1.Ultrasound Findings Suggestive of Malignancy in Thyroid Nodules Classified as Follicular Lesion of Undetermined Significance or Follicular Neoplasm based on the 2017 Bethesda System for Reporting Thyroid Cytopathology
Heui Jin JUNG ; Na Lae EUN ; Eun Ju SON ; Jeong-Ah KIM ; Ji Hyun YOUK ; Hye Sun LEE ; Soyoung JEON
Journal of the Korean Society of Radiology 2025;86(1):114-126
Purpose:
To identify US findings suggestive of malignancy in thyroid nodules with follicular lesions of undetermined significance (FLUS) or follicular neoplasm (FN) on fine-needle aspiration cytology (FNAC) and evaluate the diagnostic performance.
Materials and Methods:
Seventy FLUS (n = 57) or FN (n = 13) nodules on FNAC that underwent surgical excision between February 2018 and November 2020 were selected. US findings were retrospectively reviewed. Orientation, margin, echogenicity, calcification, additional findings of the rim, echogenicity, heterogeneity of the solid portion, and the ratio of anterior posterior diameter to lateral diameter (criteria) were assessed. The diagnostic performances of US findings, criteria, and the Korean Society of Thyroid Radiology Thyroid Imaging Reporting and Data System (K-TIRADS) were evaluated using logistic regression analysis.
Results:
Microcalcification, homogeneous solid echotexture, and thickened rims were suggestive of malignancy. Our criteria showed a highest area under the ROC curve (AUC) value of 0.771, sensitivity of 97.14%, accuracy of 77.14%, positive predictive value of 93.33%, negative predictive value of 95.24%, and specificity of 97.14%. The criteria showed a significantly higher AUC value than K-TIRADS.
Conclusion
US findings of homogenous solid portions, thick rims, and microcalcifications suggested malignancy in nodules with FLUS or FN on FNAC. These additional US findings could improve the diagnostic performance of K-TIRADS.
3.Uncommon Pediatric Presentation:Cavernous Lymphangioma Afflicting the Scalp
Kyung-Ju LEE ; Lucia KIM ; Jae Won LEE ; Ji Won BYUN ; Jeonghyun SHIN ; Gwang Seong CHOI ; Hyun-Tae SHIN
Korean Journal of Dermatology 2025;63(1):15-18
Cavernous lymphangiomas, characterized by the cystic enlargement of lymphatic vessels in the dermis and subcutaneous tissue, are rarely reported in the scalp. We present the case of a 6-month-old male infant with occipital scalp swelling, whose ultrasonographic examination identified a multiseptated hypoechoic mass in the subcutaneous layer. Histologically, the tumor exhibited irregular, dilated spaces lined with a single layer of endothelial cells, showing D2-40 positivity. This represents a rare case of pediatric cavernous lymphangioma of the scalp, accompanied by a literature review.
4.A Case of Multiple Fixed Drug Eruption Caused by Erdosteine
Korean Journal of Dermatology 2025;63(2):45-47
Erdosteine, a mucolytic expectorant with excellent tolerability, is frequently prescribed for the treatment of upper respiratory infections. Only a few cases of adverse drug reactions related to erdosteine have been reported, including drug reactions with eosinophilia and systemic symptoms, concurrent fixed drug eruption and anaphylaxis, drug-induced pemphigus in children, and atypical fixed drug eruption. Patients are often prescribed medications, such as antibiotics or nonsteroidal anti-inflammatory drugs (NSAIDs), for upper respiratory symptoms with suspected common culprits. In our case, the patient developed eruptions each time they took cold medication, with persistent symptoms despite discontinuing antibiotics and NSAIDs. This case highlights the need to consider erdosteine as a potential cause of drug eruptions and raise awareness about this less-recognized adverse effect.
5.Radiofrequency Ablation for Recurrent Thyroid Cancers:2025 Korean Society of Thyroid Radiology Guideline
Eun Ju HA ; Min Kyoung LEE ; Jung Hwan BAEK ; Hyun Kyung LIM ; Hye Shin AHN ; Seon Mi BAEK ; Yoon Jung CHOI ; Sae Rom CHUNG ; Ji-hoon KIM ; Jae Ho SHIN ; Ji Ye LEE ; Min Ji HONG ; Hyun Jin KIM ; Leehi JOO ; Soo Yeon HAHN ; So Lyung JUNG ; Chang Yoon LEE ; Jeong Hyun LEE ; Young Hen LEE ; Jeong Seon PARK ; Jung Hee SHIN ; Jin Yong SUNG ; Miyoung CHOI ; Dong Gyu NA ;
Korean Journal of Radiology 2025;26(1):10-28
Radiofrequency ablation (RFA) is a minimally invasive treatment modality used as an alternative to surgery in patients with benign thyroid nodules, recurrent thyroid cancers (RTCs), and primary thyroid microcarcinomas. The Korean Society of Thyroid Radiology (KSThR) initially developed recommendations for the optimal use of RFA for thyroid tumors in 2009 and revised them in 2012 and 2017. As new meaningful evidence has accumulated since 2017 and in response to a growing global interest in the use of RFA for treating malignant thyroid lesions, the task force committee members of the KSThR decided to update the guidelines on the use of RFA for the management of RTCs based on a comprehensive analysis of current literature and expert consensus.
