Management of Thyroid nodules in adult patients

Eng, Chee Yean; Quraishi, M. S.; Bradley, Patrick J.

doi:10.1186/1758-3284-2-11

Cited by 41 publications

(37 citation statements)

References 7 publications

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“…The presence of thyroid nodules or edema in this region may produce compressive effects that limit laryngeal mobility (6,9,11) and favor the emergence of swallowing complaints. The presence of compressive symptoms in benign thyroid diseases cannot be easily assessed objectively, but they are known to be more commonly observed in surgical cases (10) .…”

Section: Discussionmentioning

confidence: 99%

“…Swallowing dysfunctions are the result of compressive effects or the consequence of surgical interventions (2,3) , with gastrointestinal tract dysmotility leading the complaint reports (4)(5)(6) . Changes in the oropharyngeal transit differ according to the type of thyroid disease and seem to be more concentrated in the laryngopharyngeal region (4)(5)(6)(7)(8)(9)(10)(11)(12) . In hypothyroidism, discomfort is perceived in the cervical region, manifested as dry throat, dyspnea, globus pharyngeus, pain, itching, and burning (5,8) , which are symptoms related to myxedema that compromise laryngeal mobility and the proper functioning of pharyngoesophageal transit (4,6) .…”

Section: Introductionmentioning

confidence: 99%

“…In hypothyroidism, discomfort is perceived in the cervical region, manifested as dry throat, dyspnea, globus pharyngeus, pain, itching, and burning (5,8) , which are symptoms related to myxedema that compromise laryngeal mobility and the proper functioning of pharyngoesophageal transit (4,6) . In patients with thyroid nodules, the symptoms are associated with the degree of compression, and there may be surgical indication even for benign cases (9)(10)(11) . In hyperthyroidism, reports indicate specific cases of dysphagia associated with thyrotoxic myopathy, which is a more unusual condition (12) .…”

Section: Introductionmentioning

confidence: 99%

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Autopercepção da deglutição em pacientes com doença tireoidiana benigna não cirúrgica

Pernambuco

Silva²,

Almeida³

et al. 2017

CoDAS

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RESUMO Objetivo verificar a frequência de queixa para deglutir em pacientes com doença tireoidiana benigna não cirúrgica e comparar a autopercepção de intensidade da alteração de deglutição em diferentes tipos de doença tireoidiana. Método a amostra do estudo foi composta por 39 mulheres com idades entre 19 e 58 anos (38,54 ± 10,74 anos) e diagnóstico de hipotireoidismo (n=22; 56,4%) ou nódulos tireoidianos (n=17; 43,6%). Investigou-se a presença de queixa, tipo de queixa e autopercepção da intensidade da alteração de deglutição por meio da escala analógico-visual de 100 milímetros. Os dados foram analisados de forma descritiva e para comparar a autopercepção entre os diferentes diagnósticos clínicos utilizamos o teste não paramétrico de Mann-Whitney. O nível de significância foi de 5%. Resultados vinte e seis (66,7%) participantes relataram queixa para deglutir. As queixas referidas foram sensação de estase em região laringofaríngea (37,15%), engasgo (34,29%) e odinofagia (28,57%). O valor médio da autopercepção de intensidade da alteração de deglutição por meio da escala analógico-visual foi 59,35 (± 27,38) milímetros. A autopercepção não foi diferente entre os diagnósticos clínicos de doença tireoidiana. Conclusão nessa amostra, queixas para deglutir foram frequentes em mulheres com doenças tireoidianas benignas não cirúrgicas. Essas pacientes percebem a alteração de forma moderada, independentemente do diagnóstico clínico da patologia tireoidiana.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Autopercepção da deglutição em pacientes com doença tireoidiana benigna não cirúrgica

Pernambuco

Silva²,

Almeida³

et al. 2017

CoDAS

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“…The latest global estimate indicated the occurrence of about 300.000 new cases of this cancer (68.000 in men and 230.000 in women). In Brazil, it corresponds to 1.150 new cases of thyroid cancer in males and 8.050 in females, with an estimated risk of 1.15/100.000 cases in men and 7.91/100.000 cases in women, according to data recorded by INCA (National Cancer Institute) in the year 2014 (7,8).…”

Section: Introductionmentioning

confidence: 99%

Increasing diagnostic effectiveness of thyroid nodule evaluation by implementation of cell block preparation in routine US-FNA analysis

Cristo

Goldstein

Faccin

et al. 2016

Arch. Endocrinol. Metab.

