“Black Ink” Sonographic Pattern as a Predictor for Invasive Papillary Thyroid Micro Carcinoma: A Case Report

Main Article Content

Ersilio Trapanese
Basilio Angrisani
Alberto Angrisani
Ermanno D’Arco
Mariano Agrusta
Carmine De Bartolomeis
Stefano Laudati
Giulio Tarro

Abstract

Background: This study investigated the utility of the Sonographic pattern "Black Ink" with BRAF mutation testing of thyroid fine-needle aspiration cytology specimens for the risk papillary thyroid microcarcinoma (PTMC).

Case Presentation: We describe a case of a 41-year-old Caucasian woman affected by a ultrasonography “Black Ink” papillary thyroid microcarcinoma (PTMC) of the left lobe of the thyroid gland with very tiny size (Ø 0.4 cm). The characteristics, with the Diagnostic Imaging using Ultrasonography (US), Superb Micro-Vascular Imaging (SMI), fine-needle-aspiration cytology (FNAC) and mutation analysis are here discussed. There are more rare subtypes of thyroid cancer as papillary microcarcinoma "Black Ink" that even if small, are invasive and there is why the need to early diagnosis to avoid their aggressive behavior is needed. Nowadays, focusing on the size, the cut-off for non-occult tiny tumors has dropped to 0.3 cm. This value is of great relevance.

Conclusion: Ultrasonography, FNAC and BRAF molecular study have proven to be the most sensitive diagnostic combination for the early detection of thyroid cancer. Despite the size of this micro-lesion, the Black Ink ultrasonographic pattern associated with malignant cytology at FNAC represents an important biological risk factor and could still be a predictor of the PTMC and risk for neck lymph node metastases.

Keywords:
Ultrasonography, superb micro-vascular imaging, papillary thyroid micro carcinoma, black ink sonographic pattern, BRAFV600E

Article Details

How to Cite
Trapanese, E., Angrisani, B., Angrisani, A., D’Arco, E., Agrusta, M., Bartolomeis, C. D., Laudati, S., & Tarro, G. (2019). “Black Ink” Sonographic Pattern as a Predictor for Invasive Papillary Thyroid Micro Carcinoma: A Case Report. Journal of Advances in Medicine and Medical Research, 30(1), 1-13. https://doi.org/10.9734/jammr/2019/v30i130162
Section
Case Report

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