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甲状腺结节的当前评估。

Current Evaluation of Thyroid Nodules.

机构信息

Department of Internal Medicine, Section of Endocrinology, Diabetes and Metabolism, Yale Medical School, PO Box 208020, New Haven, CT 06520-8020, USA.

出版信息

Med Clin North Am. 2021 Nov;105(6):1017-1031. doi: 10.1016/j.mcna.2021.06.006.

Abstract

Thyroid nodules may be discovered in a variety of settings. Familiarity with their management is important for medical specialists. Workup should start with history and physical examination, proceed to laboratory studies, and then to imaging. Nodules are selected for fine needle aspiration (FNA) biopsy based on imaging criteria. Most nodules can be accurately diagnosed on cytopathology, but some may require additional molecular testing to evaluate risk of malignancy. Patients with malignant lesions require additional investigation before referral to an experienced thyroid surgeon. Those who have benign lesions may require monitoring by periodic ultrasound to identify nodules requiring reevaluation.

摘要

甲状腺结节可在多种情况下被发现。熟悉其管理对医学专家很重要。检查应从病史和体格检查开始,然后进行实验室研究,再进行影像学检查。根据影像学标准选择细针抽吸 (FNA) 活检的结节。大多数结节可通过细胞学准确诊断,但有些可能需要额外的分子检测来评估恶性风险。恶性病变的患者在转介给有经验的甲状腺外科医生之前需要进行进一步的检查。良性病变的患者可能需要定期通过超声检查来监测,以识别需要重新评估的结节。

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