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Approach to thyroid nodules

Yıl 2012, Cilt: 29 Sayı: 4S, 315 - 320, 07.05.2013

Elif Kılıç Kan Ramis Çolak

https://doi.org/10.5835/jecm.omu.29.s4.019

Öz

Nodular thyroid disease is a common endocrinopathy that prevalence varies according to the iodine uptake. Nodular goiter becomes more prevalent in both gender as the age increases. When patient with a thyroid nodule is seen compression symptoms, thyroid function and malign benign separation are the first investigations that should be performed. The next step should be the evaluation of the nodule to decide whether surgery or medical treatment is required. After clinical evaluation of a patient with a thyroid nodule, serum TSH measurement and ultrasonographic evaluation are the first investigations that should be performed. Cytological examination of fine needle aspiration biopsy (FNAB) specimens has been proved to be the most efficient and specific method of diagnosing thyroid cancer preoperatively.

Anahtar Kelimeler

Nodular goiter Thyroid nodule Fine-needle aspiration biopsy Iodine Thyroid neoplasm Goiter

Kaynakça

  • Alexander, E.K., Hurwitz, S., Heering, J.P., Benson, C.B., Frates, M.C., Doubilet, P.M., Cibas, E.S., Larsen, P.R., Marqusee, E., 2003. Natural history of benign solid and cystic thyroid nodules. Ann. Intern. Med. 138, 315-318.
  • Baloch, Z.W., LiVolsi, V.A., Asa, S.L., Rosai, J., Merino, M.J., Randolph, G., Vielh, P., DeMay, R.M., Sidawy, M.K., Frable, W.J., 2008. Diag- nostic terminology and morphologic criteria for cytologic diagnosis of thyroid lesions: A synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference. Diagn. Cytopathol. 36, 425-437.
  • Boelaert, K., Horacek, J., Holder, R.L., Watkinson, J.C., Sheppard, M.C., Franklyn, J.A., 2006. Serum thyrotropin concentration as a novel pre- dictor of malignancy in thyroid nodules investigated by fine-needle aspiration. J. Clin. Endocr. Metab. 91, 4295-4301.
  • Carmeci, C., Jeffrey, R.B., McDougall, I.R., Nowels, K.W., Weigel, R.J., 1998. Ultrasound-guided fine-needle aspiration biopsy of thyroid masses. Thyroid. 8, 283-289.
  • Cibas, E.S., Ali, S.Z., NCI Thyroid FNA State of the Science Conference, 2009. The bethesda system for reporting thyroid cytopathology. Am. J. Clin. Pathol. 132, 658-665.
  • Cooper, D.S., Doherty, G.M., Haugen, B.R., Hauger, B.R., Kloos, R.T., Lee, S.L., Mandel, S.J., Mazzaferri, E.L., McIver, B., Pacini, F., Schlum- berger, M., Sherman, S.I., Steward, D.L., Tuttle, R.M., 2009. American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nod- ules and Differentiated Thyroid Cancer. 19, 167-214.
  • Danese, D., Sciacchitano, S., Farsetti, A., Andreoli, M., Pontecorvi, A., 1998. Diagnostic accuracy of conventional versus sonography-guided fine-needle aspiration biopsy of thyroid nodules. Thyroid. 8, 15-21.
  • Elisei, R., Bottici, V., Luchetti, F., Di Coscio, G., Romei, C., Grasso, L., Miccoli, P., Iacconi, P., Basolo, F., Pinchera, A., Pacini, F., 2004. Impact of routine measurement of serum calcitonin on the diagnosis and outcome of medullary thyroid cancer: Experience in 10,864 patients with nodular thyroid disorders. J. Clin. Endocr. Metab. 89, 163-168.
  • Erdoğan, G., Erdoğan, M.F., Emral, R., Baştemir, M., Sav, H., Haznedaroğlu, D., Üstündağ, M., Köse, R., Kamel, N., Genç, Y., 2002. Iodine status and goiter prevalence in Turkey before mandatory iodization. J. Endocrinol. Invest. 25, 224-228.
  • Franco, C., Martı´nez, V., Allamand, J.P., Medina, F., Glasinovic, A., Osorio, M., Schachter, D., 2009. Molecular markers in thyroid fine-needle aspiration biopsy: A prospective study. Appl. Immunohistochem. Mol. Morphol. 17, 211-215.
