Management of thyroid nodules

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Thyroid nodules are very common, but only a minor proportion of these are of clinical significance. However, what is most important, some are malignant. Current guidelines recommend evaluation of cold thyroid nodules that are 10 mm or larger in size. Fine needle aspiration (FNA) is the preferred method for evaluation of the nature of the lesion. Results should be reported according to the Bethesda System for Reporting Thyroid Cytopathology. Most nodules (55%-75%) will be classified as benign and a minority (2%-5%) will be malignant. The rest of FNA specimens are reported as either inadequate or inconclusive. In the cases of inadequate specimen, FNA should be repeated under ultrasound guidance, which will result in adequate sample in 60%-80% of cases. Clinical decision regarding management of the nodules with inconclusive FNA results should be guided by the personal and family history, as well as by the presence or absence of the worrisome ultrasound features. Genetic analysis of mutations in FNA specimens has been reported to be helpful in some situations, but its role in the management of thyroid nodules is evolving and currently is not quite clear.




Škugor, M. (2015). Management of thyroid nodules. Diabetologia Croatica. Vuk Vrhovac Institute.

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