the Diagnosis and Management of Thyroid Nodules
- Introduction
Thyroid nodules are a common clinical problem. Epidemiologic studies have shown that the prevalence of palpable thyroid nodules to be approximately 5% in women and 1% in men living in iodine-sufficient parts of the world (1). In contrast, high-resolution ultrasound (US) can detect thyroid nodules in 19%–68% of randomly selected individuals, with higher frequencies in women and the elderly (2). Thyroid cancer occurs in 4%–15% of cases depending on age, sex, radiation exposure history, family history, and other factors (3-4).
Ultrasonography (US) is the primary imaging modality for evaluating thyroid nodules. The US risk stratification system (RSS) and the Thyroid Imaging Reporting and Data System (TIRADS) can help in estimating malignancy risk and guide fine-needle aspiration biopsy decisions (5).
Once FNAB has been obtained, the results can be classified according to the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). The third edition of TBSRTC, was published in 2023. Assigned single name for each of the 6 diagnostic categories: (i) nondiagnostic; (ii) benign; (iii) atypia of undetermined significance; (iv) follicular neoplasm; (v) suspicious for malignancy; and (vi) malignant, also it offers an average ROM for each category (6).