7.Uncommon Pediatric Presentation:Cavernous Lymphangioma Afflicting the Scalp
Kyung-Ju LEE ; Lucia KIM ; Jae Won LEE ; Ji Won BYUN ; Jeonghyun SHIN ; Gwang Seong CHOI ; Hyun-Tae SHIN
Korean Journal of Dermatology 2025;63(1):15-18
Cavernous lymphangiomas, characterized by the cystic enlargement of lymphatic vessels in the dermis and subcutaneous tissue, are rarely reported in the scalp. We present the case of a 6-month-old male infant with occipital scalp swelling, whose ultrasonographic examination identified a multiseptated hypoechoic mass in the subcutaneous layer. Histologically, the tumor exhibited irregular, dilated spaces lined with a single layer of endothelial cells, showing D2-40 positivity. This represents a rare case of pediatric cavernous lymphangioma of the scalp, accompanied by a literature review.
8.A Case of Multiple Fixed Drug Eruption Caused by Erdosteine
Korean Journal of Dermatology 2025;63(2):45-47
Erdosteine, a mucolytic expectorant with excellent tolerability, is frequently prescribed for the treatment of upper respiratory infections. Only a few cases of adverse drug reactions related to erdosteine have been reported, including drug reactions with eosinophilia and systemic symptoms, concurrent fixed drug eruption and anaphylaxis, drug-induced pemphigus in children, and atypical fixed drug eruption. Patients are often prescribed medications, such as antibiotics or nonsteroidal anti-inflammatory drugs (NSAIDs), for upper respiratory symptoms with suspected common culprits. In our case, the patient developed eruptions each time they took cold medication, with persistent symptoms despite discontinuing antibiotics and NSAIDs. This case highlights the need to consider erdosteine as a potential cause of drug eruptions and raise awareness about this less-recognized adverse effect.
9.Ultrasound Findings Suggestive of Malignancy in Thyroid Nodules Classified as Follicular Lesion of Undetermined Significance or Follicular Neoplasm based on the 2017 Bethesda System for Reporting Thyroid Cytopathology
Heui Jin JUNG ; Na Lae EUN ; Eun Ju SON ; Jeong-Ah KIM ; Ji Hyun YOUK ; Hye Sun LEE ; Soyoung JEON
Journal of the Korean Society of Radiology 2025;86(1):114-126
Purpose:
To identify US findings suggestive of malignancy in thyroid nodules with follicular lesions of undetermined significance (FLUS) or follicular neoplasm (FN) on fine-needle aspiration cytology (FNAC) and evaluate the diagnostic performance.
Materials and Methods:
Seventy FLUS (n = 57) or FN (n = 13) nodules on FNAC that underwent surgical excision between February 2018 and November 2020 were selected. US findings were retrospectively reviewed. Orientation, margin, echogenicity, calcification, additional findings of the rim, echogenicity, heterogeneity of the solid portion, and the ratio of anterior posterior diameter to lateral diameter (criteria) were assessed. The diagnostic performances of US findings, criteria, and the Korean Society of Thyroid Radiology Thyroid Imaging Reporting and Data System (K-TIRADS) were evaluated using logistic regression analysis.
Results:
Microcalcification, homogeneous solid echotexture, and thickened rims were suggestive of malignancy. Our criteria showed a highest area under the ROC curve (AUC) value of 0.771, sensitivity of 97.14%, accuracy of 77.14%, positive predictive value of 93.33%, negative predictive value of 95.24%, and specificity of 97.14%. The criteria showed a significantly higher AUC value than K-TIRADS.
Conclusion
US findings of homogenous solid portions, thick rims, and microcalcifications suggested malignancy in nodules with FLUS or FN on FNAC. These additional US findings could improve the diagnostic performance of K-TIRADS.
10.Ultrasound Findings Suggestive of Malignancy in Thyroid Nodules Classified as Follicular Lesion of Undetermined Significance or Follicular Neoplasm based on the 2017 Bethesda System for Reporting Thyroid Cytopathology
Heui Jin JUNG ; Na Lae EUN ; Eun Ju SON ; Jeong-Ah KIM ; Ji Hyun YOUK ; Hye Sun LEE ; Soyoung JEON
Journal of the Korean Society of Radiology 2025;86(1):114-126
Purpose:
To identify US findings suggestive of malignancy in thyroid nodules with follicular lesions of undetermined significance (FLUS) or follicular neoplasm (FN) on fine-needle aspiration cytology (FNAC) and evaluate the diagnostic performance.
Materials and Methods:
Seventy FLUS (n = 57) or FN (n = 13) nodules on FNAC that underwent surgical excision between February 2018 and November 2020 were selected. US findings were retrospectively reviewed. Orientation, margin, echogenicity, calcification, additional findings of the rim, echogenicity, heterogeneity of the solid portion, and the ratio of anterior posterior diameter to lateral diameter (criteria) were assessed. The diagnostic performances of US findings, criteria, and the Korean Society of Thyroid Radiology Thyroid Imaging Reporting and Data System (K-TIRADS) were evaluated using logistic regression analysis.
Results:
Microcalcification, homogeneous solid echotexture, and thickened rims were suggestive of malignancy. Our criteria showed a highest area under the ROC curve (AUC) value of 0.771, sensitivity of 97.14%, accuracy of 77.14%, positive predictive value of 93.33%, negative predictive value of 95.24%, and specificity of 97.14%. The criteria showed a significantly higher AUC value than K-TIRADS.
Conclusion
US findings of homogenous solid portions, thick rims, and microcalcifications suggested malignancy in nodules with FLUS or FN on FNAC. These additional US findings could improve the diagnostic performance of K-TIRADS.

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