Which worrisome sonographic features favour this thyroid nodule to be malignant?
The lesion is predominantly solid hypoechoic (compared with thyroid), has a lobulated outline, has some microcalcification, intranodular vascularity is present, and is taller than wide axially (AP > TR).
22 mm left lobe thyroid nodule containing small and large foci of calcification and with numerous small cystic spaces consistent with papillary carcinoma. Immediately adjacent to the upper pole of the left lobe An adjacent to the carotid sheath, there is a single lymph node which has slightly irregular hypoechoic cortex. The significance of this is equivocal, but because of the slight variation in cortical width an FNA of part of this was performed with 25 gauge needle ( 2 passes ).