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Determination of calcium will help early detection of C cell hyperplasia or medullary thyroid carcinoma. Because fine needle aspiration biopsy (FNA) is the most accurate assessment of thyroid nodules most effective way,[link widoczny dla zalogowanych], the new guidelines strongly recommended as the primary assessment of thyroid nodules. Malignant FNA results should be directed surgery. Small enough for the diagnosis of those cellular components, such as solid nodules should be surgically removed. The uncertainty of disease (also known as suspicious lesions or follicular lesions), or by some cytological characteristics of the clinical data can improve the diagnostic accuracy, but the overall predictive value is still low. Some molecular markers have been used to improve the diagnostic accuracy of these lesions, but information is still small, so the new guidelines do not recommend use of molecular markers to diagnose diseases of uncertainty. If these patients had no isotope imaging isotope scintigraphy should be OK, if not independent function of thyroid gland disease should be held in the side of lobectomy or total. FNA as suspicious, such as papillary carcinoma or Hurthle cell lesions do not have to line imaging examination, the line side of the thyroid gland directly or total excision. FNA Results Author: 710061, Xi'an Jiaotong University School of Medicine Department of Endocrinology, First Affiliated Hospital of fruit is healthy, temporarily do not need further diagnosis and treatment. Nodular lesions ultrasound should be first determined the size and number of nodules, as if simply puncture a large nodule or nodules may still be the primary cancer lesions missed. Ultrasound on some features, such as micro calcification, hypoechoic nodules rich in blood vessels than the size of the more valuable. If there are two or more nodules, priority should be on the ultrasound puncture suspicious nodules. If no suspicious ultrasound characteristics of all the nodules, and echocardiographic characteristics very similar to the low probability of cancer, only to puncture the largest nodule. Benign thyroid nodules diagnosed should follow, because FNA 5% false negative. Ultrasound to determine the changes of thyroid nodules than palpation is recommended in follow-up using ultrasound to monitor the process of change in nodule size. Other benign nodules after the initial FNA should be every 6 to 18 months follow-up ultrasound monitoring. If the nodule is stable then the next follow-up interval may be extended. Either palpation or ultrasound examination showed nodules were increased under ultrasound guidance should be conducted again in the FNA. In the follow-thyroxine suppression therapy used during the critical low iodine intake area in the thyroid nodules can shrink, but in iodine sufficient area that is not obvious. Nodules increased during follow-up after biopsy remained benign after continued follow-up, may also be considered if clinically indicated surgical intervention. Panel in the new guidelines do not advocate routine levothyroxine benign nodules therapy. The incidence of childhood thyroid nodules is lower than in adults, a southwest region in the United States about 5,[link widoczny dla zalogowanych],000 children aged 11 to 18 and youth studies, thyroid nodules can reach about 2.011 million, the new place about 7 / 1000 . FNA diagnosis of thyroid cancer in children sensitivity and specificity are good. Thyroid nodules in children and multiple nodules in a single diagnostic and therapeutic procedures and the same as adult. It is unclear whether pregnant women the possibility of malignant thyroid nodules found in large groups because of lack of control study. Their evaluation as non-pregnant people,[link widoczny dla zalogowanych], but the radioactive iodine scan is contraindicated. On a normal or low thyroid function in pregnant women in the nodule should be performed FNA. If the cytology of cancer, surgery should be performed. But the timing of surgery during pregnancy or after pregnancy has not yet reached consensus. To reduce the risk of miscarriage during pregnancy is 24 weeks pregnant should surgery before. However, thyroid cancer discovered during pregnancy, their biological behavior is not the same age than non-pregnant women were diagnosed with thyroid cancer worse. Prospective study that found during pregnancy, during pregnancy thyroid cancer after surgery and pregnancy,[link widoczny dla zalogowanych], surgery, both in terms of recurrence and survival rates are per difference. Another prospective study that found that thyroid cancer to 1 year after treatment delay will not adversely affect the prognosis. Therefore, cytological diagnosis of early pregnancy should be closely malignant nodules by ultrasound monitoring, if the rapid growth should be 24 weeks of gestation surgery. However,[link widoczny dla zalogowanych], if the pregnancy is still very stable medium, or in the latter half of pregnancy found, can be after the end of surgery during pregnancy. New guidelines in the diagnosis and treatment of thyroid nodules in ultrasound increased the nodules in determining the nature and value of follow-up. FNA evaluation of thyroid nodules is still the primary means of nature, the result is the main basis for clinical treatment. Benign nodules only conduct regular clinical follow-up, do not advocate routine of benign thyroid nodules agent therapy. With the new guidelines did not mention

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