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Objective: Ultrasound-guided fine-needle aspiration (US-FNA) biopsy has proven to be an accurate and efficient tool in thyroid nodule evaluation. We evaluated whether cell block adds to the diagnostic accuracy of US-FNA. Subjects and methods: Three hundred twenty-eight consecutive patients underwent US-FNA, cytology and cell block evaluation. Six slides were prepared for each patient and stained by Papanicolaou and Giemsa techniques. The residual hemorrhagic aspirate in the syringe and needle was fixed in 10% formalin and paraffin-embedded (cell block). The histological sections were examined as a complementary diagnostic tool to US-FNA. Results: The study population comprised 89% females and the mean age was 57.4 ± 13.7 years. The mean nodule size was 2.3 ± 1.2 cm. US-FNA cytological results were as follows: Bethesda I, 17.1% (n = 56); Bethesda II, 61.6% (n = 202); Bethesda III, 9.5% (n = 31); Bethesda IV, 5.8% (n = 19); Bethesda V, 2.4% (n = 8), and Bethesda VI, 3.6% (n = 12). Cell blocks were obtained in 100% of cases and were considered diagnostic in 89.6%. Combined cytological and cell block (cyto-cell block) results were as follows: unsatisfactory, 4.3% (n = 14); benign, 72.6% (n = 238); indeterminate, 11.3% (n = 37); follicular lesion, 5.8% (n = 19); suspicious for malignancy, 2.4% (n = 8), and malignant, 3.6% (n = 12). The sensitivity and specificity for cyto-cell block was 100% and 90%, respectively, and the accuracy was 94%. Cyto-cell block analysis reduced the rate of unsatisfactory samples (p < 0.001). Conclusions: The cyto-cell block interpretation improved the efficiency of US-FNA. This simple, fast and low-cost technique should be used as an adjunctive test in thyroid nodule evaluation.

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“…Thyroid cancer (Table 1) accounts for only 1% of all malignancies [1,2]. About 3%e8% of nodules are palpable and 20%e70% are detected at US examination; the overall risk of malignancy is 5%e13% [3] so a consistent diagnostic approach to patients with thyroid nodules is essential to avoid the risk of over or under treatment.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound guided fine-needle aspiration biopsy of thyroid nodules: Guidelines and recommendations vs clinical practice; a 12-month study of 89 patients

Peli

Capalbo

Lovisatti

et al. 2012

Journal of Ultrasound

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Introduction: Given the high prevalence of thyroid nodules in the general population it is essential to develop a method for identifying those nodules which require fine-needle aspiration biopsy (FNAB) due to suspicion for malignancy in order to avoid over-or under treatment of this disease. The ultrasound (US) criteria identified by Kim et al. and the American Association of Clinical Endocrinologists appear to be the most sensitive and most specific. The purpose of this study was to analyze a sample of patients who underwent FNAB of the thyroid and to compare the obtained data with the international guidelines and the recommendations for management of thyroid nodules. Materials and methods: This study analyzed the clinical, anamnestic and US reasons for which 97 nodules located in 89 patients underwent FNAB, and the data were compared with the criteria set by the guidelines and with the cytological results. Results: Echogenicity was indication for FNAB in 99% of cases, appearance of the margins in 75.3%, presence of calcifications in 93.8% and presence of vascularity in 73.2%. In a total of 4.1% of cases, cytological outcome was positive for malignancy, 21.6% necessitated monitoring, 4.1% were referred to surgery and histological examination of the surgical specimen and 63.9% resulted negative for malignancy. Discussion: The finding of hypoechoic nodules often leads to continued investigation; the presence of intranodular vascularization detected at Doppler US is perceived as suspicious and the presence of microcalcifications always leads to further investigation. On the request of the endocrinologist the dominant nodule in a goiter is in most cases subjected to FNAB even if the volume has not increased. Adequate US criteria can help identify potentially malignant nodules and guide implementation of FNAB. However, identification of malignant nodules using instrumental investigation cannot disregard medical records and clinical laboratory tests. According to the authors' experience, a close collaboration between endocrinologists, radiologists and pathologists is essential for a correct evaluation of patients with thyroid nodules in order to avoid over or under estimation of the risk of malignancy of a nodule and therefore of the necessity to perform further examinations.Sommario Introduzione: Data l'elevata prevalenza di noduli tiroidei nella popolazione generale è indispensabile un metodo di individuazione dei noduli sospetti per neoplasia da sottoporre an FNAB per evitare un sovra o sotto trattamento della patologia. I criteri ecografici individuati da Dizionario -Visualizza dizionario dettaglKim et al e dall'American Association of Clinical Endocrinologists risultano essere rispettivamente i più sensibili e più specifici. Lo scopo dello studio è di analizzare un campione di pazienti sottoposti a biopsia tiroidea con ago sottile (Fine-Needle Aspiration Biopsy -FNAB) e verificare quanto nella pratica clinica si faccia riferimento alle linee guida. Materiali e metodi: Sono state analizzate le motivazion...

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Management of Thyroid nodules in adult patients

Cited by 41 publications

References 7 publications

Autopercepção da deglutição em pacientes com doença tireoidiana benigna não cirúrgica

Autopercepção da deglutição em pacientes com doença tireoidiana benigna não cirúrgica

Increasing diagnostic effectiveness of thyroid nodule evaluation by implementation of cell block preparation in routine US-FNA analysis

Ultrasound guided fine-needle aspiration biopsy of thyroid nodules: Guidelines and recommendations vs clinical practice; a 12-month study of 89 patients

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