  • Frates, M.C., Benson, C.B., Doubilet, P.M., Kunreuther, E., Contreras, M., Cibas, E.S., Orcutt, J., Moore F.D. Jr., Larsen P.R., Marqusee, E., Alexander E.K., 2006. Prevalence and distribution of carcinoma in patients with solitary and multiple thyroid nodules on sonography. J. Clin. Endocr. Metab. 91, 3411-3417.
  • Gharib, H., Goellner, J.R., Johnson, D.A., 1993. Fine-needle aspiration cytology of the thyroid. A 12-year experience with 11,000 biopsies. Clin. Lab. Med. 13, 699-709.
  • Hoving, J., Piers, D.A., Vermey, A., Oosterhuis, J.W., 1981. Carcinoma in hyperfunctioning thyroid nodule in recurrent hyperthyroidism. Eur. J. Nucl. Med. 6, 131-132.
  • Kim, W.B., Han, S.M., Kim, T.Y., Nam-Goong, I.S., Gong, G., Lee, H.K., Hong, S.J., Shong,Y.K., 2004. Ultrasonographic screening for detec- tion of thyroid cancer in patients with Graves' disease. Clin. Endocrinol. 60, 719-725.
  • Kuy, S., Roman, S.A., Desai, R., Sosa, J.A., 2009. Outcomes following thyroid and parathyroid surgery in pregnant women. Arch. Surg. 144, 399-406.
  • Layfield, L.J., Abrams, J., Cochand-Priollet, B., Evans, D., Gharib, H., Greenspan, F., Henry, M., LiVolsi, V., Merino, M., Michael, C.V., Wang, H., Wells S.A., 2008. Post thyroid FNA testing and treatment options: A synopsis of the National Cancer Institute Thyroid Fine Needle As- piration State of the Science Conference. Diagn. Cytopathol. 36, 442-448.
  • Moosa, M., Mazzaferri, E.L., 1997. Outcome of differentiated thyroid cancer diagnosed in pregnant women. J. Clin. Endocr. Metab. 82, 2862– 2866.
  • Nayar, R., Ivanovic, M., 2009. The indeterminate thyroid fine-needle aspiration: Experience from an academic center using terminology similar to that proposed in the National Cancer Institute Thyroid Fine Needle Aspiration State of the Science Conference. Cancer. 117, 195-202.
  • Özata, M., 2005. Tiroid hastalıklarına güncel yaklaşım. Epsilon Yayıncılık, İstanbul. pp. 118.
  • Pacini, F., Pinchera, A., Giani, C., Grasso, L., Doveri, F., Baschieri, L., 1980. Serum thyroglobulin in thyroid carcinoma and other thyroid disorders. J. Endocrinol. Invest . 3, 283-292.
  • Ramos, C.D., Zantut-Wittmann, D.E., Tambascia, M.A., Assumpção, L., Etchebehere, E.C., Camargo, E.E., 2000. Thyroid suppression test with L-thyroxine and [99mTc]pertechnetate. Clin. Endocrinol. (Oxf). 52, 471-477.
  • Reiners, C., Wegscheider, K., Schicha, H., Theissen, P., Vaupel, R., Wrbitzky, R., Schumm-Draeger, P.M., 2004. Prevalence of thyroid disorders in the working population of Germany: Ultrasonography screening in 96,278 unselected employees. Thyroid. 14, 926-932.
  • Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer, 2009. Thy- roid. 19, 1167-1214.
  • Schneider, A.B., Bekerman, C., Leland, J., Rosengarten, J., Hyun, H., Collins, B., Shore-Freedman, E., Gierlowski, T.C., 1997. Thyroid nodules in the follow-up of irradiated individuals: Comparison of thyroid ultrasound with scanning and palpation. J. Clin. Endocr. Metab. 82, 4020- 4027.
  • Takashima, S., Fukuda, H., Kobayashi, T., 1994. Thyroid nodules: Clinical effect of ultrasound-guided fine-needle aspiration biopsy. J. Clin. Ultrasound. 22, 535-542.
  • Tan, G.H., Gharib, H., 1997. Thyroid incidentalomas: Management approaches to nonpalpable nodules discovered incidentally on thyroid imag- ing. Ann. Intern. Med. 126, 226-231.
  • Yang, J., Schnadig, V., Logrono, R., Wasserman, P.G., 2007. Fine-needle aspiration of thyroid nodules: A study of 4703 patients with histologic and clinical correlations. Cancer. 111, 306-315.

