American Association of Clinical Endocrinologists and Associazione Medici Endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules.

摘要: Thyroid nodules are common and frequently benign. Current data suggest that the prevalence of palpable thyroid is 3% to 7% in North America; as high 50% based on ultrasonography (US) or autopsy data. The introduction sensitive thyrotropin (thyroid-stimulating hormone TSH) assays, widespread application fine-needle aspiration (FNA) biopsy, availability high-resolution US have substantially improved management nodules. This document was prepared a collaborative effort between American Association Clinical Endocrinologists (AACE) Associazione Medici Endocrinologi (AME). Most Task Force members AACE. We used AACE protocol for clinical practice guidelines, with rating available evidence, linking guidelines strength recommendations. Key observations include following. Although most patients asymptomatic, occasionally complain dysphagia, dysphonia, pressure, pain, symptoms hyperthyroidism hypothyroidism. Absence does not rule out malignant lesion; thus, it important review risk factors disease. should be performed screening test. All nodule, however, undergo examination. US-guided FNA (US-FNA) recommended > = 10 mm; US-FNA suggested < mm only if information features suspicious. reliable safe, smears interpreted by an experienced pathologist. Patients benign follow-up, suspicious treated surgically. A radioisotope scan useful TSH level low suppressed. Measurement serum best initial laboratory test function followed measurement free thyroxine value peroxidase antibody high. Percutaneous ethanol injection treatment cystic lesions; large,symptomatic goiters may surgically radioiodine. Routine calcitonin recommended. Suggestions nodule during pregnancy presented. believe these will endocrinologists, endocrine surgeons, pediatricians, internists whose practices disorders. These thorough practical, they offer reasoned balanced recommendations evidence.