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Thyroid Nodules

Study guide:

Thyroid nodules/neoplasms:

  • 90% of the thyroid nodules are benign.

  • To detect the nodule in palpation → it should be 1 cm or more in size

  • Our aim in case of thyroid nodule presence is to determine if it is benign or malignant:

Diagnoses and treatment:

  • Start with detecting the level of TSH:

    • If low → evaluate for hyperthyroidism and scan

    • If high → evaluate for hypothyroidism and US → if US confirms nodules → fine needle aspiration (FNA)

    • If normal → FNA:

      • FNA → malignant →surgery

      • FNA → benign → observe

      • FNA → suspicious or follicular neoplasm → 123 I scan (if cold ‘no function‘ →surgery, if hot ‘hyper function‘ → observe).


  • Agabegi S, Agabegi E, Ring A. Step-up to medicine. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2013.

  • Thyroid and Parathyroid Disorders - American Family Physician [Internet]. 2015 [cited 23 December 2015]. Available from: 

  • Lipsky M, King M. Blueprints family medicine. Baltimore, MD: Lippincott Williams & Wilkins; 2011.

  • Sattar H. Fundamentals of pathology. Chicago:; 2011.

  • Kaplan. Kaplan lecture notes, Medicine, 2014.

Written by:         Rawan Al-Tuwaijri      

Reviewed by:       Jumana AlJohani
                              Bassam Alghamdi

​Format Editor:     Roaa Amer

Website publisher: Adel Yasky

                                 Bayan Alzomaili

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