Thyroid nodules

What are thyroid nodules?
Thyroid nodules are round or oval-shaped growths in the thyroid gland.
Thyroid nodules are common and are not usually harmful to a person’s health. But
sometimes, thyroid nodules are caused by a serious condition, such as cancer.
The thyroid gland makes a hormone called “thyroid hormone.” Most thyroid nodules do
not change the amount of thyroid hormone in the body. But some cause the thyroid
gland to make too much thyroid hormone. This can cause symptoms.

What tests do I need for evaluation?
Tests usually include blood tests and an imaging test of the thyroid called an ultrasound.
Sometimes, people need more tests. These include:

●Fine needle aspiration – For this test, a doctor uses a thin needle to remove a
small sample of cells from the thyroid nodule. Then another doctor looks at the cells
under a microscope. These tests can help doctors decide which nodules should be
removed by surgery and which nodules can be watched.

●Thyroid scan – People get this test only if they have too much thyroid hormone in
the body. For this test, a person gets a pill or a shot with a small amount of a
radioactive substance. Then, a special camera takes a picture of the thyroid gland.
This test is not safe for women who are pregnant or breastfeeding.

What treatment is available for the thyroid nodules?

Thyroid nodules are treated in different ways, depending on their cause and how much
thyroid hormone is in the body. Different treatments include:

●Watching and waiting – Most of the nodules can be watched and monitored.
Especially if it is small and doesn’t look serious or after a benign biopsy. This
means you might have another thyroid ultrasound and sometimes another fine
needle aspiration.

●A procedure to drain fluid from the thyroid nodule, if it is filled with fluid

●Surgery to remove one or both sides of the thyroid, especially if the nodule is
concerning for cancer or if it is large and causing obstructive symptoms

What is Fine-needle aspiration of the thyroid?
1. FNA uses a thin needle to remove small tissue samples from the thyroid nodule.
The tissue is examined with a microscope.

2. FNA biopsy is done in the office with a local anesthetic (numbing medicine) using
ultrasound guidance.

3. You do not need a driver to bring you to the clinic, and you do not need to be
fasting before the procedure. Please alert your doctor if you are on a blood
thinner.

4. You may feel mild discomfort or some pressure during the biopsy, but the level of
discomfort is similar to a visit with the dentist or withdrawing blood from the arm
for blood test.

5. The procedure usually takes between 5-10 mins. Longer time is needed for
preparation and post procedural care.

6. You are allowed to eat and drink after the procedure. Some patients experience
discomfort that gets better within 24-48 hours. This usually improves with Tylenol
or Ibuprofen.

7. This test is accurate in identifying cancer in a suspicious thyroid nodule. In some
cases, the biopsy does not contain enough tissue to make a diagnosis, and a
repeat biopsy is necessary. In other cases (15 percent), the result of the biopsy is
indeterminate. Indeterminate means that the findings are not clearly benign or
malignant, the risk of malignancy is low, and further testing may be advised.

8. The results of the biopsy come back in 2-3 weeks. We let our patients know
when the results are available. All patients are scheduled for follow up in 3-4
weeks to discuss the results in person and talk about the next step in
management