Diagnostic tactics for thyroid nodules

Aim. To determine the optimal diagnostic tactics for nodules of the thyroid gland.Methods. Examined were 1124 patients with thyroid nodules in the age from 14 to 60 years and older, of whom 159 - with malignant tumors, 180 - with adenomas, 620 - with colloid nodes, 165 - with cysts. Among the surveyed group were 844 women and 280 men. The group of healthy individuals included 400 people. The material for cytology was obtained by fine-needle aspiration biopsy (1004 studies), from smears from the cut surface of the tumor (76 studies) and from puncture biopsies of enlarged regional lymph nodes (44 studies).Results. During ultrasound investigation hypoechoic, heterogeneity, roughness and blurred contours, the presence of the internal structure of small echo-negative inclusions are characteristic for thyroid cancer. As the number of these features increases the likelihood of confirmation of a malignant tumor of the thyroid increases as well. The ultrasound picture of nodular colloid goiter is characterized by a single nodule or multiple nodules in the tissue of the thyroid gland of low or isoechoic density, sometimes with a limiting «rim». The presence of the latter feature causes difficulties in the differential diagnosis between nodular goiter and thyroid adenoma. Out of the 907 informative cases in 144 patients (15.8%) cancer was diagnosed cytologically.Conclusion. A complex diagnostic approach to the examination of thyroid nodules using fine-needle aspiration puncture biopsy of the nodules under the control of ultrasound and subsequent cytological investigation of the punctate provides valuable information on the nature of pathological changes of the thyroid gland.