Thyroid nodule laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
Laboratory findings in a patient with a thyroid nodule may reveal abnormalities in [[serum]] thyrotrophin, [[serum]] antithyroperoxidase, [[free T4]], [[Triiodothyronine|T3]], [[Serum Amyloid P component|serum]] [[thyroglobulin]] and [[plasma]] [[Metanephrine|metanephrines]]. These findings may vary depending upon whether the nodule is hot or cold. | |||
==Laboratory Findings== | ==Laboratory Findings== | ||
{| class="wikitable" | {| class="wikitable" | ||
!Test | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Test | ||
!Indication | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Indication | ||
! | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Finding | ||
|- | |- | ||
![[Serum]] [[thyrotropin]] | |||
| | | | ||
* In all thyroid nodules | |||
| | | | ||
* Increased in hot nodules that secrete [[TSH]] | |||
* Normal/Decreased in most of the cold/malignant nodules | |||
|- | |- | ||
![[Serum]] antithyroperoxidase level | |||
| | | | ||
* If suspected to [[Hashimoto's thyroiditis]] | |||
| | | | ||
* Increased | |||
|- | |- | ||
![[Free T4]] | |||
| | | | ||
* If suspected to hot, [[thyroid]] [[hormone]] producing nodule | |||
| | | | ||
* Increased | |||
|- | |- | ||
|T3 | ![[Triiodothyronine|T3]] | ||
| | | | ||
* If suspected to [[thyrotoxicosis]] | |||
| | | | ||
* Increased | |||
|- | |- | ||
![[Thyroglobulin]] | |||
| | | | ||
* Routine measurement is not recommended by ATA | |||
| | |||
* Increased | |||
* May be elevated in most thyroid diseases and are an insensitive and nonspecific test for [[thyroid cancer]] | |||
|- | |- | ||
!Basal [[serum]] [[calcitonin]] | |||
|In patients with positive family history of medullary thyroid carcinoma | | | ||
In any patients with family history of MEN | * In patients with positive [[family history]] of [[medullary thyroid carcinoma]] | ||
* In any patients with [[family history]] of [[MEN]] | |||
* In any patients with concomitant [[hormonal]] abnormalities | |||
| | |||
* Increased | |||
* Greater than 100 pg=mL, [[Medullary thyroid cancer|medullary cancer]] is likely present 39 | |||
* Routine measurement: Not recommended due to unresolved issues of [[Sensitivity (tests)|sensitivity]], [[Specificity (tests)|specificity]], and costeffectiveness | |||
|- | |- | ||
![[Plasma]] [[metanephrine]] testing | |||
| rowspan="2" |In patients suspected to MEN to evaluate pheochromocytoma | | rowspan="2" | | ||
| | * In patients suspected to [[Multiple endocrine neoplasia|MEN]] to evaluate [[pheochromocytoma]] | ||
| rowspan="2" | | |||
* Increased | |||
|- | |- | ||
!24-hour [[urinary]] collection | |||
for catecholamines and metanephrines | for [[catecholamines]] and [[Metanephrine|metanephrines]] | ||
|} | |} | ||
* [[ | === Molecular markers === | ||
* [[ | Thyroid specific molecular markers may be helpful in patients with intermediate [[cytology]] on [[Needle aspiration biopsy|FNA]] to decide on disease management: | ||
* [[ | * [[BRAF]] | ||
* [[RAS]] | |||
* [[RET proto-oncogene|RET]] | |||
** Mostly seen in [[papillary thyroid cancer]] (PTC) | |||
* Pax8-PPARg | |||
* [[Galectin]]-3 | |||
==References== | ==References== |
Latest revision as of 15:37, 3 November 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Laboratory findings in a patient with a thyroid nodule may reveal abnormalities in serum thyrotrophin, serum antithyroperoxidase, free T4, T3, serum thyroglobulin and plasma metanephrines. These findings may vary depending upon whether the nodule is hot or cold.
Laboratory Findings
Test | Indication | Finding |
---|---|---|
Serum thyrotropin |
|
|
Serum antithyroperoxidase level |
|
|
Free T4 |
| |
T3 |
|
|
Thyroglobulin |
|
|
Basal serum calcitonin |
|
|
Plasma metanephrine testing |
|
|
24-hour urinary collection
for catecholamines and metanephrines |
Molecular markers
Thyroid specific molecular markers may be helpful in patients with intermediate cytology on FNA to decide on disease management:
- BRAF
- RAS
- RET
- Mostly seen in papillary thyroid cancer (PTC)
- Pax8-PPARg
- Galectin-3