ultrasound of the central neck and empty neck · patient: 24 yo woman with ptc final path post-op...
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Ultrasound of the Central Neck and
Empty Neck
Mira Milas MD, FACS
Professor of Surgery
World Congress on Thyroid Cancer
Toronto, Canada
July 10, 2013
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No conflicts of interest or financial relationships to disclose.
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Outline and Objectives
•To recognize anatomical boundaries that facilitate
imaging of the central neck and “empty” neck
•To demonstrate the normal components of these
regions
•To illustrate thyroid cancer recurrences and other
pathology in these regions
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1. Thyroid
2. Parathyroid (normal or enlarged)
3. Thymus
4. Lymph Nodes (normal or diseased)
5. Fibrofatty tissue (“decorative fat”)
“background”: trachea, esophagus, strap
muscles, paraspinous muscle, vessels, nerves
“unusual”: lesions or tumors of other primaries
Components
of the Central Neck
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Central Neck Imaging TriangleThyroid
Thymus
Parathyroid
Lymph node
Fat
Vessels
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Correlation of Parathyroid Sonographic
Distribution to Embryologic Origin
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The “Empty” Neck
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Patient: 44 yo woman with FV PTC
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Patient: 24 yo woman with PTC
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Patient: 24 yo woman with PTC
Final path
Post-op
Tg 0.3
+TgAB
TSHR mRNA <1
Surgical specimen
PTC 3 cm, right lobe
PTC 1 cm, left lobe
3/9 +LN, central neck
Occasional tall cell
features
No extrathyroidal
extension
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Video Gallery
of
Central Neck
and “Empty” Neck
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Summary
•Use anatomical knowledge as a framework
for orientation to interpret ultrasound images
of the central neck, in presence or absence
of thyroid gland
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Thank You