, USA

    Gregory W. Randolph

  4. Massachusetts General Hospital, Boston, MA, USA

    Gregory W. Randolph

Authors
  1. Michael D. Otremba
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  2. Chia A. Haddad
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  3. Gregory W. Randolph
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Corresponding author

Correspondence to Michael D. Otremba .

Editor information

Editors and Affiliations

  1. Department of Endocrinology, Harvard Vanguard Medical Associates/Atrius Health and Harvard Medical School, Boston, MA, USA

    Leslie S. Eldeiry

  2. Departments of Pathology and Laboratory Medicine and Ophthalmology, Tufts Medicine, Tufts Medical Center, Boston, MA, USA

    Nora M. V. Laver

  3. Massachusetts Eye and Ear Infirmary, Boston, MA, USA

    Gregory W. Randolph

  4. Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Barry Sacks

  5. Department of Endocrinology, Harvard Vanguard Medical Associates/Atrius Health and Harvard Medical School, Boston, MA, USA

    Jeffrey R. Garber

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© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

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Otremba, M.D., Haddad, C.A., Randolph, G.W. (2023). Thyroid Nodule Ultrasonography: Margins and Shape. In: Eldeiry, L.S., Laver, N.M.V., Randolph, G.W., Sacks, B., Garber, J.R. (eds) Handbook of Thyroid and Neck Ultrasonography. Contemporary Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-031-18448-2_9

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  • DOI: https://doi.org/10.1007/978-3-031-18448-2_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-18447-5

  • Online ISBN: 978-3-031-18448-2

  • eBook Packages: MedicineMedicine (R0)

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