title: [Management for thyroid nodules].
abstract: Thyroid nodules are very common. Several articles suggest that thyroid nodules are detected by ultrasonography (US) in one of six males and one of 3.5 females in Japan. Thyroid cancer exists among these nodules and distinction between benign and malignant nodules is not always easy. Japan Thyroid Association (JTA) is currently preparing for guidelines for management of thyroid nodules. This article describes how to treat thyroid nodules according to the guidelines in progress. Ultrasonography and fine needle aspiration cytology (FNA) are critical to evaluate nodules. Every nodule should be examined by US, since it is safe, relatively cheap in Japan and can provide a lot of information about characteristics of nodules. Several findings suggesting benign and malignancy have been known. Regarding a FNA classification, the Bethesda system for reporting thyroid cytopathology published a few years ago is expected to become prevailing in the world. Currently the WHO classification of sixth version is used in Japan and the JTA guidelines will adopt a modified WHO classification: "Indeterminate" is divided into two categories; "Indeterminate A, considering follicular tumor" and "Indeterminate B, considering other than follicular tumor". Re-FNA is not recommended for the former subgroup, while re-FNA has a possibility to lead to a correct FNA diagnosis for the latter subgroup. This article discusses several issues regarding papillary thyroid cancer and follicular thyroid cancer also in brief.
authors.affiliation: Department of Medicine, Kuma Hospital.
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Nakamura
mesh_terms: D044963:Biopsy, Fine-Needle / Q000379:methods; D003581:Cytodiagnosis; D006801:Humans; D007564:Japan; D017410:Practice Guidelines as Topic; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000601:surgery; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography