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 | special consideration | ||||
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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Most common thyroid cancer in iodine deficient areas | ||||||||||
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 |