What is the role of lab testing in the evaluation in of thyroid nodules?

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

Answer

The most important laboratory test is a sensitive thyroid-stimulating hormone (TSH) assay, which is used to screen for hypothyroidism or hyperthyroidism. In addition, obtaining serum thyroxine (T4) and triiodothyronine (T3) levels may be helpful (eg, when TSH levels are low-normal or high-normal). In most cases of solitary thyroid nodules, the TSH level is normal. In cases of a solitary thyroid nodule with a normal TSH value, no additional laboratory studies may be required in the diagnostic evaluation unless autoimmune disease (eg, Hashimoto thyroiditis) is suspected.

When the patient's history and physical findings reveal a family history or raise clinical suspicion for Hashimoto thyroiditis, obtain serum antithyroid peroxidase (anti-TPO) antibody and antithyroglobulin (anti-Tg) antibody levels. A diagnosis of Hashimoto thyroiditis does not exclude the possibility of malignancy.

Additional laboratory studies are unnecessary in the routine initial diagnostic evaluation of a solitary thyroid nodule.


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