山田 薫¹, 矢田 宏², 金澤 暁太郎², 谷口 信行³, 斉藤 寿一¹, 伊東 紘一³

Kaoru YAMADA¹, Hiroshi YATA², Kyotaro KANAZAWA², Nobuyuki TANIGUCHI³, Toshikazu SAITO¹, Kouichi ITOH³

¹自治医科大学内分泌代謝科, ²自治医科大学消化器一般外科, ³自治医科大学臨床病理

¹Department of Endocrinology and Metabolism Jichi Medical School, ²Department of General Surgery Jichi Medical School, ³Department of Clinical Pathology Jichi Medical School

キーワード : Calcification, Papillary carcinoma, Psammoma body, Thyroid, Ultrasonography

We studied 81 consecutive cases of papillary carcinoma in surgically removed thyroid glands to elucidate the correlation between their ultrasonographic and pathohistologic characteristics. The tumor parenchyma in 71.6% of these cases contained hyperechoic structures, most of which were minute spots, some with and some without attenuation, that corresponded well with the psammoma bodies observed on histologic examination. The larger spots were assumed to be coarse calcification in necrotic tissue. Dense hyalinized fibrosis in tumor parenchyma also produced intense reflection that caused hyperluminous spots. These hyperechoic structures show a higher incidence of lymphnode or intraglandular metastasis. Most papillary carcinomas of the thyroid were hypoechoic. In the pure follicular variant of this type of cancer, the foci and the associated predominant follicular structures were more echoic than were purely papillary carcinomas. Thus ultrasonographic methods were not always able to diagnose papillary carcinoma of the thyroid.