Population: Nonpregnant adults with thyroid nodules.
Organization
NICE 2019
Recommendations
–Assess with US if palpable nodule or generalized enlargement, and then proceed with FNA if suspicious by standard grading system (which is based on echogenicity, microcalcifications, border, shape in transverse plane, internal vascularity, and lymphadenopathy) (Fig. 21–4).
FIG. 21–4 APPROACH TO THE PATIENT WITH A THYROID NODULE. FNA, FINE-NEEDLE ASPIRATION; LN, LYMPH NODE; PTC, PAPILLARY THYROID CANCER; RX, THERAPY; TSH, THYROID-STIMULATING HORMONE; US, ULTRASOUND.
–If nonmalignant, treat only if airway symptoms or narrowing on imaging; repeat workup if change in symptoms.
–If cystic, treat with aspiration +/− ethanol ablation.
–If noncystic, multinodular, or diffuse goiter, treat with surgery, RIA, or percutaneous thermal ablation.
Sources
–AACE. 2010. https://www.aace.com/files/thyroid-guidelines.pdf
–ATA. 2015. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4739132/