Thyroid Ultrasound > Sonographic Features > Calcification


Calcifications have been found in papillary, medullary, and anaplastic thyroid carcinomas as either psammoma bodies or as amorphous granular deposits. Of all the sonographic features associated with thyroid malignancy, microcalcifications are the most specific. Microcalcifications are defined as punctuate echogenic foci without acoustic shadowing or associated comet-tail artifact. The positive predictive value of a finding of microcalcifications in a thyroid nodule ranges from 24.3% to 70%. 

Other types of calcification may also be present, namely coarse calcifications and peripheral calcifications. Although formerly considered a benign finding, eggshell calcifications have been reported in thyroid cancers. Coarse central calcifications are a common feature of medullary carcinoma, although this entity represents only 1 of 250 thyroid nodules. At this time, it appears that any calcification type warrants biopsy.

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