The most cost-effective way to evaluate a patient with a thyroid nodule is to have a sensitive thyroid-stimulating hormone (TSH) blood test to document normal thyroid function and to perform a fine needle aspiration (FNA) biopsy to determine whether the nodule is benign , suspicious or malignant . Patients with benign nodules are treated with thyroid hormone to suppress TSH; about 50 percent of these nodules will shrink. Malignant nodules should be removed, as should solitary "cold" nodules. FNA is usually repeated after six months if the nodule has not decreased in size.
Physical Examination
• Careful examination of the thyroid gland and adjacent lymph nodes .
Blood and Other Tests
Blood tests are not generally useful to determine if a thyroid nodule is benign or malignant.
• Serum thyroglobulin levels are elevated in most patients with well-differentiated thyroid cancers, but the level
cannot indicate whether a lump is benign or malignant. The presence of thyroglobulin after a total
thyroidectomy (surgical removal of the thyroid gland) or the recurrence of a high level after surgery suggests
