A pragmatic approach to the indeterminate thyroid nodule
Thyroid nodules are prevalent in upto 68% of randomly selected individuals in whom high resolution ultrasound is performed . The majority of nodules are benign. The use of ultrasound coupled with FNAC has dramatically reduced the number of patients who undergo surgery for nodules. The six tier Bethe...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2017-01-01
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| Series: | Indian Journal of Endocrinology and Metabolism |
| Subjects: | |
| Online Access: | http://www.ijem.in/article.asp?issn=2230-8210;year=2017;volume=21;issue=5;spage=751;epage=757;aulast=Seshadri |
| _version_ | 1830415053184040960 |
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| author | Krishna G Seshadri |
| author_facet | Krishna G Seshadri |
| author_sort | Krishna G Seshadri |
| collection | DOAJ |
| description | Thyroid nodules are prevalent in upto 68% of randomly selected individuals in whom high resolution ultrasound is performed . The majority of nodules are benign. The use of ultrasound coupled with FNAC has dramatically reduced the number of patients who undergo surgery for nodules. The six tier Bethesda scoring system has reduced variability and increased the ability to clinicians to guide patients with thyroid nodules. There is good correlation between cytology and histopathologic outcomes. A significant proportion of patients will however fall into an indeterminate category. The availability of molecular markers enhanced with next generation sequencing technology and the expression classifier are added diagnostic aids that can help in management. However these are not available in many countries and in resource limited settings. A pragmatic approach to the diagnosis of indeterminate nodules includes utilising pre and post test probability, clinical acumen, correlation of ultrasound findings and expert opinion in some settings. Using this approach high risk patients can be appropriately chosen for surgery while relegating patients with lower risk to watchful followup. |
| first_indexed | 2024-12-20T20:57:53Z |
| format | Article |
| id | doaj.art-6cd8c7b3b92844f98f9f0b369db523bc |
| institution | Directory Open Access Journal |
| issn | 2230-8210 |
| language | English |
| last_indexed | 2024-12-20T20:57:53Z |
| publishDate | 2017-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Endocrinology and Metabolism |
| spelling | doaj.art-6cd8c7b3b92844f98f9f0b369db523bc2022-12-21T19:26:47ZengWolters Kluwer Medknow PublicationsIndian Journal of Endocrinology and Metabolism2230-82102017-01-0121575175710.4103/ijem.IJEM_143_17A pragmatic approach to the indeterminate thyroid noduleKrishna G SeshadriThyroid nodules are prevalent in upto 68% of randomly selected individuals in whom high resolution ultrasound is performed . The majority of nodules are benign. The use of ultrasound coupled with FNAC has dramatically reduced the number of patients who undergo surgery for nodules. The six tier Bethesda scoring system has reduced variability and increased the ability to clinicians to guide patients with thyroid nodules. There is good correlation between cytology and histopathologic outcomes. A significant proportion of patients will however fall into an indeterminate category. The availability of molecular markers enhanced with next generation sequencing technology and the expression classifier are added diagnostic aids that can help in management. However these are not available in many countries and in resource limited settings. A pragmatic approach to the diagnosis of indeterminate nodules includes utilising pre and post test probability, clinical acumen, correlation of ultrasound findings and expert opinion in some settings. Using this approach high risk patients can be appropriately chosen for surgery while relegating patients with lower risk to watchful followup.http://www.ijem.in/article.asp?issn=2230-8210;year=2017;volume=21;issue=5;spage=751;epage=757;aulast=SeshadriAtypia of undetermined significance follicular lesion of undeterminedBethesda scoringfollicular neoplasm/suspicious for follicular neoplasmindeterminate nodulesuspicious for malignancyThyroid Imaging Reporting and Data System |
| spellingShingle | Krishna G Seshadri A pragmatic approach to the indeterminate thyroid nodule Indian Journal of Endocrinology and Metabolism Atypia of undetermined significance follicular lesion of undetermined Bethesda scoring follicular neoplasm/suspicious for follicular neoplasm indeterminate nodule suspicious for malignancy Thyroid Imaging Reporting and Data System |
| title | A pragmatic approach to the indeterminate thyroid nodule |
| title_full | A pragmatic approach to the indeterminate thyroid nodule |
| title_fullStr | A pragmatic approach to the indeterminate thyroid nodule |
| title_full_unstemmed | A pragmatic approach to the indeterminate thyroid nodule |
| title_short | A pragmatic approach to the indeterminate thyroid nodule |
| title_sort | pragmatic approach to the indeterminate thyroid nodule |
| topic | Atypia of undetermined significance follicular lesion of undetermined Bethesda scoring follicular neoplasm/suspicious for follicular neoplasm indeterminate nodule suspicious for malignancy Thyroid Imaging Reporting and Data System |
| url | http://www.ijem.in/article.asp?issn=2230-8210;year=2017;volume=21;issue=5;spage=751;epage=757;aulast=Seshadri |
| work_keys_str_mv | AT krishnagseshadri apragmaticapproachtotheindeterminatethyroidnodule AT krishnagseshadri pragmaticapproachtotheindeterminatethyroidnodule |