Computed tomography of the thyroid ,88 and and9).9). CT scans are also the most sensitive diagnostic tool for the detection of pulmonary micro-metastases. Many of the neck US features that are considered as suggestive signs of disease recurrence are also applicable to CT examination. These signs might include sizable rounded nodules in the thyroid bed, fine calcifications, or cystic change. In cases of elevated thyroglobulin with negative neck US and iodine whole body scintigraphy (WBS), fluorodeoxyglucose (FDG) positron emission tomography (PET) is the next modality of choice. Dedifferentiated thyroid carcinoma usually has avid FDG-PET uptake and a negative radioiodine scan, typically does not respond to
Computed tomography of the thyroid with controversial management guidelines. Wilhelm et al. followed 41 patients with a known extra-thyroid malignancy and ITNs; 35 of them met the criterion for biopsy (nodule ≥ 1 cm). Pathology revealed four papillary thyroid cancers and five micropapillary thyroid cancers. Only two metastatic cancers were detected. Clinical history (history of radiation, age, endocrine syndromes), TSH, nodule size, and sonographic features are important to determine which nodule(s) should be followed or biopsied. However, existing guidelines do not specifically address how to approach ITNs detected on CT scans in such a specific patient population. Thyroid lymphoma represents about 5 % of thyroid