Four case scenarios illustrate the selection and interpretation of investigations to diagnose benign and malignant thyroid lumps.
- Thyroid nodules are common.
- Investigation requires clinical assessment, thyroid function tests and ultrasonography.
- Use of fine needle aspiration biopsy is guided by clinical and ultrasound-based suspicion of malignancy.
- If the patient is hyperthyroid (low serum TSH [thyroid stimulating hormone] level) then a thyroid radionuclide uptake scan is indicated.
- Thyroid cytopathology drives further surgical or nonsurgical management.
- Radioactive iodine ablation is undertaken when the patient is in a hypothyroid state or after thyrotrophin-alfa administration.
- Serum thyroglobulin level is used to monitor disease recurrence.
- Thyroid cancer prevalence may be increased in autoimmune thyroid disease.