ENT

Thyroid Nodules and Cancer

Thyroid nodules are common and usually benign; assess a clinically concerning lump with thyroid function tests, greyscale ultrasound and ultrasound-guided FNAC when the established ultrasound threshold is met, then manage cytology and cancer by risk and subtype.

Definition

A thyroid nodule is a discrete lesion within the thyroid gland, distinguishable from surrounding thyroid tissue on examination or imaging. Thyroid cancer comprises several subtypes, including differentiated papillary and follicular carcinoma, medullary carcinoma, anaplastic carcinoma and primary thyroid lymphoma.

First principles

The aim is risk-stratified diagnosis, not removal of every nodule

Most thyroid nodules are benign. The useful sequence is to identify clinical red flags, assess thyroid function, characterise the gland and cervical nodes with greyscale ultrasound, and sample only when the established ultrasound system indicates FNAC or clinical concern remains. This reduces both missed cancer and unnecessary diagnostic surgery.

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