Approach to the patients with thyroid nodules

Thyroid nodules are the most common endocrine and metabolic diseases, and most of them are accidental nodules. How to distinguish the state between benign and malignant thyroid nodules is the clinical core problems in diagnosis and treatment. In addition to detailed history collecting and physical examination, high-resolution ultrasound, serum thyrotrophin levels, and fine needle aspiration biopsy(FNAB)form the basis for the diagnosis of thyroid nodules. Endocrinologists should grasp the indications of FNAB. When the pathological finding is unable to distinguish between benign and malignant nodules, molecular or genetic diagnosis should be adopted for further diagnosis. Appropriate treatment is selected according to the definitive results. In this article, we share the whole process that one case with thyroid nodule was diagnosed as papillary thyroid carcinoma and eventually treated with surgery, so as to make clinicians pay more attention to thyroid nodules with standardized clinical diagnosis and treatment. (Chin J Endocrinol Metab, 2015, 31: 89-92) Key words: Thyroid nodules; Differential diagnosis; Therapy