To the Editor.—We read with interest the article by Drs Hammer, Wortsman, and Folse (Archives 1982;117: 1020-1023). We think they have made valid observations and we appreciate the publication of this series of correlating studies in thyroid lesions. Several points are raised, however, regarding the sonographic studies reported.
The authors initially referred to reporting sonographic patterns of solid, cystic, and mixed. After this, the category of mixed characteristics is never again mentioned and this is the pattern most commonly seen with necrotic nodules. The authors discussed the total number of pathologically confirmed cystic lesions that were reported as solid by sonography and vice versa, but they do not mention the number of cancer cases that were reported as purely cystic patterns. This is an important and neglected observation. We tend to agree that the results of sonography reported in this series are disappointing. Perhaps one of the reasons is