Thyroid nodule differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]

Thyroid nodule differential diagnosis

In rare cases, a thyroid nodule may reflect one of the hereditary nonmedullary thyroid cancer syndromes such as familial adenomatous polyposis, Werner’s syndrome, Carney complex type 1, or Gardner’s syndrome

		Nodule property			Spread			Sudden growth of neck mass	Laboratory		Thyroid scintigraphy				Biopsy result if indicated
		Fixed	Mobile	Painful	LN	Vessle	Metastasis		TSH	FT4/T3	Hot	Cold	US finding	FNA finding		Associated mutation	special consideration
Benign	Colloid adenoma
	Hashimoto's thyroiditis
	Cysts nodules
	Follicular adenomas								↑↑↑							PAX8-PPAR gamma 1	May occur in association with thyroiditis or nodular hyperplasia 24857573
	Hyperplastic nodules								↑↑↑
	Macrofollicular adenomas								↑↑
	Microfollicular or cellular adenomas								↑↑
	Hürthle cell adenomas								↑↓
Malignant	Papillary carcinoma				↑↑↑												Most common tumor associated with childhood head and neck radiation
	Follicular carcinoma					↑↑↑	Bone Lung		↑↓					FLUS	Tumor capsule Vascular invasion	RAS mutations PAX8-PPAR gamma 1	Most common thyroid cancer in iodine deficient areas
	Oxyphilic (Hürthle cell) type carcinoma
	Noninvasive follicular thyroid neoplasm  with papillary-like nuclear features
	Medullary carcinoma
	Anaplastic carcinoma								↑
	Primary thyroid lymphoma
	Metastatic carcinoma