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The indications to do FNAC are: nodules more than 1 cm with two ultrasound criteria suggestive of malignancy, nodules of any size with extracapsular extension or lymph nodes enlargement with unknown source, any sizes of nodules with history of head and neck radiation, family history of thyroid carcinoma in two or more first degree relatives ...
Thyroid neoplasm is a neoplasm or tumor of the thyroid. It can be a benign tumor such as thyroid adenoma, [1] or it can be a malignant neoplasm (thyroid cancer), such as papillary, follicular, medullary or anaplastic thyroid cancer. [2] Most patients are 25 to 65 years of age when first diagnosed; women are more affected than men.
Biopsy or cytology are required if the ultrasound characteristics suggest malignancy. If ultrasound results are equivocal or unclear, or if the thyroid nodule is small (typically less than 1 cm), the nodule can be monitored over time with serial ultrasounds. [10]
The thyroid ultrasound is also very effective to discover microcarcinomas, which refer to very small carcinomas (<1 cm). Papillary thyroid carcinomas are also discovered when a hard nodule is found in multinodular goiter, when enlarged cervical lymph nodes are detected, or when there are unidentified metastatic lesions elsewhere in the body. [5]
Histopathology of NIFTP, H&E stain. [1]Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is an indolent thyroid tumor that was previously classified as an encapsulated follicular variant of papillary thyroid carcinoma, [2] necessitating a new classification as it was recognized that encapsulated tumors without invasion have an indolent behavior, [2] and may ...
Although the correlation between thyroid nodule size and malignancy risk is limited, nodule size affects prognosis in malignant nodules. Small thyroid cancers (less than 2 cm) tend to have an indolent course, with favourable prognosis even if not treated. Less than 7% of the imaging-detected ITNs are seen in younger populations.
Medullary thyroid carcinoma may also produce a thyroid nodule and enlarged cervical lymph nodes. [4] Sites of spread of medullary thyroid carcinoma include local lymph nodes in the neck, lymph nodes in the central portion of the chest (mediastinum), liver, lung, and bone. Spread to other sites such as skin or brain occurs but is uncommon.
Some experts [13] recommend that nodules > 1 cm (unless the TSH is suppressed) or those with ultrasonographic features of malignancy should be biopsied by fine needle aspiration. Computed tomography is inferior to ultrasound for evaluating thyroid nodules. [14] Ultrasonographic markers of malignancy are: [15] solid hypoechoic appearance