Ultrasonographic features of cervical lymph node metastases from medullary thyroid cancer: a retrospective study

Xiaofeng Ni, Shangyan Xu, Weiwei Zhan, Wei Zhou, Xiaofeng Ni, Shangyan Xu, Weiwei Zhan, Wei Zhou

Abstract

Background: To investigate sonographic features of cervical lymph node metastases from medullary thyroid cancer (LNM-MTC), as compared with lymph node metastases from papillary thyroid cancer (LNM-PTC).

Methods: A total of 42 MTC patients with 52 metastatic LNs and 222 PTC patients with 234 metastatic LNs who were confirmed by fine needle aspiration and post-operative pathology, were enrolled in this study. The clinical characteristics and sonographic features of LNs were compared between the two groups. Univariate analysis and multivariate logistic regression analysis were performed on the sonographic features of LNs, including short and long-axis diameter, long-axis diameter/short-axis, shape, border, hilum, echogenicity, calcifications, cystic change and vascularity pattern. The discriminating performance was assessed with the area under the receiver operating characteristic curve (AUC).

Results: The mean age of patients with LNM-MTC was older than that of patients with LNM-PTC (46.81 ± 13.05 vs 39.09 ± 12.05, P < 0.001). No differences were observed in gender, location, long-axis diameter/short-axis, shape, border, echogenicity, cystic change and vascularity pattern between LNM-MTC and LNM-PTC groups (P > 0.05, for all). However, long-axis and short-axis diameter, hilum and calcifications were statistically different between these two groups (P < 0.05, for all). The AUC of discriminate value between LNM-MTC and LNM-PTC was 0.808 (95% confidence interval 0.739-0.877).

Conclusion: Compared with LNM-PTC, LNM-MTC tended to have the sonographic characteristics of larger size, absence of hilum, and less calcifications, and awareness of these features might be helpful to in the diagnosis of LNM-MTC.

Keywords: Lymph node; Medullary thyroid cancer; Metastases; Papillary thyroid cancer; Ultrasound.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Ultrasonographic images of LNs. (A, B) A metastatic LN in a 53-year-old man with MTC. (C, D) A metastatic LN in a 29-year-old man with PTC. (A) The LN was located at left level IV, and the grey ultrasonographic images showed a LN measured 35.1 × 15.6 mm, with hyperechogenicity, L/S > 2 and absence of hilum. (B) Color Doppler showed that the LN had a mixed vascularity pattern (white arrow). (C) The LN was located at right level III. The grey ultrasonographic images showed a LN measured 15.7 × 9.0 mm, and it demonstrated absence of hilum, L/S ≤ 2, hyperechogenicity and microcalcifications (white arrow). (D) Color Doppler showed that the LN had a mix vascularity pattern (white arrow)
Fig. 2
Fig. 2
Receiver operating characteristic curve analysis of logistic regression model for predicting LNM-MTC and LNM-PTC. AUC was 0.808, and the 95% CI was 0.739–0.877

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