To analysis the characteristics of the thyroid nodules which were inclined to be misdiagnosed as malignancies by ultrasound, so as to raise the awareness and reduce misdiagnosis rate.

A retrospective analysis of a total of 61 cases with highly suspicious thyroid malignancies in sonography, which were consistent with neither final pathological findings nor further examination results, were conducted. Both ultrasonic and pathological results were analyzed and summarized. The strategies and methods to facilitate the ability of differential diagnosis were further discussed.

The misdiagnosed cases included 9 types: parathyroid lesion, esophageal diverticula, medullary thyroid carcinoma, metastatic thyroid carcinoma, cervical neoplasm with thyroid gland invading, thyroid lymphoma, follicular thyroid carcinoma, absorption of thyroid adenoma with cystic degeneration and subacute thyroiditis. Four types of misdiagnosed cases were summarized: papillary thyroid carcinoma (72.1%), thyroid adenoma (19.7%), anaplastic thyroid carcinoma (3.3%) and Hashimoto′s thyroiditis (4.9%). By combining with laboratory examinations, ultrasound guided fine-needle aspiration cytology examinations, MIBI and other relative examinations, corresponding countermeasures were made.

Even if the sonograph of thyroid nodules has some typical features of malignancies, it should be further identified by combining the necessary auxiliary examinations or coordinate with scanning skills to reduce the misdiagnosis.