Thyroid Nodules
6
Figure 1. Evaluation and Management of Patients With
Thyroid Nodules Based on US Pattern and FNA Cytology
Suspected Thyroid nodule
TSH normal or elevated
(R2C)
Thyroid/neck Sonography
(R6, 21)
High
Suspicion
pattern
Intermediate
Suspicion
pattern
Low
Suspicion
pattern
Very Low
Suspicion
pattern
Benign
pattern
No nodule or
nodule not
meeting FNA
size cutoff
FNA not required
(R8E, 8F, 23)
FNA
≥ 2 cm
(R8D)
FNA
≥ 1.5 cm
(R8C)
FNA
≥ 1 cm
(R8A, B)
Nondiagnostic Benign
AUS/
FLUS
FN/
SFN
Suspicious Malignant
Cytology
Bethesda system
(R9)
Repeat FNA
(R10)
No
Surgery
(R11,
23)
See Recommendations 13–17
Surgery
(R12)
