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Association of the Thyroid Nodules With FNA

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Association of the Thyroid Nodules With FNA







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Thyroid nodules are a common finding in clinical practice.


Although ultrasonography is an accepted method for evaluating



these nodules, Fine Needle Aspiration (FNA) is the procedure of



choice for assessing the risk of malignancy. This study aims to determine



the association between sonographic features of thyroid nodules based on



Thyroid Imaging Reporting and Data System classification and the cytology results.



In this prospective cohort study, 147 patients from Tehran Medical Imaging Center




who had thyroid nodules underwent ultrasonography-guided FNA,



and their sonographic features were recorded.



The pathologic findings were also obtained according to the Bethesda system.




inally, the association between sonographic features and cytological results was






Eighteen (12.3%) nodules were malignant, and 129 nodules (87.7%) were benign. The




association of TIRADS categories with the risk of malignancy is as follows:




TIRADS 1 (n=0, 0%), TIRADS 2 (n=10, 16.9%), TIRADS 3 (n=6, 10.5%), TIRADS 4 (n=2, 16.7%), and TIRADS 5 (n=0, 0%).





The bloody lamellae of thyroid nodules were significantly correlated with



the risk of malignancy (P<0.05).



However, there was no statistically significant association between



the risk of malignancy and gender (P=0.47), calcification (P=0.9),



firmness (P=0.19), halo sign (P=0.95), location of nodules (P=0.35),



and nodules' echogenicity (P=0.058).




Although there are trusted classifications such as TIRADS for



categorizing thyroid nodules, there is still uncertainty in utilizing them,



especially in the management of nodules classified as TIRADS 2,





in which various sonographic features are shared between benign and malignant nodules.



Although, based on the ACR guideline, we do not perform FNA


with all nodules that have TIRADS 2, regardless of the size or other characteristics


of the nodule,


there is a possibility that some of these nodules will be malignant in the future,



so it is considered.


It seems that the guideline should be revised regarding TIRADS 2,


and under certain circumstances,



these types of nodules should also be sampled under FNA ultrasound guidance


with some criteria such as size or other features,


because there may be problems in the future,


contrary to what the guideline currently recommends,


that sampling TIRADS 2 is not required.


 be created and find out that some of these types of nodules are malignant 


Although currently, the ACR guideline does not recommend performing


thyroid nodule FNA with TIRADS 2


unless the patient has a positive family history of thyroid cancer,



. especially if family history is the MTC type or MEN.

































Author and compiler:


Dr. Alireza Arefzadeh









endocrinology and metabolism specialist in Tehran


specialist in endocrine diseases in Tehran



the best endocrinologist in Tehran


the best endocrinologist in Tehran


the best subspecialist in Iran


the best endocrinologist in Iran


the best endocrinologist in Tehran


the best endocrinologist in Iran


the best specialist Thyroid in Tehran




thyroid ultrasound






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About Us :

Dr. Alireza Arefzadeh
Assistant Prof of Endocrinology & Metabolism
Faculty Member of Medical University
Internal Medicine Specialist
Endocrinology and Metabolism SubSpecialist
Clinician and Researcher
Member of American Diabetes Association(ADA).
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