Assessment of nodular goitre

Area of Science:

• Endocrinology
• Oncology
• Radiology

Background:

• Nodular goitres represent thyroid gland enlargements.
• Non-toxic nodular goitre occurs endemically and sporadically, distinct from thyroid dysfunction or malignancy.
• Diffuse goitres can progress to nodular forms, potentially leading to hyperthyroidism or asymptomatic presentation.

Purpose of the Study:

• To outline the diagnostic approaches for non-toxic nodular goitre.
• To highlight the role of fine-needle aspiration biopsy (FNAB) and emerging molecular testing in evaluating thyroid nodules.
• To improve the diagnostic accuracy and malignancy prediction in nodular thyroid disease.

Main Methods:

• Neck palpation.
• Imaging modalities including ultrasonography (US), US elastography, scintigraphy, computed tomography (CT), and magnetic resonance imaging (MRI).
• Fine-needle aspiration biopsy (FNAB) with cytology and molecular testing.

Main Results:

• FNAB offers direct and specific information on thyroid nodules.
• The combination of cytology and molecular testing significantly enhances diagnostic accuracy.
• Improved prediction of malignancy in patients with nodular thyroid disease is achievable.

Conclusions:

• Non-toxic nodular goitre requires comprehensive diagnostic evaluation.
• Advanced techniques like molecular testing alongside FNAB are crucial for accurate diagnosis and malignancy risk assessment.
• These methods improve patient management and prediction of outcomes in nodular thyroid disease.