Tiroit nodüllerine yaklaşım

Yıl 2012, Cilt: 29 Sayı: 4S, 315 - 320, 07.05.2013

Elif Kılıç Kan Ramis Çolak

https://doi.org/10.5835/jecm.omu.29.s4.019

Öz

Nodüler tiroit hastalığı sık görülen endokrinolojik bir hastalık olup prevalansı iyot alımına göre önemli ölçüde değişmektedir. Her iki cinsiyette de yaş ile birlikte nodüler guatr prevalansında artış saptanmıştır. Tiroit nodülü ile karşılaşıldığında ilk yapılması gereken malign-benign ayırımı, sonrasında kompresyon belirtileri, tiroit fonksiyonlarının değerlendirilmesi ve cerrahi gereken nodül ile medikal tedavi gereken nodül ayırımını yapmak olmalıdır. Klinik değerlendirme sonrasındaki ilk değerlendirme serum TSH ölçümü ve ultrasonografik inceleme olmalıdır. Preopeartif olarak tiroit kanserinin teşhisinde Tiroit ince iğne aspirasyon biyopsisi sitolojik incelemesinin en etkili ve spesifik metod olduğu ispatlanmıştır.

Anahtar Kelimeler

Nodüler guatr Tiroit nodülü İnce iğne aspirasyon biyopsisi Tiroit kanserleri İyot Guatr

