[Value of echography and fine needle biopsy for diagnosis of thyroid nodules]

Value of ultrasonography and fine needle biopsy for the diagnosis of thyroid nodules. From 1/1/1986 to 31/7/1987, thirty patients with a nodular disease of the thyroid (14 solitary nodules, 9 multiple nodules, 5 colloid cysts, 2 carcinomas) were included in a controlled prospective study using clinical examination, scintigraphy, sonography and fine needle biopsy of the gland. All the patients were operated on and the specimens were submitted to pathological examination. It is shown that palpation is not able to provide an accurate evaluation of the consistancy and number of nodules. The images derived from the scintiscans were not very helpful for discerning a possible malignancy. Sonography was revealed as a fiable method of investigation (21 nodules discovered on a total of 25) allowing to find discrete lesions of 0.5 cm diameter, and also fluid collections with a high resolution rate. Needle biopsy is very useful in diagnostic studies specially for screening of remote malignant lesions with an excellent accuracy approaching 95%. Although considerable progress has been made through these methods of study, a final diagnosis about a solitary solid nodule will always need a surgical exploration to be sure to exclude the risks of an occult carcinoma of the thyroid.