Thyroid nodules

• Prevalence 5–10% (50–60% if screen with U/S), ♀ > ♂, ~7–15% malignant
• Screening U/S recommended if FHx of MEN2 or medullary thyroid cancer, personal h/o neck XRT, palpable nodules or multinodular goiter
• Features a/w ↑ risk of malig: age <30 y, h/o neck XRT, family history of thyroid cancer
• U/S features a/w benign dx: cystic nodules, “spongiform” sonographic pattern
• Worrisome findings: hypoechoic, solid, irregular borders, microCa2+, height>width, >20 mm
• Indications for FNA: >10-mm nodule w/ suspicious features