Kaynakça

  • Alexander, E.K., Hurwitz, S., Heering, J.P., Benson, C.B., Frates, M.C., Doubilet, P.M., Cibas, E.S., Larsen, P.R., Marqusee, E., 2003. Natural history of benign solid and cystic thyroid nodules. Ann. Intern. Med. 138, 315-318.
  • Baloch, Z.W., LiVolsi, V.A., Asa, S.L., Rosai, J., Merino, M.J., Randolph, G., Vielh, P., DeMay, R.M., Sidawy, M.K., Frable, W.J., 2008. Diag- nostic terminology and morphologic criteria for cytologic diagnosis of thyroid lesions: A synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference. Diagn. Cytopathol. 36, 425-437.
  • Boelaert, K., Horacek, J., Holder, R.L., Watkinson, J.C., Sheppard, M.C., Franklyn, J.A., 2006. Serum thyrotropin concentration as a novel pre- dictor of malignancy in thyroid nodules investigated by fine-needle aspiration. J. Clin. Endocr. Metab. 91, 4295-4301.
  • Carmeci, C., Jeffrey, R.B., McDougall, I.R., Nowels, K.W., Weigel, R.J., 1998. Ultrasound-guided fine-needle aspiration biopsy of thyroid masses. Thyroid. 8, 283-289.
  • Cibas, E.S., Ali, S.Z., NCI Thyroid FNA State of the Science Conference, 2009. The bethesda system for reporting thyroid cytopathology. Am. J. Clin. Pathol. 132, 658-665.
  • Cooper, D.S., Doherty, G.M., Haugen, B.R., Hauger, B.R., Kloos, R.T., Lee, S.L., Mandel, S.J., Mazzaferri, E.L., McIver, B., Pacini, F., Schlum- berger, M., Sherman, S.I., Steward, D.L., Tuttle, R.M., 2009. American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nod- ules and Differentiated Thyroid Cancer. 19, 167-214.
  • Danese, D., Sciacchitano, S., Farsetti, A., Andreoli, M., Pontecorvi, A., 1998. Diagnostic accuracy of conventional versus sonography-guided fine-needle aspiration biopsy of thyroid nodules. Thyroid. 8, 15-21.
  • Elisei, R., Bottici, V., Luchetti, F., Di Coscio, G., Romei, C., Grasso, L., Miccoli, P., Iacconi, P., Basolo, F., Pinchera, A., Pacini, F., 2004. Impact of routine measurement of serum calcitonin on the diagnosis and outcome of medullary thyroid cancer: Experience in 10,864 patients with nodular thyroid disorders. J. Clin. Endocr. Metab. 89, 163-168.
  • Erdoğan, G., Erdoğan, M.F., Emral, R., Baştemir, M., Sav, H., Haznedaroğlu, D., Üstündağ, M., Köse, R., Kamel, N., Genç, Y., 2002. Iodine status and goiter prevalence in Turkey before mandatory iodization. J. Endocrinol. Invest. 25, 224-228.
  • Franco, C., Martı´nez, V., Allamand, J.P., Medina, F., Glasinovic, A., Osorio, M., Schachter, D., 2009. Molecular markers in thyroid fine-needle aspiration biopsy: A prospective study. Appl. Immunohistochem. Mol. Morphol. 17, 211-215.
  • Frates, M.C., Benson, C.B., Doubilet, P.M., Kunreuther, E., Contreras, M., Cibas, E.S., Orcutt, J., Moore F.D. Jr., Larsen P.R., Marqusee, E., Alexander E.K., 2006. Prevalence and distribution of carcinoma in patients with solitary and multiple thyroid nodules on sonography. J. Clin. Endocr. Metab. 91, 3411-3417.
  • Gharib, H., Goellner, J.R., Johnson, D.A., 1993. Fine-needle aspiration cytology of the thyroid. A 12-year experience with 11,000 biopsies. Clin. Lab. Med. 13, 699-709.
  • Hoving, J., Piers, D.A., Vermey, A., Oosterhuis, J.W., 1981. Carcinoma in hyperfunctioning thyroid nodule in recurrent hyperthyroidism. Eur. J. Nucl. Med. 6, 131-132.
  • Kim, W.B., Han, S.M., Kim, T.Y., Nam-Goong, I.S., Gong, G., Lee, H.K., Hong, S.J., Shong,Y.K., 2004. Ultrasonographic screening for detec- tion of thyroid cancer in patients with Graves' disease. Clin. Endocrinol. 60, 719-725.
  • Kuy, S., Roman, S.A., Desai, R., Sosa, J.A., 2009. Outcomes following thyroid and parathyroid surgery in pregnant women. Arch. Surg. 144, 399-406.
  • Layfield, L.J., Abrams, J., Cochand-Priollet, B., Evans, D., Gharib, H., Greenspan, F., Henry, M., LiVolsi, V., Merino, M., Michael, C.V., Wang, H., Wells S.A., 2008. Post thyroid FNA testing and treatment options: A synopsis of the National Cancer Institute Thyroid Fine Needle As- piration State of the Science Conference. Diagn. Cytopathol. 36, 442-448.
  • Moosa, M., Mazzaferri, E.L., 1997. Outcome of differentiated thyroid cancer diagnosed in pregnant women. J. Clin. Endocr. Metab. 82, 2862– 2866.
  • Nayar, R., Ivanovic, M., 2009. The indeterminate thyroid fine-needle aspiration: Experience from an academic center using terminology similar to that proposed in the National Cancer Institute Thyroid Fine Needle Aspiration State of the Science Conference. Cancer. 117, 195-202.
  • Özata, M., 2005. Tiroid hastalıklarına güncel yaklaşım. Epsilon Yayıncılık, İstanbul. pp. 118.
  • Pacini, F., Pinchera, A., Giani, C., Grasso, L., Doveri, F., Baschieri, L., 1980. Serum thyroglobulin in thyroid carcinoma and other thyroid disorders. J. Endocrinol. Invest . 3, 283-292.
  • Ramos, C.D., Zantut-Wittmann, D.E., Tambascia, M.A., Assumpção, L., Etchebehere, E.C., Camargo, E.E., 2000. Thyroid suppression test with L-thyroxine and [99mTc]pertechnetate. Clin. Endocrinol. (Oxf). 52, 471-477.
  • Reiners, C., Wegscheider, K., Schicha, H., Theissen, P., Vaupel, R., Wrbitzky, R., Schumm-Draeger, P.M., 2004. Prevalence of thyroid disorders in the working population of Germany: Ultrasonography screening in 96,278 unselected employees. Thyroid. 14, 926-932.
  • Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer, 2009. Thy- roid. 19, 1167-1214.
  • Schneider, A.B., Bekerman, C., Leland, J., Rosengarten, J., Hyun, H., Collins, B., Shore-Freedman, E., Gierlowski, T.C., 1997. Thyroid nodules in the follow-up of irradiated individuals: Comparison of thyroid ultrasound with scanning and palpation. J. Clin. Endocr. Metab. 82, 4020- 4027.
  • Takashima, S., Fukuda, H., Kobayashi, T., 1994. Thyroid nodules: Clinical effect of ultrasound-guided fine-needle aspiration biopsy. J. Clin. Ultrasound. 22, 535-542.
  • Tan, G.H., Gharib, H., 1997. Thyroid incidentalomas: Management approaches to nonpalpable nodules discovered incidentally on thyroid imag- ing. Ann. Intern. Med. 126, 226-231.
  • Yang, J., Schnadig, V., Logrono, R., Wasserman, P.G., 2007. Fine-needle aspiration of thyroid nodules: A study of 4703 patients with histologic and clinical correlations. Cancer. 111, 306-315.
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Surgery Medical Sciences
Yazarlar

