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Incidental diagnosis of a thyroid nodule is very common on adult neck ultrasound (US) examination. In such cases, extensive knowledge of thyroid nodule semiology on high frequency Doppler ultrasound and of thyroid imaging reporting and data system (TIRADS) nodule classification is mandatory.1 Thyroid nodules presenting with US findings suspicious for malignancy (ie, strong hypoechogenicity, irregular margins, microcalcifications, greater height than width, and a high stiffness ratio on elastography) should undergo fine needle aspiration cytology (FNAC) and further cytological analysis according to the Bethesda 2010 classification, irrespective of thyroid nodule size. Doppler US assessment may also help identify supplementary suspicious features including anarchic central vasculature and a high resistance index (RI >0.75).
Medullary thyroid carcinomas (MTC) represent 5% of thyroid malignancies and …