Thyroid Cancer (cont.)
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Thyroid Cancer Symptoms
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A thyroid nodule larger than 1 cm that is found to have decreased iodine uptake on a nuclear medicine thyroid scan needs to be evaluated with a fine needle aspiration biopsy.
Thyroid Cancer Exams and Tests
The diagnosis of thyroid cancer is usually established by examination of cells obtained from a fine-needle aspiration biopsy or a surgical biopsy of a thyroid nodule.
In a fine-needle aspiration biopsy, a thin needle is inserted through the skin into the thyroid nodule and cells are withdrawn into a syringe and sent to the laboratory for analysis by a pathologist.
Blood tests are generally not useful in determining whether a particular thyroid nodule is cancerous. Most patients with thyroid cancer have normal blood levels of thyroid hormones, including a thyrotropin (TSH) level.
Other imaging studies may be useful. An ultrasound of the neck can help identify local cancer spreading to the lymph nodes and blood vessels. Nuclear medicine imaging of the thyroid with radioactive iodine (I-123 or I-131) can identify a thyroid nodule with decreased iodine uptake (sometimes referred to as a "cold" nodule) that may warrant further testing for cancer with a fine-needle aspiration biopsy. Computerized tomography (CT) of the neck can be used to outline the extent of the thyroid tumor into the lymph nodes, blood vessels, and upper GI tract. Computerized tomography is never performed with IV contrast material if the patient is going to have a radioactive iodine scan or treatment within six to eight weeks.
Medically Reviewed by a Doctor on 11/17/2017
Stephanie L Lee, MD, PhD, FACE
Sonia Ananthakrishnan, MD
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