Elif Kılıç Kan Bu kişi benim

Ramis Çolak

Yayımlanma Tarihi 7 Mayıs 2013
Gönderilme Tarihi 7 Haziran 2012
Yayımlandığı Sayı Yıl 2012 Cilt: 29 Sayı: 4S

Kaynak Göster

APA Kılıç Kan, E., & Çolak, R. (2013). Tiroit nodüllerine yaklaşım. Journal of Experimental and Clinical Medicine, 29(4S), 315-320. https://doi.org/10.5835/jecm.omu.29.s4.019
AMA Kılıç Kan E, Çolak R. Tiroit nodüllerine yaklaşım. J. Exp. Clin. Med. Mayıs 2013;29(4S):315-320. doi:10.5835/jecm.omu.29.s4.019
Chicago Kılıç Kan, Elif, ve Ramis Çolak. “Tiroit nodüllerine yaklaşım”. Journal of Experimental and Clinical Medicine 29, sy. 4S (Mayıs 2013): 315-20. https://doi.org/10.5835/jecm.omu.29.s4.019.
EndNote Kılıç Kan E, Çolak R (01 Mayıs 2013) Tiroit nodüllerine yaklaşım. Journal of Experimental and Clinical Medicine 29 4S 315–320.
IEEE E. Kılıç Kan ve R. Çolak, “Tiroit nodüllerine yaklaşım”, J. Exp. Clin. Med., c. 29, sy. 4S, ss. 315–320, 2013, doi: 10.5835/jecm.omu.29.s4.019.
ISNAD Kılıç Kan, Elif - Çolak, Ramis. “Tiroit nodüllerine yaklaşım”. Journal of Experimental and Clinical Medicine 29/4S (Mayıs 2013), 315-320. https://doi.org/10.5835/jecm.omu.29.s4.019.
JAMA Kılıç Kan E, Çolak R. Tiroit nodüllerine yaklaşım. J. Exp. Clin. Med. 2013;29:315–320.
MLA Kılıç Kan, Elif ve Ramis Çolak. “Tiroit nodüllerine yaklaşım”. Journal of Experimental and Clinical Medicine, c. 29, sy. 4S, 2013, ss. 315-20, doi:10.5835/jecm.omu.29.s4.019.
Vancouver Kılıç Kan E, Çolak R. Tiroit nodüllerine yaklaşım. J. Exp. Clin. Med. 2013;29(4S):315-20.
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