Hashimoto’s Thyroiditis 101: Thyroid Ultrasound Appearance

Hashimoto’s Thyroiditis 101: Thyroid Ultrasound Appearance

Hashimoto’s Thyroiditis 101:  Thyroid Ultrasound Appearance

Hashimoto’s Thyroiditis 101: Thyroid Ultrasound Appearance

  1. US features Hashimoto’s thyroiditis.
  2. p137
  3. The US appearance is highly variable and
    correlates with the progression of histopathologic changes along the course of the disease.
  4. The lymphoid and oncocytic cell appear homogeneous on US.
  5. hashimoto1
  6. Fibrosis­ elements as hyperechoic septa.
  7. indianjendocrmetab_2013_17_2_219_109667_f11
  8.  Early in the course of the disease, the gland appears dif­fusely enlarged and profound hypoechoic. which corre­lates with lymphocytic infiltration and colloid depletion without fibrosis.
  9. Subclinical thyroid dysfunction is com­mon at this stage.
  10.  As the disease progresses, there is mild hyperechogenicity, heterogeneity, and pseudo-micronodularity (“moth-eaten·· or cotton weave) that is the result of destruction of thyroid tissue.
  11. Poorly outlined hypoechoic pseudonodules may be vari­ably present, often transient. and may represent coalescent aggregates of lymphoid cell-rich tissue. which may be sur­rounded by echogenic septa.
  12. A Swiss-cheese” appearance on US. the result of small cystic lesions may be seen in the course of the disease.
  13. thyroid-ultrasound-13-638
  14. Hyperechogenic pseudonodules seen in·regener­ative” nodules or as a result of aggregated fibrous tissue (“white knight “).
  15. “Detached” tissue nodules may be seen in chronic stages.
  16. Blood flow is variable: it range from absent to normal to increased on Doppler examination.
  17. The gland is small, atrophic, hypoechoic, and heteroge­neous in end-stage disease.
  18. True distinct hypoechogenic thyroid nodules with or with­out calcifications may be seen and need USG-FNA sam­pling to rule out PTC or lymphoma.
  19. Cytologic material for confirmatory flow-cytometry studies can be easily obtained by this means.
  20. A “speckled” pattern is occasionally seen and probably needs a USG-FNA, because the numerous “colloid bodies” may be difficult to distinguish from the numerous psam­moma bodies present in the sclerosing variant of PTC.
  21. Prominent lymph nodes in the central and lateral neck are almost always present.
Add Your Comment

Contact Info
1328 16th Street, Santa Monica, CA 90404
Monday – Friday
9:00 AM to 5:00 PM
(310) 393-8860