Thyroid Nodules - Exams and Tests

Exams and Tests

The first step in diagnosing thyroid nodules is a medical history and physical exam. Thyroid nodules often are found during a physical exam or during a CT scan or ultrasound of the neck, chest, or head done for another problem. Most people do not find thyroid nodules on their own because they are difficult to feel and usually do not cause symptoms.

If your doctor finds a thyroid nodule, he or she may refer you to an endocrinologist for more tests and treatment.

Common tests for people with thyroid nodules are:

• Thyroid-stimulating hormone (TSH) test. This is a blood test to see how well your thyroid gland is working.
• Thyroid biopsy. This test checks to see if your nodule is cancerous. A biopsy involves removing a piece of your thyroid nodule, often through a needle. This test is a simple procedure that can be done in your doctor's office.
• Thyroid ultrasound. Ultrasound uses reflected sound waves to create a picture of organs and other structures inside your body. Ultrasound cannot determine whether a nodule is cancerous, but it can help your doctor:
  • Confirm that you have thyroid nodules if other tests have not been clear.
  • See what is happening to nodules that are not going away.
  • Find your nodule during a thyroid biopsy done with a needle.

Other tests you may have include:

• Thyroid hormone tests. These blood tests are done to see if a nodule is causing your thyroid gland to make too much or too little thyroid hormone.
• Calcitonin test. This test checks your level of a hormone called calcitonin as a way to help find out if you have cancer. This test will probably be done if other people in your family have had thyroid cancer or any other type of cancer of the endocrine glands.
• Thyroid scan. This test uses radioactive material and a camera to see how well your thyroid gland is working and to see if you have hyperthyroidism.

Ongoing exams

If your nodule is not cancerous, your doctor will check its size once a year. He or she may also do a thyroid-stimulating hormone (TSH) test to see how well your thyroid is working. An ultrasound may also be used to see if your thyroid nodule has grown. If your nodule has gotten bigger, another biopsy, and surgery, may be necessary.

If your thyroid gland was removed because of cancer, your doctor may test for thyroglobulin, a protein made by both normal and cancerous cells. High levels of thyroglobulin may mean that the cancer has spread (metastasized) to other parts of your body.