Abordagem diagnóstica do nódulo tiroideu: indícios clínicos e imagiológicos de malignidade

Thyroid nodule (TN) is a common pathology in clinical practice. Although most of these nodules are benign,\nit is important to identify the malignant pathology. Thus, a correct use of diagnostic tools is essential\nin distinguishing patients with severe pathology requiring intervention from those with benign changes to\nbe monitored in subsequent evaluations. Evaluation of the patient with TN requires a clinical history with\nresearch of risk factors for malignancy, as well as a detailed physical examination. Ultrasonography has\nbeen widely used in the risk malignancy stratification of TN and as a guide for fine needle aspiration cytology\n(FNAC). Although some ultrasound parameters are associated with an increased risk of malignancy,\nno isolated ultrasound features appear reliable enough to diagnose or exclude malignancy. The use of\nscintigraphy is limited, because carcinomas and remaining benign nodules normally present as cold nodules.\nFNAC is the best test in the research of malignant thyroid nodules that require surgical removal. The\nBethesda classification is easy to interpret and it allows to establishing the way of acting. The correct evaluation\nof patients with TN allows an early diagnosis, appropriate treatment and consequent resource saving.\nIn present work, it is intended to review the diagnostic approach of patients with a TN, focus on clinical\nand imaging suspicious features of malignancy