Which factors suggest a benign diagnosis in patients with thyroid nodules?

Updated: Jan 09, 2018
  • Author: Steven K Dankle, MD; Chief Editor: George T Griffing, MD  more...
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Answer

Answer

Factors suggesting a benign diagnosis include the following:

  • Family history of autoimmune disease (eg, Hashimoto thyroiditis)

  • Family history of benign thyroid nodule or goiter

  • Presence of thyroid hormonal dysfunction (eg, hypothyroidism, hyperthyroidism)

  • Pain or tenderness associated with nodule

  • Soft, smooth, and mobile nodule

Of importance, the factors mentioned above are only guidelines to assist in decision-making, and they do not provide absolute diagnostic information. For example, a historical axiom is that a multinodular goiter without a dominant nodule or a solitary cyst suggests a benign diagnosis. Data from contemporary studies, including those incorporating image-guided fine-needle aspiration biopsy (FNAB), have raised questions about this axiom. Furthermore, the ultrasonographic size of a solid thyroid nodule may have some diagnostic importance, because nodules larger than 3 cm are thought to have an increased risk of malignancy. However, findings suggest that nonpalpable nodules (incidentalomas) incidentally found on high-resolution ultrasonography may have a risk of malignancy comparable to that of palpable nodules.


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