갑상선 nodule FNA상. follicle neoplasm 보임. 무엇을 할것인가? radioiodine scan
A 42-year-old woman presents with a palpable mass on the left side of her neck. She has no neck pain and no symptoms of thyroid dysfunction. Physical examination reveals a solitary, mobile thyroid nodule, 2 cm by 3 cm, without lymphadenopathy. The patient has no family history of thyroid disease and no history of external irradiation. Which investigations should be performed? Assuming that the nodule is benign, which, if any, treatment should be recommended?
문제)The initial lab work-up is ?
TSH
If TSH is low, check free T3 & T4. If TSH high, check anti-TPO Ab-but, even with Hashimoto's thyroiditis, cancer can coexist in a nodule and a biopsy still needed. Basal calcitonin level is checked if there is a family history of MEN 2 or medullary thyroid carcinoma.
문제 )The FNA reveals follicular neoplasm. What do you do?
radionuclide scan. Follicular neoplasm is an all too common result (15% biopsies)and 20% are actally cancer. If scan shows a functioning nodule, surgery is avoided-it is benign. If not, try to rebiopsy a solid area. However, the patient will likely need to get surgery to excise nodule.
