[Treatment of patient having thyroid nodules: dimension of disease, diagnostic choices and guide-lines].
The demand of nodule thyroid diagnosis has increased very much in the last years, because of large diffusion of medical information among the population, the increased use and improvement of medical technology that evidences more and more morphology alterations of the gland. The prevalence of palpable thyroid nodule is 2.1-4.2%, but when the ultrasonography is used the prevalence can reach in average 67%. The thyroid cancer however is a rare event: 1% of all malign tumours. The medium incidence is 2.1 for 100,000 men per year, and 5.19 for 100,000 women per year. pretest illness low probability presents a necessity of a very accurate diagnostic test. The introduction of FNA in the 70 has changed the diagnosis, and allowed to spare time and money. The patient with thyroid nodules should be evaluated by experienced physicians in the thyreopathy field, using efficient remote and family anamnesis, by an accurate palpation of the thyroid and the neck, cl


OBJECTIVE
ing necessary diagnostic controls. The physician should perform the FNA with a cytopathologist and should convey to him all the clinical and biotumoral information. He should be able to interpret correctly the results of the FNA and to suggest the diagnostic and therapeutical follow-up. This review reveals the best compromise between cost-effectiveness, based on the evidence results taken from international literature, taking into consideration various diagnostic opportunities at our disposal. Guide-lines for the treatment of patients with thyroid nodule are proposed.
Pedrazzini
L
L
U.O. Medicina Nucleare, Azienda Ospedaliera, Ospedale di Circolo di Busto Arsizio, Busto Arsizio (Varese). lpedrazzini@aobusto.it
D000367:Age Factors; D044963:Biopsy, Fine-Needle / Q000379:methods; D002277:Carcinoma / Q000175:diagnosis / Q000628:therapy; D002454:Cell Differentiation; D005260:Female; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D013961:Thyroid Gland / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000628:therapy; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D013965:Thyroidectomy