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Thyroid Adenoma
Luke N. Ledbetter, MD; Kathryn E. Dean, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Definitions

              • True adenoma: Benign neoplasm of thyroid glandular epithelium with fibrous encapsulation
                • Follicular adenoma and Hürthle cell adenoma
              • Adenomatous nodule: Focal adenomatous hyperplasia with incomplete capsule
                • a.k.a. colloid nodule

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Alexander LF et al: Thyroid ultrasound: diffuse and nodular disease. Radiol Clin North Am. 58(6):1041-57, 2020
                                            2. Traylor KS: Computed tomography and MR imaging of thyroid disease. Radiol Clin North Am. 58(6):1059-70, 2020
                                            3. Tappouni RR et al: ACR TI-RADS: pitfalls, solutions, and future directions. Radiographics. 39(7):2040-52, 2019
                                            4. Yoon JH et al: Malignancy risk stratification of thyroid nodules: comparison between the thyroid imaging reporting and data system and the 2014 American Thyroid Association Management Guidelines. Radiology. 278(3):917-24, 2016
                                            5. Hoang JK et al: Managing incidental thyroid nodules detected on imaging: white paper of the ACR incidental thyroid findings committee. J Am Coll Radiol. 12(2):143-50, 2015
                                            6. Nachiappan AC et al: The thyroid: review of imaging features and biopsy techniques with radiologic-pathologic correlation. Radiographics. 34(2):276-93, 2014
                                            7. Zhang JZ et al: Sonographic features of thyroid follicular carcinoma in comparison with thyroid follicular adenoma. J Ultrasound Med. 33(2):221-7, 2014
                                            8. Kamran SC et al: Thyroid nodule size and prediction of cancer. J Clin Endocrinol Metab. 98(2):564-70, 2013
                                            9. Ahn SS et al: Biopsy of thyroid nodules: comparison of three sets of guidelines. AJR Am J Roentgenol. 194(1):31-7, 2010
                                            10. Iared W et al: Use of color Doppler ultrasonography for the prediction of malignancy in follicular thyroid neoplasms: systematic review and meta-analysis. J Ultrasound Med. 29(3):419-25, 2010
                                            11. Baier ND et al: Fine-needle aspiration biopsy of thyroid nodules: experience in a cohort of 944 patients. AJR Am J Roentgenol. 193(4):1175-9, 2009
                                            12. Gabalec F et al: Benign fine-needle aspiration cytology of thyroid nodule: to repeat or not to repeat? Eur J Endocrinol. 161(6):933-7, 2009
                                            13. Hartl DM et al: The updated American Thyroid Association Guidelines for management of thyroid nodules and differentiated thyroid cancer: a surgical perspective. Thyroid. 19(11):1149-51, 2009
                                            14. Lee EW et al: How diagnostic is ultrasound-guided neck mass biopsy (fine-needle capillary sampling biopsy technique)?: evaluation of 132 nonthyroid neck mass biopsies with pathologic analysis over 7 years at a single institution. J Ultrasound Med. 28(12):1679-84, 2009
                                            15. Liu Y: Clinical significance of thyroid uptake on F18-fluorodeoxyglucose positron emission tomography. Ann Nucl Med. 23(1):17-23, 2009
                                            16. Lumachi F et al: FNA cytology and frozen section examination in patients with follicular lesions of the thyroid gland. Anticancer Res. 29(12):5255-7, 2009
                                            17. Stevens C et al: Pediatric thyroid fine-needle aspiration cytology: a meta-analysis. J Pediatr Surg. 44(11):2184-91, 2009
                                            18. Desser TS et al: Ultrasound of thyroid nodules. Neuroimaging Clin N Am. 18(3):463-78, vii, 2008
                                            19. Loevner LA et al: Cross-sectional imaging of the thyroid gland. Neuroimaging Clin N Am. 18(3):445-61, vii, 2008
                                            20. Yeung MJ et al: Management of the solitary thyroid nodule. Oncologist. 13(2):105-12, 2008
                                            21. Baloch Z et al: Role of repeat fine-needle aspiration biopsy (FNAB) in the management of thyroid nodules. Diagn Cytopathol. 29(4):203-6, 2003
                                            22. Demirel K et al: A comparison of radionuclide thyroid angiography, (99m)Tc-MIBI scintigraphy and power Doppler ultrasonography in the differential diagnosis of solitary cold thyroid nodules. Eur J Nucl Med Mol Imaging. 30(5):642-50, 2003
                                            23. Khati N et al: Ultrasound of the thyroid and parathyroid glands. Ultrasound Q. 19(4):162-76, 2003
                                            24. Kim EK et al: New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid. AJR Am J Roentgenol. 178(3):687-91, 2002
                                            25. Hegedus L: Thyroid ultrasound. Endocrinol Metab Clin North Am. 30(2):339-60, viii-ix, 2001
                                            26. Solbiati L et al: Ultrasound of thyroid, parathyroid glands and neck lymph nodes. Eur Radiol. 11(12):2411-24, 2001
                                            27. Brander AE et al: Importance of thyroid abnormalities detected at US screening: a 5-year follow-up. Radiology. 215(3):801-6, 2000
                                            28. Gotway MB et al: MR imaging of the thyroid and parathyroid glands. Magn Reson Imaging Clin N Am. 8(1):163-82, ix, 2000
                                            29. Hermus AR et al: Treatment of benign nodular thyroid disease. N Engl J Med. 338(20):1438-47, 1998
                                            30. Tan GH et al: Thyroid incidentalomas: management approaches to nonpalpable nodules discovered incidentally on thyroid imaging. Ann Intern Med. 126(3):226-31, 1997
                                            31. Brander A et al: Thyroid gland: US screening in a random adult population. Radiology. 181(3):683-7, 1991
                                            32. Brander A et al: Thyroid gland: US screening in middle-aged women with no previous thyroid disease. Radiology. 173(2):507-10, 1989
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      TERMINOLOGY

