Thyroid Ultrasound > Sonographic Features > Cystic/Ring-Down

Cystic Changes and Ring-Down Artifact

Thyroid cancer is not common in predominantly cystic nodules. Nodules that are nearly completely cystic are virtually never cancers in the absence of other concerning features. Nevertheless, a cystic component may be seen in 13% to 26% of thyroid cancers. When FNA is to be performed on a cystic nodule, the biopsy should be targeted to the solid components. A "honeycomb’’ appearance of multiple cystic spaces bordered by numerous thin septations virtually always correlates with benign cytology on FNA. Punctate echogenic foci associated with comet-tail artifact (see below) representing inspissated colloid seems to be present only in benign cystic nodules.


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