| Abstract: |
Thyroid nodularity is a common problem. The main indication for surgery is a fear of malignancy. A variety of diagnostic tests, including imaging studies, are available; of these, the best and most cost-effective diagnostic test is a fine-needle aspiration (FNA) biopsy. However, a variety of pitfalls of FNA need to be kept in mind before interpreting the information it provides. The FNA is helpful to decide the surgical versus nonsurgical approach. Recently, a large number of incidentalomas of thyroid have been noted during routine magnetic resonance imaging (MRI) or ultrasound of the neck. An ultrasound-guided fine-needle aspiration biopsy is helpful for further evaluation of these incidentalomas. When the fine-needle aspiration biopsy is reported as follicular neoplasm, generally a surgical intervention is considered, especially if the tumor is more than 3 cm because the fine-needle aspiration will not distinguish between benign follicular adenoma and minimally invasive follicular carcinoma, which requires complete evaluation of the capsule of the thyroid nodule. An algorithmic approach to the diagnostic evaluation of thyroid nodule is described. |
