dimps
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4) A 53-year-old woman comes to the physician because of a "lump" in her neck. She says that her masseuse noticed it 1 month ago. There is no associated pain, pressure, or hoarseness. She feels fine and has no other complaints. She has no history of radiation exposure. Examination reveals a palpable thyroid nodule that is approximately 3 cm. Which of the following is the most appropriate next step in diagnosis?
A. Cutting needle biopsy
B. Fine needle aspiration (FNA)
C. Neck ultrasound
D. Surgical resection
E. Thyroid hormone replacement
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| VM
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Id say FNAC.
VM
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| tasneembanu
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even i think FNA
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| Saeed
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I think one should go for noninvasive test first that is C. Neck ultrasound and then FNA will be next step. One should also do TFT in this patient
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| lucky
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either a or b
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| kalyanb
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FNAC in my opinion is correct
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| miky
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A 53-year-old woman comes to the physician because of a "lump" in her neck. She says that her masseuse noticed it 1 month ago. There is no associated pain, pressure, or hoarseness. She feels fine and has no other complaints. She has no history of radiation exposure. Examination reveals a palpable thyroid nodule that is approximately 3 cm. Which of the following is the most appropriate next step in diagnosis?
A. Cutting needle biopsy
B. Fine needle aspiration (FNA)
C. Neck ultrasound
D. Surgical resection
E. Thyroid hormone replacement
Here's my opinion:
The patient most probably has a benign mass in her neck. However, you should never assume it being bening on clinical grounds only.
I would do next a Neck U/S. It's relatively inexpensive and non-invasive. I think you should aslways start with the least invasive procedures first.
If the mass belongs to the thyroid gland - next: TFTs - next: Nuclear scan - Next: FNA (usually not required if a banign lesion is most probable)
If the mass does not belong to the thyroid, the U/S usually can tell with whether the mass is a cyst / cystic formation or a solid mass. If a cyst - FNA is the next procedure (both therapeutically and investigationally)
If the mass seems solid - if looking benign - next: FNA; if looking malignant - next: Biopsy / Surgical excision and postoperative histopathological exam
Hope I'm right. :roll:
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| Waziri
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B. FNA.
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| Dot
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According to harrison
IF THYROID NODULE is palpable that ia >1cm do first FNAC but if its very small do thyroid scan .In case of very small cold nodule do USG guided FNAC.
In this case FNAC is the best option
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| yutaro
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this Q is a kinf of unkind, I think.
I need more about character of this nodule.
It is movable or not? firm or not? painful or not? Where in thyroid is it located?
ENT doctor thinks more careful exams importance.
probably experienced ENT doctor thinks DDx,
parathyoid nodule or thyroid nodule
Anyway ultrasound is the first.
nodular border, internal echogenity,lymphnode metastasis,location and micrcarcifications become clear so as to make more exact diagnosis.
Such anatomical information must procede invasive procedure and can
contribute to better FNA
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| SA
Forum Elite
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Dear all
I think any question like this go for FNA. WHY well US is non invasive but it will not add any thing to your knowledge about the diagnosis and you need to get the diagnosis as early as possible in a case of bigger masses like this one (any one more than 1 cm)
The question is not invasive or noninvasive her the question which investigation will lead to diagnosis and those are
A. Cutting needle biopsy
B. Fine needle aspiration (FNA)
And in these two B is less invasive.
Any comment from any one?
(Saeed yar I am also saeed)
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| arpit
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i agree with u SA
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| msashraf
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i will go for FNA
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