Abstract
Cystic changes are a well-recognized finding in papillary carcinoma of the thyroid, being described in 10–30% of cases. Much less commonly, cystic changes predominate and the diagnosis of malignancy can be difficult. Differentiation between extremely common benign cystically degenerate hyperplastic nodules and the rare entity of cystic papillary carcinoma can be difficult. In this pictorial review we consider five cases of cystic papillary carcinoma and highlight the ultrasound features, which should alert the sonographer to the possibility of this diagnosis. The role of fine needle aspiration cytology in these difficult cases is discussed, as is the potential for recommending surgery based on the ultrasound features.
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