Sonographic patterns and risk of malignancy. A Sonographic patterns and risk of malignancy. A. Ultrasound of the normal thyroid gland. (Tr, trachea; LL, left lobe of thyroid; RL, right lobe of thyroid; Is, isthmus; CA, carotid artery; JV, jugular vein; STM, sternothyroid muscle.) (Used with permission from Dr. RA Filly.) B. Ultrasound of the thyroid illustrating various sonographic features of thyroid nodules. A: Hypoechoic nodule; B: Spongiform nodule; C: Thyroid cancer showing irregular margins and microcalcifications; D: Hyperechoic nodule. C. Ultrasound of the thyroid illustrating a large thyroid cyst (A) and Graves’ disease (B) with enlarged heterogeneous echotexture and markedly increased vascular flow on Doppler ultrasound (C). (Reproduced with permission from Baskin HJ, Duick DS, Levine RA. Thyroid Ultrasound and Ultrasound-guided FNA, 3rd ed. New York: Springer Verlag; 2013.) Source: The Thyroid Gland, Greenspan's Basic & Clinical Endocrinology, 10e Citation: Gardner DG, Shoback D. Greenspan's Basic & Clinical Endocrinology, 10e; 2017 Available at: http://accessmedicine.mhmedical.com/DownloadImage.aspx?image=/data/books/2178/gardgreen10_ch07_f027a-1.png&sec=166248384&BookID=2178&ChapterSecID=166248172&imagename= Accessed: November 15, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved