Thyroid Flashcards
Ultrasonography (high risk criterias)
- hypoechoic
- microcalcifications
- irregular borders
- taller than wider
FNA if
> 1cm if - previous radiation exposure - fam hx of thyroid cancer - hoarseness - rapid growth > 1cm with high risk > 2cm with low risk
FNA gives Bethesda
I non diagnostic or unsatisfactory II benign (3% malignity risk) III AUS Atypia of undetermined significance (5-15%) IV Follicular neoplasm (15-30%) V Suspicion of malignancy (60-75%) VI Malignant (97-99%)
Indication to operate a nodule
III or higher
> 4cm
complex cysts
Relative indication : toxic nodule
T4
Thyroxin
T3
Triiodothyronine
TSH
Thyroid Stimulating Hormone
or Thyrotropin
Thyroglobuline (TG)
Precursor of T4 and T3
Iod scintigraphy useful for
Hyperthyroid situation
do differentiate between:
- diffuse Hyperthyroidism (M.Basedow)
- localized hyperfunction (autonome or toxic nodule)
Autonomous nodule
TSH is suppressed
T4 normal
Toxic Adenoma
Clinically manifest hypertoxicosis
Indication to operate a Struma
Multinodose
Benign with compression (Trachea, Esophagus)
If Hyperthyreotic before operation
Bring to euthyreosis
Screening for Hashimoto
antimicrosomal and antithyreoglobulin antibody
Hasimoto on US
Diffuse heterogenous hypoechogenicity