Info

🌱 來自: Huppert’s Notes

Thyroid Nodule

   Etiologies

-   Benign follicular epithelial cell adenomas (common, present in 5–10% of adults)

-   Malignant tumors: Papillary carcinomas (80–90%), follicular carcinomas (5–10%), medullary thyroid cancer (<10%), other (1–2%)

-   Clinical features: Palpable nodule, symptoms from mass effect; alternatively, may note as an incidental finding on imaging

Diagnosis: First check thyroid-stimulating hormone (TSH)

-   If TSH is high or normal: Get thyroid ultrasound (to assess features of nodule, evaluate for other nodules/lymph nodes). If a concerning features, biopsy with a fine needle aspiration (FNA)

-   If TSH is low: Check FT4, T3, and thyroid uptake and on a 131iodine scan

-   If functioning “hot” thyroid nodule: Treat hyperthyroidism (with medication vs. ablation/resection)

-   If nonfunctioning “cold” thyroid nodule: Biopsy and surgically resect if needed

-   Multinodular goiter: Diagnose using the same principles described above for single thyroid nodules. Higher risk of malignancy. Consider surgery if compressive symptoms.