Cervical lymph node metastases from medullary thyroid cancer (LNM-MTC) seemed to have sonographic features of fewer calcifications, lack of hilum, and larger size in comparison to the lymph node metastases from papillary thyroid cancer (LNM-PTC), a study suggests.

The results showed similarities in long-axis diameter, short-axis diameters, gender, shape, cystic change, echogenicity, border, vascularity, and location between LNM-PTC and LNM-MTC cohorts (P >0.05, for all), reported Xiaofeng Ni, of the Shanghai Jiao Tong University School of Medicine in China, and colleagues.

Notably, calcifications, hilum, and short-axis and long-axis diameters varied statistically between the cohorts (P <0.05, for all), they found.

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These data were published in the journal BMC Medical Imaging.

Read more about MTC differential diagnosis.

“When the primary tumor was MTC, LNs with these features should be suspected of metastatic lymph nodes,” the authors noted.

The research team assessed 222 PTC patients with 234 LNM-PTC and 42 MTC patients with 52 LNM-MTC. Both fine-needle aspiration and postoperative pathology were used to verify all the tumors.

Other sonographic characteristics of LNs, like long-axis and short-axis diameter, border, shape, hilum, calcifications, vascularity pattern, and cystic change, were assessed using multivariable logistic regression analysis and univariate analysis. The researchers looked at the area under the receiver operating characteristic curve to evaluate discriminating performance.

Notably, no significant differences in gender or location were found between the 2 groups. Patients with LNM-PTC were younger than patients with LNM-MTC (39.09 vs 46.81 years, P <0.001).

Other findings showed that the discriminate value of the area under the receiver operating characteristic curve between LNM-PTC and LNM-MTC was 0.808 (95% CI, 0.739–0.877). Given the relatively small sample size for the LNM-MTC cohort, more research involving a larger sample size is needed.


Ni X, Xu S, Zhan W, Zhou W. Ultrasonographic features of cervical lymph node metastases from medullary thyroid cancer: a retrospective study. BMC Med Imaging. 2022;22(1):151. doi:10.1186/s12880-022-00882-7