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Surveillance of Benign Thyroid Nodules

  • Elizabeth H. HoltEmail author
Chapter

Abstract

Thyroid nodules are very common, and most are benign. Controversy exists regarding the optimal follow-up of benign thyroid nodules. Longitudinal studies show that a subset of cytologically benign thyroid nodules grow over time. Nodule growth is often perceived to be a sign of concern, although many benign nodules grow as well. Selection of growing nodules for rebiopsy is an area of interest. Fine needle aspiration (FNA) of thyroid nodules is associated with an error rate of approximately 5 %. Whether cytologically benign thyroid nodules should be rebiopsied to improve the accuracy of the diagnosis is controversial. Management of thyroid nodules larger than 3–4 cm in size is an area of ongoing debate. Some investigators find these nodules more likely to be malignant and more likely to yield false-negative results on FNA. This is why some investigators have recommended that large nodules should be uniformly removed surgically; however, this is still controversial. The use of molecular diagnostics to improve the accuracy of FNA is a growing area in thyroid cancer research. Molecular tests have been used primarily for evaluation of cytologically indeterminate nodules but may be of value for cytologically benign nodules in some cases.

Keywords

Thyroid nodule Thyroid cancer Fine needle aspiration biopsy Surveillance Molecular markers False negative Large nodules Ultrasound Cytopathology Benign 

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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Section of Endocrinology and MetabolismYale School of MedicineNew HavenUSA

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