The reader is also introduced to the different thyroid nodule risk stratification systems in ultrasound imaging, when and how to perform thyroid fine needle aspiration biopsies, and the use of percutaneous ethanol injections for cystic thyroid nodules.

 Chapters which begin with an introduction to thyroid ultrasound and progressively explain relevant diagnostic imaging and biopsy procedures for different thyroid diseases (including thyroid cancer and autoimmune diseases)

multiple tables and figures which summarize and highlight important points. more than 60 ultrasound images which illustrate various ultrasound signs and artifacts from patients. A summary of the current standards for the evaluation and clinical management of thyroid nodules based on clinical practice guidelines

A detailed list of references, abbreviations, and symbols The textbook is an essential reference for both practicing and training endocrine surgeons, endocrinologists, radiologists, cytopathologists, sonographers as well as any health care worker with an interest in managing thyroid and parathyroid diseases in their daily practice.

Thyroid nodules are lumps that commonly arise within an otherwise normal thyroid gland. Most commonly, these abnormal growths of thyroid tissue do not produce any symptoms whatsoever. Thyroid nodules are usually found during a routine examination of the neck by a health care provider, or from X-ray studies obtained for other reasons. 

When thyroid nodules do produce symptoms it is either due to their larger size or their location within the gland. Thyroid nodules which are located at the edge of the thyroid gland can sometimes be felt as a lump in the throat or even seen as a lump in the neck when they occur in very thin individuals.

After an appropriate work-up, most thyroid nodules will yield an answer of no to all of the above questions. In this most common situation, there is usually a small- to a moderate-sized nodule that is simply an overgrowth of normal thyroid tissue. Even when thyroid nodules are quite large, thyroid function is most commonly totally normal.

Research work about thyroid Nodules

Patients with multiple thyroid nodules in a diffusely enlarged thyroid (called a goiter or multinodular goiter) will have what is perceived at first to be a nodule but is later found to be only one of many benign enlarged growths within the thyroid (a goiter).

There are three tests that may be considered in any patient with a thyroid nodule.  The first is a blood test in order to determine how much thyroid hormone is being produced.  Thyroid nodules rarely produce too much thyroid hormone. 

But when excessive thyroid hormone is being produced by the thyroid nodule this is almost always associated with a benign (non-cancerous) nodule. Benign thyroid nodules that produce extra thyroid hormone are usually removed to cure the excessive hormone production.

The second test considered in the evaluation of a thyroid nodule is an ultrasound. Ultrasound of the thyroid must include the analysis of lymph nodes of the neck, as well.  Because thyroid cancers can frequently spread to neck lymph nodes, the ultrasound analysis of the neck lymph nodes can provide important information about an unknown thyroid cancer sometimes far superior to the ultrasound of the thyroid itself.

The quality of the thyroid ultrasound is dependent upon several factors.  Each of these factors plays an important role in determining the quality of the thyroid ultrasound.  Any one factor that limits the ultrasound can decrease the quality of the information available by the ultrasound.  The ultrasound is necessary to determine the characteristics of the thyroid nodule and the neck lymph nodes in determining the risk of thyroid cancer.

For thyroid nodules that are greater than 1 cm (one half an inch) in size, a fine needle aspiration biopsy (FNA) is frequently considered.  Smaller thyroid nodules are generally not biopsied unless other concerning findings are noted. 

Pathologists that are expert at looking at thyroid cells under a microscope, called thyroid cytopathologists, can commonly determine whether a nodule is benign or cancerous. When the thyroid cytopathologist diagnosis falls somewhere in between a benign and malignant determination, today, several commercially available genetic studies of the FNA material can be considered to help patients and doctors determine the relative risk of thyroid cancer. 

Thyroid nodules most commonly cause no symptoms at all. In this light, thyroid nodules are most commonly found by routine neck examinations by health care providers or due to x-ray studies obtained for other reasons. Thyroid nodules which are found because the patient is undergoing a CT scan, MRI scan, or ultrasound scan of the neck for some other reason (such as parathyroid disease, trauma, carotid artery disease, or cervical spine pain).

When thyroid nodules are found accidentally, they are cancerous even less than 1% of the time. A more sophisticated type of imaging x-ray called a PET/CT scan is being used to screen for other types of cancers.  Unlike other x-ray studies, thyroid nodules found on PET/CT scans may be diagnosed as cancerous in 50% of cases. When thyroid nodules do produce symptoms, the most common of these symptoms is a lump in the neck followed by a sense of mass while swallowing.