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]
Overview
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 |
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|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Fixed | Mobile | Painful | LN | Vessle | Metastasis | TSH | FT4/T3 | Hot | Cold | US finding | FNA finding | Associated mutation | ||||
| Benign | Colloid adenoma | |||||||||||||||
| Hashimoto's thyroiditis | ||||||||||||||||
| Cysts nodules | ||||||||||||||||
| Follicular adenomas | ↑↑↑ |
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| Hyperplastic nodules | ↑↑↑ | |||||||||||||||
| Macrofollicular adenomas | ↑↑ | |||||||||||||||
| Microfollicular or cellular adenomas | ↑↑ | |||||||||||||||
| Hürthle cell adenomas | ↑↓ | |||||||||||||||
| Malignant | Papillary carcinoma | ↑↑↑ | ||||||||||||||
| Follicular carcinoma | ↑↑↑ | Bone
Lung |
↑↓ | FLUS |
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| Oxyphilic (Hürthle cell) type carcinoma | ||||||||||||||||
| Noninvasive follicular thyroid neoplasm
with papillary-like nuclear features |
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| Medullary carcinoma | ||||||||||||||||
| Anaplastic carcinoma | ↑ | |||||||||||||||
| Primary thyroid lymphoma | ||||||||||||||||
| Metastatic carcinoma | ||||||||||||||||