It's estimated that 50% of the population by 50 years will have a radiologically discrete lesion within the thyroid gland. Nodule work up was designed for nodule which was visible, but now with more and more imaging being done these "invisible" nodules are picked up. The main concern when you approach a nodule is not to miss cancer. How to incorporate clinical findings, ultrasound, and cytology to pick up the nodules that should go under the knife?
History look for extremes of age, male, compressive symptoms, the sudden increase in size, family history of cancer, radiation exposure (treated case of lymphoma, bone marrow transplant), lateral neck nodes. In these euthyroid patients when you ask for USG thyroid ask for TIRADS. Once you see suspicious features ask for an ultrasound guide FNAC from the suspicious lesion. Ask the cytologist to give you cytology report in Bethesda reporting…
