Abstract
It is known from autopsy data that thyroid nodules are far more common than can be detected by palpation alone. With the wide use of modern non-invasive imaging many nonpalpable thyroid nodules are discovered but the proper approach to these nodules is still debatable. In a retrospective study, we reviewed the data from 186 US-guided FNA biopsies (US-FNAB) performed between May 1995 and March 1997 at the Sapir Medical Center, Israel, a iodine-sufficient urban area. Sixty-one of the 186 US-FNAB of the thyroid were performed in non-palpable nodules. The mean size of these nodules was 2.4±1.0 cm (mean±SD) ranging from 1.1–5.5 cm. Description of the nodule consistency was available in 53 cases; 42/53 were solid and 11/53 were solid-cystic. FNAB was diagnostic in 46 patients and non-diagnostic in 15. Forty-three of the diagnostic cytology reports were benign, one revealed papillary carcinoma, one had suspicious findings and the third was suspicious for a follicular neoplasm. The last two patients were referred to surgery and a follicular adenoma was found in both. Among the 61 non-palpable thyroid nodules, only one was papillary carcinoma, a prevalence of 1.6%. The other two patients referred to surgery had benign lesions. We found a low prevalence of malignancy in relatively large nonpalpable thyroid nodules.
Similar content being viewed by others
References
Tan G.H., Gharib H. Thyroid incidentalomas: management approaches to nonpalpable nodules discovered incidentally on thyroid imaging. Ann. Intern. Med. 1997, 126: 226–231.
Burguera B., Gharib H. Thyroid incidentalomas: Prevaence, Diagnosis, Significance, and Management. Endocrinol. Metab. Clin. North Am. 2000, 29: 187–203.
Brander A., Viinkonski P., Tuuhea J., Voutilainen L, Kivisaari L. Clinical versus ultrasound examination of the thyroid gland in common clinical practice. J. Clin. Ultrasound. 1992, 20: 37–42.
Wiest P.W., Hartshorne M.F., Inskip P.D. et al. Thyroid palpation versus high-resolution ultrasonography in the detection of nodules. J. Ultrasound Med. 1998, 17: 487–496.
Rago T., Chiovato L., Aghini-Lombardi F., Grasso L., Pinchera A., Vitti P. Non-palpable thyroid nodules in a borderline iodine-sufficient area: Detection by ultrasonography and follow up. J. Endocrinol. Invest. 2001, 24: 770–776.
Leenhardt L, Hejblum G., Franc B. et al. Indications and imits of ultrasound-guided cytology in the management of nonpalpable thyroid nodules. J. Clin. Endocrinol. Metab. 1999, 84: 24–28.
Hagag P., Strauss S., Weiss M. Role of ultrasound-guided fine-needle aspiration biopsy in evaluation of nonpalpable thyroid nodules. Thyroid 1998, 8: 989–995.
Bisi H., Fernandes V.S.O., Asato de Camargo R.Y. et al. The prevalence of unsuspected thyroid pathology in 300 sequential autopsies, with special reference to the incidental carcinoma. Cancer 1989, 64: 1888–1893.
Harach H.R., Franssila K.O., Wasenus V. Occult papillary carcinoma of the thyroid, a “normal” finding in Finland. A systematic autopsy study. Cancer 1985, 56: 531–538.
Ross D.S. Nonpalpable thyroid nodules-managing and epidemic. J. Clin. Endocrinol. Metab. 2002, 87: 1938–1940.
Khurana K.K., Richards V.I., Chopra P.S., Izquierdo R., Rubens D., Mesonero C. The role of ultrasonography-guided fine-needle aspiration biopsy in the management of nonpalpable and palpable thyroid nodules. Thyroid 1998, 8: 511–515.
Bramley M.D., Harrison B.J. Papillary microcarcinoma of the thyroid gland. Br. J. Surg. 1996, 83: 1674–1683.
Takashima S., Fukuda H., Kobayashi T. Thyroid nodules: Clinical effect of ultrasound-guided fine needle aspiration biopsy. J. Clin. Ultrasound 1994, 22: 535–542.
Ezzat S., Sarti D.A., Cain D.R., Braunstein G.D. Thyroid incidentalomas: prevalence by palpation and ultrasonography. Arch. Intern. Med. 1994, 154: 1838–1840.
Tambouret R., Szyfelbein W.M., Pitman M.B. Ultrasound-guided fine-needle aspiration biopsy of the thyroid. Cancer 1999, 87: 299–305.
Rago T., Chiovato L, Mazzeo S. et al. Role of conventional ultrasonography and color flow-doppler sonography in predicting malignancy in “cold” thyroid nodules. Eur. J. Endocrinol. 1998, 138: 41–46.
Papini E., Guglielmi R., Bianchini A. et al. Risk of malignancy in nonpalpable thyroid nodules: Predictive value of ultrasound and color-dopler features. J. Clin. Endocrinol. Metab. 2002, 87: 1941–1946.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Nabriski, D., Ness-Abramof, R., Brosh, T. et al. Clinical relevance of non-palpable thyroid nodules as assessed by ultrasound-guided fine needle aspiration biopsy. J Endocrinol Invest 26, 61–64 (2003). https://doi.org/10.1007/BF03345124
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03345124