Thyroid Noudle

Thyroid Nodules ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Type of thyroid nodules Cyst : simple cyst, mixed cystic-solid Colloid nudule : dominant nodule in MNG Adenoma : Follicular, Hurthle cell, Atypical Thyroiditis : Hashimoto’s, subacute Infection : Granulomatous disease, Abscess Developmental anomalies : unilateral lobe agenesis, cystic hygroma, Dermoid, Teratoma Carcinoma : papillary ( 75 %), follicular ( 5-10 %), medullary ( 5-10 %) , anaplastic ( 5 %), lymphoma ( 5 %), metastatic

Factors associated with increase risk for malignant thyroid nodule ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Factors suggesting benign thyroid nodule ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Investigation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

US: A solitary hypoechoic nodule at Rt. Lobe thyroid Slide 12 Slide 12

Isotope scan : Left: Normal thyroid Right: A cold nodule Lt.lobe thyroid

Diagnostic procedure: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Thyroid Nodule TSH test Euthyroid Thyrotoxic Thyroid scan FNA Cold nodule Hot nodule 131 I or surgery Benign Suspicious Malignant Inadequate Observe or T 4 - Px Surgery Repeat FNA FU 6-12 M Suggested strategy for the management of thyroid nodules

Thyroid incedentalomas ,[object Object],[object Object],[object Object],Thyroid incedentaloma Hx. H+N RT, F.Hx. CA thyroid Positive Negative US guide FNA US finding Cytology Suspected Benign appearance Malignant or (< 1.5 cm) ( > 1.5 cm ) Observe Malignant Benign Surgery Observe

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Result of thyroid FNA interpretation

Colloid nodule : A: FNA B: Histopathology

Hoshimoto’s thyroiditis A: FNA B: Histopathology

Papillary carcinoma : A: FNA B: Histopathology

A: FNA B: Follicular adenoma C: Follicular carcinoma

Thyroid Noudle

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Thyroid Noudle