                                                      • Definitions

                                                        • True adenoma: Benign neoplasm of thyroid glandular epithelium with fibrous encapsulation
                                                          • Follicular adenoma and Hürthle cell adenoma
                                                        • Adenomatous nodule: Focal adenomatous hyperplasia with incomplete capsule
                                                          • a.k.a. colloid nodule

                                                      IMAGING

                                                      • General Features

                                                        • CT Findings

                                                          • MR Findings

                                                            • Ultrasonographic Findings

                                                              • Nuclear Medicine Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Alexander LF et al: Thyroid ultrasound: diffuse and nodular disease. Radiol Clin North Am. 58(6):1041-57, 2020
                                                                                      2. Traylor KS: Computed tomography and MR imaging of thyroid disease. Radiol Clin North Am. 58(6):1059-70, 2020
                                                                                      3. Tappouni RR et al: ACR TI-RADS: pitfalls, solutions, and future directions. Radiographics. 39(7):2040-52, 2019
                                                                                      4. Yoon JH et al: Malignancy risk stratification of thyroid nodules: comparison between the thyroid imaging reporting and data system and the 2014 American Thyroid Association Management Guidelines. Radiology. 278(3):917-24, 2016
                                                                                      5. Hoang JK et al: Managing incidental thyroid nodules detected on imaging: white paper of the ACR incidental thyroid findings committee. J Am Coll Radiol. 12(2):143-50, 2015
                                                                                      6. Nachiappan AC et al: The thyroid: review of imaging features and biopsy techniques with radiologic-pathologic correlation. Radiographics. 34(2):276-93, 2014
                                                                                      7. Zhang JZ et al: Sonographic features of thyroid follicular carcinoma in comparison with thyroid follicular adenoma. J Ultrasound Med. 33(2):221-7, 2014
                                                                                      8. Kamran SC et al: Thyroid nodule size and prediction of cancer. J Clin Endocrinol Metab. 98(2):564-70, 2013
                                                                                      9. Ahn SS et al: Biopsy of thyroid nodules: comparison of three sets of guidelines. AJR Am J Roentgenol. 194(1):31-7, 2010
                                                                                      10. Iared W et al: Use of color Doppler ultrasonography for the prediction of malignancy in follicular thyroid neoplasms: systematic review and meta-analysis. J Ultrasound Med. 29(3):419-25, 2010
                                                                                      11. Baier ND et al: Fine-needle aspiration biopsy of thyroid nodules: experience in a cohort of 944 patients. AJR Am J Roentgenol. 193(4):1175-9, 2009
                                                                                      12. Gabalec F et al: Benign fine-needle aspiration cytology of thyroid nodule: to repeat or not to repeat? Eur J Endocrinol. 161(6):933-7, 2009
                                                                                      13. Hartl DM et al: The updated American Thyroid Association Guidelines for management of thyroid nodules and differentiated thyroid cancer: a surgical perspective. Thyroid. 19(11):1149-51, 2009
