Thyroid Cancer: Early Diagnosis of Thyroid Nodules through Cervical Ultrasound and Fine Needle Aspiration (FNA)

Thyroid cancer is a pathology that has gained relevance in recent decades due to the increase in its detection, partly thanks to advances in imaging and diagnostic techniques. The evaluation of a thyroid nodule is crucial to determine the benign or malignant nature of the lesion, and fine needle aspiration (FNA) has become an essential tool in this process. This article explores the importance of the early evaluation of thyroid nodules and the role of FNA in the diagnosis of thyroid cancer.
Evaluation of Thyroid Nodules
Cervical ultrasound is the method of choice for the initial evaluation of thyroid nodules. This non-invasive technique allows for the differentiation between benign and malignant nodules with high precision, although it has limitations in diagnosing follicular carcinomas [1]. Ultrasound is also useful for guiding FNA, improving the accuracy of sampling [2].
FNA is a minimally invasive procedure that allows for the collection of cellular samples from the nodule for cytological analysis. However, its sensitivity can vary, especially in the case of certain types of cancer such as medullary thyroid carcinoma. In these cases, measuring calcitonin in serum and in the aspiration needle washout can significantly enhance early and accurate detection [3].
Moreover, the combination of FNA with immunohistochemical techniques and cell block has been shown to improve diagnostic accuracy in cases of primary thyroid lymphoma [4]. The implementation of specialized clinics for thyroid nodules, which integrate these techniques, has demonstrated a reduction in the number of non-diagnostic biopsies and improved diagnostic quality [5].
Conclusions
The early diagnosis of thyroid cancer is fundamental to improving the prognosis and quality of life of patients. The evaluation of thyroid nodules through ultrasound and FNA, complemented by advanced techniques such as calcitonin measurement and the use of cell block, offers a comprehensive and effective approach for the early detection of thyroid malignancies. Standardizing these procedures in specialized clinics can optimize diagnostic outcomes and reduce the need for unnecessary surgical interventions.
Referencias
- [1] Thyroid ultrasonography
- [2] Ultrasound and the Evaluation of Pediatric Thyroid Malignancy: Current Recommendations for Diagnosis and Follow-up
- [3] An old friend, a new insight: Calcitonin measurement in serum and aspiration needle washout fluids significantly increases the early and accurate detection of medullary thyroid cancer
- [4] The diagnosis of primary thyroid lymphoma by fine-needle aspiration, cell block, and immunohistochemistry technique
- [5] Impact of a multidisciplinary approach to ultrasound-guided thyroid fine-needle aspiration biopsy at Tygerberg Hospital, Cape Town, South Africa: A retrospective audit
Created 13/1/2025