Table 1 Patient characteristics and disease etiology
Characteristic | Patient | |||||||
|---|---|---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | 5 | 6 | 7 | ||
Gender | F | F | F | F | M | F | F | |
Age, years | 56 | 34 | 57 | 54 | 52 | 50 | 49 | |
Reason | Thyroid nodule follow-up. | Bone pain (mainly right upper limb) for half a year. | Thyroid nodule follow-up. | Thyroid nodule follow-up. | Thyroid and parathyroid nodule during annual examination | Thyroid nodule follow-up. | Thyroid nodule follow-up. | |
History | No history of radiation exposure | ·Lobectomy history (Left lobe-thyroid adenoma).·Brown tumor.·No history of radiation exposure | No history of radiation exposure | No history of radiation exposure | No history of radiation exposure | No history of radiation exposure | No history of radiation exposure | |
Preoperative biochemistry | ||||||||
Calcium, mg/dL | 2.65 | 3.63 | 2.66 | 3.01 | 2.75 | 2.51 | 2.98 | |
Phosphate, mg/dL | 1.15 | 0.98 | 1.34 | 0.87 | – | 0.95 | 0.75 | |
Parathyroid hormone, pg/mL | 189.9 | 769.2 | 57.99 | 164.3 | 114.9 | 86.87 | 425 | |
Ultrasound features | ||||||||
Number | 1 | 2 | 1 | 1 | 1 | 1 | 1 | |
Echo | Hypoechoic/Homogeneous/Calcification | Hypoechoic/Homogeneous | Hypoechoic/Heterogeneous | Hypoechoic/Heterogeneous | Hypoechoic/Heterogeneous | Hypoechoic/Homogeneous | Hypoechoic/Homogeneous | Hypoechoic/Homogeneous/Calcification |
Size | 10 mm × 6 mm | 12 mm× 8 mm | 22 mm × 15 mm × 32 mm | 21 mm × 10 mm× 5 mm | 16 mm× 9 mm | 23 mm × 9 mm | 12 mm × 7 mm | 7.5 mm × 7.2 mm |
Location | Posterior to the right thyroid lobe, lower pole | Inferior pole of the right thyroid lobe, adjacent to the trachea | Zone of left thyroid lobe | Near the upper pole, posterior to the right thyroid lobe | Inferior pole of the left thyroid lobe | Posterior to the middle right thyroid lobe, adjacent to the trachea | Near the superior pole of the right thyroid lobe | Inferior pole of the left thyroid lobe |
Form | regular | regular | irregular | regular | regular | regular | regular | irregular |
Border | clear | unclear | unclear | clear | clear | clear | clear | clear |
Blood | II | III | III | III | III | III | III | III |
Elastography | 1 | 2 | 2 | – | – | – | – | 3 |
Other | Hypoechoic thyroid nodule measuring 8.6 mm × 9.1 mm to the upper pole of left lobe with irregular form, unclear border, calcification, a little blood. Elastography grade: 4. | Several hypoechoic thyroid nodules and cysts in the right lobe. | Hypoechoic thyroid nodule measuring 5.9 mm× 6.8 mm in the middle of right lobe next to the anterior membrane, taller-than-wide, irregular form, unclear border. No blood detected. | Hypoechoic thyroid nodule measuring 14 mm× 6 mm in the left lobe with irregular form, unclear border, micro-calcification, a little blood. | Several small (Diameter 3 mm to 10 mm) hypoechoic thyroid nodules highly suspicious malignant according to the ATA 2015 guideline. | Hypoechoic thyroid nodule measuring 11 mm × 7 mm near the inferior pole of the left thyroid lobe with irregular form, unclear border, micro-calcification, a little blood. Elastography grade: 4. Other two nodules of very low suspicious. | Several hypoechoic and mixed echo thyroid nodules in both lobes. The biggest one in the right lobe was in size of 23 mm× 16 mm with irregular form, unclear border, arc-like calcification, a little blood. | |
99mTc-MIBI or CT features | – | Cervical CT: Right lobe nodules, left side lesion suspicious series from parathyroid | – | 99mTc-MIBI: Highly suspicious of left side parathyroid adenoma. | – | 99mTc-MIBI: Suspicious of left side PHPT.Cervical CT: Nodule in the left lobe of malignant suspicious. Nodule inferior to the right lobe can not excepted the possibility of parathyroid original. | Cervical CT: Multiple nodules in both thyroid lobes. | |