PL EN
REVIEW PAPER
Review of basic diagnostics of thyroid nodules at a time of increasing frequency of endocrine and oncological diseases
 
 
More details
Hide details
1
Uniwersytet Medyczny w Łodzi, Polska
 
 
Corresponding author
Kinga Krawiec   

Uniwersytet Medyczny w Łodzi, Polska
 
 
Med Og Nauk Zdr. 2021;27(1):50-53
 
KEYWORDS
TOPICS
ABSTRACT
Introduction and objective:
Due to increased availability and frequency of imaging tests the diagnosis of thyroid nodules is becoming very common. Focal echostructure abnormalities in the ultrasound examination may be visible in more than a half of the examined patients. The aim of this study is to present the most important information about thyroid nodules in a way useful for everyday clinical practice of a physician, regardless of the specialization.

Review of the current state of knowledge:
The basis of the diagnostic algorithm in case of suspicion of thyroid focal changes is a thorough interview and physical examination of the patient. The risk of thyroid cancer should be assessed by analysing exposure to external factors and family history. Special oncological vigilance should be aroused by abnormal symmetry, size and consistency of the gland, and the presence of hard, non-painful and immovable surrounding lymph nodes. Thyroid nodules may manifest their presence giving local symptoms, mainly associated with compression and systemic symptoms resulting from disturbed hormone production. Compression symptoms are associated with reduced esophageal lumen, dyspnea and hoarseness. Ultrasound, TSH and US-FNAB examination of the thyroid gland are the basic tools for appropriate therapeutic management, which can range from simple observation to surgical resection.

Conclusions:
The key role of the physician is to identify patients with a significant probability of malignant process. In most cases, current diagnostic methods of thyroid nodules enable accurate diagnosis, saving unnecessary surgical interventions in patients with mild lesions.

REFERENCES (26)
1.
Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyro-id Association Guidelines Task Force on Thyroid Nodules and Dif-ferentiated Thyroid Cancer. Thyroid. 2016; 26(1): 1–133. https://dx.doi.org/10.1089%2Ft....
 
2.
Paschou SA, Vryonidou A, Goulis DG. Thyroid nodules: Α guide to assessment, treatment and follow-up. Maturitas. 2017; 96: 1–9. https://doi.org/10.1016/j.matu....
 
3.
Burman KD, Wartofsky L. CLINICAL PRACTICE. Thyroid Nodu-les. N Engl J Med. 2015; 373(24): 2347–2356. https://doi.org/10.1056/nejmcp....
 
4.
Bongiovanni M, Spitale A, Faquin WC, et al. The Bethesda System for Reporting Thyroid Cytopathology: a meta-analysis. Acta Cytol. 2012; 56(4): 333–339. https://doi.org/10.1159/000339....
 
5.
Durante C, Grani G, Lamartina L, et al. The Diagnosis and Management of Thyroid Nodules: A Review. JAMA. 2018; 319(9): 914–924. https://doi.org/10.1001/jama.2....
 
6.
Wong R, Farrell SG, Grossmann M. Thyroid nodules: diagnosis and management. Med J Aust. 2018; 209(2): 92–98. https://doi.org/10.5694/mj a 17. 012 0 4.
 
7.
Pemayun TG. Current Diagnosis and Management of Thyroid Nodules. Acta Med Indones. 2016; 48(3): 247–257.
 
8.
Pellegriti G, Frasca F, Regalbuto C, et al. Worldwide increasing incidence of thyroid cancer: update on epidemiology and risk factors. J Cancer Epidemiol. 2013; 2013: 965212. https://doi.org/10.1155/2013/9....
 
9.
Popoveniuc G, Jonklaas J. Thyroid nodules. Med Clin North Am. 2012; 96(2): 329–349. https://dx.doi.org/10.1016%2Fj....
 
10.
Park YJ, Ahn HY, Choi HS, et al. The long-term outcomes of the se-cond generation of familial nonmedullary thyroid carcinoma are more aggressive than sporadic cases. Thyroid. 2012; 22(4): 356–362. https://d x.doi.org/10.1089%2Fthy.2011.0163.
 
