Question:
A patient presents with a thyroid nodule measuring 1.9 $\times$ 1.7 cm. Which of the following statements is false?
A patient presents with a thyroid nodule measuring 1.9 $\times$ 1.7 cm. Which of the following statements is false?
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Ultrasound keywords for Benign Nodules: Spongiform, pure cyst, comet-tail artifacts. (Action: Observe).
Ultrasound keywords for Malignant Nodules: Microcalcifications, irregular margins, hypoechoic, taller-than-wide. (Action: FNAC/Surgery).
Ultrasound keywords for Malignant Nodules: Microcalcifications, irregular margins, hypoechoic, taller-than-wide. (Action: FNAC/Surgery).
Updated On: Sep 3, 2026
- Thyroidectomy is done for spongiform/cystic nodule
- Nodules with suspicious US features (microcalcifications, irregular margins) may require surgery
- Nodules with malignant cytology on FNAC require thyroidectomy
- Nodules causing compressive symptoms are indications for surgery
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The Correct Option is A
Solution and Explanation
Concept:
The clinical scenario presents a patient with a standard-sized thyroid nodule (less than 2 cm).
The clinician must determine which of the provided management principles regarding thyroid nodule workup and surgical indications is clinically incorrect (false).
Explanation:
• The management of any thyroid nodule relies heavily on Ultrasound (US) risk stratification (e.g., TI-RADS) and Fine Needle Aspiration Cytology (FNAC).
• Let us evaluate the given management statements.
• Statement B: Nodules demonstrating highly suspicious ultrasound features (such as microcalcifications, irregular/infiltrative margins, marked hypoechogenicity, or taller-than-wide shape) carry a high risk of malignancy. These nodules require FNAC, and if suspicious, will require surgical resection. This statement is true.
• Statement C: A nodule that returns a definitive malignant diagnosis on FNAC (Bethesda VI) is an absolute indication for a definitive thyroidectomy. This statement is true.
• Statement D: Even if a nodule is proven entirely benign, if it grows large enough to cause mechanical compressive symptoms (dysphagia, stridor, or a choking sensation), surgical resection is indicated to relieve the obstruction. This statement is true.
• Statement A: A "spongiform" nodule is a very specific ultrasound descriptor defined as an aggregation of multiple microcystic components comprising more than 50% of the total nodule volume.
• According to all major ATA and TI-RADS guidelines, spongiform nodules, as well as purely cystic nodules, are universally classified as benign entities (carrying a $<1\%$ risk of malignancy).
• Because they are inherently benign, asymptomatic spongiform nodules of this size (1.9 cm) are managed with simple conservative observation and routine follow-up.
• They absolutely do not require surgical intervention (thyroidectomy) unless they become massively enlarged and symptomatic.
• Therefore, stating that a thyroidectomy is done for a spongiform/cystic nodule is clinically false.
Final Answer:
Statement A is false because spongiform and cystic nodules are benign and are managed conservatively, not with immediate thyroidectomy.
The clinical scenario presents a patient with a standard-sized thyroid nodule (less than 2 cm).
The clinician must determine which of the provided management principles regarding thyroid nodule workup and surgical indications is clinically incorrect (false).
Explanation:
• The management of any thyroid nodule relies heavily on Ultrasound (US) risk stratification (e.g., TI-RADS) and Fine Needle Aspiration Cytology (FNAC).
• Let us evaluate the given management statements.
• Statement B: Nodules demonstrating highly suspicious ultrasound features (such as microcalcifications, irregular/infiltrative margins, marked hypoechogenicity, or taller-than-wide shape) carry a high risk of malignancy. These nodules require FNAC, and if suspicious, will require surgical resection. This statement is true.
• Statement C: A nodule that returns a definitive malignant diagnosis on FNAC (Bethesda VI) is an absolute indication for a definitive thyroidectomy. This statement is true.
• Statement D: Even if a nodule is proven entirely benign, if it grows large enough to cause mechanical compressive symptoms (dysphagia, stridor, or a choking sensation), surgical resection is indicated to relieve the obstruction. This statement is true.
• Statement A: A "spongiform" nodule is a very specific ultrasound descriptor defined as an aggregation of multiple microcystic components comprising more than 50% of the total nodule volume.
• According to all major ATA and TI-RADS guidelines, spongiform nodules, as well as purely cystic nodules, are universally classified as benign entities (carrying a $<1\%$ risk of malignancy).
• Because they are inherently benign, asymptomatic spongiform nodules of this size (1.9 cm) are managed with simple conservative observation and routine follow-up.
• They absolutely do not require surgical intervention (thyroidectomy) unless they become massively enlarged and symptomatic.
• Therefore, stating that a thyroidectomy is done for a spongiform/cystic nodule is clinically false.
Final Answer:
Statement A is false because spongiform and cystic nodules are benign and are managed conservatively, not with immediate thyroidectomy.
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