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Unraveling the Mystery: What are Indeterminate Thyroid Nodules?
Published: Aug 25, 2024
Thyroid nodules with indeterminate cytology can be perplexing. This article explores what they are and why they matter.
Understanding Indeterminate Cytology
Thyroid nodules are often evaluated using fine-needle aspiration (FNA) to check for cancer. Sometimes, the results are unclear, or 'indeterminate.' This means the nodule could be benign or malignant, making it tricky to decide on the next steps. These cases fall into categories like 'atypia of undetermined significance' or 'follicular neoplasm,' with a cancer risk ranging from 10 to 40 percent.
The Role of Molecular Testing
Molecular testing has revolutionized how we deal with indeterminate nodules. Before these tests, many patients underwent surgery, often finding out later that their nodules were benign. Now, molecular tests help doctors better assess the cancer risk without immediate surgery, making it a vital tool for decision-making.
The Bethesda Classification
The Bethesda System classifies FNA results into six categories, with III and IV being indeterminate. Understanding these categories helps doctors communicate risks and plan further steps. For instance, Bethesda III nodules have a malignancy risk of 13 to 30 percent, while Bethesda IV ranges from 23 to 34 percent.
Frequently Asked Questions
Indeterminate cytology means the nodule's cancer risk is unclear.
It helps determine cancer risk without immediate surgery.
A classification system for FNA results, including indeterminate nodules.
They account for 10 to 40 percent of thyroid nodule cases.
The Bottom Line
Indeterminate thyroid nodules require careful evaluation to avoid unnecessary surgery.
References
- Ali SZ, et al. The 2023 Bethesda System for Reporting Thyroid Cytopathology.
- Olson MT, et al. Spectrum of risk of malignancy in subcategories of 'atypia of undetermined significance'.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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