We see these echogenic, almond-shaped nodules below the thyroid nearly every day in our practice. I agree – we used to call them fatty-replaced lymph nodes and ignore them. However, there’s never a correlate on CT. I’ve discussed this topic with our ENT colleagues who specialize in parathyroid surgery. They see them at surgery and often remove them, but say they don’t usually come back as parathyroid tissue on path. We’ve started calling them fatty thyrothymic rests (essentially fatty replaced ectopic thymic and/or thyroid tissue) – and still ignore them.
The article is interesting, but I think it’s misleading to patients and providers who may think we routinely see normal parathyroid glands with US. I plan to discuss the article at our next parathyroid conference and get some other opinions.
