Case 2

Female
60
-

Exam Date: 15/11/2023

Margin: lobulated
Echogenic foci: none
TIRADS :4 moderately suspicious

Nodule #4
Location: upper pole of left lobe
Composition: solid
Size: 0.65×0.47×0.93 cm
Echogenicity: hypoechoic
Shape: wider-than-tall
Margin: well-defined
Echogenic foci: none
TIRADS 4: moderately suspicious

– Multiple colloid cysts and simple cysts scattered at bilateral thyroid lobes, largest at lower pole of left lobe- measures up to 1.42cm.
– Lymph node: No significant cervical lymphadenopathy.
– Normal appearance of bilateral submandibular glands.

IMPRESSION:

-Few TIRADS4 nodules at lower pole of right lobe (0.29×0.19 cm), isthmus (0.41×0.40) and upper
pole of left lobe (0.65×0.47×0.93 cm).
– Multiple colloid cysts and simple cysts scattered at bilateral thyroid lobes, largest at lower pole of left lobe- measures up to 1.42cm.

ACR TI-RADS 2017 management recommendations

– TI-RADS 1: Benign – No FNA
– TI-RADS 2: Not suspicious – No FNA
– TI-RADS 3: Mildly suspicious – FNA fi >= 2.5 cm, Follow fi >= 1.5 cm
– TI-RADS 4: Moderately suspicious – FNA fi >= 1.5 cm, Follow fi >= 1 cm
– TI-RADS 5: Highly suspicious – FNA fi >= 1 cm, Follow if >= 0.5 cm