[Lymphadenopathy as specific ultrasonography index of subacute thyroiditis. Preliminary data].

INTRODUCTION

We report the preliminary results of a study on the importance of juxtajugular and supraisthmian lymph node enlargement at US as a sign of occult subacute thyroiditis.

MATERIAL AND METHODS

We examined patients submitted to thyroid US for noninflammatory thyroid conditions and for positive familiarity and studied the presence of supraisthmian and juxtajugular lymph node enlargement. The patients were then divided into two groups: the clinical history, antibody titer and symptoms were studied in group A (patients with enlarged lymph nodes) and the antibody titer, symptoms and US findings were studied in group B (patients with a history of thyroiditis).

RESULTS

Fifty-nine of 600 patients were allocated to group A and 25 of 600 to group B. Of the former 59 asymptomatic patients (10% of the total), 29% had supraisthmian and 85% juxtajugular lymph node enlargement, with some patients positive at both sites. Forty-seven patients (80%) had subacute thyroiditis (33 of them with positive antibodies and 23 with a clinical history); we had 12 false positives. Twenty-two of 25 group B patients (91%) had supraisthmian (40%) or juxtajugular (83%) lymph node enlargement: 3 patients with no enlarged lymph nodes had an over 3-year history of low antibody titers.

DISCUSSION

Forty-seven of 600 (8%) asymptomatic patients who had been never examined are or were affected with subacute thyroiditis. Ninety-one per cent of all thyroiditis patients had supraisthmian or juxtajugular lymph node enlargement, more frequently the latter than the former.

CONCLUSIONS

Supraisthmian and/or juxtajugular lymph node enlargement appears to be a very useful US sign of subacute thyroiditis, even though these data need confirmation from larger series of patients.