11.
Ciampi R, Romei C, Ramone T, et al. Genetic Landscape of Somatic Mutations in a Large Cohort of Sporadic Medullary Thyroid Carcinomas Studied by Next-Generation Targeted Sequencing. iScience. 2019; 20: 324–336. https://doi.org/10.1089/thy.20....
 
12.
Luzón-Toro B, Fernández RM, Villalba-Benito L, et al. Influencers on Thyroid Cancer Onset: Molecular Genetic Basis. Genes (Basel). 2019; 10(11): 9.
 
13.
https://d x.doi.org/10.3390%2Fgenes1011091313. Wells SA Jr, Pacini F, Robinson BG, et al. Multiple endocrine neo-plasia type 2 and familial medullary thyroid carcinoma: an upda-te. J Clin Endocrinol Metab. 2013; 98(8): 3149–3164. https://dx.doi.org/10.1210%2Fj....
 
14.
Hińcza K, Kowalik A, Kowalska A. Current Knowledge of Germli-ne Genetic Risk Factors for the Development of Non-Medullary Thyroid Cancer. Genes (Basel). 2019; 10(7): 482. https://dx.doi.org/10.3390%2Fg....
 
15.
Cabanillas ME, McFadden DG, Durante C. Thyroid cancer. Lancet. 2016; 388(10061): 2783–2795. https://doi.org/10.1016/s0140-....
 
16.
Jarząb B, Dedecjus M, Słowińska-Klencka D et al. Guidelines of Po-lish National Societies Diagnostics and Treatment of Thyroid Carci-noma. 2018 Update. Endokrynol Pol. 2018; 69(1): 34–74. https://doi.org/10.5603/ep.201....
 
17.
Ruchala M, Szczepanek E. Thyroid nodular disease. Family Medicine and Primary Care Review. 2018; 10(4): 1383–1392.
 
18.
Durante C, Costante G, Lucisano G, et al. The natural history of benign thyroid nodules. JAMA. 2015; 313(9): 926–35. https://doi.org/10.1001/jama.2....
 
19.
Brito JP, Morris JC, Montori VM. Thyroid cancer: zealous imaging has increased detection and treatment of low risk tumours. BMJ. 2013; 347: f4706. https://doi.org/10.1136/bmj.f4....
 
20.
Cibas ES, Ali SZ. The 2017 Bethesda System for Reporting Thyroid Cy-topathology. Thyroid. 2017; 27(11): 1341–1346. https://doi.org/10.1089/t hy. 2 017. 0 5 0 0.
 
21.
Swirta J, Romaniszyn M, Barczynski M. Czynniki ryzyka złośliwości zmian ogniskowych tarczycy zweryfikowanych w biopsji aspiracyjnej cienkoigłowej celowanej jako „podejrzenie nowotworu pęcherzykowe-go”. Wiad Lek. 2020; 73(7): 1323–1329. doi: 10.36740/WLek202007103.
 
22.
Mahony GT, Mahony BS. Low nondiagnostic rate for fine-needle capilla-ry sampling biopsy of thyroid nodules: a singular experience. J Ultraso-und Med 2013; 32: 2155–2161. https://doi.org/10.7863/ultra.....
 
23.
Choi YS, Hong SW, Kwak JY, et al. Clinical and ultrasonographic findings affecting nondiagnostic results upon the second fine needle aspiration for thyroid nodules. Ann Surg Oncol. 2012; 19: 2304–2309. https://doi.org/10.1245/s10434....
 
24.
Jessie WU, Harrison B. Hypocalcemia after Thyroidectomy: The Need for Improved Definitions. World J Endoc Surg. 2010; 2(1): 17−20. https://dx.doi.org/10.1308%2F0....
 
25.
Jeannon JP, Orabi AA, Bruch GA, et al. Diagnosis of recurrent laryngeal nerve palsy after thyroidectomy: a systematic review. Int J Clin Pract. 20 09; 63(4): 624−629. ht t ps://doi.org /10.1111/j.1742-1241.20 08.01875.x.
 
26.
Nikiforova MN, Tseng GC, Steward D, et al. MicroRNA expression profiling of thyroid tumors: biological significance and diagnostic utility. J Clin Endocrinol Metab. 2008; 93(5): 1600–16008. https://doi.org/10.1210/jc.200....
 
eISSN:2084-4905
ISSN:2083-4543
Journals System - logo
Scroll to top