Toxic multinodular goiter other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

The most important diagnostic test to differentiate thyroid nodules from each other is fine needle aspiration (FNA).

Other Diagnostic Studies

Fine needle aspiration

The most important diagnostic test to differentiate thyroid nodules from each other is fine needle aspiration (FNA). As FNA is considered as an aggressive procedure, the American Thyroid Association developed the following criteria for FNA indication:

  • Nodules ≥ 1 cm with intermediate or high suspicion US pattern
  • Nodules ≥ 1.5 cm with low suspicion US pattern
  • Nodules ≥ 2 cm with very low suspicion US pattern (e.g., spongiform). Observation an alternate option
  • For nodules that do not meet the above criteria, FNA is not required, including nodules < 1 cm (with some exceptions) and purely cystic nodules.[1]
  • Criteria for US-guided FNA:
    • A higher likelihood of either a nondiagnostic cytology (>25–50% cystic component)
    • A higher likelihood of sampling error
      • Difficult to palpate nodules
      • Posteriorly located nodules

FNA biopsy is sensitive and specific in the diagnosis of childhood thyroid nodules. [2][3]

References

  1. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, Tuttle RM, Wartofsky L (2016). "2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer". Thyroid. 26 (1): 1–133. doi:10.1089/thy.2015.0020. PMC 4739132. PMID 26462967.
  2. Chang SH, Joo M, Kim H (2006). "Fine needle aspiration biopsy of thyroid nodules in children and adolescents". J. Korean Med. Sci. 21 (3): 469–73. doi:10.3346/jkms.2006.21.3.469. PMC 2729953. PMID 16778391.
  3. Hung W (1999). "Solitary thyroid nodules in 93 children and adolescents. a 35-years experience". Horm. Res. 52 (1): 15–8. doi:23426 Check |doi= value (help). PMID 10640894.

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