                                                                                      14. Lee EW et al: How diagnostic is ultrasound-guided neck mass biopsy (fine-needle capillary sampling biopsy technique)?: evaluation of 132 nonthyroid neck mass biopsies with pathologic analysis over 7 years at a single institution. J Ultrasound Med. 28(12):1679-84, 2009
                                                                                      15. Liu Y: Clinical significance of thyroid uptake on F18-fluorodeoxyglucose positron emission tomography. Ann Nucl Med. 23(1):17-23, 2009
                                                                                      16. Lumachi F et al: FNA cytology and frozen section examination in patients with follicular lesions of the thyroid gland. Anticancer Res. 29(12):5255-7, 2009
                                                                                      17. Stevens C et al: Pediatric thyroid fine-needle aspiration cytology: a meta-analysis. J Pediatr Surg. 44(11):2184-91, 2009
                                                                                      18. Desser TS et al: Ultrasound of thyroid nodules. Neuroimaging Clin N Am. 18(3):463-78, vii, 2008
                                                                                      19. Loevner LA et al: Cross-sectional imaging of the thyroid gland. Neuroimaging Clin N Am. 18(3):445-61, vii, 2008
                                                                                      20. Yeung MJ et al: Management of the solitary thyroid nodule. Oncologist. 13(2):105-12, 2008
                                                                                      21. Baloch Z et al: Role of repeat fine-needle aspiration biopsy (FNAB) in the management of thyroid nodules. Diagn Cytopathol. 29(4):203-6, 2003
                                                                                      22. Demirel K et al: A comparison of radionuclide thyroid angiography, (99m)Tc-MIBI scintigraphy and power Doppler ultrasonography in the differential diagnosis of solitary cold thyroid nodules. Eur J Nucl Med Mol Imaging. 30(5):642-50, 2003
                                                                                      23. Khati N et al: Ultrasound of the thyroid and parathyroid glands. Ultrasound Q. 19(4):162-76, 2003
                                                                                      24. Kim EK et al: New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid. AJR Am J Roentgenol. 178(3):687-91, 2002
                                                                                      25. Hegedus L: Thyroid ultrasound. Endocrinol Metab Clin North Am. 30(2):339-60, viii-ix, 2001
                                                                                      26. Solbiati L et al: Ultrasound of thyroid, parathyroid glands and neck lymph nodes. Eur Radiol. 11(12):2411-24, 2001
                                                                                      27. Brander AE et al: Importance of thyroid abnormalities detected at US screening: a 5-year follow-up. Radiology. 215(3):801-6, 2000
                                                                                      28. Gotway MB et al: MR imaging of the thyroid and parathyroid glands. Magn Reson Imaging Clin N Am. 8(1):163-82, ix, 2000
                                                                                      29. Hermus AR et al: Treatment of benign nodular thyroid disease. N Engl J Med. 338(20):1438-47, 1998
                                                                                      30. Tan GH et al: Thyroid incidentalomas: management approaches to nonpalpable nodules discovered incidentally on thyroid imaging. Ann Intern Med. 126(3):226-31, 1997
                                                                                      31. Brander A et al: Thyroid gland: US screening in a random adult population. Radiology. 181(3):683-7, 1991
                                                                                      32. Brander A et al: Thyroid gland: US screening in middle-aged women with no previous thyroid disease. Radiology. 173(2):507-10, 1989